Are you a good fit for hormonal birth control?

You might as yourself, “Am I a good fit for hormonal birth control?” The choice of contraceptive methods has considerably increased over recent years. However, all of the methods are not appropriate for everyone, especially those with medical conditions or those with higher risks if they were to get pregnant. 

Below are some common reasons why you might not be the right fit for hormonal birth control options. 

Migraines & Hormonal Contraception:

It is important for a person to describe their migraines to a doctor when discussing birth control options. Many people often mistake severe headaches for migraines. It is important to receive a professional diagnosis, which can lead to better treatment and more birth control options. It is also very important to diagnose the type of migraine a person has because different types can impact your medications.

Migraines often occur with other symptoms, such as:

  • nausea
  • vomiting
  • sensitivity to light
  • visual auras, which can appear as flashes at the corners of visio

 Migraines may begin while a person is sleeping or in response to specific triggers. Migraines are different from tension headaches, which can often be improved with massage. Migraines also often get worse when a person stands up and moves around. The pain is usually a pulsing on one side of the head. For many with migraines, it is important to weigh the risks and benefits of hormonal birth control.


Having migraines does not mean you are not a match for birth control. If you do not experience migraines with aura, birth control can actually help with common migraines caused by hormonal changes. As hormonal levels become more consistent throughout the month, a reduction in headaches can result. If your migraines include limb numbness, speech or language difficulty, muscle weakness, visual changes like zigzag lines, flashes of light, or blind spots- be sure you include these details whenever you discuss your medical history with your healthcare provider – the more information they have, the better equipped they’ll be to help you.

Who else should not take the pill?

The Medical eligibility criteria for contraceptive use (US MEC) provides guidance regarding which patients can use contraceptive methods safely. When the pill was first introduced in the 1960s, the doses of both hormones (estrogen and progestin) were quite high. Because of this, cardiovascular complications occurred, such as high blood pressure, heart attacks, strokes, and blood clots in the legs and lungs. The pills prescribed today have much lower doses of progestin and estrogen, which has decreased the risk of these complications.

Because of an increased risk of complications, you should not take the combination pill if you:

  • Are 35 or older and smoke cigarettes (as this puts you at high risk for cardiovascular complications such as blood clots or heart attack).
  • Could be pregnant.
  • Have had blood clots or a stroke in the past (as this increases your risk of blood clots while taking the pill).
  • Have a history of an “estrogen-dependent” tumor (eg, breast or uterine cancer).
  • Have abnormal or unexplained menstrual bleeding (in which case the cause of the bleeding should be investigated before starting the pill).
  • Have active liver disease (the pill could worsen the liver disease).
  • Have migraine headaches associated with certain visual or other neurologic symptoms (e.g., aura), which increases your risk of stroke.

Risk vs. Benefits of Hormonal Contraception

It can be difficult to decide which birth control method is best due to the variety of options available. The best method is one that will be used consistently and does not cause bothersome side effects. Other factors to consider include:

  • Efficacy (how well it works to prevent pregnancy)
  • Convenience
  • How long the drug or device can be used
  •  Type and frequency of side effects
  • Affordability 
  • Whether or not it also protects against sexually transmitted diseases
  • How quickly your fertility will return if you stop taking it

 If you are not a good candidate for hormonal contraceptives and are looking for hormone-free contraception, here is a list of non-hormonal birth control options.

  • Consider diaphragms, male or female condoms, and/or spermicides. Female and male condoms also protect against sexually transmitted infections, and most insurances cover female condoms.
  • Fertility awareness-based methods (FABM): This option isn’t just one method, in fact, fertility awareness is a broad category that includes a range of natural family planning methods such as the rhythm method, calendar methods and temperature-based methods. These methods rely on getting to know your fertility indicators, or by counting days to work out your own fertile window. o Calendar rhythm methods are becoming more prevalent and reliable with emerging technology. Natural Cycles and Femometer are two great options in this category (it is worth noting that not all birth control apps are calendar-based apps, and there are a few key differences you should be aware of if you choose to use a birth control app).

Very few health apps are FDA approved, and this can be a useful thing to check before you sign up for one. Free apps may also make their money out of selling your data, so it’s worth checking out their stance on data privacy too.

On average fertility awareness-based methods such as calendar methods are estimated to be around 85% effective. There is a higher risk of unplanned pregnancy if this is your only contraceptive method. Using backup protection, especially when you are first beginning, is strongly recommended.