Our natural cycles serve more than just the purpose of making babies. These hormones in our ovulatory cycles also benefit our mood, energy levels, skin, brain & bone health, metabolism, libido & more! Your choice of contraception will impact the natural rhythms and beneficial functions of your natural hormones. We want you to make an informed decision when it comes to choosing which way to go. After all, there's only so much information about contraceptives that our doctors tell us!
Hormonal contraception methods work to prevent pregnancy by suppressing our natural sex hormones (either partly or entirely). The common hormonal methods used these days include the combined oral contraceptive pill (OCP), mini-pill and the Mirena IUD - though there are others too, like the rod/implant and depo-provera injection.
The Combined OCP and mini-pill are pills taken daily. While the Combined OCP contains both a synthetic form of oestrogen, and one of a range of different forms of synthetic progesterone, the mini-pill contains a form of synthetic progesterone known as progestin, but no synthetic oestrogen. The mini-pill is an option for women who are breastfeeding. These synthetic hormones act to shut off the communication between your brain & ovaries to prevent ovulation & natural production of sex hormones. The combined pill also thicken cervical mucus to prevent sperm from fertilising egg and thins the uterine lining so that a fertilised embryo cannot attach.
Traditional progestin-only pills work by thickening cervical mucus, making it difficult for sperm to make their way through the uterus. It is still possible that ovulation may still occur, depending on the pill and the individual. Other progestin-only formulations such as Cerazette can also suppress natural production of FSH and LSH & therefore ovulation and also thin uterine lining.
While it can be an easy option for some, the combined pill can cause side effects such as breast tenderness, nausea, headaches, & adverse changes to mood, weight & libido. The combined OCP also Increases your body’s requirements for nutrients, particularly B vitamins, vitamin C, E, copper, magnesium, selenium & zinc.
Natural progesterone is so important as it is needed for our mood & skin health so side effects of taking the mini pill can include low moods, anxiety, weight gain, acne, breast tenderness, headaches, nausea & even ovarian cysts. It should be emphasised that synthetic progestins are not the same as our naturally produced progesterone so by taking the pill, you forego the fantastic benefits that you may otherwise naturally produce on your own! It is also common for women on the mini pill to experience irregular and prolonged bleeding.
It's unfortunate that so many young girls and women are immediately prescribed the pill when it comes to acne, heavy periods, irregular periods and period pain present themselves. We are told that the pill will help to "regulate" and "fix" our symptoms, but really that's super misleading. The pill only acts to mask these symptoms and does nothing to resolve the underlying issues, so once you come off, you are faced with all the same symptoms again.
For both forms of OCP, disruption of gut microbiome can occur; shifting our digestive health, immunity and mental health in a negative direction. There is also a risk of blood clots so it is extremely important to look at your own health history and your families to see if you are at high risk.
For those who feel that taking a pill every single day at the same time of day is too much to keep on top of, the other hormonal contraceptives like the Depo-Provera injection, rod/implant and Mirena IUD serve as alternatives.
The Depo-Provera is an injection given by a health practitioner every 12 weeks that contains a form of synthetic progesterone called Medroxyprogesterone acetate. This disrupts communication between your brain & your ovaries. This prevents both ovulation and your body from making its own natural hormones; also affecting cervical mucus and uterine lining. Long-term, levels of oestrogen and progesterone are suppressed to levels of post-menopausal women! This can be problematic long-term as evidence has shown a direct correlation between the depo injection and osteoporosis, and delayed return of a natural cycle and fertility after coming off compared to other forms of contraception! Weight gain appears to be a major issue as this injection can affect the regulation of blood sugar levels.
The rod/implant is a long-acting, reversible contraceptive implant for women. It is a small plastic rod that is inserted into the underside of the upper arm that can be left for up to five years & is easily removed. It slowly releases synthetic progesterone which like the Depo-Provera, acts to suppress communication between the brain & ovaries, preventing ovulation & your body from making its own natural hormones. It also thickens the cervical mucus to prevent fertilisation. Some women experience side effects such as depression, weight gain & decreased libido, nausea, tender breasts, fluid retention & irregular bleeding, heavy bleeding & even no bleeding at all.
The Mirena IUD works by delivering small doses of synthetic progesterone levonorgestrel directly to the uterus with a dose much lower than that of oral contraceptives. Once fitted in the uterus, the Mirena can be left in for 3-5 years (depending on which one). It partially suppresses ovulation for some women by minimising hormone production but does not fully disrupt communication between the brain & ovaries. This is another option for breastfeeding mums. Once again this method thins the uterine lining and thickens cervical mucus. The lower doses of synthetic hormones mean you are less likely to encounter side effects, though some may experience headaches, acne, breast tenderness, irregular bleeding, mood changes & pelvic pain. Because the Mirena IUD lightens periods, this is often recommended for women with heavy periods. There is a risk that the Mirena is not inserted in properly and can become misplaced, causing pain and inflammation in the pelvic region.
Like the Mirena IUD, the Copper IUD is a small, T-shaped device coiled in copper that is inserted into the uterus by a medical professional. The Copper IUD contains no synthetic hormones, using copper instead as a contraceptive by inhibiting the motility of sperm, reducing their ability to penetrate and fertilise an egg. Theoretically, because it does not contain any synthetic hormones it therefore does not disrupt ovulation or natural hormone production and fertility resumes instantly once removed. However some women will experience an-ovulation after being on the copper IUD for some time; this may be due to copper disrupting zinc levels in the body. Once fitted, the Copper IUD is effective for up to 10 years but can also be removed at any time. Side effects may include bleeding between periods and it can affect the vaginal microbiome and increase the risk of developing bacterial vaginosis. Since many women experience a heavier period in the first year especially, it is not recommended if you have a heavy flow already.
Many are familiar with condoms which are a thin rubber barrier worn over the penis during sex. If fitted correctly, it creates a barrier to ensure sperm does not enter the vagina. Because it is a barrier method that is only used during intercourse, condoms do not affect our ability to ovulate and produce hormones for a natural cycle, yay! They also protect against a wide array of STIs which the other contraceptive methods do not.
Lastly, the fertility awareness method (FAM) is a way of recognising the signs of fertility and identifying the fertile window of your cycle, to either plan a pregnancy, avoid pregnancy, or just become more familiar with your menstrual cycle. This is usually done by tracking basal body temperature (BBT), paying attention to cervical mucus and the position of your cervix. When using the FAM for contraception, the idea is that you abstain from sex or use another method (e.g. condoms) during your identified fertile window. It should be noted that if using for contraceptive purposes, that you should consult with a practitioner who is well-versed in the approach and that you take the time to track a few cycles to understand your body before attempting!
Whether you are currently on or have been on a form of contraceptive and have been wanting to learn more, change methods or even come off contraception for whatever reason, we hope that this served as good quality information to help with decisions around your hormone and overall health and figure out the best fit for you.
When in doubt, always speak to a healthcare practitioner you trust.