Someone asked us:

Q. I can’t take birth control pills (the estrogen in them gives me massive migraines). What other types of birth control are out there that don’t involve changing a person’s hormones.

Bummer about the migraines, but fortunately there are a lot of birth control options available for someone who wants to avoid estrogen, or hormonal contraception altogether.

If estrogen is the problem, there are hormonal birth control methods that do NOT contain estrogen, but instead use a different hormone — progestin — to prevent pregnancy. Check out the birth control shot, implant, the Mirena IUD, or even progestin-only birth control pills.

If you need to avoid hormones altogether, the most effective form of birth control (other than abstinence) is the ParaGard IUD - a small device that is inserted into the uterus by a health care provider and left there for as long as you want, up to 10-12 years. It doesn’t contain any hormones and is 99% effective at preventing pregnancy.

The diaphragm, cervical cap, sponge, condom, and female condom (which can also be used by anyone to protect against sexually transmitted infections during vaginal AND anal sex) are all barrier methods of birth control that don’t involve any hormones. They work by creating a physical barrier that prevent sperm and egg from meeting up.

Various forms of spermicide can be inserted into the vagina before intercourse and release chemicals that prevents sperm from reaching an egg.

There are actions people can take that can help them avoid pregnancy while sexually active; things like avoiding ejaculation inside of the vagina (withdrawal), and avoiding vaginal intercourse during the times in the menstrual cycle when pregnancy is most likely to happen (fertility awareness-based methods).

For permanent, non-reversible birth control, vasectomy and sterilization are two options. 

As you can see, even someone who wants to avoid birth control that contains estrogen has a lot of options!

-Nathan at PPFA