Words by Joanna Anagnostou

Taking contraceptives can really affect our menstrual periods, as they alter how and when we ovulate. But did you know that different methods of contraceptives affect our cycles and bodies in different ways? Here's how...

How do I know which hormonal contraceptive is right for me?

Deciding what type of contraceptive may work best for you is ultimately a conversation you need to have with a Doctor or Nurse, and will depend on what your main concern is; for example, is it birth control, wanting to regulate irregular periods, minimising period pain or clearing up problematic skin (just to name a few!)?

Unfortunately, there is no way to know definitively know which contraception will work best for you without having to go through the process of trying them. Your Doctor will help guide you, but you may choose to also use this info as a guide of what to expect and how your period might change on the different types of hormonal contraceptives so that you can make an informed choice on that which you want to use.

The important thing to remember is that no-one will have the exact same experience on a specific form of hormonal contraceptive. If a friend or someone you know has had a bad experience on particular pill, for example, it doesn't necessarily mean that you will have a bad experience, too. In fact, that particular pill could be the perfect one for you!

How will my body be affected?

Your body will likely react differently to different contraceptives; your skin, weight, menstrual cycle and even your mental health can be affected. For any contraceptive that alters your hormones, there is usually an adjustment period, as your body learns to adapt and establish a new rhythm. Sometimes, your body will settle into a good, 'new' cycle relatively quickly, and sometimes it might take a bit longer. It's different for everyone - there is no 'one size fits all' when it comes to the possible affects of hormonal contraceptives.

Most medications come with the risks of side effects, with some worse than others. Some people might experience these side effects and others won't, but it's important to understand the precautions. From a hormonal contraceptive perspective, there are positive effects like it being a proven sand effective method of birth control, reducing symptoms associated with period pain and endometriosis and also in combating problematic skin.

However, on the flip side, there are some side effects that might be deemed more negative, such as irregular bleeding or spotting, headaches, bloating, mood changes and skin breakouts. These are just some of the side effects you may experience when trying new hormonal contraceptive methods. If these symptoms persist for a period longer than described by your doctor, or, if you feel like something's not quite right, it's worth checking in with them to discuss your situation and possibly another type of contraception that may be better suited to your body and your needs.

What are the different types of hormonal contraceptives available?

There are lots of different types of contraceptives but I'm going to delve deeper into hormonal contraceptives, as unlike some others, like condoms, these are more likely to affect your menstrual cycle as they do their job by altering your hormones.

The four main categories of hormonal contraceptives are: contraceptive pills, the contraceptive implant (implanon), intrauterine devices (IUD) and the vaginal ring.

Contraceptive Pills

Contraceptive pills are tablets you take daily to prevent pregnancy. There are two different types of contraceptive pill: The Combined Pill and The Mini Pill.

The Combined Pill

The Combined Pill is more commonly referred to as “the Pill” and gets its name because it contains the two hormones oestrogen and progestogen (the synthetic version of the naturally occurring hormone 'progesterone'). The Pill works by stopping the ovaries from releasing eggs each month, as well as thickening fluid around the cervix so that sperm cannot easily enter the uterus (and fertilise eggs!).

On the Pill, you will experience what’s called withdrawal bleeding, which is bleeding similar to a period, but it is not an actual regular/natural period, as it's caused by the withdrawal of hormones in your pill and in turn, your body. This dip in hormones causes the lining of your uterus to shed, which is what results in the bleed.

Most brands of the Pill contain two different types: a series of pills with hormones, which you take for the majority of the month, and then about a week's worth of pills often known as 'sugar pills' (placebo pills), which do not contain any hormones - it's these sugar pills that are responsible for the dip in hormones that will generally result in the bleed. You can also skip your “period” when taking the Pill by skipping over the sugar pills and continuing to take the hormone pills. The Pill packets typically have 21 hormone pills and 7 sugar pills (though this may vary between brands).

The Mini Pill

The mini Pill differs from the combined Pill as it is made up of only one hormone, namely progestogen. A packet of the Mini Pill will not contain sugar/placebo pills, so you will not have a withdrawal bleed. It releases a lower dose of hormones and is good choice if you cannot have the hormone oestrogen.

Some of the benefits of the Pill are that 'periods' may become lighter, less painful and will also likely become more regular - at least during the time you are taking it. It also can help with symptoms associated with endometriosis and Polycystic Ovarian Syndrome (PCOS). Negative side effects can include irregular bleeding (or 'spotting' in between 'periods'), bloating, sore breasts, skin breakouts, mood changes and bloating.

Both types of contraceptive Pill need to be taken daily, ideally at the same time of day. If you miss a Pill, this can not only alter the effectiveness of preventing pregnancy, but can disrupt your cycle and possibly cause some irregular bleeding. 

Please remember that it takes time for your body to adjust to the new hormones in your system. You may experience some side effects initially, but should settle nicely into a new routine whilst on the Pill. Your body can also react differently to different brands of the Pill (or mini pill), so it may take a few gos until you find the right fit. If you're unsure about anything, have any more specific questions about the Pill or are experiencing any side affects whilst on the Pill, please see your Doc ASAP.

The Contraceptive Implant (Implanon)

The Contraceptive implant, or 'Implanon', is a 4cm long rod that is inserted under the skin of the upper arm and slowly releases the (synthetic) hormone progestogen. Similar to the Pill, it prevents the ovaries from releasing an egg monthly and thickens the fluid around the cervix, making it more difficult for sperm to pass through.

As a Long Acting Reversible Contraception (LARC), a big benefit of the Implanon is that it lasts for 3 years. Whilst it is not designed to specifically target pain, it has been known to reduce pain associated with periods.

The Implanon can change your pattern of bleeding; it might make periods very light, or stop your period altogether. Conversely, it can also cause irregular bleeding for the first couple of months after insertion. Some people might experience more frequent periods, irregular periods and/or prolonged periods. Initially, bleeding may last for more than 14 days as your body adjusts to the implant, but should become more regular over the following months. If bleeding remains frequent or prolonged, please speak to your doctor, who may prescribe some medication to help regulate your cycle.

Intrauterine Device (IUD)

IUDs are small T-shaped contraceptive devices that are placed inside the uterus. There are two different types of IUD: the copper IUD and the hormonal IUD.

The Copper IUD

This IUD does not contain hormones and therefore does not stop ovulation. It releases copper into the uterus to stop sperm and egg meeting in the uterus. It also changes the lining of the uterus so that it is harder for a fertilised egg to stick to the lining (which would result in the beginning of a pregnancy).

This is a good LARC option for those that do not want to use hormonal contraception and it can last for 5-10 years. This means that the side effects like mood changes, breast tenderness or headaches that are often associated with hormonal contraceptives aren't of concern here.

However, the Copper IUD is known to cause spotting or frequent bleeding within the first 3 months after insertion. It is also known to make periods heavier than before and possibly more painful. This can of course decrease over time as your body adjusts to it, but if you already experience heavy or painful periods, it might be best to give the copper IUD a miss.

The Hormonal IUD (Mirena)

Often referred to as the 'Mirena', the hormonal IUD slowly releases progestogen into the uterus. Similar to the copper IUD, the Mirena prevents sperm and egg from meeting in the uterus due to thickened fluid at cervix and the changed lining of the uterus, making it difficult for fertilised eggs to attach to it.

The Hormonal IUD will also change the pattern of your period - for the first 3-6 months after getting the Mirena, you may experience irregular spotting or frequent bleeding. Once you body adjusts to it, you'll likely experience a light, regular period and in some cases, your periods might disappear altogether. Periods can become less painful on the Mirena and it's also useful in controlling heavy bleeding. It lasts for 5 years.

Like other hormonal contraceptives, you may initially experience headaches, mood changes and sore breasts. However, it does use a lower dose of hormone compared to other contraceptives as the contraceptive device is localised to the area it needs to work (the uterus).

The Vaginal Ring

This hormone secreting disc-like ring is inserted inside the vagina and secretes estrogen and progestogen. It is said to be 99% effective against preventing pregnancy, as it basically stops the ovaries from releasing an egg every month and also thickens the fluid around the cervix. Although, much like other hormonal contraceptives, it doesn't protect against STDs or STIs. You can leave your ring in for three weeks at a time.

On the PROs side, the vaginal ring can help improve acne, can lighten periods, can help with symptoms of Polycystic Ovarian Syndrome (PCOS) and endometriosis, and you don't have to remember to take a pill every day - but on the CONs side, it may cause irregular bleeding, headaches, bloating, mood changes and nausea. There are also some other associated risks with the vaginal ring, which you can read more about here.

Choosing a method of contraception is incredibly personal - it's worth considering consider what you want to get out of it and how it will affect your body and your periods. Please do your research, talk to a trusted Doctor, understand your options and remember that no two periods or people are the same, so find and go with the one that's going to work best for you. 

*Please note that the information provided in this piece does not constitute a personalised medical diagnosis and the information provided is to be used as a guide only. If you have any specific concerns about your own situation please consult a trusted medical professional for a more specialised diagnosis and treatment plan.

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About the writer

Joanna Anagnostou (pronouns she/her) is a Master of Public Health graduate, specialising in sexual health promotion and health literacy. She is passionate about providing comprehensive, inclusive, and accessible education to all. Joanna engages and facilitates discussions with young people through different platforms to give them access to information about sex, health and society. She has done this through designing activities for high school students that discuss sexuality and gender diversity, respectful relationships, consent, and safer sex discussions, and teaching workshops on consent and what that means in the modern (and digital) age. Joanna is driven and passionate about sexual health promotion. She loves to talk about all things health and anything that has been historically thought of as “taboo.” She writes about sexuality, relationships, and health to help break down stigma, champion the rights of womxn and the LGBTQIA+ community and promote taking care of your mental health.