What to Know About Birth Control and Diabetes

Most birth control is safe for people with type 1 and 2 diabetes. However, contraceptives that contain hormones may need further evaluation by your healthcare provider.

Effective birth control is an important issue for people with diabetes, as unplanned pregnancies can result in complications. For people with diabetes, weighing the benefits against the risks is essential in choosing the right birth control.

This article will discuss how birth control affects diabetes and blood sugar.

Does Birth Control Affect Blood Sugar?

Birth control that contains hormones can elevate some people's blood glucose levels. Hormonal contraceptives increase the female sex hormones estrogen and progesterone. In addition to preventing pregnancy, a rise in these hormones can also increase blood sugar. However, contraception containing less than 35 micrograms of ethinyl estradiol (synthetic estrogen found in hormonal contraceptives) may not affect blood sugar or insulin resistance.

Metformin is a common medication used to manage diabetes and polycystic ovary disease (PCOS). Since this medication can cause ovulation, it's essential to incorporate effective contraception to prevent pregnancy. For many diabetic people, the risks of pregnancy outweigh the small risk of hyperglycemia (high blood sugar) with birth control use.

Using Birth Control to Prevent High-Risk Pregnancy

One study found diabetic females use less effective contraception than non-diabetic females. Common causes for this finding were inadequate contraception counseling, lack of consistent contraception use, not planning pregnancies, and not seeking preconception care. The consequences of an unplanned diabetic pregnancy affect both the pregnant person and the fetus.

Risks faced by a newborn if born to a female with diabetes include:

• Stillbirth: A fetus is five times more likely to die in utero (in the uterus), especially if the pregnant person's A1C level (how well your body controls blood sugar) is 10% or greater.
• Perinatal death: Infants are three times as likely to die within the first few months of life.
• Congenital abnormalities: Babies are twice as likely to have a significant congenital anomaly (unusual body structure or function present at birth).

Risks to a diabetic pregnant person include:

• Cesarean birth: Diabetic people can have large babies due to uncontrolled blood sugar levels. A large baby can increase the risk of cesarean delivery (C-section).
• High blood pressure: Pregnant people with type 1 or 2 diabetes are at higher risk for hypertension during pregnancy (preeclampsia).
• Stroke: Hypertension can result in a stroke during labor and delivery.

Diabetes Interactions Based on Type

Birth control medications are either hormonal or non-hormonal. If you have diabetes and want birth control coverage all the time, you may want a hormone-based contraceptive. If you prefer protection on an as-need basis, then non-hormonal options may be a better choice.

Hormonal

Hormonal contraceptives release a steady amount of estrogen and/or progestin into your system each day, preventing ovulation. Types of hormonal birth control include:

• Birth control pills: Combined oral contraceptives (COCs) contain estrogen and progestin. There are also birth control pills containing only progestin (POPs). COCs and POPs are safe for most people with diabetes without cardiovascular (heart) disease or risk of blood clots.
• Skin patch: Placed on a non-bony area of the body, estrogen and progestin can enter the bloodstream through the skin. This method has been proven safe for most diabetic people.
• Vaginal ring: Estrogen and progestin are released from the ring and enter the bloodstream through the vaginal wall for three weeks. There are no contraindications for people with diabetes.
• Intrauterine device (IUD): This small T-shaped piece of plastic continually releases the hormone levonorgestrel. An IUD can stay in the uterus for three to five years.

Non-Hormonal

If hormonal birth control is not a good option, there are still ways to prevent pregnancy in people with diabetes. Common non-hormonal birth control methods include:

• Copper IUD: Like the hormonal version, the copper IUD is placed in the uterus for up to 10 years. The device prevents the implantation of a fertilized egg, thus preventing pregnancy.
• Barrier methods: A condom, cervical cap, sponge, and diaphragm are ways to block sperm from entering the uterus, preventing fertilization of an egg.
• Spermicide: Spermicides come in foam, jelly, cream, or suppository forms and contain a toxic chemical resulting in sperm death.
• Vaginal gel: Phexxi makes the vagina more acidic, decreasing the sperm's ability to fertilize an egg.
• Sterilization: Birth control that is permanent and prevents pregnancy by the male or female is called sterilization. Tubal ligation and vasectomy are types of permanent birth control.

Finding the Right Method for You

There is no perfect birth control for people with diabetes. Choosing a safe, consistent, and effective method is most important in preventing pregnancy. Being well-informed about contraceptive choices is the first step, followed by understanding how those methods may or may not affect diabetes and blood sugar. Communication between you and your healthcare provider should be nonjudgmental, informative, and supportive.

Summary

Although certain types of birth control may increase blood sugar, evidence shows that most birth control methods are suitable for people with diabetes. Unfortunately, contraceptives are under-used in the diabetic population, resulting in high-risk pregnancies.

Being well-informed about birth control options is essential to preventing pregnancy. People with diabetes should speak to their healthcare providers about safe and effective contraception.

A Word From Verywell

Diabetes can lead to several health complications, including high-risk pregnancy. Using birth control may feel like one more thing to do on a long list of ways to manage diabetes, but you're not alone. Birth control should be a regular discussion between you and your healthcare provider. You may need to initiate the conversation, but choosing safe and effective contraception is essential to your well-being.