One of the most important things for paleo women to consider is what we are going to do about birth control.
Should you take hormonal birth control? Is it really all that good? Bad? What happens to you when you’re on it? Of course, non-hormonal would be ideal for any woman who prioritizes having a natural menstrual cycle. Unfortunately, natural options are really not as abundant as they should be. Check out my top picks for low dose birth control options.
Non-hormonal birth control options
1) condoms and other prophylactics
2) pulling out
3) fertility awareness
4) the copper IUD
This last one is pretty powerful–and popular–but it carries a modest risk of copper toxicity with it and may exacerbate bleeding and cramps during your cycle. The copper IUD also costs a pretty penny… somewhere in the neighborhood of $500-$1000.
So, hormonal alternatives seem like a reasonable choice to many women. And they are. Side effects are often minimal (but again, I caution you against them), and many women are completely happy on the birth control pill.
One way to give yourself the best chance of this happening is to go on a low dose birth control option.
There are more than 60 varieties of the birth control pill available today, and every one of them is different. The dosages for the least impactful birth control pills are classified as: “ultra-low dose” and “low dose.”
Different ways higher hormone birth control can affect you
- Can cause nutrient deficiencies
- May effect appetite in return causing weight gain
- May cause water retention
“Ultra-low dose” birth control pills are those that contain 0.02 mg of estrogen
0.02mg of estrogen is just about the lowest you can go and still prevent pregnancy. The reason many people opt for higher doses is that the side effects of spotting and breakthrough bleeding are more common with ultra-low dose birth control pills versus low dose birth control pills.
There are two ultra-low dose varieties:
Alesse (Aviane, Lessina, Lutera, Sronyx)
Contains 0.02 mg ethinyl estradiol and 0.1 mg levonorgestrel (a kind of progestin – read more about progestin types in my blog here and here)
Contains 0.02 mg ethinyl estradiol and 0.15 mg desogestrel (a kind of progestin)
Five low dose birth control pills:
Pills containing 0.02mg- 0.035mg.of estrogen fall into this category. They have a lower incidence of spotting and breakthrough bleeding.
ethinyl estradiol : 0.03 mg
norgestrel (progestin) : 0.3 mg
ethinyl estradiol : 0.03 mg
levognorgestrel : 0.15 mg
Ortho-Cept (Reclipsen, Solia)
ethinyl estradiol : 0.03 mg
desogestrel : 0.15 mg
ethinyl estradiol : 0.03 mg
desogestrel : 0.15 mg
ethinyl estradiol : 0.03
levonorgestrel : 0.15 mg
ethinyl estradiol : 0.03mg
levonorgestrel : 0.15 mg
Other favorites of women interested in natural health are low dose “triphasic” pills, which better approximate the hormonal fluctuations a woman normally experiences. They also tend to be a bit better than average for weight maintenance and even weight loss.
- Phase 1: ethinyl estradiol : 0.025 mg and desogestrel (a kind of progestin) : 0.1 mg
- Phase 2: ethinyl estradiol : 0.025 mg and desogestrel : 0.125 mg
- Phase 3: ethinyl estradiol : 0.025 mg and desogestrel : 0.15 mg
- Phase 1: 0.025 mg ethinyl estradiol and 0.180 mg of norgestimate
- Phase 2: 0.025 mg of ethinyl estradiol and 0.215 mg norgestimate
- Phase 3: 0.025 mg of ethinyl estradiol and 0.250 mg of norgestimate
(Ortho Tricyclen and Ortho-Cyclen, each with 0.035 mg of ethinyl estradiol, contain slightly higher amounts of estrogen in each type of pill than Ortho Tricyclen Lo)
Finally, YASMIN and YAZ are two more low dose birth control pills containing 0.03 mg and 0.02 mg respectively of estrogen. What is unique about them is that they have a different type of progestin from the other pills called drospirenone (3.0 mg).
Drospirenone has the benefit of reducing acne and water retention in a lot of women. On the other hand, and this is a huge ON THE OTHER HAND, I have taken a similar substance and nearly died from a potassium overload, as well as developed a severe case of insomnia and anxiety that I am still dealing with two years later. If you take Yaz or Yasmin, please keep your potassium-containing foods to a minimum, drink plenty of fluids, and regularly check in with your doctor on your potassium levels. If you experience muscle weakness or heart palpitations, stop taking your pill immediately.
So aside from the YAZ, those are my favorite low dose birth control pills. These are the ones I fear the least, as they are the lowest dose birth control pills I know of. If I were to use hormonal birth control (to be clear: I don’t, I use prophylactics) – these are the ones I would investigate using, or at least ask my doctor about trying.
If you happen to struggle with acne and be on a birth control pill or contemplating it, take a moment and think about it. Each type of birth control pill has a different relationship with your skin! I discuss the nuances of hormone balance and specifics kinds of pills as they relate to acne in my brand new, 50% off program on the topic, Clear Skin Unlocked: The Ultimate Guide to Acne Freedom and Flawless Skin.
If you happen to struggle with PCOS, it is worth learning about the condition and how to overcome it naturally before going on the pill. I describe how I did and how you can do it too in my manual on the topic, PCOS Unlocked: The Manual.
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Yaz is deadly.
Why no mention of nuvaring? Lower dose than any pill, continually delivered, put a new one in every 3 weeks and you can skip periods (and hormone drop) all together. But you can do that with any pill too, worth mentioning avoiding that useless placebo week.
I think one of my team members changed the title of this post from having the words ‘birth control pill’ in it, so now it just says ‘hormonal.’ this was intended just to be a list of pills – you are right that nuvaring belongs with the category of low dose options
Hi, thanks for sharing this information. What about Lo Loestrin Fe?
It’s a low dose pill but with some iron added, I presume for women who struggle with their iron levels due to heavy menstrual flow. If this fits the bill for you it’s worth a try – otherwise the added iron is probably unnecessary <3
Nuvaring has been the cause of numerous deaths due to blood clots in the lungs
I suffered from 3 blood clots in my right lung this March due to NuvaRing
My 12 year old started taking birth control 5 months ago due to an ovarian cyst. She is very fit and muscular w/ low body fat(5’3 and 105 lbs.). I recently noticed cellulite appearing on her lower back and on the back of her upper thighs. Her face also looks a little puffy. I haven’t mentioned this to her as I don’t want her to feel insecure. Is this likely due to her hormone levels being too high from the birth control?
mmm, this is possible, though not necessarily a bad thing. in any case you may want to get her hormone levels checked again by the doctor to make sure that the BCP is having the right effect on mitigating the cyst 🙂
You may want to inquire about cushings syndrome
Taking progestogens and also mirena iud made my face puffy, like I was injecting steroids. Progestogens build up in my body and it takes months to clear it.
Just came here to say that another barrier method option that does not get mentioned a lot is the diaphragm. I used it on and off for 10 years with great success (i.e. no pregnancies). Hormonal birth control made me anxious and depressed, and the copper IUD gave me hideous cramps and heavy periods for a year, so it’s the only option I will consider aside from condoms. There’s a new diaphragm called the Caya that’s an updated version that I’m planning to check out soon. If you’re in a monogamous relationship and don’t need to worry about STDs but are sick of condoms, consider the diaphragm. They’re hard to get these days because nobody seems to remember they are an option, but I really hope that changes!
Thank you for mentioning this! I was looking for an alternative to hormonal birth control (I’m doing so well off of it after I had my baby) and I totally forgot about these! I’m going to talk to my doctor about one tomorrow!!
What are your thoughts about the hormonal (progesterone) IUD? If you need to use a hormonal birth control method, is there any advantage to the hormones being local (IUD) rather systemic (BCP)?
Once a hormone is in the bloodstream, it’s in the bloodstream, though if you put it in a local spot then there’s a higher likelihood it will be taken up by local tissues. I think probably a progesterone IUD is one of the more safe hormonal birth control options out there in terms of long term hormone balance and health 🙂
Hi Stefani, I have recently been prescribed levlen after being on no bc for quite awhile. I previously have only taken a triphasil pill (which I think I quite liked). I’m concerned about trying levlen though, and wasn’t sure if I should just go back to what I had used previously. My main concerns were side effects relating to weight gain or bloating, as I’ve been using cyclic progesterone for the past year or so to actually have a regular period but have felt like i just keep steadily gaining weight! So worried if levlen will make it worse. Or am I just overthinking it?! Thanks J
Hi Jayne! So, cyclic progesterone is JUST progesterone, and levlen has both progesterone and estrogen in it. My guess is that it could have a different effect on you than your old method. It’s possible the balance of E and p could really help you; on the other hand, you are right that it could be worse. There’s really only one way to find out, which is trying it. Of course, getting off of birth control and using prophylactics is also a totally legitimate option (and the one I use)
Thanks Stefani, much appreciated!
I had quite enjoyed being off of the pill but have been feeling like I’ve really noticed some PMS symptoms once I ovulate and until I get a period (which I’ve found can still be a bit hit and miss even with the progesterone).
I know I probably just need to give it a go to see. Do I need to use for a few months to see how it goes properly though…?
I think I’m just confused if the estrogen or progesterone is what would be making me feel bloated and the weight gain! I had always thought it was more estrogen, but since using the progesterone more consistently I’m feeling it quite a lot lately (particularly around upper thighs / hips)
yes, I find this to be entirely plausible, and I would follow my instincts if I were you and seek a different option if that feels better. There are different kinds of synthetic progesterones, so it’s possible that a different kind will work better for you <3
Man, yaz gets a lot of hate but it’s honestly the only pill that was symptom-free for me. I tried around 4 different pills before landing on yaz, and they all had various bad effects – acne, menstrual pains, bloating, weight gain, mood fluctuations, etc. With yaz, even if I missed a pill or didn’t take it on time I was totally symptom free. And without birth control I often had incredibly debilitating cramps that became WAY more manageable with yaz. I stayed on it for 7 years (through most of my 20s) without a single issue. In the end, I think it’s really down to our own individual bodies. Nobody’s hormone levels are exactly the same and so different pills will affect each woman a lot differently.
Now I’m off birth control though. It took my body about 6 months to completely normalize again. I don’t like the idea of putting synthetic hormones into my body as I’m trying to move towards as natural a lifestyle as I can. It’s been about a year since I’ve even taken any painkillers or drugs. As most of the Paleo community hopefully knows, it turns out there’s a lot of great natural alternatives for most ailments out there if you look for them. (:
I’m looking at switching from YAZ to a different bc pill due to its side effects on me (chronic yeast infections and ZERO libido) however I definitely enjoyed that it didn’t make me break out. Is there a pill that is relatively easy going on libido that won’t make my skin flare up either? Unfortunately I need to take hormonal bc for my anemia and I know I’m asking for the best of both worlds here .. but hopefully there’s a middle ground?
Unfortunately the pills don’t work like that – each person’s response is highly individual. If you go with an option that has estrogen in it, that will probably protect you against the potential downsides of certain kinds of progesterones. You can also be sure to get a pill with a kind of progesterone in it that is anti androgenic. If you’re interested in further reading I talk about this at pretty great length in my skincare program (http://clearskinunlocked.com) <3 🙂
What about women who deal with depression normally during pms. Is there a birth control option that doesn’t exacerbate this issue?
It’s possible a pill would help – though i’m not sure if one with more estrogen or progesterone would be good, or different kinds of progestin. it depends on your personal biochemistry – you may have to try a few <3
Plz can give me a email address I would like to contact u for advice thanks
Hi stefani I suffer from androgenetic alopecia I am worried about my daughter who is 19 and has irregular periods she was on a progesterone pill which stopped her periods completely and said that the side effect of this pill she may never b able to conceive now she wants to go on a combined pill to regulate her period and not cause weight gain she has been suggested Qlaira,Cilest,Marvelon,Mercillon,Zoely I am not sure as I am scared for her as she is naive n young not to onset AGA plz plz can u help me advise her on the best low androgen pill which is safe for her that she can go on to regulate her periods thank u so much ur advice is greatly received from a worried mum
Hi stefani my daughter wants to regulate her periods she has been on a progesterone only pill which stopd her period completely also she says it may effect her chances of conceiving in future progesterone only pills have this side effect plz can you advise me she has been given a list of low dose androgen pill mercillon marvelon cilest zoely Qlaira can you plz plz suggest the best ones to go on with less weight gain I am worried as I suffer from androgenetic alopecia and I dnt want her to onset anything she is young and naive plz help thank you
for irregular periods i would normally recommend getting some hormone tests done and perhaps working to treat PCOS or other underlying issues. reducing inflammation is also really helpful. otherwise if you’re not willing to do that, then yes, pills are an option; a low dose progesterone/estrogen comibnation pill may be what you’re looking for
any good reviews or bad reviews for this birth control pill Microgestin??
I’m on microgestin after not having taken birth control for three years, and had two kids in the meantime. I’ve experienced breakthrough bleeding every day since starting it (not surprising due to stage 4 endometriosis) severe bloating, and panic attacks and anxiety (I have no history of mood or mental disorders). I have been taking it for such a short time but the side effects have been so frightening that I’m quitting taking it immediately. I would look into other options.
What is mononessa considered?
Thoughts on Estrostep?
Hi there. I started Junel 4 days ago and immediately began waking up in the morning with heart pounding anxiety, which is typical of panic attacks I used to get but not in a long time and not unprompted. I didn’t take a pill yesterday but I’m not much better this morning. I wonder if I should skip it another day and see if I feel better or continue taking it and see if it balances out?
The same thing happened to me 11 years ago in college with the Nuva Ring. I became suicidal after having it in for 4 days but felt entirely better 24 hours after taking it out. It was terrifying, I was literally struck suicidal, and I had never felt anything like that before so I’m a little scared of this.
i would personally continue with the experiment of staying off the pill for a few days, yes. definitely worth the fertility for the sake of helping take care of yourself and especially your mental heatlh <3
My daughter has reacted terribly with Jadelle/Norplant 2 (Levonestrogel) and two contraceptives pills Ava 30 (Ava also contained Levonestrogel) and Zoely which is supposed to be a new generation pill. Her anxiety skyrocketed on Zoely. She gets VERY depressed – to suicidal stage, rages, high emotionability and lots of anxiety. I’ve taken her off all hormonal contraceptives at the beginning of Nov. She’s been so much better and life is improving week by week. But now she’s wanting to try another pill. I’m petrified of another bad reaction. Do you think I should strongly discourage her from going down this path again as it was so treacherous for us all. I’m so scared.
My daughter was on microgynon combined pill for 3 months it made her really down and depressed. She was going around half mad in temper all the time. After sitting studying why she had went from being happy to this complete emotional mess I realised this just started few weeks after her starting the pill. I took her off it straight away after going online reading reviews on it. We went to gp who recommended she stay off it for 3 months till it was completely out of her system. Inside a week after stopping she even noticed herself that she felt a lot better. She went back to gp as she really needed contraceptive he gave her Cileste. Now at the end of her first three months on it the exact same symtoms have returned. Crying all the time , not wanting to leave her room , very depressed , just an emotional mess. I have stopped her from last night taking this pill. Just wondering has anyone any recommendations of a low dose pill that doesn’t affect mental well-being.
Thank you for this list it was very informative! I did not see the hormone: “norethindrone acetate”
I just got on “Blisovi FE 1.5/30” with norethindrone acetate 1.5 mg and estradiol 0.03 mg. This is to treat extremely painful periods. Have you heard of this birth control?
I was just wondering if there’s a mini pill that won’t make my anxiety worse! I’m currently on Lyza and it’s made me feel crazy! (I have to take a mini pill because of my migraines and I don’t won’t to get off because it actually cures my hormonal hemiplegic migraines.)
Maybe try a different mini pill?
Different kinds of progestins or estrogen/progestin combos could have a different effect, yes <3
Can you get rid of the pulling out ‘method’ as it is not a method?
What category (ultra low-dose, low dose, or triphase) would Natazia birth control fall into? Thanks!
It’s regular dose! 🙂
I am currently on the generic for Yaz/Beyaz called Gianvi! I will stop using after this month and try something else because I HAVE NO SEX DRIVE anymore and that is NEVER okay with me!! I do not want a cooper IUD. Do you have any suggestions on what may help? I want my crazy Sex drive back ASAP!!! HELP! lol
A different formulation of the pill, if you want to be on some form of regular contraceptive. There are some very low dose varieties – as listed here – worth experimenting with
This question is in regard to women who were on Ortho Tricyclen original and did very well on it for years until they went into perimenopause, menopause, and are now postmenopausal and wanting to return safely to HRT(Hormone Replacement Therapy.
If you were on Ortho Tricyclen which doses you
in Phase 1: 0.35mg ethinyl eastradiol & 0.180 norgestimate
Phase 2: 0.35 ethinyl estradiol & 0.215 mg norgestimate
Phase 3: 0.35 mg ethinyl estradiol & 0.250 mg norgestimate
Now postmenopausal what would be your dosages to ‘get back to being yourself? with a
Continuous dosing Estrogen like a Climara or Vivelle Dot patch and
a progesterone replacement like a copper iud brand either Mirena or Skyla?
My primary knows nothing about this and we only have 2 choices for an OB/GYN in our small town who don’t know much more about it although they freely rx birth control pills ( hrt) for those still menstruating, they don’t seem to be in the know for those of us in postmenopausal stage ; which btw, is THE REST OF YOUR LIFE, Once you stop menstruating, like 50+ years to live and to me this is a huge part of your life to live WITHOUT YOUR ESSENTIAL HORMONES.
* Should we as women try to ‘maintain’ the near same amounts of our hormones after menopause as we do during menstruation years? or go a bit lower?
Its necessary to have hormones in order to prevent osteporosis, alzheimers, heart issues, maintain collagen, elastin, hair growth and prevent hair loss, and so much more- but not one TELLS women this until AFTER you’re already in menopause.
* Please don’t say ‘talk to your doctor’