Can’t Take Estrogen? Here Are Alternative Birth Control Options

birth control

When starting to take birth control, there are a lot of aspects of your life to consider. Birth control doesn’t have the same effect on everyone, and certain types might not be right for you. After three years on combination (estrogen and progesterone based) birth control pills, I found that out the hard way.

I’ve gotten migraines since I was a kid. Intense pain that would leave me bedridden, nauseous and sometimes unable to see properly. This summer, my migraines took a turn for the worse. Before the pain even started, I began seeing little dots flash before my eyes, my vision would go in and out and sometimes my face would go numb.

I found out from my doctor that these were migraines with aura.

On the American Migraine Foundation website it says:

The symptoms and effects of aura vary widely. Some of the visual distortions can be exotic and bizarre. It’s interesting to note that migraine aura symptoms are thought to have influenced some famous pieces of art and literary works. One of the better known is Lewis Carroll’s “Alice in Wonderland.”

This vaguely romanticized version of the migraine with aura doesn’t capture how migraines with aura impacted my life. I would have to leave work or class early, lay in bed alone with the lights off and wait for it to pass. It was debilitating. Eventually, I went to see my doctor.

She told me that because of my newfound aura migraines, I couldn’t take estrogen-based birth control any more because there was a slight chance it could cause a stroke. I was surprised and anxious. I had never taken another type of birth control before, and I wasn’t sure how it would affect my body.

My doctor put me on progesterone-based birth control pills in the interim, but I did some research on my own to find birth control options without estrogen. Most of my friends were on the pill, and I didn’t feel secure in my knowledge of other options. According to the Guttmacher Institute: As of 2012 in the United States, 25.9 percent of contraception users use the pill. But that’s by no means the only option if, like me, you can’t take estrogen.

Birth Control

If you like the idea of the pill, there are progesterone-only birth control pills called the Minipill.

Unlike the combination pill, these pills don’t have estrogen and there is no placebo week. This means, there are hormones in every pill and it’s very important to take it at the same time everyday. My doctor told me within the same thirty minutes everyday is best.

Benefits: No estrogen, usually causes less cramping than the combination pill, easy to take
Drawbacks: Can cause irregular bleeding and period length (this definitely happened for me), increased risk of functional ovarian cysts, only 87 to 99.7 percent effective in preventing pregnancy (most birth control options are 99 percent or more).

Birth Control

If you want a more permanent option, look into an IUD (Intrauterine device).

An IUD is a birth control method that can last up to ten years without having to be replaced. There are hormonal options and non-hormonal options. So, for people who are negatively impacted by hormones this is a good choice. The IUD does include an insertion process that can be slightly painful; but it depends on your pain tolerance and again, the device lasts a long time. Some IUDs allow you to get your period and some don’t, that’s a good choice to make with your doctor’s assistance.

Benefits: No estrogen (less hormones overall), more affordable than other birth control options, don’t need to take a pill everyday, long-term protection
Drawbacks: Needs to be inserted and removed by a doctor, procedure can be painful, the insertion process could cause uterine perforation which could lead to infection

Birth Control

Another long term birth control option is the implant.

The implant is a small rod about the side of a matchstick. It’s inserted into your upper arm and releases progesterone to prevent pregnancy. The implant can last up to four years. I know it seems a little weird, but I know a few friends who have it and love it. They all have a little bump on their arm, and they ask everyone to feel it (you’ll have a new fun party trick).

Benefits: No estrogen, lighter period, less cramping, don’t need to take pill every day
Drawbacks: Has to be inserted and taken out, can cause irregular periods and bleeding, can cause side effects like breast pain or nausea

Birth Control

Personally, I made the decision to get an IUD. But the great thing about birth control is that it is entirely your choice! If you can’t take estrogen, or decide hormones aren’t for you, there are many routes you can take. Remember, none of these birth control options protect from STDs, STIs or HIV. It’s always safe to use a back up birth control option, like a condom. Do some research, talk to your doctor, and make the decision that works best for you and your health.


Also published on Medium.