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Birth Control When You Have Medical Conditions: What's Safe?

Medically Reviewed by Brunilda Nazario, MD on April 13, 2021

Birth control methods like the pill and intrauterine device (IUD) are very effective at preventing pregnancy, and they're generally safe. But not all of these methods are right for everyone. If you have certain medical conditions, your doctor might recommend that you avoid one or more of these birth control types.

Combination Birth Control Methods

Birth control pills contain a combination of the hormones estrogen and progestin, or progestin alone. These hormones stop your ovaries from releasing an egg to prevent pregnancy. They also thicken the mucus in your cervix and have effects on the lining of your uterus to make it unsuitable for a fertilized egg to implant there.

The birth control patch and ring also release estrogen and progestin, but in different ways. The patch releases these hormones through your skin. The ring releases them through a flexible plastic ring you place in your vagina.

Combination birth control methods slightly increase the risk for blood clots called deep vein thrombosis (DVT), and for heart attack and stroke. This risk is greatest in women who have uncontrolled high blood pressure, women who smoke, and those whose birth control contains higher doses of estrogen. Combination birth control methods may also slightly raise the risk for breast cancer and can sometimes harm the liver.

You shouldn't use these methods if you:

  • Are over age 35 and smoke
  • Have a history of blood clots, stroke, or heart attack
  • Get migraines with aura
  • Have coronary artery disease
  • Have cancer of the breast, uterus, or liver
  • Have uncontrolled high blood pressure or diabetes
  • Had yellowing of your eyes and skin called jaundice during a pregnancy or when you used hormonal birth control
  • Plan to have major surgery soon and won't be able to move around afterward

IUDs

An IUD is a T-shaped device your doctor inserts into your uterus. There are two types of IUDs. They work in various ways to prevent pregnancy. The copper IUD prevents sperm from fertilizing the egg and makes it harder for the egg to implant. The other IUD releases the hormone progestin to prevent sperm from fertilizing the egg.

IUDs come with a few risks. First, if you are exposed to a sexually transmitted infection while using an IUD, you could develop an infection called pelvic inflammatory disease (PID). With the copper IUD, you could have heavier periods. If you get pregnant while the IUD is in place, it could increase your risk for a miscarriage.

You shouldn't get an IUD if you:

  • Have abnormal bleeding from your vagina
  • Have cancer of the cervix or uterus
  • Have AIDS or a pelvic infection
  • Think you might be pregnant
  • Are allergic to copper (for the copper type)

Birth Control Implants

With this method, your doctor inserts a small plastic rod under the skin of your upper arm. The implant constantly releases a low dose of progestin to prevent pregnancy.

Implants have many of the same risks as birth control pills, including blood clots and cancer. You should not use this method if you:

  • Have a history of blood clots, heart attack, or stroke
  • Have liver disease or liver cancer
  • Now have or had breast cancer in the past
  • Have abnormal bleeding from the vagina
  • Are allergic to any of the materials in the implant

The implant is safe for women who are overweight, but it may not work as well if your body mass index (BMI) is higher than 30.

Birth Control Shot

With this method, you get an injection of progestin once every 3 months. It works like the pill to thicken cervical mucus and prevent your ovaries from releasing an egg.

The birth control shot could weaken your bones and increase your risk for osteoporosis and fractures later in life. It might also affect your mood.

This method isn't for women who have:

Barrier Methods: Condoms, Diaphragms, and Sponges

Condoms are thin sheaths usually made of latex. The male condom fits over the penis. The female condom goes inside the vagina. They both block sperm from getting into the vagina.

A diaphragm is a rubber or silicone cup. A sponge is a soft, disk-shaped device made of foam. Each one goes inside the vagina and covers the cervix to prevent sperm from entering the vagina. You need to use spermicide with both methods to protect against pregnancy.

You shouldn't use latex condoms if you're allergic to latex. Avoid diaphragms if you're allergic to silicone or rubber. Any of these barrier methods could be a problem if you're allergic to spermicide.

Your doctor might not recommend using a diaphragm or sponge if you have a:

  • Urinary tract, pelvic, or vaginal infection
  • History of toxic shock syndrome
  • Problem with the shape of your vagina opening, or if your uterus drops into your vagina (called prolapse)

With so many birth control options available, you should be able to find at least one that's safe for you. Talk to your doctor about the best birth control method based on your health, personal preferences, and other factors.

WebMD Medical Reference

Sources

SOURCES:

ACOG: "Combined Hormonal Birth Control: Pill, Patch, and Ring."

CDC: "Contraception."

FamilyDoctor.org: "Intrauterine Device (IUD)."

LiverTox: "Estrogens and Oral Contraceptives."

Mayo Clinic: "Birth Control Patch," "Choosing a Birth Control Pill," "Contraceptive implant," "Contraceptive Sponge," "Depo-Provera (contraceptive injection)," "Diaphragm," "Vaginal ring."

MD Anderson Cancer Center: "The pill and cancer: Is there a link?"

MGH Center for Women's Mental Health: "Does Depo-Provera Cause Mood Changes?"

Nemours KidsHealth: "Condoms." "The IUD (for Teens)."

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