Types of contraception and how they can affect your period

With so many contraception options out there, it can be hard to find what really works for you. The combined pill, the mini pill, the hormonal coil, the copper coil, the implant, the injection, condoms, and emergency contraception – where do you even begin?

It might be a good idea to understand how each type works and what side effects they can have. This will help you to be more informed about your choices, giving you the confidence and knowledge you need to open up the conversation with your doctor, who will be able to give you a more personalised recommendation.

So, let’s take a closer look…

• The combined and mini pill
• The contraceptive injection
• The hormonal intrauterine device (IUD) or coil
• The contraceptive implant
• The copper intrauterine device (IUD) or coil
• Condoms and other barrier methods
• Emergency contraception

Contraception is basically a way to prevent sperm from meeting and fertilising the egg (which is how a pregnancy starts). Different methods work in different ways, making some more effective than others.

You can find various types of contraception, from chemical (hormonal) to barrier (physical) ones. And a few can be used beyond just avoiding babies. For example, some hormonal contraception options can double up as a treatment for Polycystic Ovary Syndrome (PCOS) ^[1] or Premenstrual Syndrome (PMS), while barrier methods can also protect you from Sexually Transmitted Infections (STIs) ^[2].

There’s no one right answer when it comes to which method is best for you. That’s why it’s a good idea to reach out to a nurse or doctor who can recommend the safest contraceptive for you. As a routine check-up question, they might ask about your and your family’s general health. They might also check that you understand what you’re doing and that you’re not being pressured into having sex when you don’t want to – they’re just looking out for you, so don’t be alarmed.

If going to a doctor’s appointment makes you feel anxious and keeps you from seeing them, you can always ask your partner (if you already have one), a friend, or a family member to go with you. Taking someone you trust will remind you that you’re not alone and might help make the situation feel less daunting.

So, what are the different methods of contraception out there? And how can they affect the way we experience periods?

The combined and mini pill

The combined pill is an oral contraceptive (meaning you swallow it), containing oestrogen and progesterone. The mixture of these hormones stops the release of an egg from your ovaries (known as ovulation), thus avoiding pregnancy.

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].

Be mindful that some pill packets might come with extra sugar pills. They are there to help you maintain your daily habit of taking the pills but are not actual contraceptives (known as placebos). Alternatively, your doctor might recommend that you take a break in between packets.

During this time, your body might go through what’s known as withdrawal bleeding (a light and short flow). Though it might look and feel like menstruation, withdrawal bleeding is just an outcome of the change in hormones that occurs when you take a break – so it’s actually not quite a period. This does not mean that the pill isn’t working, though – it’s just means your body is adjusting to the new hormones.

If you experience persistent flows over a long period of time when starting on either of these pills, it might be a good idea to reach out to your doctor. They will provide you with personalised and professional advice to put your mind at ease and get any treatment if needed.

The contraceptive injection

The contraceptive injection is a shot that steadily releases the hormone progesterone into your bloodstream, preventing ovulation from happening ^[6]. Some people find it more convenient than the pill because it can be taken only every 8 or 13 weeks (depending on the brand).

Irregular periods during the first few months of getting the contraceptive injection are common, however, once your body adjusts itself to the hormones, your flow tends to be lighter or stop altogether.

But, if the mention of needles sounds like the stuff of your nightmares, don’t worry, there are other methods to choose from!

The hormonal intrauterine device (IUD) or coil

Though it has a complicated name, the hormonal IUD or coil is quite simple. It is a small, often T-shaped device that releases progesterone into your body, which thickens your cervical mucus and blocks sperm from meeting an egg ^[3]. It is inserted into your womb by a doctor or nurse and can be used as a contraceptive continuously for 3 to 5 years.

While using the hormonal coil, it’s very likely that your periods will become lighter, less painful and may even stop altogether. That’s because all that extra progesterone from the coil is meant to make the lining of the womb thinner – so thin that when it’s time for your period, there is little to no lining to shed as menstrual flow ^[3]. Whether a period-less month makes you freak out or dance with joy, this is a very common side effect of the hormonal intrauterine device and usually nothing to worry about.

Some women+ may experience spotting or bleeding between periods within the first few months of having the coil inserted, but that’s normal. It’s just your body figuring out how to deal with the new hormones.

The contraceptive implant

If inserting a small device in your uterus doesn't sound like your kind of thing, how about having it fitted in your arm? The contraceptive implant does just that.

It is a device inserted in your arm by a medical professional and can be used for up to 3 years without any breaks. Just like the IUD, it works by releasing the hormone progesterone into your body to prevent pregnancy ^[5]. The implant also thins the lining of the womb, making some periods lighter or stopping them completely. That is just a side effect of this particular type of contraceptive and is usually nothing to worry about.

The copper intrauterine device (IUD) or coil

If you’re not particularly keen on hormones, then the copper IUD may be right for you! Unlike other coils, this is a completely hormone-free option. The copper coil is a small device that is inserted into your womb by a doctor or nurse and can be used as a contraceptive for up to 10 years ^[3]. It works by releasing copper in the lining of your womb, which is toxic to sperm ^[8]. This stops it from surviving inside your body and avoids pregnancy.

Unlike the combined pill, the copper IUD does not stop ovulation, so you will still have a menstrual cycle like usual — period included! However, you may experience heavier and more painful bleeding in the first 3 to 6 months of wearing it. Though the exact reason for heavier periods is unknown, research suggests that when this intrauterine device is inserted, some small tissue damage may occur, increasing your blood flow to help repair it ^[4].

Scary as that may sound, our bodies are amazing at healing themselves, so the tissue tends to go back to normal and the heavy bleeding often fades. But if heavy periods are getting in the way of your usual routine or you’re experiencing particular discomfort while on the copper coil, consider checking in with your doctor for professional advice.

Condoms and other barrier methods

Remember those awkward lessons at school, with the condoms and the bananas? Well, there’s more to barrier contraception methods than just that!

Male condoms and other options such as female condoms, diaphragms, and cervical caps are some of the few contraceptives which do not contain hormones, and therefore they do not interfere with your body or affect your periods. Barrier methods still offer great protection against pregnancy by using physical boundaries to prevent sperm from reaching an egg.

Keep in mind that both male and female condoms protect against Sexually Transmitted Infections (STIs) too, so they’re worth using whether you’re also on other contraception or not.

Emergency contraception

Sometimes, there will be days when things don’t go as planned – including when having sex. If you’ve had unprotected penetrative sex or, for whatever reason, the contraception you used has failed (for example, a condom split), using emergency contraception can help prevent pregnancy.

It’s easy to put yourself down a spiral of shame and guilt if you realise that you need emergency contraception but try to be kinder to yourself. Remember that we’re all prone to accidents and that you have shared responsibility with your partner. Try to stay calm, take a deep breath, and keep in mind that there’s a solution for everything.

So, which types of contraception can you use in case of emergency?

The emergency contraceptive pill – also known as the morning after pill

Not to be confused with the combined and mini varieties – the ‘morning after pill’ is a progesterone-only hormone pill that works by delaying the release of an egg to prevent pregnancy. Usually, there is just one pill to take.

If you’re seeking the emergency contraceptive pill, reach out to your doctor as soon as possible, who will be able to give you professional advice regarding your options and guide you in the right direction.

When should I take my morning after pill?

Though the answer might seem obvious (the next morning, right?), this contraceptive's name can be misleading.

Generally, it’s recommended to take it as soon as possible after you’ve had unprotected penetrative sex. However, the time frame depends on which exact kind of emergency contraceptive pill your doctor has recommended. Some can be taken within 72 hours (3 days), while others give you up to 120 hours (5 days) to take it, allowing you a larger time window ^[7].

How effective is the morning after pill?

As a rule of thumb, the sooner you take the pill, the more effective it'll be. Just be mindful that the morning after pill is unlikely to be effective if it’s taken after the ovulation phase of your menstrual cycle (after the egg has been released from one of your ovaries).

It’s a good idea to use a period tracker to help you know the phases of your cycle so that you don’t miss out on taking the pill at the right time.

Can the morning after pill delay my period?

It is highly likely that taking the morning after pill may affect your next period. However, all bodies are different so it really depends.

For some, their period might arrive earlier than expected, while for others, it could be later (even up to 1 week!). As the morning after pill delays your ovulation, it’s quite common to have irregular or missed periods — that’s completely normal and nothing to worry about.

However, if you notice that your period is later than 7 days or if something feels off, listen to your body. You can try taking a pregnancy test or speaking to a doctor who will be able to give you professional support and advice to put your mind at ease.

The copper intrauterine device (IUD) or coil

Another method of emergency contraception is the copper intrauterine device. For it to be effective, it needs to be inserted in your womb by a doctor or nurse up to 5 days after unprotected penetrative sex or the earliest time you could have ovulated.

A big benefit of using a copper IUD as emergency contraception is that you can choose to have it left in and avoid any future scares, since it can be used as a contraceptive for up to a decade.

Although you wouldn’t feel the copper coil at all when properly placed, not everyone feels comfortable having a device inside their body, so go for what feels right for you.

It can be worrying if your cycle suddenly changes in ways you aren’t used to, even if you’re expecting it to as a result of changing or starting new contraception. So the best thing you can do is sit back, relax and give yourself some time to get used to it After all, the human body is amazing at adjusting to what life throws at it!

You can be prepared for surprise flows, though, by wearing liners or period pants during the first few months of using a new type of contraception. Knowing you’re protected will help put your mind at ease.

You can also keep a diary or use a period tracker to easily spot and keep a record of anything out of the ordinary going on with your cycle. This can be helpful information for your doctor too if you end up going to them for advice at some point.

Like most things related to your V-Zone (this refers to everything to do with our vagina, vulva and the V-shaped front of our body), using the right kind of contraception is all about listening to your needs. It may take some testing and learning, but it’s worth it for your own health and peace of mind. And remember, you don’t have to figure it out alone, getting support from a medical professional can more easily lead you to what works for you.

Keep in mind that contraception is not the only thing that can mess with your usual menstrual cycle – stress can also affect your period! So it’s a good idea to not jump into any conclusions and go to your doctor for a check-up whenever something feels off.

Now that you’ve learned all about how contraception can affect your period, why not look into signs that your period is coming or whether it’s possible to stop or postpone a period?

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

^[7]  https://www.nhs.uk/conditions/contraception/emergency-contraception/?tabname=questions-about-the-pill

^[8]  https://www.brook.org.uk/your-life/iud-intrauterine-device/