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Got a health condition? Know your birth control options!

Period problems, obesity, diabetes, high blood pressure, breast cancer... There’s a method that can work for you.

by Nerys Benfield, MD

published 07/11/13

There is an effective birth control option for everyone—including those with health conditions like heavy or irregular periods, obesity, diabetes, high blood pressure, or breast cancer. Some methods can actually help treat certain conditions. Let’s look at six fairly common medical conditions and the birth control methods that are best for each.

1. Painful or heavy periods
Good methods: All hormonal methods, especially the hormonal IUD, the implant, and the shot.

Painful or heavy periods are—unfortunately—pretty common. About one in five U.S. women have menorrhagia. All types of hormonal birth control will decrease or eliminate monthly bleeding, including the pill, patch, ring, shot, implant and hormonal IUD. For women with conditions that can cause heavy bleeding (endometriosis, adenomyosis, or uterine fibroids), hormonal methods can help make periods shorter, lighter, and less painful. Decreasing or stopping monthly bleeding is also a great treatment to improve anemia (sickle cell anemia or thalassemia) and bleeding disorders (e.g. factor V deficiency).

2. Irregular periods
Good methods: The pill, the patch, and the ring.

For women with irregular periods who would prefer a more predictable cycle, the pill, patch, and ring can help regulate periods. Medical conditions that can cause an irregular cycle include poly cystic ovary syndrome (PCOS) and thyroid disorders.

3. Obesity
Good methods: Any and all, except emergency contraception pills.

Over one in three adult women in the U.S. are considered obese. We’ve written about birth control and weight before. Nearly all forms of birth control are effective for women regardless of weight. The one important exception is emergency contraception (EC). Research shows that levonorgestrel EC (like Plan B and Next Choice) and ella are less effective for obese women. How much less effective? For these women, taking an EC pill is the same as doing nothing. However, there is an EC that works for women of any weight: the copper IUD. It’s the most effective form of EC—including for women who aren't obese.

4. Diabetes
Good methods: Depends on your health, but nearly always includes progestin-only options like the implant, hormonal IUDs, or mini pills.

About one in ten adult women in the U.S. have diabetes, although it’s estimated that half don’t know it. For women who have diabetes without other complications like heart, circulatory system, eye or kidney diseases, the good news is that they can safely use all types of birth control. Diabetic women who do have any of those additional conditions need to talk with their doctors about their options, which will usually include the implant, IUDs, or progestin-only mini pills.

5. High blood pressure
Good methods: Depending on risk factors, estrogen-free methods might be best.

Relatively few women under age 30 have high blood pressure—only about one in 50. But of those women who do, many don’t know about their condition. It’s important to get an annual exam and have your blood pressure measured before you choose a method of birth control. High blood pressure can increase the risk of a blood clot when using the pill, the patch, or the ring.

Women who know about their high blood pressure can manage it through a variety of tactics, including medication. Women with well-controlled blood pressure should be able to safely use the pill, the patch, or the ring. However, women who have other risk factors for blood clots like smoking or obesity should talk to a doctor about options that do not contain the hormone estrogen.

6. Breast cancer
Good methods: Non-hormonal options like the copper IUD and condoms.

Breast cancer is rare in women under age 30, with less than one in 1,500 affected. But current or past breast cancer means that a woman should avoid all hormonal methods of contraception. The non-hormonal IUD is a highly effective and safe option in these cases, and condoms are the most effective of the barrier methods.

Looking for something else?

We couldn’t tackle every health condition here, so if there’s one you'd like to see us cover in the future, let us know below! Whatever it may be, it's likely that there is a safe and effective birth control for you. And as always, talk to your health care provider about what's best for you. (Don’t have your own health care provider? Find one here.)

Originally published on Bedsider.org on May 14, 2013.

Nerys Benfield, MD MPH, is an obstetrician/gynecologist at Albert Einstein College of Medicine, Montefiore Medical Center in New York City. She is the director of family planning services and specializes in contraception, working to promote contraceptive counseling and distribution locally and internationally.
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