The Breakdown on Birth Control and Type 1 Diabetes

A variety of things can raise blood sugar besides carbohydrates. In fact, the hormones in some birth control methods can also alter the body’s regulation of blood sugar for those with type 1 diabetes (T1D). 

There are many contraceptive methods available to women and people assigned female at birth (AFAB) living with T1D. Let’s break down some of the most common forms of birth control and how they can impact life with type 1 diabetes. 

Editor’s Note: This article is not a substitute for professional medical advice but rather a guide to inform. Consult with your healthcare team about the different options available to find the best form that works for you.

Understanding Birth Control Hormones 

Our hormones control many of the different cycles and behaviors within the inner workings of our body. They are also involved with our ability to become pregnant. Additionally, preventing pregnancy can rely heavily on certain female sex hormones. 

Some, but not all, birth control methods require female sex hormones in order to prevent pregnancy. For people living with type 1 diabetes, the hormones used in a few birth control options are the main elements of the medication that can affect blood sugar levels. 

The hormone progesterone, or its synthetic version, progestin, is the primary hormone used in hormonal contraceptives and has been linked to increased insulin resistance. For T1Ds, this may lead to higher blood sugar levels while on certain hormonal birth controls. 

However, this doesn’t mean T1Ds should avoid all hormonal forms of birth control. Instead, they should be aware of certain proactive steps, like adjusting insulin needs, that might combat higher blood glucose levels. 

Be sure to consult with your healthcare team about taking any birth control with type 1 diabetes and making changes to your insulin dosages. 

Types of Birth Control 

Contraceptive Pill

Birth control pills are a form of oral contraceptive typically taken every day to prevent pregnancy. The contraceptive pill commonly comes in two forms: a combined pill that contains the hormones estrogen and progesterone and a pill with just the hormone progesterone. 

Intrauterine Devices (IUDs)

An intrauterine device, also known as an IUD, is a small, one-and-a-half-inch T-shaped device that is inserted by a medical team into the uterus. The length of time that an IUD stays in the body depends on the type inserted, though it can be removed at any time. 

Copper IUD

A copper IUD is a non-hormonal form of birth control. Available in the United States under the brand name ParaGard, the copper IUD slowly releases copper into the uterus, stopping sperm from fertilizing an egg. Because no hormones are being emitted from the copper IUD, increased blood sugar due to the birth control is very unlikely. Copper IUDs can last up to ten years before needing removal or replacement. 

Hormonal IUD 

The hormonal IUD is similar to the copper IUD, but instead of relying on copper’s natural properties to prevent pregnancy, it emits the hormone progesterone into the bloodstream. 

Depending on the brand of hormonal IUD, they can last in the body anywhere from three to eight years before needing to be replaced or removed. Be sure to discuss removal options with your doctor and medical team when deciding on a hormonal IUD. 

Implant 

The implant, available in the United States by the name Nexplanon, is a type of hormonal contraceptive inserted under the upper arm's skin. Similar to the hormonal IUD, the implant releases the hormone progestin into the bloodstream, thickening cervical mucus and preventing pregnancy. 

Progestin is a synthetic hormone mimicked after the female sex hormone progesterone. So, just as progesterone can increase insulin sensitivity and therefore raise blood sugar, so can progestin. Like many of the hormonal contraceptives on this list, the added hormones used to prevent pregnancy can lead to higher blood glucose levels. 

Morning After Pill 

The “morning-after pill” is an emergency contraceptive that is taken the day or a few days after intercourse and works to prevent conception after sex. Unlike the rest of the birth control methods listed, it is not a routine medication and is only taken after sex to prevent pregnancy. 

Unlike many of the birth control methods listed above, the emergency contraceptive pill is available over the counter and does not require a prescription. 

Ring

A vaginal ring is a form of hormonal birth control that is inserted into the vagina, where the vaginal wall absorbs the hormones. Similar to the combination birth control pill, the vaginal ring releases two hormones into the body, estrogen and progestin. 

However, because the hormones are absorbed through the vaginal wall instead of into the bloodstream, there is little impact on blood glucose levels and insulin resistance. 

The vaginal ring is worn for three weeks before being removed for a week before the cycle starts again. Unlike the IUD, the vaginal ring does not require a doctor or medical staff to insert and is instead done by the patient. 

Non-prescription Based Methods 

While the science and technology surrounding birth control grows, some women and AFAB people, especially those living with conditions like T1D, may want birth control routes that don’t rely on medication or implantation. The barrier method and family planning can allow people living with type 1 diabetes to feel more in control of their lifestyle without an added medication or implant. 

Barrier Method 

Barrier methods, such as the use of male or female condoms, can work to prevent pregnancy without taking any medications or abstaining from sex. Because there are no hormones used in these methods, there are no rising blood glucose complications that come with using barrier methods for T1Ds. 

Family Planning

Family planning is another way for women and AFAB people to be in control of their pregnancy status. It involves tracking menstrual cycles in order to know when ovulation occurs and avoid intercourse during that time to prevent pregnancy. Like other non-hormonal contraceptives, family planning will not cause complications in type 1 diabetes. 

Find the Right Fit for You

Unfortunately, no birth control method is right for everyone. When choosing the best option for you, review the ease of use, effectiveness, accessibility, and side effects like rising glucose levels. Also, consider the learning curve, as some methods take time and practice to use correctly.