Contraception and your period
Females are only fertile for 6 days. Eggs are only viable for 24hrs but sperm can live for up to 7 days. So does the majority of contraception methods (and arguably the responsibility) fall at the feet of women?
Is it because they are the ones who ‘carry the can’ if contraception fails?
16 different types of contraception
There are lots of different types of contraception which I’m going to describe here. There are 2 main groups: synthetic hormonal methods and non-hormonal contraception.
Non-hormonal:
- Male and female condoms – these form a physical barrier between the sperm and egg. A male condom is single use and is put on an erect penis. Effectiveness with typical use: 82%
A female condom is much larger and is placed inside the vagina. The male penis should be guided inside this for correct use. Effectiveness with typical use: 79%. Condoms also protect against STIs.
- Male and female sterilisation *– A vasectomy is when the tubes carrying sperm to the penis are cut and tied. This is normally done under local anesthetic and is very effective (98%). Female sterilization is a major abdominal surgery as the fallopian tubes are cut and tied, so the egg cannot reach the womb to be fertilised. Vasectomy’s can be reversed but female sterilisation is permanent
- Copper IUD* – this small T-shaped intrauterine device sits inside the womb, preventing implantation of a fertilised egg. Copper is toxic to eggs and sperm. Your periods may be heavier and more painful whilst using this device. It can be used for up to 10yrs. It is fitted by your nurse or GP. Effectiveness: over 99%
Hormonal:
- COC pills – combined oral contraceptive pill pills. COC contains oestrogen and progesterone and act to stop ovulation occurring. Hence pregnancy cannot occur as there is no egg. You take 1 pill daily for 21days then stop for 7 days to allow a ‘breakthrough bleed’ to occur (a fake period). Effectiveness with typical use: 91%
- POP contains only progesterone as the name suggests and works to thicken the lining of the womb a little and to thicken cervical mucus to make it harder for the sperm to enter the womb. 1 pill is taken every day for 28 days and then the next pack is started. You will still ovulate but the conditions in the womb are not optimal for a fertilised egg to implant and start a pregnancy. Effectiveness with typical use: 91%
- Implant* – a small flexible plastic rod which contains progesterone which is released slowly over 3yrs. This is inserted under local anesthetic into the upper inner arm area. This works in the same way as the POP but without having to remember to take a tablet everyday. 33% of women have irregular bleeding on this method. Effectiveness: over 99%
- Patch – small sticky plaster type patches worn on the skin below the waist which contain oestrogen and progesterone. 1 patch is worn every week continuously for 3 weeks in total, before having a ‘patch-free’ week, during which a ‘breakthrough’ bleed will occur. This works in a similar way to the COC pill. Effectiveness with typical use:91%
- IUS – This is a small T-shaped intrauterine system which sits inside the uterus and has a central rod which contains progesterone which is releases slowly over a period of 5yrs. This works in a similar way to POP pill.
- Depo-injection – this contains progesterone and is typically given in the top part of the buttock. This releases progesterone slowly over a period of 8 or 12 weeks. 60% of women have no period whilst using this method. 40% have irregular bleeding. Most women gain a lot of weight on this method. The effects need to wear off, rather than be removed which can be an issue if you are having side effects. Effectiveness: 94%
- Ring – this is a small flexible plastic ring which sits low down in the vagina. It contains oestrogen and progesterone and works in a similar way to the patch and COC. You wear 1 ring per week for the whole week for 3 weeks then have a ‘ring-free’ week during which time you’ll have a breakthrough bleed. Effectiveness with typical use: 91%
- Diaphragms and caps – flexible rubber dome-shaped devices designed to be used with spermicide. These cover the entrance to the womb and stop any sperm getting inside. They must be inserted 3hrs before intercourse, and left in for 8hrs afterwards. Their effectiveness with ‘perfect’ use is: 92%.
- Natural family planning – using ovulatory signs and knowing when to avoid having intercourse when there is an egg there, thus avoiding pregnancy. This needs to be taught correctly. Effectiveness with ‘perfect’ use is 76%. Withdrawal method is when a man withdraws his penis before he ejaculates, but there is sperm present in pre-ejaculate fluid.
- Abstention – this is not having intercourse so you then can’t get pregnant! This may also include other methods of intimacy such as masturbation or oral sex.
2 important decisions
Each women needs to decide if she would like to have synthetic hormonal contraception or non-hormonal. Bleeding patterns are also very important. Do you want a monthly bleed? Are you happy to have irregular bleeding all month long? Would a heavier bleed be acceptable?
Some of the above methods have got an element of ‘user input’. For example, male condoms are 99% effective with perfect use, but with typical use this comes down to 82%. However some methods have no ‘user input’ at all such as the LARC (long-acting reversible contraception) methods, indicated above with an asterix (*). These methods, once done or fitted, have a higher percentage of effectiveness as they don’t need to be remembered to be effective.
Side effects of hormonal contraception
Any contraception that contains synthetic versions of oestrogen and progesterone will have side effects.
Common COC side effects are: nausea, abdominal cramps, headache, depression, irritability, breast tenderness, etc.
The COC depletes your body of: magnesium, zinc, B vitamins, most minerals and Vit C. Zinc and selenium are needed for healthy thyroid function. Every cell in your body has a thyroid receptor! Symptoms can include: hair loss, feeling sluggish, poor immunity, fatigue, anxiety and brain fog, IBS, fungal infections, insomnia, memory loss and nerve pain.
COC/POP also affects your beneficial gut microbiome so absorption of nutrients is not optimal. An unhealthy gut microbiome can allow reabsorption of oestrogen from the gut, which is there to be excreted. It can then be reactivated and lead to higher oestrogen levels in the body. Oestrogen triggers the release of histamine in the ovaries and the uterus which can then result in symptoms of hayfever, hives or itchy skin at ovulation. Zinc and histamine are also on a ‘seesaw’. When zinc is low, perhaps due to stress or being on COC/POP then histamine levels will be higher. The opposite is also true.
These synthetic hormones disrupt the delicate balanced communication between the hypothalamus, pituitary and ovaries.
Hidden cost of contraception
The main way of COC working is to ‘switch off’ your ovulation. It tells your body not to release an egg. However sending your body this message, both chemically and mentally (women who are on contraception by default are not wanting to conceive) can have consequences.
Most women want to conceive later in life so will use some form of hormonal contraception. Let’s say you’ve used COC from the age of 16yrs old until you are 26yrs old. That’s 10yrs of telling your body that you don’t want a baby. If you then want to start trying to conceive, its not always as simple as you may think.
Endocrine disruption and how to minimise it
Endocrine (hormone) disruption is ubiquitous. There are chemicals in the water we drink, to the food we eat to the skincare we use on our skin. Most of us are far to oestrogen dominant and this is taking its toll on our health. I’m seeing younger and younger girls who are not only starting their periods before senior school, but have signs of early endocrine disruption. No one goes to sleep a girl and wakes up a woman!
My eldest daughter:
8yrs – smelly armpits
9yrs – Few pubic hairs
10yrs – Budding started on her chest
11yrs – Spots under the skin on forehead and chin (hormonal areas)
12yrs – Tearful for no reason at the end of each calendar month
13yrs – Actually started her periods.
Hormones are chemical messengers in the body. Endocrines or hormones are chemical messengers in the body. They play a key role in our health. The key ones for menstruation are oestrogen and progesterone. However we are surrounded by endocrine disruptors in what we eat, drink, put on our skin, breathe, etc.
This list is not exhaustive but gives you a place to start, not a place to get overwhelmed! (More in the menopause module)
Tips:
- Organic cotton sanitary pads which are wrapped in biodegradable wrap. However in 2024, a study was done on organic and non-organic cotton tampons and levels of arsenic and lead were found. Washable period pads or period pants may be the way to go instead. Or menstrual cups.
- Drink filtered water to decrease some of the toxins in there. Use a metal or glass water bottle to carry water with you when out and about.
- Buying organic meat, milk and fresh produce. GMO and non-organic food is full of chemicals, antibiotics and steroids. 20% of non-organic cow’s milk is PUS!
- 60% of what you put on your skin is absorbed within 6 secs! Switching to natural skincare products, like Tropic is better for your hormones!
- Glass or ceramic containers are better for food storage and reheating food too. Plastic containers including take away coffee cups can leach chemicals into the food and drink. Carry a glass reusable one of your own!
- Use fluoride free toothpaste so your pineal gland doesn’t become calcified.
- Decrease stress! Cortisol and insulin are the King and Queen at the top of the 3-level system that ultimately controls our periods. Balancing your blood sugar and managing your stress can really make a big difference to your periods. In addition, cortisol can actively cause PMT, anxiety and even miscarriages as it competitively binds to progesterone receptors. High levels of cortisol mean that you may have plenty of progesterone, but the body can’t detect it!
- Seed cycling. This helps with water retention, decreases hot flushes and regulates your cycle. 1 tsp-1tbsp daily from relevant box.
- New Moon/ Day 1 of bleeding – Day 14: Flaxseeds + Pumpkin seeds. Full Moon/Day 15 -28 – Sesame + Sunflower seeds
- What the seeds contain:
Flaxseeds: Omega 3 rich, high in fibre and protein
Pumpkin seeds: Magnesium, melatonin and zinc
Sesame seeds: Magnesium, Co Enzyme Q10, iron and zinc
Sunflower seeds: Magnesium, Vit E, selenium, rich in antioxidants and protein.
If you’d like my help with your contraceptive choicee, please do get in touch!
