Contraception: What Stops Ovulation and What Doesn’t?

My sister had a hysterectomy in her late 30s for bleeding issues. As is common in young women having hysterectomies, the surgeons left her ovaries behind. Then, in her 40s, she began to have problems with ovarian cysts that were painful but not harmful.

She called me to ask what she could do. Because cysts tend to form from where ovulation occurs, I suggested that she do something to stop her ovaries from ovulating. Let's look at how this problem can be addressed through various types of birth control.

How do you stop ovulation?

The easiest way to stop ovulation is to use certain types of birth control. Some types of birth control work by stopping ovulation, while others work by different methods. It is important to know how each type works in order to choose the right type for each individual.

Birth Control Methods and How They Work

  • Combined Oral Contraceptives, or “birth control pills.” These pills are made with a combination of the hormones estrogen and progesterone. They must be taken daily and they do stop ovulation, the thin lining of the uterus, and thicken the cervical mucus. Women with contraindications to estrogen should not take them.
  • Progesterone Only Contraceptives, or “The Mini Pill.” These pills are made with the hormone progesterone only. They do not always stop ovulation, but they do thin the lining of the uterus, thicken the cervical mucus, and slow the motility of the fallopian tubes. These pills must be taken at the same time each day.
  • The NuvaRing. This flexible ring is placed inside the vagina and left there for 3 weeks at a time. The ring emits the hormones estrogen and progesterone, stops ovulation, thins the lining of the uterus, and thickens the cervical mucus. Women with contraindications to estrogen should not use the NuvaRing. The old ring must be removed in 3 weeks and then, after no ring has been in the vagina for 1 week, a new ring is inserted.
  • The Patch. This is a patch that's placed on the skin for 1-week intervals and that emits the hormones estrogen and progesterone. The patch stops ovulation, thins the lining of the uterus, and thickens the cervical mucus. Women with contraindications to estrogen should not use the patch. It must be removed and replaced by a new patch weekly for 3 weeks and then left off for a week before resuming.
  • Depo-Provera. This is an injection of the hormone progesterone that's given every 12 weeks. It stops ovulation, thins the uterine lining, and thickens the cervical mucus, and it also leaches calcium from the bones. The injection must be received every 12 weeks.
  • IMPLANON. This is a flexible silicone rod placed under the skin of the inner upper arm that emits the hormone progesterone for 3 years. The rod stops ovulation, thins the uterine lining, and thickens the cervical mucus. It must be placed and removed by a trained health care provider.
  • The Mirena IUD (intrauterine device). This is a small plastic device inserted into the uterus that emits the hormone progesterone locally to the uterus only. This permanent device lasts for 5 years but does not stop ovulation. It does thicken the cervical mucus, thin the uterine lining, and slow the spontaneous movement of the fallopian tubes. It must be placed and removed by a trained health care provider.
  • The ParaGard IUD. This is a small plastic device wrapped in copper and inserted into the uterus for 10 years. The device does not stop ovulation and, like the Mirena IUD, it thickens the cervical mucus, disrupts the uterine lining, slows the motility of the fallopian tubes, and must be placed and removed by a trained health care provider.
  • Barrier methods (condoms, diaphragms, cervical caps, spermicides). These methods block the sperm from progressing up to the egg. They do not stop ovulation, may help prevent some sexually transmitted diseases, and must be used consistently with every act of intercourse.
  • The morning-after pill. This is a concentrated dose of the hormone progesterone that must be taken within 5 days of unprotected intercourse. The sooner it’s taken after intercourse, the better it works. It stops ovulation, thins the uterine lining, and thickens cervical mucus. This pill should only be used as a backup method, not as a primary method of birth control.

Choosing the Right Method

Birth control obviously works for preventing pregnancy and there are many options to choose from. Some methods of birth control are also used to treat and prevent other problems that women encounter, such as ovarian cysts or the overgrowth of the uterine lining that leads to uterine cancer. Whether you need birth control to prevent pregnancy or for another reason, you will need to work with your health care provider to choose the method that's right for you.

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