5 Subtle Signs Your Birth Control Isn't Working The Way It Should

Birth control is awesome for a lot of reasons. Besides the whole “preventing unwanted pregnancy” thing (which, let’s be honest, is amazing in itself), various methods of birth control can help to alleviate severe PMS symptoms, clear up acne, and lead to lighter (or even nonexistent) periods. It can also be used to effectively treat more serious conditions like endometriosis and uterine fibroids. However, as you may have already discovered, birth control is far from a “one size fits all” deal. If you’re on a type of birth control that doesn’t suit you, you can find yourself experiencing unpleasant side effects that negate any benefits that the method might provide — after all, it’s hard to be excited that your acne is improving when you’re being plagued by severe mood swings.

The body is a sensitive machine, one that varies from person to person, and every body responds to medication and other birth control methods in its own way. The pill that works wonders for one woman may not work for you, and the IUD that you adore may not suit someone else. And that’s totally OK. Many people have to try a number of brands and types of birth control before they find the method that does what it’s supposed to do without causing unwanted side effects. Below, I discuss a number of signs that your birth control isn’t right for you. If these symptoms feel all too familiar, it may be time to have a talk with your doctor about other options. Just remember that you never need to feel like you’re locked into a birth control method that makes you feel sick or unhappy. There are a lot of different contraception options out there, and it may take some trial and error to find the one that suits you best. 

For this post, I’m focusing on long-term birth control methods like hormonal birth control (with comes in a number of forms, including pills, patches, rings, implants, IUDs, and injections) and intrauterine devices (IUDs). Of course, there are also a variety of barrier contraceptives available, including condoms and diaphragms, which can be especially good options for people who want to steer clear of hormonal birth control.

Mood Swings or Depression

Hormones are really powerful, and some people are more sensitive to hormonal changes than others. Many birth control methods — including the pill, patches, vaginal rings, injections, under-skin implants, and hormonal IUDs* — rely on hormones to prevent pregnancy. These methods use either a combination of estrogen and progesterone (or progestin, the synthetic form of progesterone) or progesterone only. Although plenty of people may use hormonal birth control without any trouble, others may find that their birth control has a major affect on their emotions, causing mood swings and even depression. In an interview with Women’s Health, Dr. Mary Jane Minkin, clinical professor of obstetrics and gynecology at Yale Medical School, explained, “The important thing to remember is that all birth controls have very different progestin components. We don’t necessarily know how exactly it affects the brain, but we do know that certain kinds of progestin affect women’s emotions differently.”

If you feel like, since starting birth control, you haven’t been yourself — if you’re suddenly depressed or experiencing atypically severe mood swings — talk to your doctor about whether your birth control might be the problem. Simply discontinuing use or switching to a different type (with a slightly different cocktail of hormones) could make all the difference in allowing you to feel normal again. Some people may find that hormonal methods in general simply don’t work for them; luckily, there are plenty of ways to prevent pregnancy that don’t involve hormones at all, such as condoms, diaphragms, and non-hormonal IUDs like ParaGard.

Acne

One of the best side effects of hormonal birth control for a lot of people is that it can help with acne. This acne-fighting effect is limited to methods that use a combination of estrogen and progesterone, like some pills, the patch, and the ring. Three types of birth control have been approved by the FDA specifically as treatments for acne, though people who use other estrogen/progesterone combos may notice similar results.

However, not everyone gets clearer skin when they take birth control — in fact, some people’s acne gets worse. Many people find that they break out when they first start hormonal birth control, so if you’re having acne within the first couple of months of trying a new brand, give your skin a bit more time to normalize. If your skin is still going crazy after a few months, talk to your doctor about finding a hormonal mix that works better for your skin.

Decreases in libido.

Our sex drives are deeply affected by our hormones, so it’s no wonder that hormonal birth control can interfere with women’s desires to get it on. Although some women on hormonal methods like the pill or vaginal ring experience no changes in their libidos, others might find theirs tanking after starting birth control. Minkin explained, “Birth control pills suppress ovulation, but the problem is they also stop the ovaries from making the sex hormone testosterone like they normally do.” If you’ve lost your sexual appetite and want it to come back, talk to your doctor about how switching up your birth control might help.

Headaches and migraines.

A lot of women experience headaches that are influenced by hormones; for example, many report getting migraines just prior to getting their periods — when their estrogen levels sink. Some women will find that hormonal birth control helps reduce the number of headaches and migraines they get, but others will find that the hormones in the birth control actually trigger headaches. If you start experiencing migraines when you’re on birth control, tell your doctor about it. A 2013 study found that women who get migraines while on combination birth control have an increased risk of blood clots and stroke. If you experience auras (such as flickering lights) during your migraines, you are at even greater risk, so it’s important to talk to your doctor about it.

Heavier periods.

Most hormonal birth control methods reduce or even eliminate periods. But as the side affects I’ve just discussed have demonstrated, hormonal birth control isn’t suited to everyone. One hormone-free contraception option that doesn’t require using a condom/diaphragm every time you have sex is ParaGard, an IUD that doesn’t have any hormones at all — instead it has a copper wire wrapped around its stem, which, according to the Mayo Clinic, “produces an inflammatory reaction in the uterus that is toxic to sperm, which helps prevent fertilization.” The drawback is that in some cases, women will experience increased bleeding and worse-than-usual menstrual cramps. Dr. Cheryl Chastine of South Wind Women's Center in Wichita, Kansas, told Cosmopolitan that these effects “most commonly [last] for the first six months,” but if you’re having intense bleeding long beyond that time and it’s interfering with your life, go have a chat with your gyno.

* A note about IUDS: There are two types of IUDs available in the US — hormonal (Mirena or Skyla) and copper (ParaGard). Because these types rely on different mechanisms for pregnancy prevention, they have different side effects. Because hormonal IUDs have, you know, hormones, they have some of the same risks and side effects as other hormonal methods, like the pill.

Images: Monik Markus/Flickr; Giphy (1, 2, 3, 4, 5)

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