updated April 17, 2025
Before diving into some of the long-term side effects of hormonal birth control, let’s look at a few statistics:
In the United States:
While most people associate the term “hormonal birth control” with the pill, there are a variety of hormone-releasing birth control methods.
Birth control is prescribed for preventing pregnancy and to control acne, but also for a variety of fertility issues such as endometriosis, PCOS, ovarian cysts, pain associated with fertility issues, PMS, and irregular menstrual cycles.
These are the most popular types of hormonal birth control that you’ll find on the market:
the implant — 99% effective
The birth control implant (AKA Nexplanon) is a tiny, thin rod about the size of a matchstick. The implant releases hormones into your body that prevent you from getting pregnant.
the IUD — 99% effective
The Mirena, Kyleena, Skyla, and Liletta IUDs use the hormone progestin to prevent pregnancy.
the shot — 94% effective
The birth control shot (sometimes called Depo-Provera, the Depo shot, or DMPA) contains the hormone progestin. Progestin stops you from getting pregnant by preventing ovulation. When there’s no egg in the tube, pregnancy can’t happen. It also works by making cervical mucus thicker. When the mucus on the cervix is thicker, the sperm can’t get through.
the patch — 91% effective
The transdermal contraceptive patch is worn on the skin of your belly, upper arm, butt, or back. Put on a new patch every week 3 weeks, and it releases hormones that prevent pregnancy. Then you take the patch off for a week before you repeat the cycle.
the ring — 91% effective
The NuvaRing is worn inside your vagina. The small, flexible ring prevents pregnancy by releasing hormones into your body.
the pill — 91% effective
The hormones in the pill stop ovulation. No ovulation means there’s no egg hanging around for sperm to fertilize, so pregnancy can’t happen. The pill’s hormones also thicken the mucus on the cervix. Thicker cervical mucus makes it hard for the sperm to swim to an egg.
If you’ve ever taken any hormone-based birth control methods, you know that they come with an assortment of short term side effects:
But did you know that some of the long term side effects can actually impact your overall health for a lot longer than just the first few months you’ve come off them?
And — something that’s rarely talked about — there can be long term side effects to your fertility health.
Hormonal birth control acts like an antibiotic in your gut, destroying the essential microbiome balance.
I’ve said it before, and I’ll say it again, GUT HEALTH IS SO IMPORTANT TO YOUR HEALTH.
It quite literally affects all aspects of your life — from your physical health right on up to your psychological health. So when your gut flora is out of whack and imbalanced, you could be struggling with inflammation, weight gain, gastrointestinal discomfort, leaky gut, etc.
Unfortunately, the impact of the hormone-releasing birth control on the microbiome will last long after you stop taking it, and while it is possible to rebalance your microbiome, it takes a lot of work.
Besides preventing pregnancy, there are two main reasons that women are prescribed birth control: to ease PMS symptoms and to regulate an irregular cycle.
Here’s the thing — these issues are a result of a hormonal imbalance and can be cured with diet and lifestyle choices!
Birth control “treats” these symptoms by masking them, instead of treating the root cause. This puts you at a higher risk of the big diseases of inflammation – heart disease, cancer, and dementia – later in life.
Hormonal birth control changes the uterine lining to make it unreceptive to the implantation of a fertilized egg. By controlling the body’s estrogen and progesterone levels with synthetic hormones, birth control does not allow for the proper levels of progesterone to build a healthy uterine lining for implantation.
Many women begin taking birth control at a very young age and don’t stop until they want to begin trying to conceive. While hormonal birth control doesn’t cause infertility, it does impact long-term fertility by “silencing a woman’s biological clock for so long that, in some cases, they forget it’s ticking away.”
Hormonal birth control can prevent the absorption of micronutrients, vitamins, and minerals. It doesn’t allow for the absorption of B vitamins, magnesium, and vitamin C in particular, which can lead to short and long term impacts on your health. These micronutrients are essential for hormonal balance and a deficiency can lead to infertility issues, even after you’ve stopped taking birth control.
When you’re micronutrient deficient and unable to absorb what you need even from additional supplementation, you are set up for poor physical and mental health.
Research from the University of Copenhagen has revealed that the birth control pill and other hormonal contraceptives (including the hormonal IUD, patch, and ring) could be causing depression for some women. The new study tracked over 1 million Danish women between the ages of 15 to 34 over the course of 13 years. None of the women had a history of depression, but upon starting with the birth control pill, hormonal IUD, patch or ring, developed depression at significant rates. The women who were diagnosed with depression were prescribed antidepressants — adding more synthetic hormones into the body which further interrupt your delicate hormonal balance.
So, what are some alternatives to hormonal birth control when trying to avoid pregnancy?
First and foremost, getting in tune with your cycle, recognizing your fertile cues, and using ovulation predictor tests to know exactly WHEN you’re ovulating (and therefore very fertile) is my top recommendation.
The Natural Cycles app uses a unique algorithm that combines specific fertile cues such as your basal body temperature (your temp taken first thing in the morning before you get out of bed), your personal cycle fluctuations, LH hormone tests, and even the survival rate of sperm to give you “green days” — when you’re highly unlikely to conceive — and “red days,” when you’ll want to abstain or use protection.
For those of you with irregular cycles, chronic anovulatory cycles, or another issue that prevents your cycles from being reliable, my top pick would be the hormone-free copper IUD. Because it doesn’t contain synthetic hormones, you can still treat and resolve hormone imbalances and cycle issues with diet and lifestyle changes because there are no synthetic hormones interfering.
Read more about the Hormone-Free Copper IUD.
Hormonal birth control covers more than just the Pill – it’s also the implant, IUD, shot, patch, and birth control ring.
Long term use of hormonal birth control affects not only your overall health, but can have lasting effects on your fertility health as well.
There ARE alternatives to hormonal birth control!
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Sarah Jane Sandy is a certified nutrition therapist, and a fertility and women’s health expert. She has helped hundreds of women increase their fertility naturally and go on to have healthy full-term pregnancies. She has been working with women and couples trying to get pregnant for over 16 years and over 90% of the women who work with her get pregnant and have healthy babies.
She also works with women trying to fix their hormone imbalances, as well as supporting women through pregnancy and the postpartum period. Learn more about her own fertility and hormone journey here. To send Sarah a message, complete her Contact Form.
Curious about your fertility health? Take this simple quiz to find out what factors may be harming your fertility, and learn what you can do about it!
