It is important to note that almost all hormonal birth control methods cause irregular bleeding and spotting within the first months of use but this eventually gets better with time. With implants, IUDs and shots, it is possible to not have any bleeding at all even in the first month of use.
A study by the National Institute of Health also notes that long-acting reversible contraception improves menstrual control. While a majority of participants in the study felt that menstruation is normal and should be left to take its course, some found that suppressing the process was abnormal and resulted in negative health outcomes, which is not quite accurate.
In fact, it has been found that menstruation increases the risk of developing ovarian, endometrial, and breast cancer. Pre-industrial women menstruated 100 times, a quarter of what the modern-day woman experiences. This is because they had longer gestation periods, had more children, and longer breast-feeding periods. It is therefore completely healthy and beneficial to use hormonal birth control methods to regulate menstruation either for birth control or even reduce frequency of menstruation.
With that said, there are a number of birth control methods that affect your periods. The use of each is dependent on your preferences and how it affects your body.
1. The progestin-only pill
- Works to thicken the mucus membrane of your cervix to block sperms from accessing the egg.
- Contains the hormone progestogen, but no oestrogen.
- It’s taken daily.
- Your periods may stop or become lighter, irregular or more frequent after 1 year of use.
- In the first three months of use, users will experience 3-7 days of blood or spotting.
2. Combination pill (the pill)
- Just like the progestin-only pill, this needs to be taken daily.
- It’s made of artificial progestogen and estrogen hormones which help prevent ovulation and fertilisation.
- Users may experience breakthrough periods in their first months of use.
- Bleeding days may decrease between 3-5 days after one year of use.
- People with heavy menstrual flow may experience normal flow after 6 months of using the combination pill.
3. The patch
- Contains enough hormones to last a week that can be absorbed through your skin.
- You stick it on your outer upper arm, stomach, butt cheeks, or back.
- Stick a new patch on clean dry skin each week for the first three weeks of your period.
- During week four, you’ll get bleeding that mimics your period.
- If you want to skip the bleeding altogether, wear a patch even in week four. It’s completely healthy and normal.
- There should be no spaces between changing an old patch with a new one. So replace it immediately.
- There’ll be bleeding or spotting during the first month, and bleeding days may be reduced to 3 after a year of use. (i.e. without wearing a 4th patch in your cycle)
4. The ring
- The ring is a round soft flexible ring inserted into the vaginal wall.
- It gradually releases hormones into the vaginal which get absorbed by the vaginal wall.
- These hormones, progestin and estrogen, prevent ovulation or implantation of a fertilized egg on the uterine wall.
- It also thickens the cervical mucus making it hard for the sperm to reach the egg.
- Once inserted, it should remain in place for three weeks in a row. It should be placed before the 5th day of your cycle.
- It’s not worn on the fourth week.you will get your period and repeat the cycle again in the first week.
- You may experience irregular bleeding during the first few weeks of use.
- Fewer than 1 in 10 users may experience breakthrough bleeding or spotting during their first cycle with the ring
- After one year of use, bleeding days may reduce to three.
5. Hormonal IUD
- Hormonal IUD contains levonorgestrel hormone.
- It’s a T-shaped device inserted in the uterus and it releases the hormone gradually.
- It can last between
- An average 52 mg dose of levonorgestrel reduces period flow or may stop bleeding completely.
- Users who use copper IUD experience a heavy period within the first six months.
- After one year of use, bleeding and spotting days may reduce to 4 per month
- This is the most effective hormonal contraception for managing heavy menstrual bleeding.
6. 3-month shot
- Also known as the depo shot, this is a 3-month injection that contains the hormone progestin.
- Progestin prevents ovulation and also thickens the cervical mucus.
- It should be taken every 12-13 weeks.
- During the first 6 months, at least 10% of uses have reported continuous bleeding for more than 21 days.
- After one year of use, more than 50% of users do not bleed at all, and those that do, experience an average of 3 days of bleeding per month.
7. The implant
- It’s a small flexible plastic rod inserted on the outer upper arm under the skin by a doctor.
- It steadily releases the progestogen hormone into the blood stream to prevent pregnancy by thinning the uterine wall and thickening the cervical mucus.
- It lasts 3 years without needing to replace it.
- You can remove it at any time and your fertility will return to normal.
- One of its side effects is stopping periods completely within the first month of use.
- It’s best for women who can’t use contraception with oestrogen.
- At least a quarter of users experience bleeding that lasts more than 14 days within the first 3 months of use.