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Hormonal contraceptives and periods
7-minute read
Key facts
- Hormonal contraceptives are a type of contraception (birth control).
- There are different types of hormonal contraceptives.
- Hormonal contraceptives can change how often you get your period.
- Some hormonal contraceptives can ease period pain and often lead to lighter periods.
- They can sometimes cause bleeding between periods (also called spotting).
What are hormonal contraceptives?
Hormonal contraceptives are a type of birth control. They can stop pregnancy by one or more of these ways:
- stopping ovulation (the release of an egg from your ovary)
- making the mucus in your cervix (the opening of the uterus) thick and sticky, so sperm can't reach the egg
- stopping a fertilised egg from implanting in your uterus (womb)
Some hormonal contraceptives are short acting while others are long acting.
How do hormonal contraceptives work?
Your period (menstruation) is bleeding from your vagina that happens about once a month. Periods are a part of your menstrual cycle, which is controlled by your hormones.
Taking hormonal contraceptives can affect your periods and menstrual cycle. Some types of hormonal contraception may change how often you get your period and how heavy your period is.
What types of hormonal contraceptives might I be prescribed?
There are many types of hormonal contraceptives available to suit the needs of different people.
The pill
There are various types of oral contraceptive pill available. The main type of oral contraceptive is the combined oral contraceptive pill ('the pill').
The combined pill contains 2 hormones — oestrogen and progestogen. These hormones:
- stop ovulation
- thicken the mucus in your cervix so that sperm can't get into your uterus
The pill might make your periods more predictable. It can be used to help with menstrual problems like heavy bleeding and painful periods (dysmenorrhoea).
Taking the pill might also improve premenstrual syndrome (PMS).
The pill often comes in a packet of 28 pills, with 21 active pills and 7 inactive (sugar) pills. Some brands have fewer inactive pills. When you take the inactive pills, you will get a withdrawal bleed.
It's sometimes possible to skip the inactive pills to avoid a withdrawal bleed. Talk to your doctor about this to see if it is suitable for you.
Always take prescription medicines as directed by your doctor.
The progestogen-only pill
The progestogen-only pill (POP) only contains progestogen hormones. One type of POP is called the mini pill. The POP is used by people who can't take oestrogen.
The POP has a lower risk of causing blood clots than the combined oral contraceptive pill.
Your periods may change when using a POP. You may get spotting (bleeding between your periods) or irregular bleeding. Some people have no vaginal bleeding at all.
Contraceptive implants
A contraceptive implant is a small, thin, flexible rod. It's put under the skin on the inside of your arm. This is done by a doctor or a nurse.
The implant releases a steady dose of progestogen into your body. This stops pregnancy by stopping ovulation and thickening the mucus in your cervix.
The contraceptive implant can also reduce period pain.
The contraceptive implant can change your periods. Most people bleed less than before the implant, but some have periods that come more often or last longer.
Hormonal intrauterine devices (IUD)
An intrauterine device (IUD) is a small device that is put inside your uterus (womb). This is done by a doctor or nurse. An IUD is sometimes called a 'coil'.
Some IUDs release the hormone progestogen.
An IUD may affect your periods. Hormonal IUDs can reduce bleeding and period pain. Irregular periods and spotting are also likely in the first 3 to 5 months of use.
The vaginal ring
The contraceptive vaginal ring is a soft plastic ring that you put in your vagina. It contains low doses of oestrogen and progestogen.
The ring stays in your vagina for 3 weeks and then you take it out for 1 week. When the ring is out, you will have a withdrawal bleed.
It can help control your periods and often makes bleeding more regular, lighter and sometimes less painful.
Contraceptive injections
Contraceptive injections are usually given every 3 months. The injections work by stopping ovulation. They can make your periods irregular for a while, until your body adjusts to the hormone.
Some people have heavier periods when they start contraceptive injections.
Over time, your periods will usually become much lighter and less regular. Many people stop having periods after 2 to 3 injections.
What are the side effects or risks of hormonal contraception?
Side effects of hormonal contraception can be:
- headaches
- nausea (feeling sick)
- breast tenderness (feeling sore)
- acne
- mood changes
- lowered interest in sex
Some hormonal contraceptives increase the risk of:
However, the overall chance of getting these side effects is very low.
Your chances of side effects when using hormonal contraception are higher if you:
- smoke
- have high blood pressure
- have diabetes
It's important to speak with your doctor to find the right method for you.
When should I see my doctor?
Talk to your doctor about the benefits and risks of hormonal contraception.
Your doctor will discuss with you whether a hormonal contraceptive is suitable. They will also be able to tell you how using birth control may affect your periods.
Speak to your doctor if you are using a hormonal contraceptive and are worried about the side effects.
Are there any alternatives to hormonal contraception?
Barrier contraception
Barrier options are alternative methods of contraception without hormones. They work by physically blocking sperm from entering the cervix and vagina and don't affect your periods.
There are 2 forms available:
- condoms — male or female
- diaphragms
Condoms also offer protection from most sexually transmitted infections (STIs).
Fertility awareness (natural family planning)
You can also use fertility awareness methods, sometimes called natural family planning. Most women are fertile the week before ovulation. These methods involve avoiding sex when you are most fertile by tracking your period. You can track your cycle by:
- checking for fertile signs such as increased cervical mucus and changes to your body temperature.
- using a calendar to keep track of your menstrual cycle.
It can be difficult to predict your ovulation and fertile days correctly. It can take up to 6 cycles to identify your fertile days. Also, your fertile signs can change if you are sick or stressed.
Even if this method is used correctly, it is less effective at preventing pregnancy than other methods of contraception.
Fertility awareness methods also do not protect against STIs.
Resources and support
Family Planning Australia has fact sheets on contraception, including in languages other than English.
The Women with Disabilities Australia Our site has lots of easy-to-read resources about sex and contraception.
You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.