Which non-estrogen birth control works in heavy periods?

Question

Hello doctor,

I am 24 and urgently looking for an effective birth control method, but I have encountered significant challenges with every option I have tried so far.

The combined pill caused severe migraines with aura lasting several days, and my doctor advised against using estrogen.
The mini-pill resulted in persistent breakthrough bleeding for three months.
The Depo-Provera shot led to a 20-pound weight gain, a complete loss of libido, and highly irregular periods, which made me fear I might be pregnant multiple times.
I am hesitant about a copper IUD due to my already heavy, painful periods and anemia (hemoglobin 10.2 g/dL).
A hormonal IUD could be a possibility, but I am concerned about potential weight gain and mood changes.
Condoms alone are unreliable, as they break too frequently, and I am not comfortable depending solely on them.

My boyfriend and I are sexually active, and an unintended pregnancy would be very difficult for me right now. Could you please advise on birth control options that are safe for someone who cannot take estrogen and also has heavy periods?

Thank you so much for your guidance and support.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

Thank you for expressing your concern.

Your migraine history with aura makes it unsafe for you to use estrogen-containing methods, which lead to a higher stroke risk. Your treatment options are now limited to progestin-only or non-hormonal methods.

You should consider a hormonal intrauterine device (IUD) as your next treatment because your mini-pill caused extended bleeding, and your Depo shot resulted in weight gain. It decreased sexual desire and menstrual irregularities.

The hormonal IUD system releases a small amount of levonorgestrel, which directly targets the uterus. The treatment reduces heavy menstrual flow, which sometimes results in the complete cessation of periods. This treatment improves your anemia condition without causing weight gain or mood changes, which are common side effects of systemic medications.

The treatment provides excellent user tolerance while delivering one of the most effective long-term results. Many people experience anxiety about insertion and side effect possibilities, but the system has proven to be life-changing for people who experience heavy bleeding and cannot tolerate estrogen.

You can test your hormone tolerance through a short clinical trial of low-dose oral progestin, which contains Norethindrone, before you decide about IUD use. You can use condoms with spermicide as backup protection or interim protection until you choose your permanent contraceptive method.

I hope this information helps.

Thank you.