Choosing The Right Birth Control With Hypothyroidism 

Hypothyroidism is a condition in which your thyroid gland doesn't produce enough hormones. The thyroid is the small gland at the base of your neck that, as part of the endocrine system, helps regulate the body's metabolism in blood pressure, blood temperature, and heart rate. When your thyroid hormone production drops, your body processes slow down and change, affecting virtually every system in the body and causing frustrating symptoms. 

But hypothyroidism does not have to get in the way of your reproductive and sexual health! If you are diagnosed with and treated for hypothyroidism, it is still safe to use most forms of birth control. 

Ahead, board-certified doctors at Twentyeight Health offer some advice about finding the right birth control for you with hypothyroidism. 

Types of birth control

There are many different kinds of birth control—both hormonal and non-hormonal. 

Intrauterine devices (IUDs)

An IUD is a small device inserted into the uterus, containing either copper or hormones to prevent pregnancy.

Birth control pills

Oral birth control pills are medication tablets that contain hormones to stop ovulation and stop sperm from joining with an egg (fertilization). Birth control pills come in two forms: the combination pill or the mini-pill. The combination pill contains the hormones estrogen and progestin. It is the pill that most people refer to when saying they are taking oral birth control. The mini-pill only contains only progestin. 

Birth control ring

The birth control ring is a flexible device that goes inside the vagina and releases hormones through the vaginal wall into the bloodstream to help prevent pregnancy.

Birth control patch

The birth control patch is a patch you wear on your skin that releases the hormones estrogen and progestin into your bloodstream to keep your ovaries from releasing an egg.

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Implant

The birth control implant is a small rod placed beneath the skin in your upper arm. The implant releases progestin to keep your ovaries from releasing an egg.

Shot

The shot contains progestin, which prevents your ovaries from releasing an egg. To be effective, you need to get the shot every three months. 

Barrier methods

Using a physical barrier like condoms, diaphragms, or sponges keep sperm from entering the uterus and reaching the egg. 

Natural family planning

Fertility awareness methods, such as the rhythm method, are when you track your menstrual cycle so that you know when you are ovulating and avoid vaginal sex during that time. On average, these methods are only 76-88% effective. This rate is because it takes careful planning and diligence to track your cycles accurately. Some women have more variability in their menstrual cycles.  

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Sterilization

If you are confident that you don't want any or any more children, men can have a vasectomy, and women can have tubal ligation as permanent birth control. 

Emergency contraception

If you didn't use another form of birth control or a condom breaks, emergency contraception in pill form or a copper IUD can be used as soon as possible after unprotected sex. 

The only sure way to prevent pregnancy is not to have sex. But finding the right method of birth control for you can help you avoid an unplanned pregnancy.

How to choose the right birth control for you

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Most importantly, talk to your doctor

Your doctor will ask you to share your medical history, and for people with hypothyroidism, this is particularly important. Share your entire medical history and be sure to mention the following:

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• Your hypothyroidism diagnosis and any other medical history of any illnesses, diseases, conditions or cancers

• Any / all medications including thyroid medications, antibiotics, supplements, drugs, and herbs (including St. John's Wort)

• History of depression and/or anxiety

• History of sexual trauma (IUD insertion and removal can be triggering)

• If you smoke cigarettes or e-cigarettes

• Any / all medications (including antibiotics) supplements, drugs, and herbs you take (including St. John's Wort)

• If you could be pregnant or had recent unprotected intercourse

• If you have delivered a baby in the last six weeks and/or are currently breastfeeding

• If you are scheduled for upcoming surgery or had recent surgery 

• If you have been told you should avoid estrogen 

• Your height and weight. The medical practitioner will calculate your BMI, which can impact the effectiveness of different birth control methods. 

Monitor your thyroid-levels after initiating birth control

Birth control usually does not affect your thyroid levels significantly, but there may be some impact. Therefore, it may be a good idea to test your thyroid levels after being on birth control for three months. However, being on thyroid medication will not lower the effectiveness of your birth control.

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Consider your thyroid-related symptoms

It may be essential to choose a birth control option that will not exacerbate or mask your thyroid-related symptoms. 

Weight-gain

If your thyroid-related condition has resulted in weight gain or obesity, you will want to avoid birth control methods known to cause weight gain, such as Depo-Provera (the shot).

Depression

Thyroid disease causes depression and mood-swings for many people. If this is the case for you, you may want to choose oral birth control pills like Yaz or Yazmin that often relieve period-related mood symptoms. 

Irregular periods

Another common side-effect of thyroid disease is irregular periods. If you experience this, it may be best to avoid birth control methods associated with spotting, like the implant or the shot.

Consider the timing of when you take your thyroid medication

Your doctor may recommend that you take your thyroid medication on its own and to wait a few hours before taking your birth control pill. This gap minimizes potential drug interactions and ensures that both drugs will remain effective. 

Importantly, if you are sexually active and have untreated thyroid disease, or are adjusting your medication levels for thyroid disease, make sure you are on a birth control regimen that is effective and that works for you. Untreated thyroid disease is associated with several pregnancy-related complications such as an increased risk of miscarriage and placental abruption.

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A note from Twentyeight Health

At Twentyeight Health, board-certified doctors can prescribe you birth control in three easy steps. We offer birth control pill, patch, ring, and emergency contraception prescriptions, with free delivery. Often $0/month with insurance (including Medicaid) and as low as $16/month without insurance.

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You can take schedule a free doctor consultation ($20 value) with code PALOMA on Twentyeight Health's website.