Hormonal & Non hormonal birth control

Hormonal Birth Control (HBC)

The are many different types of HBC - the pill, the mini pill, the patch, the injection etc. all of these contain synthetic hormones, despite the fact you have probably been told there is progesterone in HBC, there is not. However there is a synthetic version - a type of progestin. Progestins are derived from testosterone, progesterone or Spiro-lactone. Although some HBC can reduce androgens, some can in fact have an androgenic impact.

Androgenic Progestins:

Norethisterone acetate

Etynodiol diacetate

Levonorgestrel

Norgestimate

Desogestrel

So lets take a look at different types of HBC:

• Combination pill (Synthetic Estrogen plus a Progestin)

• The Patch (Synthetic Estrogen plus a Progestin)

• Progestin only pill or Mini Pill (A Progestin)

• Implants (A Progestin)

• Injection (A Progestin)

• IUD (A Progestin)

Combination oral contraceptives contain a synthetic Estrogens such as Ethinylestradiol in combination with a progestin, classically given in a cyclic manner with 21 days of active pills followed by 7 days of placebo, this is what causes the bleed. Preventing pregnancy by shutting down ovulation, they do this by shutting down the communication from the brain to the ovaries. The combination oral contraceptive pill is commonly prescribed for those with PCOS, unfortunately, it does not address the cause and can further worsen insulin resistance, which is a main driver of PCOS in some.

Progestin only methods prevent pregnancy by thinning the lining of the uterus, and by making cervical mucus less favourable to sperm, thickening it and acting like an impermeable barrier! The progestin only method can also supress ovulation. This study found, the IUD did shut down ovulation in 85% of cycles in the first year and in 15% of cycles after that. Ovulation has many other health benefits, such as promoting bone health,

There are pros and cons to each method of hormonal birth control. Hormonal birth control methods have been proven effective in preventing pregnancy, and can supress symptoms in PCOS, but that does not mean that they treat symptoms, and contrary to what you may have been told, HBC will not regulate your hormones. HBC has been linked to weight gain, erratic bleeding, depression and anxiety. Furthermore, a large study found that "users of oral contraceptives with desogestrel, gestodene, or drospirenone were at least at twice the risk of venous thromboembolism compared with users of oral contraceptives with levonorgestrel". It's also important to keep in mind, if you do have regular bleeds while taking hormonal birth control, it is not a menstrual period. This is because, a menstrual period is part of the menstrual cycle, following ovulation. As some HBC shut down ovulation, it cannot be a true menstrual cycle. Instead it is a withdrawal bleed caused by the drop in synthetic hormones.

Can I get pregnant when I stop taking hormonal birth control?

There are many things to take into consideration here, if your periods were normal before taking HBC, you should see a regular cycle within a couple of months, this can range from 3 to 12 months. However, if you were taking it to help manage symptoms of PCOS or amenorrhea, it will not have addressed the underlying cause, the key here, will be to work with a women's health specialist to restore regular ovulation and ensure a healthy luteal phase length.

In conclusion, there are many different types if HBC, some shut down ovulation, which in my opinion is of no benefit to women's health, as ovulation has so many health benefits beyond fertility. Bleeds while on some types of HBC are not true periods. Depending on your location HBC will contain different synthetic hormones and go under different brand names.

Non Hormonal Birth Control

Fertility awareness method (FAM).

FAM uses physical signs and symptoms such as cervical mucus, LH and BBT to monitor hormone fluctuations throughout the different phases of the menstrual cycle to predict and confirm the fertile window, this is the only time during your cycle that you can become pregnant! Effectiveness depends on the method being used and how it is followed. For example with perfect use the Symptothermal Double-Check Method is 99.6% effective with perfect use. Please be mindful that these results were achieved by working with a qualified instructor.

Copper IUD

The copper IUD is non hormonal and is the most widely used method of contraception, it does not shut down ovulation! It works by releasing copper ions into the uterus making it inhospitable to sperm, the copper concentration in cervical mucus is substantial and leads to an inhibition of sperm motility, meaning sperm are not swimming anywhere! It is effective for up to 10 years, although you don't have to have it for that long if you don't want to, and a study found that uninterrupted use of a copper IUD should not exceed 5 years. Initially the copper IUD can increase blood loss when your period begins, this can last up to 6 months but then should return to normal. Other cons to this type of birth control can be pelvic inflammatory disease, if you have had a prior infection. It is also important to be mindful it may cause copper excess, this study observed higher copper blood levels with IUD users compared to non-users. There are some contraindications, read more here.

Informed choice is important!

Ailish 🌻