How does each method of contraception affect your menstrual cycle? A step-by-step guide

 

How does each method of contraception affect your menstrual cycle? A step-by-step guide.

By Kate McGreary

Finding the right contraception option for you is really important, and it can take a bit of time before this happens. How each option affects your menstrual cycle is a factor that a lot of people take into account when researching which contraception they want to try. This article outlines how each method of contraception can affect your menstrual cycle and will give you some more information on each option out there. One important thing to note is that contraception can affect a person’s body in different ways. There is not one universal experience with the combined pill for example. So be aware that this information is there as a guide rather than gospel - each experience with contraception is different for every individual. It’s important to find the one that works best for you!

As a side note, for nearly all hormonal methods, irregular bleeding and spotting are more common in the first months of use and usually get better over time.[1] Below are the options available, and a brief explanation on how they can affect your menstrual cycle.

1)     The combination pill

-        The combination pill contains the hormones progestin and oestrogen. These hormones work to stop ovulation, thicken cervical mucus, and thin the uterus lining.[2]

-        When you first start on the combined pill, you may experience some irregular bleeding or spotting in the first three months.[3]

-        After 21 days of taking the pill, you can have a week’s break, and usually start bleeding three or four days after taking the last pill in the strip.[4]

-        You also have the option to delay your bleeding by taking up to 3 strips in a row without a break. This can increase the chance of breakthrough bleeding or side effects like bloating, and for some people, leads to more painful periods.[5]  However, there is little evidence found to correlate the number of consecutive pills taken with the heaviness/painfulness of the withdrawal bleed – again, each experience is different!  [6]

-        Since you don’t ovulate on the pill, you don’t have a “real” period.[7] The bleed you experience when on the pill is a withdrawal bleed, and it happens when the hormones levels in your blood drop.[8] 

-        An advantage of this option is that the combination pill can relieve menstrual cramps, premenstrual syndrome (PMS), and lighten bleeding.[9]

2)     The mini pill (progesterone only pill)

-        The minipill thickens the cervical mucus and thins the uterus lining.[10]

-        It affects ovulation but doesn’t stop it consistently like the combination pill does.[11]

-        When taking the mini pill, your periods may become irregular or stop altogether.

-        Spotting (breakthrough bleeding) in between periods is also common. In fact, spotting is one of the most common reasons why people stop taking the mini pill. [12]

-        48% of Lowdown users who use the progestogen-only pill reported that their bleeding stopped altogether, while 23% reported spotting and 34% said their period become more irregular.[13]

3)     The contraceptive implant and injection

-        The contraceptive implant and injection both contain a synthetic version of progesterone and act by preventing ovulation.[14]

-        Usually, the implant causes periods to be lighter and less frequent, however one in five people experience prolonged or heavier or bleeding. Another one in five people’s periods stop altogether.[15]

-        In terms of the injection, after the first one it’s common to experience irregular bleeding or, in some cases, heavy prolonged bleeding.

-        One in ten women will completely stop having periods after three months, and about 50% of women after a year. There’s an even higher chance periods stop with longer duration of use.[16]

4)     The hormonal coil (IUS)

-        The hormonal IUS acts by releasing a low, daily dose of progestin, a synthetic version of progesterone.[17]

-        With the hormonal coil, periods are as much as 96% lighter, shorter and less painful. Initially, bleeding may be slightly irregular, taking as much as six months to settle down completely.[18]

-        However, in terms of the level of bleeding, a report showed that hormonal IUS decreased it by more than 90% over the course of a year.[19]

-        In fact, 54% of women who reviewed the IUS at The Lowdown reported no bleeds at all. In fact, it’s the site’s highest-rated method in terms of overall satisfaction, with an average score of 3.6 out of 5.[20] 

5)     The copper coil (IUD)

-        Although they look very similar, the copper coil (IUD) and hormonal coil (IUS) not only function very differently, but also have vastly different effects on your period. [21]

-        The IUD (intrauterine device) works by releasing small doses of copper that alter your cervical mucus, making it more difficult for sperm to survive in your uterus.[22] It therefore doesn’t contain hormones.

-        Since the IUD doesn’t impact ovulation or your endometrium, you will still experience a monthly period. Although the frequency of your periods won’t be affected, many users report having much heavier, longer and even more painful periods when on IUD. [23] 

6)     The contraceptive patch

-        Like the combined pill, the contraceptive patch contains synthetic versions of oestrogen and progesterone.

-        The contraceptive patch is applied once a week, every week for 21 days, followed by a break.[24]

-        However, like the combined pill, the weeks break can be skipped if you’d rather avoid the monthly bleed.

-        Similarly, to the combined pill, you don’t ovulate on the contraceptive patch, which means your bleeding can become much lighter and potentially less painful.

 

Ultimately, each method of contraception affects your period differently: the combination pill and the contraceptive patch will likely mean you will continue to experience a monthly bleed, whereas the mini pill, the IUS, the injection and the implant can lead to your periods stopping altogether. There are however no guarantees and you have to find the one which is best for your body.

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[1] K.Wahl, ‘How every method of hormonal contraception affects your period’, Clue,  31 January 2020

[2] M.Chepenik, ‘How Do Different Birth Control Methods Affect Your Period? A Guide’, Healthline, 29 July 2020

[3] L.Abbersteen, ‘How all the different contraception methods affect your period’, Cosmopolitan, 19 April 2018

[4] Ibid.

[5] C.Harvey-Jenner, ‘What happens to your body when you double-back your pill to skip a period?’, Cosmopolitan, 21 January 2019

[6] Ibid.

[7] L.Cassano, ‘How Each Contraception Method Can Affect Your Period’, Daye, 1 July 2020

[8] Ibid.

[9] M.Chepenik, ‘How Do Different Birth Control Methods Affect Your Period? A Guide’, Healthline, 29 July 2020

[10] Ibid.

[11] Ibid.

[12] L.Cassano, ‘How Each Contraception Method Can Affect Your Period’, Daye, 1 July 2020

[13] Ibid.

[14] Ibid.

[15] L.Abbersteen, ‘How all the different contraception methods affect your period’, Cosmopolitan, 19 April 2018

[16] Ibid.

[17] L.Cassano, ‘How Each Contraception Method Can Affect Your Period’, Daye, 1 July 2020

^[18] L.Abbersteen, ‘How all the different contraception methods affect your period’, Cosmopolitan, 19 April 2018

[19] L.Cassano, ‘How Each Contraception Method Can Affect Your Period’, Daye, 1 July 2020

[20] Ibid.

[21] Ibid.

[22] Ibid.

[23] Ibid.

[24] Ibid.