Different methods of contraception

Thinking of changing or starting a new method of contraception? Unsure how it will impact you? Here’s how it may affect your cycle and the way you experience your period.

The combined pill, the mini pill, the hormonal coil, the copper coil, the implant, the injection, condoms… there are many different contraceptives that people choose to use for all sorts of reasons. Contraception can be used to treat some PCOS symptoms [1], prevent pregnancy, relieve PMS symptoms and even guard against STIs [2], but just how can different contraceptive methods affect your cycle and bleeding?

Research shows that people can experience side effects involving their menstrual cycle while using contraception, in the form of irregular periods, heavy bleeding, spotting, brown discharge or having no periods at all! It may feel scary if your period suddenly stops or if you notice some irregular bleeding mid-cycle, but remember these side effects are usually nothing to worry about; often it just takes a bit of time for your body to adjust to new and different contraceptive methods.

You may want to familiarise yourself with how each method could potentially affect your period so that if it does happen, you’ll be able to recognise why and be able to tell when it’s nothing to stress about and when to book an appointment with your gynaecologist. Similarly, if you’re window shopping for new contraception, it might be helpful to consider the ways in which different methods could affect your period.

So, how can each contraception affect my period?

Even though the way in which each contraceptive method will affect you will vary from person to person, here’s a general guide to the most common menstrual side effects according to some of the most popular forms of contraception.

Keep in mind that if you are thinking about changing or starting a new form of contraception, it’s advisable to go to either your doctor or a sexual health clinic so that you can discuss what your contraceptive options are and more importantly, get advice on what’s best for you. After all, all bodies are different which means sometimes it’s best to get some professional advice on what might be the best solution for yours!

The combined and mini pill

It’s probably one of the most well-known contraceptive methods out there, but just how much do you know about how the pill actually works? Let’s get into the nitty gritty details and find out!

The combined pill is an oral contraceptive (meaning you swallow it), containing a mixture of the hormones oestrogen and progesterone. It needs to be taken every day, with a possible break in between pill packets as recommended by your doctor. The combined pill works as a contraceptive by stopping the release of an egg (this is known as ovulation). The mini pill is also an oral contraceptive, but it only contains the hormone progesterone, and works by thickening the cervical mucus to block sperm from reaching an egg [2].

When beginning to take the pill or mini pill, some people report spotting or breakthrough bleeding (bleeding between periods) as a menstrual side effect during their first few months of using it. But watch out as this does not mean that the pill isn’t working! It’s usually just that your body takes a bit of time to adjust to the new hormones.

With some pills, your doctor might recommend that you take a break in between pill packets. During this time, your body might go through what’s known as withdrawal bleeding. Though it might look and feel like a period, withdrawal bleeding is just an outcome from the change in hormones that occurs when you opt for a break – so it’s actually not quite a period!

Though as always, it’s a good idea to get a medical opinion if you feel particularly worried, or if you experience persistent spotting over a long period of time. If you need guidance on taking breaks between pill packets, then your doctor will be able to recommend the best way for you to take your contraceptive based upon your specific needs.

The hormonal IUD

The hormonal coil is inserted into your womb by a doctor or nurse, and can be used as a contraceptive for 3 to 5 years. Though they have different names that can be a little confusing, they all work in the same way – by releasing the hormone progesterone to the womb [3].

While using the hormonal coil, it’s very likely that your periods will become lighter, less painful and may even stop. Whether a period-less month makes you freak out or dance with joy, it's a very common side effect from this method and it doesn’t mean that something’s wrong or that the contraceptive isn’t working.

All that’s happening is that the progesterone hormone in the coil is controlling the lining of the womb by making it thinner, so when it’s time for your period there is little to no lining to shed as period blood [3]. It’s also possible that you could experience some random bleeding within the first few months of having the coil inserted, as your body gradually regulates the new hormones.

The contraceptive implant

If inserting a small device in your womb doesn't sound like your kind of thing, how about having it fitted in your arm? This is possible with the contraceptive implant. (And no, it’s not a type of futuristic tracking device!)

The contraceptive implant is a device fitted in your arm by a doctor or nurse and can be used for up to 3 years. The implant works as a contraceptive by releasing the hormone progesterone, which thickens the cervical mucus and blocks sperm from coming into contact with an egg [5].

Similar to the hormonal coil, the implant also thins the lining of the womb, making some periods lighter or stopping them all together. Again, this is completely normal and just a side effect of this particular type of contraceptive.

The contraceptive injection

The contraceptive injection can be given every 8 or 13 weeks (depending on the brand) and works as a contraceptive by releasing progesterone [6]. Of course, if the mention of needles sounds like the stuff of your nightmares, you may want to skip to the next section!

Irregular periods during the first few months of taking the injection are common, but once your body adjusts itself to the hormones, your periods tend to be lighter or stop altogether.

The copper IUD

Not particularly keen on hormones? There’s another IUD option which is completely hormone free! Let’s find out more.

Copper in my womb? We know it may sound strange and uncomfortable but the copper IUD is an extremely popular option given that it’s a non-hormonal method of contraception – and no, you won't be able to feel it either!

The copper coil is an IUD (intrauterine device) which is also inserted into your womb by a doctor or nurse, and can be used as a contraceptive for up to 10 years or until it gets removed. It works by releasing copper to the womb, which produces an inflammatory reaction that neutralises sperm and eggs [3].

Unlike the combined pill, the copper coil does not stop ovulation, so you will still have a “real period” and ovulate. You may experience heavier and more painful bleeding with the copper coil in the first 3 to 6 months. Though the exact reason for heavier periods is unknown, research suggests that when the copper coil is inserted, some small tissue damage may occur and fatty acids known as prostaglandins are made to help repair the damaged tissue by increasing your blood flow [4].

The tissue tends to repair itself though, and the heavy bleeding will often go away after the first few months. But if you feel like you’re experiencing particular discomfort while on the copper coil, always check in with your doctor so that they can give you some professional advice.

Condoms and other barrier methods

Remember those awkward lessons at school, with the condoms and the bananas? We certainly do. Now it’s time to revisit those days once again and understand more about how they can affect your period.

Male condoms and other barrier methods such as female condoms, diaphragms and cervical caps are some of the few contraceptive options which do not contain hormones, and therefore they do not interfere with your body or affect your periods.

Barrier methods still offer great protection as a contraceptive by using physical barriers to prevent sperm from reaching an egg though. It’s also worth noting that both male and female condoms protect against STIs too.

What can I do to help regulate my period when using contraception?

It can be worrying if your cycle suddenly changes in ways you aren’t used to, even if you are expecting it to as a result of changing or starting a new contraception. The best thing you can do is sit back, relax and give your body time to adjust. After all, the human body is amazing at adjusting to what life throws at it (we make it through puberty, after all!)

If you do want to be extra cautious, you can always stock up on some liners, to help you with any unexpected spotting you may experience during the first few months of using a new type of contraception. You can also keep a diary or use an app, to write down the days when you have irregular bleeding so that you can clearly keep track of your own progress as well as show your doctor if you’d like to.

At the end of the day, it’s all about listening to your body. It’s also important to realise that other factors such as stress can also affect you period – so it may not necessarily be your contraception! As always, allow time for your body to process any changes and if you’re ever particularly worried, don’t hesitate to confide in a friend or close relative, and speak to a medical professional for advice.

Now that you’ve learnt all about how contraception can affect you period, why not expand your knowledge further by reading our other helpful articles about signs that your period is coming and whether it’s possible to stop or postpone a period.

Medical disclaimer

The medical information in this article is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. Please consult your doctor for guidance about a specific medical condition.



[References]

[1] https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/treatment/
[2] https://www.cdc.gov/reproductivehealth/contraception/index.htm/ 
[3] https://www.mayoclinic.org/tests-procedures/mirena/about/pac-20391354
[4] Roy S, Shaw ST Jr. Role of prostaglandins in IUD-associated uterine bleeding--effect of a prostaglandin synthetase inhibitor (ibuprofen). Obstetrics and Gynecology. 1981 Jul;58(1):101-106.
[5] https://www.mayoclinic.org/tests-procedures/contraceptive-implant/about/pac-20393619
[6] https://www.mayoclinic.org/tests-procedures/depo-provera/about/pac-20392204 

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