Managing type 1 diabetes involves juggling various aspects of daily life, including making decisions about birth control. Hormonal birth control methods, like the pill, can have an impact on blood glucose (blood sugar) levels and overall diabetes management.

Here are nine essential things to know if you have type 1 diabetes and are considering or currently using birth control.

1. Hormonal Birth Control Influences Blood Sugar Levels

Hormonal birth control methods, such as the pill, patches, and implants, contain estrogen and/or progestin. These hormones can influence blood sugar levels. Some people with type 1 diabetes may experience higher blood sugar levels when using these methods due to how hormones affect insulin sensitivity.

It’s crucial to monitor blood sugar levels more closely when starting or changing hormonal birth control methods. Talk with your health care provider about adjusting your insulin dosage if necessary.

2. Intrauterine Devices Have Less or No Effect on Hormones

For those looking to avoid the potential blood-sugar impact of hormonal methods, intrauterine devices (IUDs) are a good option.

There are two main types of IUDs: hormonal (like Mirena, Skyla, Kyleena, and Liletta) and nonhormonal (copper-based, like Paragard). Hormonal IUDs release progestin within the uterus, which typically results in fewer hormonal side effects compared to systemic hormonal methods (types of birth control that release hormones into the bloodstream, affecting the entire body).

Nonhormonal IUDs, on the other hand, do not affect hormone levels and have no impact on blood sugar levels. For these reasons, IUDs make a great contraceptive option for someone with type 1 diabetes.

How To Choose the Right IUD

When considering an IUD, discuss with your health care provider which type is best for you. Factors to consider include:

• Your overall health
• Menstrual cycle regularity
• Side effects

Hormonal IUDs can reduce menstrual bleeding and cramps, while copper IUDs may cause heavier periods initially but typically stabilize over time. Both types offer long-term contraception (three to 12 years, depending on what kind) and are reversible, allowing you to return to your natural fertility after removal.

3. Contraceptive Implant May Affect Blood Sugar

Nexplanon, a small rod-shaped contraceptive implant, is inserted under the skin of the upper arm and releases progestin. Although it provides long-term birth control for up to three years, there have been questions about its potential impact on blood sugar levels.

Health care professionals generally tell people that this method can affect blood sugar. However, a small study in women with diabetes showed that there was no effect on blood sugar levels and no impact on insulin requirement. This finding shows that more research is needed.

As with other hormonal methods, close monitoring of blood sugar levels is recommended when using Nexplanon. Talk to your doctor to decide if this method is a good choice for you.

4. A Contraceptive Ring Is Another Alternative to the Pill

NuvaRing is a flexible vaginal ring that releases both estrogen and progestin. It’s inserted for three weeks and then removed for one week to allow for a menstrual period.

Like other combined hormonal methods, NuvaRing can influence blood sugar levels. However, because the bulk of absorption is happening in the vaginal lining, it may have less effect on blood glucose. Users should be mindful of potential changes in their blood sugar readings and work with their health care team to make any necessary insulin adjustments.

Benefits of NuvaRing

NuvaRing offers several benefits. It’s easy to use and has lower hormone doses compared to some oral contraceptives. It also releases hormones consistently, which can help stabilize hormone levels and reduce side effects. However, it’s important to insert and remove the ring on schedule to make sure it works effectively and to help manage your diabetes.

5. Having Certain Diabetes Complications May Impact What Birth Control Methods Are Safe for You

Women with type 1 diabetes need to be aware of specific health risks associated with hormonal birth control, according to Mayo Clinic. There is a slightly increased risk of blood clots, especially for those who smoke or have a history of cardiovascular problems. Hormonal birth control can also increase the risk of hypertension (high blood pressure). Regular check-ups and talking with your health care provider can help manage these risks and ensure the birth control method you choose is safe.

The Society of Academic Specialists in General Obstetrics and Gynecology states that hormonal birth control is safe for women with diabetes who need insulin unless they have one of more of the following:

• A confirmed diagnosis of diabetic neuropathy (nerve pain caused by diabetes)
• Retinopathy (vascular eye damage caused by diabetes)
• Nephropathy (kidney damage caused as a complication of diabetes)
• Diabetes that has lasted for more than 20 years

Monitoring Your Health

Regular monitoring of your blood pressure, cholesterol levels, and overall cardiovascular health is essential when using hormonal birth control. Your health care provider may recommend more frequent check-ups to ensure that any potential health risks are identified and managed early. This proactive approach can help you maintain optimal health while using birth control.

6. Regulating Your Menstrual Cycle Might Help With Diabetes Management

Johns Hopkins Medicine states that hormonal birth control can help regulate menstrual cycles, which may benefit some women with type 1 diabetes. Irregular periods can complicate blood sugar management due to fluctuating (changing) hormone levels. By stabilizing these fluctuations, hormonal birth control might help maintain more consistent blood sugar levels. However, this effect is different in everyone, so make sure to track your patterns and adjust as needed.

Understanding Your Cycle

Understanding how your menstrual cycle affects your blood sugar levels can help you manage both more effectively. Keeping a menstrual diary, including blood sugar readings, type 1 diabetes symptoms, and any changes in insulin needs, can provide valuable insights. Share this information with your health care provider to tailor your diabetes management plan to your specific needs.

7. Emergency Contraception Can Affect Blood Sugar

Planned Parenthood has found that emergency contraception, such as Plan B, is generally safe for women with type 1 diabetes. However, it can cause temporary changes in blood sugar levels due to the high dose of hormones. If you need to use emergency contraception, monitor your blood sugar closely for a few days and be prepared to adjust your insulin if necessary. It’s always a good idea to check with your health care provider about the best course of action.

Using Emergency Contraception Effectively

Emergency contraception should be used as soon as possible after unprotected sex or contraceptive failure to maximize its effectiveness. It is not intended for regular use and should not replace a consistent birth control method. Discuss any concerns or questions with your health care provider to ensure you’re using it correctly and safely.

8. The Role of Nonhormonal Methods

Planned Parenthood also states that nonhormonal birth control, such as condoms, diaphragms, and the copper IUD, can be effective options for women with type 1 diabetes. These methods don’t interfere with hormone levels or blood sugar control. However, they need to be used consistently and correctly to effectively prevent pregnancy. Discuss these options with your health care provider to figure out if they are suitable for you.

Advantages and Disadvantages

Each nonhormonal method has its advantages and disadvantages. Condoms protect against sexually transmitted infections in addition to preventing pregnancy. Diaphragms must be used with spermicide and correctly positioned to be effective. The copper IUD provides long-term contraception without hormonal side effects but may cause heavier periods initially. Weigh these factors carefully when choosing a method.

9. The Right Birth Control for You Depends on Your Health Factors, Lifestyle, and More

Ultimately, the best birth control method for you is one that fits your lifestyle and health needs. This decision should be made in consultation with your health care provider, who can help you weigh the benefits and potential risks of each option. Factors such as your age, overall health, blood sugar control, and preferences all play a role in choosing the most suitable method.

Talk With Others Who Understand

On myT1Dteam, the social network for people living with type 1 diabetes and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with type 1 diabetes.

Are you living with type 1 diabetes? Share your experience in the comments below, or start a conversation by posting on your Activities page.