Your Period On Birth Control: To ovulate, or not to ovulate? - Allbodies

Your Period On Birth Control: To ovulate, or not to ovulate?

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We are all very familiar with our bleeding phase (well, we’re kinda forced to be!) But it turns out your menstrual cycle is actually geared around ovulation, not your period. That’s right, your whole cycle is set up to support ovulation and its aftermath. And your period on birth control can sometimes get a bit…wonky. We’ll explain. 

 

The first part of your cycle is all about producing hormones that help stimulate the follicles in your ovary to release an egg (i.e. ovulation). Once that egg is released (i.e. ovulation has occurred), your body is focused on producing hormones to help your uterus support that egg if it gets fertilized. Your period is a byproduct of all that hard work to support that egg, and a healthy menstrual cycle is one without any ovulation problems. So now maybe you are starting to get the picture of how ovulation is really the shebang!

 

All that said, unless you are actively trying to get pregnant, perhaps you’ve never thought about when you ovulate. And you probably have never thought to track your ovulation! But ovulation is important for the health of your whole body. Like your bone health (1), your heart health (2), and the list goes on! 

 

This is why we love tools like Daysy.  Daysy is a smart fertility tracker that uses a simple color-coded system to inform you when you’re in your ovulatory phase (and can help you determine if you have any ovulation problems). How cool to have a tool to help you understand the parts of your body you can’t see! 

 

All of the above is what happens in an undisturbed menstrual cycle. But what if you are using contraception? What exactly does your period do while you are on birth control? Read on, our friends. 

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How does Birth Control affect your Period?

There are two main categories of birth control: Hormonal, and non-hormonal. And your period on these various birth control methods can be affected in a variety of ways. For instance, while non-hormonal birth control methods do not stop you from ovulating, hormonal methods might!  

 

The most common forms of hormonal birth control that stop ovulation are:

  •  the combined pill (3), 
  • the progestin-only pill (4), 
  • the hormonal IUD (5) (although you can sometimes ovulate on it (6)) 
  • contraceptive implant (7)
  • contraceptive shot (8)
  • transdermal patch (Evra) (9) 
  • vaginal ring (Nuvaring) (10)

So yeah, like all of them. 🙂

How does hormonal birth control stop ovulation?

Remember how we shared that our bodies are constantly making hormones to support the creation and release of the egg? What hormonal birth control does is affect those hormone levels so that your pituitary gland never gets the thumbs up to allow ovulation to happen (11).  There are some forms of hormonal birth control, – like certain IUDs that release hormone levels that change over time – in which your hormone levels are not affected enough to stop you from ovulating (6), but this is only certain forms of birth control. So your period on birth control might be missing the ovulation part! If you are wondering if your hormonal birth control affects your ovulation, ask your healthcare provider!

 

Okay, so if your period is actually the byproduct of an unfertilized egg after ovulation, why might you see bleeding even while on hormonal birth control?

 

That’s something called withdrawal bleeding (12). While hormonal birth control stops the uterine lining from thickening, and therefore shedding, substantially, in some forms the hormonal shift still softens the uterine lining just slightly enough to cause some bleeding (13, 14). This is due in part to the sudden withdrawal of hormones from your birth control, hence the title “withdrawal bleeding.” The sudden withdrawal causes the uterine lining to become unstable and begin to shed, leading to a fake period. This is NOT your period, if no ovulation has occurred. So your period on birth control = potentially not a real period at all! 

Is it bad if I’m not ovulating because of hormonal birth control?

A better question to ask yourself might be, Why am I using hormonal birth control in the first place? For some, stopping ovulation is important for their mental or physical health. And, the majority of Western medicine currently indicates that if you’re on hormonal birth control that purposely suppresses ovulation, there shouldn’t be anything to worry about. 

 

But because hormonal birth control is changing your entire hormonal system, it is important you think a little more critically before deciding if it’s right for you. (We even made you a convo guide to have with your practitioner!) Really consider if you mind that your period on birth control will be disrupted. 

 

In 2015 the American College of Obstetricians and Gynecologists recommended doctors use the menstrual cycle as a vital sign (15) of our health.  When we artificially add hormones to our body, we may miss out on the symptoms our bodies are showing us to say they need a little TLC. For instance, cycles in which you don’t ovulate (known as anovulatory cycles) are a possible sign of Polycystic Ovary Syndrome (PCOS), thyroid issues, chronic stress, undereating, and more (16). So ovulation is a great health indication, and our “period” while on birth control isn’t actually a period, and so consequently can’t be used as a vital sign. It is also important to remember that while hormonal birth control can help with health symptoms, it will not treat or cure the underlying problem. 

 

Even if you have no underlying health issues, because everything in our bodies is interrelated, altering your hormones can have unexpected consequences. It is not uncommon for those on hormonal birth control to experience changes in their thyroid hormones (17),  experience adrenal fatigue (18), mood swings, depression and other mental health issues (19), and increased vaginal infections (for those on an IUD).  Plus a whole plethora of other side effects.

 

This isn’t to say everyone will experience these side effects. We also don’t want to demonize hormonal birth control. For some, the symptom relief provided is necessary for wellbeing, and suppressing one’s cycle is necessary for physical or mental health.  We are all for that! We just want to remind you how important it is to check in with your body and watch how it responds whenever you introduce anything new to it.  

So, if I don’t want to stop ovulating, what are my options?

Options include…

 

Copper IUD: This works by causing inflammation in the uterine tissue and thickening cervical mucus, which stops sperm (20) from swimming through. So your period on this birth control would actually be a proper period. The copper IUD does come with some possible side effects, though, which can include increased bleeding and cramps on your period (21), a copper allergy (although this is rare) (20), and you also need to be sure to check the string regularly to ensure it hasn’t moved out of place, which can cause issues. 

 

Barrier Methods: These are methods such as the diaphragm, cervical cap, external condom, and internal condom. They are used only when you are having sexual intercourse and work by stopping the sperm from entering the uterus. Some of them also utilize spermicide as an additional layer of protection, killing sperm that enter the vagina (22).

How to Track your Ovulation

If you use non-hormonal birth control (or if you use hormonal birth control, but want to come off of it), how do you figure out if you’re actually ovulating or if you have ovulation problems? That’s right: Tracking, baby! Tracking ovulation is helpful for everyone to learn about their body and symptoms throughout their cycle, and to figure out if you do have ovulation problems. 

 

To track ovulation and your cycle you will need to monitor your cervical fluid and basal body temperature (BBT), which will give you info about your cycle patterns and phases. It is also useful to monitor your cervical changes (jump over to this article to learn more about that!). We know the idea of taking your temps and touching your vaginal fluids each day can sound….overwhelming. So we definitely suggest you use tools to help you. And we’ve got a great one for you: The smart fertility tracker, Daysy! Please note, Daysy is not a form of birth control. Instead, it’s a tool to help you better understand your unique cycle.

 

The algorithm Daysy uses is based on over 30 years of research and 5 million menstrual cycles.  All you need to do is take your temperature every morning, enter in your menstruation days, and Daysy keeps track of all the data for you. Daysy will give you your fertility status via a simple light system that indicates different cycle phases. If you are stuck, or unsure, or need help understanding your cycle, you can check in with their customer service team (who are really more like period coaches) to help you sort through your charts and figure it out. 

 

Man, do we wish we had this when we were first figuring our periods out!

Written by: Martha Michaud

Medically reviewed by: Danielle LeBlanc, RN

All content found on this Website, including: text, images, audio, or other formats, was created for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. 

1. Li, D., Hitchcock, C., Barr, S., Yu, T. and Prior, J., 2020. Negative Spinal Bone Mineral Density Changes And Subclinical Ovulatory Disturbances—Prospective Data In Healthy Premenopausal Women With Regular Menstrual Cycles. [ebook] Available at: http://www.cemcor.ubc.ca/sites/default/files/uploads/Li%202013%20Negative%20BMD…ovulatory%20disturbances%20Epidemiol%20Rev.pdf [Accessed 12 August 2020].

 

2. Prior, J., 2020. Progesterone Within Ovulatory Menstrual Cycles Needed For Cardiovascular Protection: An Evidence-Based Hypothesis. [ebook] Available at: http://www.cemcor.ubc.ca/sites/default/files/uploads/Prior%202014%20Progesterone…%20needed…%20CV%20protection…%20J%20Restor%20Med.pdf [Accessed 12 August 2020].

 

3. “Combined Pill.” Accessed August 12, 2020. https://www.nhs.uk/conditions/contraception/combined-contraceptive-pill/.

 

4. “The Progestogen-Only Pill.” NHS Choices. NHS. Accessed August 12, 2020. https://www.nhs.uk/conditions/contraception/the-pill-progestogen-only/.

 

5. “Hormonal IUDs.” Planned Parenthood. Accessed August 12, 2020. https://www.plannedparenthood.org/learn/birth-control/iud/hormonal-iuds.

 

6. Sarah Toler, DNP. “What the Latest Research Says about How the Hormonal IUD and the Copper IUD Work.” The IUD: How the hormonal IUD and the copper IUD work to prevent pregnancy. Clue, February 24, 2020. https://helloclue.com/articles/sex/how-do-iuds-prevent-pregnancy.

 

7. “Contraceptive Implant.” Mayo Clinic. Mayo Foundation for Medical Education and Research, August 15, 2019. https://www.mayoclinic.org/tests-procedures/contraceptive-implant/about/pac-20393619.

 

8. “Depo-Provera (Contraceptive Injection).” Mayo Clinic. Mayo Foundation for Medical Education and Research, January 14, 2020. https://www.mayoclinic.org/tests-procedures/depo-provera/about/pac-20392204.

 

9. “Birth Control Patch: Ortho Evra: Transdermal Patch.” Accessed August 26, 2020. https://www.plannedparenthood.org/learn/birth-control/birth-control-patch.

 

10. “NuvaRing: Birth Control Vaginal Ring: Estrogen Ring.” Planned Parenthood. Accessed August 26, 2020. https://www.plannedparenthood.org/learn/birth-control/birth-control-vaginal-ring-nuvaring.

 

11. Stacey, Dawn. “Do You Ovulate on the Pill?” Very Well Health, September 23, 2019. https://www.verywellhealth.com/when-do-you-ovulate-906752.

 

12. Nottke, Amanda. “TAMING THE CYCLE: HOW DOES THE PILL WORK?” Harvard University, March 15, 2008. http://sitn.hms.harvard.edu/flash/2008/issue40/.

 

13. Stacey, Dawn. “Why Do You Get a Period on Birth Control?” Verywell Health, October 3, 2019. https://www.verywellhealth.com/withdrawal-bleeding-906612.

 

14. “Withdrawal Bleeding: Birth Control, Causes, and Symptoms.” Medical News Today. MediLexicon International. Accessed August 12, 2020. https://www.medicalnewstoday.com/articles/withdrawal-bleeding.

 

15. Brighten, Jolene. “Do Birth Control Pills Stop Periods? What You Need to Know.” Dr. Brighten, May 11, 2020. https://drbrighten.com/does-birth-control-stop-periods/.

 

16. “Menstruation in Girls and Adolescents: Using the Menstrual Cycle as a Vital Sign,” 2015. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2015/12/menstruation-in-girls-and-adolescents-using-the-menstrual-cycle-as-a-vital-sign.

 

17. Brighten, Jolene. “The Pill & Thyroid Connection – How the Pill Sabotages Thyroid Health.” Dr. Brighten, May 4, 2020. https://drbrighten.com/birth-control-thyroid-connection/.

 

18. Brighten, Jolene. “Does the Birth Control Pill Cause Adrenal Fatigue?” Dr. Brighten, April 30, 2020. https://drbrighten.com/birth-control-pill-adrenal-fatigue/.

 

19. Brighten, Jolene. “Birth Control Mood Swings & How to Feel Better.” Dr. Brighten, May 5, 2020. https://drbrighten.com/birth-control-and-mood-swings/.

 

20. Jewell, Tim. “Copper Toxicity: Signs, Causes, Treatment, & the IUD.” Healthline. Healthline Media, March 8, 2019. https://www.healthline.com/health/copper-toxicity.

 

21. “What Are the Side Effects of IUDs?” Planned Parenthood. Accessed August 12, 2020. https://www.plannedparenthood.org/learn/birth-control/iud/iud-side-effects.

 

22. Barrier Methods of Birth Control. Accessed August 20, 2020. https://wa.kaiserpermanente.org/kbase/topic.jhtml?docId=hw138685.

1. Li, D., Hitchcock, C., Barr, S., Yu, T. and Prior, J., 2020. Negative Spinal Bone Mineral Density Changes And Subclinical Ovulatory Disturbances—Prospective Data In Healthy Premenopausal Women With Regular Menstrual Cycles. [ebook] Available at: http://www.cemcor.ubc.ca/sites/default/files/uploads/Li%202013%20Negative%20BMD…ovulatory%20disturbances%20Epidemiol%20Rev.pdf [Accessed 12 August 2020].

 

2. Prior, J., 2020. Progesterone Within Ovulatory Menstrual Cycles Needed For Cardiovascular Protection: An Evidence-Based Hypothesis. [ebook] Available at: http://www.cemcor.ubc.ca/sites/default/files/uploads/Prior%202014%20Progesterone…%20needed…%20CV%20protection…%20J%20Restor%20Med.pdf [Accessed 12 August 2020].

 

3. “Combined Pill.” Accessed August 12, 2020. https://www.nhs.uk/conditions/contraception/combined-contraceptive-pill/.

 

4. “The Progestogen-Only Pill.” NHS Choices. NHS. Accessed August 12, 2020. https://www.nhs.uk/conditions/contraception/the-pill-progestogen-only/.

 

5. “Hormonal IUDs.” Planned Parenthood. Accessed August 12, 2020. https://www.plannedparenthood.org/learn/birth-control/iud/hormonal-iuds.

 

6. Sarah Toler, DNP. “What the Latest Research Says about How the Hormonal IUD and the Copper IUD Work.” The IUD: How the hormonal IUD and the copper IUD work to prevent pregnancy. Clue, February 24, 2020. https://helloclue.com/articles/sex/how-do-iuds-prevent-pregnancy.

 

7. “Contraceptive Implant.” Mayo Clinic. Mayo Foundation for Medical Education and Research, August 15, 2019. https://www.mayoclinic.org/tests-procedures/contraceptive-implant/about/pac-20393619.

 

8. “Depo-Provera (Contraceptive Injection).” Mayo Clinic. Mayo Foundation for Medical Education and Research, January 14, 2020. https://www.mayoclinic.org/tests-procedures/depo-provera/about/pac-20392204.

 

9. “Birth Control Patch: Ortho Evra: Transdermal Patch.” Accessed August 26, 2020. https://www.plannedparenthood.org/learn/birth-control/birth-control-patch.

 

10. “NuvaRing: Birth Control Vaginal Ring: Estrogen Ring.” Planned Parenthood. Accessed August 26, 2020. https://www.plannedparenthood.org/learn/birth-control/birth-control-vaginal-ring-nuvaring.

 

11. Stacey, Dawn. “Do You Ovulate on the Pill?” Very Well Health, September 23, 2019. https://www.verywellhealth.com/when-do-you-ovulate-906752.

 

12. Nottke, Amanda. “TAMING THE CYCLE: HOW DOES THE PILL WORK?” Harvard University, March 15, 2008. http://sitn.hms.harvard.edu/flash/2008/issue40/.

 

13. Stacey, Dawn. “Why Do You Get a Period on Birth Control?” Verywell Health, October 3, 2019. https://www.verywellhealth.com/withdrawal-bleeding-906612.

 

14. “Withdrawal Bleeding: Birth Control, Causes, and Symptoms.” Medical News Today. MediLexicon International. Accessed August 12, 2020. https://www.medicalnewstoday.com/articles/withdrawal-bleeding.

 

15. Brighten, Jolene. “Do Birth Control Pills Stop Periods? What You Need to Know.” Dr. Brighten, May 11, 2020. https://drbrighten.com/does-birth-control-stop-periods/.

 

16. “Menstruation in Girls and Adolescents: Using the Menstrual Cycle as a Vital Sign,” 2015. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2015/12/menstruation-in-girls-and-adolescents-using-the-menstrual-cycle-as-a-vital-sign.

 

17. Brighten, Jolene. “The Pill & Thyroid Connection – How the Pill Sabotages Thyroid Health.” Dr. Brighten, May 4, 2020. https://drbrighten.com/birth-control-thyroid-connection/.

 

18. Brighten, Jolene. “Does the Birth Control Pill Cause Adrenal Fatigue?” Dr. Brighten, April 30, 2020. https://drbrighten.com/birth-control-pill-adrenal-fatigue/.

 

19. Brighten, Jolene. “Birth Control Mood Swings & How to Feel Better.” Dr. Brighten, May 5, 2020. https://drbrighten.com/birth-control-and-mood-swings/.

 

20. Jewell, Tim. “Copper Toxicity: Signs, Causes, Treatment, & the IUD.” Healthline. Healthline Media, March 8, 2019. https://www.healthline.com/health/copper-toxicity.

 

21. “What Are the Side Effects of IUDs?” Planned Parenthood. Accessed August 12, 2020. https://www.plannedparenthood.org/learn/birth-control/iud/iud-side-effects.

 

22. Barrier Methods of Birth Control. Accessed August 20, 2020. https://wa.kaiserpermanente.org/kbase/topic.jhtml?docId=hw138685.