How hormonal birth control affects your cycle

Hands up if you’ve discussed your birth control and other menstrual products over dinner with friends? In bathrooms with strangers? Had multiple conversations about it at different times of your life? Because using birth control is a big decision. It’s not just about finding out which one works best for your body; but understanding that all hormonal birth control will have an impact on your cycle.

So how does birth control affect the menstrual cycle? Most people don’t realize that they won’t have a ‘typical’ menstruation (or ovulation) — we can talk about typical and irregular in more detail another time — when on most forms of Hormonal Birth Control (HBC).

No matter the birth control method — whether birth control pills, hormonal IUD, or patch — they can all have an effect on the body and the menstrual cycle. From irregular periods to imbalanced hormone levels, birth control can change what you may have thought was your normal menstrual cycle. So, first, let's get into the hormonal birth control types and how they change your cycle.

How many types of hormonal birth control are there?

There are multiple forms of HBC that you can go on. The most common is the combined pill (aka ‘the pill’), which is what you were probably prescribed when you were younger. You take this pill daily, trying to do so at the same time each day for consistency. There are options within the range of combined pills too, many suitable for extended use.

 You’ve also got the option of: 

• the patch (change every week for three weeks; then have a week off)

• the ring (insert it into your vagina for three weeks; then have a week off)

• the hormonal IUD (intrauterine device that lasts for up to five years) 

• the copper IUD (non-hormonal intrauterine device that lasts for up to ten years)

• the mini pill (progesterone-only pill — you have to take the pill within 3 hours of the same time each day) 

• the shot (every 3 months) 

• the Implant (small plastic rod placed underneath your skin — often in your left arm — and lasts for up to three years)

The One With The Combined Pill

We could hazard a guess as to why the combined pill has become the most common choice. Around since the 1960s., it's easy to get it prescribed, and — unlike an IUD or implant — it’s not something you have to have inserted and removed. 

However, it can be hard to remember to take it every day though, which makes it less effective for most people than the methods you don't have to think about.

There Will Be Blood (Sometimes) 

You will bleed when on the combined pill, but ‘withdrawal bleeding’ rather than a regular period or menstrual bleeding (this refers to the withdrawal of hormones in your pill and in your body; this drop of hormone levels causes your uterus lining to shed). The bleeding will typically be lighter and different to your period before you started taking the combined pill. But it’s not a one-size-fits-all kind of situation. Some people won’t bleed at all when on the pill; or only experience very light bleeding/spotting. And just a reminder: your bleeding will probably change over time while on the pill. 

No More Ovulation (If You’re Taking The Pill Consistently)

This is something people often don’t realize. When you take the pill consistently, it will stop you from ovulating. This is how it prevents you from getting pregnant. During your cycle, reproductive hormones fluctuate, which preps your body for ovulation. But when you’re on the pill, it stops your ovaries from releasing eggs and preparing your uterus for a potential pregnancy. This also stops your ovaries from producing the estrogen and progesterone they typically produce when you’re not on the pill, and you have a menstrual cycle. If you’re curious about what is estrogen or what is progesterone, these hormones are important to your menstrual cycle. 

What To Expect (But Remember It’s Different For Every Body) 

It really depends on which birth control pill you take (there are multiple kinds, which you can talk to your health care provider about). Some might make you bleed for a few days during their placebo week; some might bleed for one day mid-week; or experience bleeding that goes from one pill pack to the next. Outside of your withdrawal bleeding time, you might experience spotting. When on the pill this is called breakthrough bleeding. It may just be a brief side effect and last a few weeks; or it could be caused by missing pills. It may also mean you’re not on the right pill for your body. Talk to your health care provider if you’ve been on your pill for a few months and you’re still getting breakthrough bleeding.