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7 Types of birth control without estrogen

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Written by Lauren McKay

Lauren McKay

Lauren McKay is a writer and journalist with more than ten years of experience writing across a variety of topics. She is a passionate advocate for driving women’s health knowledge and is a trained yoga teacher. She earned a Masters in Creative Writing from the University of Glasgow and currently lives in Scotland.

Not only are our birth control needs individual, but they also change throughout our fertile lifetimes. With this in mind, we've put together a list of seven birth control options without the hormone estrogen. Whether you can’t or don’t want to use this hormone, or are looking to go entirely hormone-free, read on to discover our list of 7 types of birth control without estrogen…

This article is also available in Spanish

What is estrogen?

In simple terms, estrogen is one of the main female sex hormones. It’s responsible for regulating the menstrual cycle and is an important player during the first half of the cycle in the lead-up to ovulation. By taking synthetic estrogen, it’s possible to alter the menstrual cycle and stop ovulation from happening - that’s how a number of contraceptive options, such as the combined birth control pill, prevent pregnancy. 

Why consider a birth control option without estrogen?

There are several reasons why you might want to consider a birth control option that doesn’t contain synthetic estrogen. For some it’s a medical decision, as birth control containing estrogen isn’t recommended for those who are:

  • Over 35 and smoke 
  • Very overweight 
  • Using certain medications
  • Affected by medical conditions such as problems with circulation
  • Prone to a certain type of migraine (get symptoms, such as vision changes, before a headache)

For others, the decision to choose birth control without this hormone might be because of unwanted hormonal birth control side effects, or may be a lifestyle change motivated by the desire to go completely hormone-free. 

Whatever the reason, if you’re considering switching birth control methods, it’s worth having a frank discussion with your doctor about your contraceptive options. There are several birth control methods without this hormone so it’s important to talk to your healthcare provider to find the best method for you, from oral contraceptives to natural family planning methods. In the meantime, check out some of the options you might want to consider:

1. The mini pill (progestogen-only pill)

Unlike the more commonly prescribed combination birth control pill (otherwise known as the combined pill or regular birth control pills), the mini pill is a type of birth control pill that only contains a synthetic version of the hormone progesterone, known as progestin, this mimics the effects of progesterone in the body. The mini pill must be taken every day and there’s no break between pill packets. An advantage of the mini pill is that it’s pretty non-invasive in that you can start and stop when you’re ready. 

The mini pill works by thickening the mucus in your cervix while thinning the lining of your uterus. This combination of thick mucus and thin lining makes it harder for sperm to reach an egg in order to fertilize it. Progesterone can also make it harder for any fertilized eggs to implant, helping to prevent pregnancy. Some mini pills even prevent your ovaries from releasing eggs entirely.

The progesterone-only pill (sometimes also called the progestin-only pill) is suitable for most women, including those who are breastfeeding, smokers (including those over the age of 35), and those with existing health conditions like high blood pressure or liver disease. Because it doesn’t contain estrogen, it doesn’t put you at an increased risk of blood clots or deep vein thrombosis, unlike other combination birth control pills. That may mean that if you can’t take regular birth control pills, the mini pill could be a good option for you if you still want to take an oral contraceptive.

This type of birth control pill is usually available with a prescription, but can now be purchased over the counter in some UK pharmacies. The mini pill is 93% effective with typical use and more than 99% effective with perfect use.

There are some side effects and health risks to be aware of with the progestin-only pill that you may not have with combination birth control pills, including:

  • Acne: as progesterone causes your skin to produce more sebum, which can block pores, you may find that your skin breaks out more when you take the progestin-only pill.
  • Changes to your period: your menstrual bleeding may become lighter, irregular or even stop completely. You may also experience spotting in between periods.
  • Breast tenderness
  • Changes to your sex drive

Side effects are most likely to appear in the first few months of taking this birth control pill, and should clear up after another few months. If you have any concerns, always speak to your doctor.

2. IUDs

A type of long-acting contraception, IUD stands for intrauterine device - these are small plastic or metal objects that are inserted into the uterus. There are two types of IUD, the hormonal IUD (only containing progesterone), and the hormone-free copper IUD. IUDs can be a useful option for those who want a long-term birth control option that they don’t want to think about every single day. 

The copper IUD works by releasing copper into the womb. This alters your cervical mucus, making it harder for sperm to reach an egg and survive. As with the combined pill, it can also stop fertilized eggs from implanting, preventing you from getting pregnant.

Most women can use an IUD as their chosen method of birth control, but you may not be able to use one if:

  • There’s a possibility that you’re pregnant
  • You have a sexually transmitted infection
  • Have any womb or cervix issues
  • Frequently have unexplained vaginal bleeding between menstrual periods or after sex
  • If you’ve previously had an ectopic pregnancy (when a fertilized egg implants itself in a fallopian tube)

Always speak to your doctor before getting an IUD fitted to find out if it’s suitable for you.

IUDs are highly effective at preventing pregnancy, in fact, they are more than 99% effective as there is very little work required from the individual user. You can have an IUD fitted at any time during your cycle, providing you’re not pregnant. Once fitted, IUDs protect against pregnancy straight away and can prevent pregnancy for as long as ten years before they must be removed or swapped out for a new one.

You can also have an implant fitted at any time after giving birth. If you get it before day 21 after giving birth, you’ll be immediately protected against pregnancy, while if you get it fitted on or after day 21, you’ll need to use backup birth control for seven days.

Keep in mind that you may experience some initial discomfort and cramping during and after an IUD is fitted. With the copper IUD you may experience increased cramping or bleeding during each period. 

3. The implant

The implant works in a similar way to the hormonal IUD, releasing a dose of the progesterone hormone over a long period of time. However, the implant doesn’t sit in the uterus. Instead, it’s inserted under the skin in the upper arm by a doctor or nurse.

The implant can be used for up to three years before it should be removed or swapped out for a new one by a healthcare professional. The implant is also more than 99% effective at preventing pregnancy.

As you don’t need to do anything for three years once it’s inserted, this method of birth control can be a good option for women who struggle taking a birth control pill at the same time every day. There’s no need to worry about missed pills - simply have a small procedure to insert the implant, and you’re good to go for three years. Once the three years is up, you’ll need to have the implant removed or swapped out for a new one.

You may have some side effects with this contraceptive method. The most common is that your periods may stop completely. Other women may experience lighter, shorter, longer or more irregular menstrual bleeds. You may also experience other side effects such as headaches, mood swings and breast tenderness. Some women feel sick or experience nausea, but all of these side effects should only last for a few months. Speak to your doctor if you have any concerns around side effects.

4. Injection/birth control shot

The birth control shot (or injection) also contains the hormone progesterone. It requires more work than the implant or the IUD, but doesn’t require you to think about it every single day, as the shot is used around every twelve weeks.

The injection releases progestogen into your bloodstream, ensuring your ovaries don’t release any eggs and thus preventing pregnancy. This method of birth control also thickens your cervical mucus, making it harder for sperm to reach any eggs. It also thins the lining of your womb, making it less likely for any eggs that are fertilized to implant.

The injection is given in fleshy parts of the body such as the buttocks, thighs, upper arms, or abdomen. It’s usually administered by a healthcare professional, but in some cases, you might be able to do it yourself at home. The shot is 96% effective with typical use and more than 99% effective with perfect use.

Birth control shots can be given at any time during your cycle, providing you’re not pregnant. If you get the shot within the first five days of your cycle, you’ll be protected from getting pregnant straight away. If you have the injection on another day of your cycle, you’ll need to use a backup method of birth control like condoms for seven days to protect against pregnancy.

5. Condoms

Condoms are a hormone-free option that can be used as and when you need them. This barrier method can also prevent the spread of sexually transmitted infections and is an over-the-counter birth control method you can find in most supermarkets, pharmacies, and drugstores, or you can also order condoms online. There are two types of condoms: external condoms, which are worn on the penis, and female condoms which are worn inside the vagina. External condoms (sometimes called male condoms) are more common. Condoms are the only birth control method that protects against sexually transmitted infections.

Condoms are easy to get hold of and great for wider protection, but if you’re relying on condoms as your only form of birth control, they are something you’ll have to think about every time you have sex. 

There are several things which can make condoms less effective, such as if:

  • The condom splits
  • The condom slips off
  • The condom is not stored properly 
  • The condom is out of date
  • The condom is damaged, such as by jewelry or fingernails
  • You’re also using something that can stop condoms from working properly, such as creams, pessaries or suppositories
  • You use oil-based lubricants that can damage condoms like baby oil, petroleum jelly and lotion

If the condom fails as a method of birth control you can use emergency contraception to prevent pregnancy. Male condoms are 87% effective with typical use and 98% with perfect use. Female condoms are 95% effective with perfect use. 

6. The calendar method

Another option is the calendar method, a fertility awareness-based method of birth control (known as FABM). It’s hormone-free and involves counting cycle days to work out when you’re most likely to be fertile. It’s then up to you and your partner to then either avoid sex or use a backup method of birth control protection on fertile days. 

The calendar method may not be a suitable option for those with short or irregular cycles, and it does also require a six-month monitoring period before it can be used as birth control. The standard days method (a type of calendar method) is thought to be 88% effective with typical use and 95% effective with perfect use.

7. Natural Cycles birth control app

Like the calendar method, Natural Cycles is completely hormone-free. However, there are a few important differences. Firstly, Natural Cycles doesn't work by counting cycle days. Instead users measure their temperature most days, and the Natural Cycles app analyzes this body temperature data and identifies ovulation day. Your body temperature changes throughout your cycle based on whether you’re ovulating or not, meaning your temperature can be used to detect ovulation and identify your fertile window.

By identifying temperature shifts the app can learn the pattern of your unique cycle. The app gives you a daily fertility status: on green days you’re not fertile, but on red days you must either avoid sex or use protection.

Unlike the calendar method, Natural Cycles does not require a monitoring period, although the app will likely give you more red (fertile) days at the start until it gets to know you. With perfect use, Natural Cycles is 98% effective and it’s 93% effective with typical use.

Natural Cycles, unlike some other birth control methods, doesn’t have any side effects and doesn’t require a prescription, It’s important to be aware that your data can be affected by external factors such as if you’re hungover, unwell, stressed, or if you’re traveling and your sleep cycles are affected. On your most fertile days (your red days), you’ll either have to abstain from sex or use a backup method of birth control to protect against pregnancy.

Find the best birth control for you

Thanks for checking out our list of types of birth control without estrogen! We’ve only touched on some of the methods available and how they work, so if you’re serious about switching birth control, it’s always worth discussing your options in full with your doctor. In the meantime, why not find out if Natural Cycles could be an option for you?

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