What contraception can I use if hormonal birth control is not an option?

Dear Desperate,  

Although health conditions like factor V Leiden can add some extra layers to your birth control search, your situation may be less desperate than meets the eye. Many health care providers recommend that people with factor V Leiden avoid contraceptives with estrogen, as they can raise your risk of blood clots. Luckily, there are plenty of estrogen-free birth control methods.  

That said, if your health care provider has recommended that you avoid hormonal birth control entirely, there are also contraceptive options that are completely non-hormonal. Read on to learn more about the options available to you!  

Do all hormonal birth control methods contain estrogen? 

Hormonal contraceptives contain either both estrogen and progestin or just progestin. These are synthetic versions of hormones that the body already produces. Although health care providers suggest that people with factor V Leiden avoid estrogen, they’re usually able to use progestin-only birth control. Many forms of emergency contraception (EC), including Plan B, contain similar forms of progestin to daily contraceptive pills.   

Considering your specific health history, your provider might have recommended that you avoid progestin or limit it to an occasional EC dose. Therefore, speaking to your health care provider before trying out any new contraceptive methods is the best way to align with your unique health needs.  

Which hormonal birth control methods can you use? 

If you’re able to use contraception with progestin, there are lots of options available, including:  

• Progestin-only pills: Also called the “mini pill,” this is a daily contraceptive pill. Someone might opt for this method if they know they can take the pill on a regular schedule or if they prefer a non-invasive method that they can stop at any point. 
• The implant: One of the most effective forms of birth control, the implant is a small plastic rod that is placed in your arm by a health care provider and releases progestin. It provides protection for at least five years and can be removed by a health care provider whenever you like. 
• Hormonal intrauterine device (IUD): Another highly effective long-acting method, the IUD is placed in the uterus and releases progestin to the surrounding area.  
• The contraceptive shot: A health care provider administers this shot every three months and contains progestin.  

Are there birth control methods without any hormones?  

If your provider recommends that you avoid all hormonal methods of birth control, there are still options available for you.  

• Condoms: These are an incredibly effective form of birth control when used consistently and correctly! This means using one every time you have sex, keeping it on the entire time, and making sure that its fully rolled onto the penis. When used perfectly, condoms are 98 percent effective at preventing pregnancy. 
• Spermicide: This gel can kill sperm if you insert it into the vagina around ten minutes before sex. However, it can cause irritation to the vagina or penis. It’s also less effective if its inserted more than an hour before sex. 

• Copper IUD: This is a small device inserted into the uterus. It disrupts how sperm move, so they can’t swim to the egg. It’s over 99 percent effective and can last up to twelve years, if desired. The most common side effect is heavier or more uncomfortable periods, especially during the first few months. IUD insertion can also be painful. If you’re considering it, you may want to discuss pain relief options with your provider.  

Should you use emergency contraception as your primary form of birth control?  

EC isn’t intended to be taken frequently. It’s less effective than other forms of regular contraception, like daily progestin-only pills. It also contains a larger dose of hormones than daily methods, which can cause more uncomfortable side effects. Some people who take EC frequently report disruptions to their menstrual cycle, headaches, and nausea.  

Given that you have factor V Leiden, consider a visit to your health care provider to discuss your options. With a little research and discussion, you can have a method of contraception that is safer, more comfortable, and effective for you. 

Through thick and thin,