Combination and Estrogen-free Birth Control Options


Children can bring joy to your life but if you are not ready, contraception is a must.  One option is birth control pill. If you are considering taking birth control pill then here is what you need to know.

Some birth control pills can also help control heavy periods or estrogen dominance females.

As of this writing, you can only get birth control pill from a licensed healthcare provider or clinic. In order to have it filled a the pharmacy you will need a prescription.

Most of the birth control options on the market are combination birth control options as they contain a combination of two hormones: estrogen and progestin (a synthetic form of the natural hormone progesterone). The goal of these pills is to prevent pregnancy by preventing ovulation through maintaining more balanced, consistent hormone levels as well as thickening cervical mucus so that the sperm won’t be able to reach the egg and fertilize it.

Although most women will be fine with taking the combination of birth control pills, for some women, these simply won’t be the best option and they will be recommended to consider birth control pills without estrogen. Since estrogen is a female hormone body and our body naturally produces it, in some cases, a doctor may recommend you to switch to birth control options without estrogen, considering it to be a safer option for you.

But why do you need to do that? What are the birth control options without estrogen, how do they work and what are the things you need to consider before you switch to these methods? Let’s discuss it!

Why some women need/choose birth control options without estrogen?


Even if you have used birth control options which include estrogen in the past and you haven’t experienced any major side effects or had any issues with using them, in some situations your doctor may recommend that you switch to birth control options that don’t include estrogen. The reasons why they may do so and why some women need to or choose to move to birth control methods without estrogen are:

1.These methods/pills are considered safer: in comparison with the combined pills, progestin-only pills or methods are considered safer, with fewer side effects and still as effective because they also are 87-99% effective in preventing pregnancy.

2.  You have certain health issues that don’t go well with estrogen: estrogen can increase health risks and is not recommended for women   who  have certain health issues such as high blood pressure or issues with their cardiovascular system, blood clots, or are fighting obesity; switching to birth control options without estrogen in these cases is really about preserving the patients overall health and making sure they won’t suffer any major side effects.

3.  You are breast-feeding: although it is still debatable and there are researches on both sides, still many doctors choose to prescribe birth control options without estrogen during breast-feeding due to the fact that for years it was thought that the estrogen hormone in the combination pills might affect lactation. To play it safe, even if estrogen doesn’t affect lactation, many health providers prescribe birth control pills without estrogen during the breast-feeding period.

4.  General concern about taking estrogen: estrogen is a hormone and as such it really influences our body and how it works; that’s why many women simply do not want to take combination pills or any birth control option that includes estrogen. They also may have experienced some side effects and consider the birth control option without estrogen as the better, more appropriate alternative for their body.

Birth control options without estrogen: different types, how they work and are there any side effects?

The birth control options that don’t include estrogen typically, but not always, rely on the hormone progestin to prevent pregnancy. Progestin stops pregnancy by preventing ovulation: simply put, if there is no egg to be fertilized, pregnancy won’t happen. Additionally, it also thickens the mucus of the cervix so that the sperm won’t get through.

There are several types of birth control options that don’t include estrogen and work on this principle, such as:

 Birth Control Implant

Birth control implant is a small rod that your health provider inserts under the skin of your upper inner arm. An example of a birth control implant is Nexplanon.

How does it work?

Considered as one of the most effective methods of birth control, this implant contains progestin which is released regularly into your body. The birth control implant can stay up to 3 years in your body, however, you can also remove it earlier if you need to. It does not offer any protection from sexually transmittable diseases.

What are the side effects?

The most bothersome and common side effects of the birth control implant are irregular bleeding. Other side effects can be:
 Nausea, stomach pain
 Dizziness
 Flu-like symptoms
 Breast tenderness, in some cases even pain
 Vaginal itching or discharge
 Breakthrough bleeding, followed by menstrual cramps
 Acne, mood changes, weight gain
 Infection where the implant was inserted or bruising

Symptoms may vary from person to person, but if they are causing any major pain or discomfort, one must consult their health provider instantly.

IUD with Progestin

The IUD with progestin are intrauterine devices that contain a type of progestin hormone called levonorgestrel. You can find several IUDs on the market, some of them are Mirena, Liletta, Kyleena, Skyla, etc.

How does it work?

Generally speaking, these IUD typically are T-shaped devices inserted into the uterus; inside them, there is a progestin that gets released over a certain period of time. Depending on which type of IUD you have, you can use it as a pregnancy prevention method for up to 3,4,5 years: Mirena up to 5, Liletta up to 4, Kyleena up to 5, and Skyla up to 3 years. They all release hormone progestin to prevent the egg from getting fertilized and thicken the mucus of the cervix so that the sperm won’t be able to reach your egg.

What are the side effects?

Depending on the brand, the side effects may vary slightly, and you need to consult your doctor before inserting an IUD to make sure you understand the potential side effects and risks of the specific IUD device and brand you are considering; in general, usually, the side effects of IUD include:

 Irregular bleeding for several months
 Nausea
 Headaches, skin blemishes
 Breast tenderness
 Lighter or shorter in some cases even no periods (but in Kyleena, it may be opposite and have painful periods)
 Ovarian cysts

The side effects really can vary depending on the brand, but if you are experiencing fever, long-lasting heavy bleeding, unusual vaginal discharge, pain or you can no longer detect the IUD strings, you should immediately contact your doctor.

Injectable Birth Control

Injectable birth control options are injections filled with progestin that a doctor or nurse gives you every 12-13 weeks. Some people use birth control apps to keep track when they need to get their next shot.

How does it work?

Injectable birth control option without estrogen is an injection that you have every 3 months – 4 times in total each year; currently, the most popular (and the only type available in the USA) is Depo-Provera, in other parts of the world in Europe, and Africa or Central America people also use Noristerat Injection. These injections, just like the other birth control options, rely on progestin to prevent the pregnancy. It is considered quite effective, but you must take the shot regularly, no skipping.

What are the side effects?

These shouldn’t be used for a longer period of time, 2 years is the maximum period; you need to take a break afterward and consult a doctor on how to proceed. Like with any other birth control option, these too have some side effects, such as:

Irregular, prolonged bleeding or spotting
 No menstrual periods after 1 year of use (noticed in almost 50% of users)
 Weakness, depression, nervousness, headaches, even dizziness
 Acne, weight gain, change in appetite
 Facial and body hair growth or hair loss
 Stomach ache, pain or bloating
 Less interest in sex

Who shouldn’t take the shot?

While most women can get the shot, still, you need to consult a doctor before getting it, and discuss it, as in some occasions it is not recommended, for instance, if you had/have:
 Unexplained vaginal bleeding
 Liver disease
 Diabetes
 Blood clots
 Depression
 Osteoporosis or high risk of it
 Cardiovascular diseases or history of strokes, heart attacks
 Breast cancer

Birth control pills without estrogen

Probably the most common solution, the birth control pills without estrogen are birth control pills that contain only progestin, and are available in 28-days package, with no placebo pills. They are also known as mini-pills or POPs, and you need to take them every day during your 4-week cycle.

How do they work?

The progestin-only birth control pills rely on progestin to stop pregnancy from occurring. By taking them every day regularly (at the same time!) you are inserting enough progestin which stops your ovulation and thickens the cervical mucus and thins the lining of the uterus so the sperm can’t get anywhere near the egg.

What are the side effects?

The mini pill is not as strong protection as other pills or solutions as recent studies showed that 13 out of 100 women who take them can get pregnant. Additionally, chances are, if you do get pregnant while on these pills, you will most likely have fertilized egg outside the uterus – ectopic pregnancy. Like the other birth control options without estrogen, the mini-pills also due to the progestin, have pretty much the same side effects, like:
 Acne
 Breast tenderness
 Pain in the stomach
 Decreased sex drive
 Depression, headaches
 Ovarian cysts
 Nausea
 Irregular menstrual bleeding
 Vaginal dryness

Who shouldn’t take these pills?

Since these pills and the shot both rely on progestin, they too are not meant for everyone. Always make sure you talk to a doctor before you start taking them, and give the doctor your medical history as well as a list of any medications you may take. These pills shouldn’t be taken by people who:
 Have/had liver disease
 Have/had breast cancer or cardiovascular diseases
 Have unexplained uterine bleeding
 Are taking medications for HIV/AIDS, tuberculosis or control seizures
 Are not regular in taking the pill or experience some major side effects.

What is the correlation between the pills and vaginal dryness?

Usually, vaginal dryness is associated with menopausal women, however, it can occur to women of any age; typically, the symptoms are burning or itching, pain during sex and discomfort. Recently, many researchers are looking into the connection between birth control pills and vaginal dryness. This is because vaginal dryness is a hormonal issue, meaning, it is a result of a lack of estrogen.

Estrogen is responsible for keeping the tissues of our vagina lubricated, and if the birth control pills, (typically it is the case with combination, not so much with mini pills) cause changes in the estrogen levels this will lead to vaginal dryness. If you are experiencing any of the symptoms, you should always consult your doctor immediately to see what is causing it and if it is the pills, find birth control solution that works for you.


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