Hormonal contraceptioncan both positively and negatively affect your menstrual health. As such, it is essential to have an open discussion with your gynecologist when considering hormonal birth control options.
This will allow you to make an informed decision based on your medical history, preferences, and goals.
Types of Hormonal Contraception
Several categories of hormonal contraception are available, and the type you choose will depend on a wide range of factors, including your lifestyle preferences, reproductive health goals, and your medical history.
It is a topic you should certainly discuss with your gynecologists, but it’s good to be aware of what is available in advance. Therefore, the different types of hormonal contraception include:
- Combined oral contraceptives or COCs: Also referred to as “the pill,” COCs include estrogen and progestin. They are taken in pill form on a daily or continuous basis.
- Progestin-only pills (POPs): Unlike COCs, POPs only feature progestin with no estrogen. They may be an option if estrogen is contraindicated.
- Intrauterine devices (IUDs): IUDs are small devices that are inserted into the uterus and release either progestin or copper. The Mirena IUD releases progestin, while the Paragard IUD releases copper without hormones.
- Contraceptive implants: These are small plastic rods placed under the skin of the upper arm. They release progestin slowly over several years. The Nexplanon implant lasts up to 3 years.
- Contraceptive injections: Also known as depot medroxyprogesterone acetate (DMPA) or Depo-Provera, these injections contain progestin and are administered every 12 weeks.
- Vaginal rings: The NuvaRing is a flexible ring placed in the vagina for three weeks per month. It discharges estrogen and progestin, similar to COCs.
- Transdermal patches: Patches such as Xulane stick to the skin and release estrogen and progestin transdermally. A new patch is applied weekly for three weeks out of the month.
Discussing Your Medical History
Hormonal contraception may have some risks, depending on what your medical history is, which is why you should tell your OB/GYN about any of the following:
Personal or Family History of Blood Clots
Estrogen found in COCs, patches, and vaginal rings may slightly increase clotting risk. If you have a blood clot history or if it runs in the family, you should use progestin-only methods instead.
History of Migraines with Aura
Migraines with neurological aura symptoms can increase your risk of stroke on combination hormonal birth control. Progestin-only options are considered safer.
Smoking Habits
Smokers over the age of 35 face higher clotting and heart disease risks on COCs; they should avoid estrogen-containing contraception.
Obesity
People with a BMI over 30 kg/m2 may experience lower efficacy and higher health risks on some forms of hormonal birth control.
Other Medications and Supplements
Some medications can interact with hormonal contraception, reducing its effectiveness. Always disclose any medications or supplements you take.
Addressing Menstrual Health Concerns
Hormonal contraception often leads to changes in menstruation. You should inform your gynecologist about any bothersome symptoms. Common concerns include:
Changes in menstrual flow and duration: It is common to experience lighter, predictable periods on hormonal birth control. Heavier or prolonged bleeding may indicate an underlying problem.- Irregular bleeding or spotting: Breakthrough bleeding and spotting are common when first starting hormonal contraception. If it lasts longer than three months or is heavy, consult your gynecologist.
- Amenorrhea (absence of periods): Missing periods can occur as a side effect of contraceptive shots, implants, IUDs, and sometimes pills. Rule out pregnancy and inform your doctor of any amenorrhea.
- Dysmenorrhea (painful cramps): Hormonal birth control often reduces menstrual cramps but may worsen pain in some cases. Pelvic exams help identify the causes of persistent cramping.
- Premenstrual syndrome (PMS): Mood swings, breast tenderness, bloating, and other PMS symptoms may improve or persist on hormonal birth control. Track your symptoms.
Potential Menstrual Health Benefits
When used properly, hormonal contraception can:
- Regulate irregular menstrual cycles
- Lessen heavy bleeding and cramping
- Treat gynecological conditions such as endometriosis and polycystic ovary syndrome (PCOS)
- Improve symptoms of premenstrual syndrome (PMS)
For those with painful, heavy periods or irregular cycles, the menstrual regulation from hormonal birth control can vastly improve their quality of life.
Possible Side Effects and Risks
While many tolerate hormonal contraception well, potential side effects include:
- Nausea, headaches, breast tenderness
- Increased or decreased libido
- Weight gain or loss
- Mood changes
- Breakthrough bleeding
In rare cases, serious complications may occur, such as blood clots, stroke, or liver tumors. Cigarette smoking combined with estrogen use significantly increases these major health risks.
Long-Term Considerations
When used over many years, hormonal contraception may impact:
- Bone mineral density: Some evidence suggests DMPA injections may decrease bone mineral density or BMD, leading to osteoporosis risk. Estrogen-containing contraceptive methods maintain BMD.
- Return to fertility: Most people regain normal fertility within months after discontinuing hormonal birth control. It may take longer with DMPA injections.
- Cancer risks and benefits: There is mixed evidence regarding breast cancer risk, which appears slightly elevated on COCs. However, hormonal contraception reduces endometrial, ovarian, and colorectal cancer risks.
Monitoring and Follow-Up
While using hormonal birth control, it is essential to:
- Get regular pelvic exams, Pap tests, and blood pressure checks
- Report any persistent side effects or warning signs
- Discuss alternative options if problems arise
Get Personalized Hormonal Contraceptive Care from Raleigh Gynecology & Wellness
With many hormonal contraception options available, the best choice is dependent on your specific health profile and preferences.
Raleigh Gynecology & Wellness’ caring providers offer personalized consultations to find the right solution for your needs and lifestyle.
Contact us today at (919) 636-6670 or schedule an online consultation for individualized care and compassionate understanding as you navigate contraception options and menstrual wellness.