Serenity Mirabito, MSN, RN, OCN, is a published oncology nurse writer who advocates for those surviving and thriving with cancer.
Do-Eun Lee, MD, has been practicing medicine for more than 20 years, and specializes in diabetes, thyroid issues and general endocrinology. She currently has a private practice in Lafayette, CA.
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.
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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.
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:
Risks to a diabetic pregnant person include:
Studies clearly show that preconception diabetes education is sub-optimal. If you have diabetes and do not want to conceive, you should contact your healthcare provider to discuss safe contraceptive choices.
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 contraceptives release a steady amount of estrogen and/or progestin into your system each day, preventing ovulation. Types of hormonal birth control include:
Emergency progestin-only contraceptive (morning-after pill) is safe for people with diabetes. However, it should be taken as soon as possible to be effective.
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:
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.
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.
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.
There is no perfect birth control method for people with diabetes. The best contraceptive is one that is safe, consistent, and effective.
Increased levels of estrogen and progesterone can cause sugar cravings. Since hormonal contraceptives increase these hormones to prevent ovulation, some people may experience sugar cravings while taking them.
Centers for Disease Control and Prevention. Type 1 or type 2 diabetes and pregnancy.
Robinson A, Nwolise C, Shawe J. Contraception for women with diabetes: challenges and solutions. Open Access J Contracept. 2016;7:11-18. doi:10.2147/OAJC.S56348
Britton LE, Hussey JM, Berry DC, et al. Contraceptive use among women with prediabetes and diabetes in a us national sample. J Midwifery Womens Health. 2019;64(1):36-45. doi:10.1111/jmwh.12936
American Diabetes Association. Diabetes and pregnancy.
Centers for Disease Control and Prevention. Diabetes and pregnancy.
Nwolise CH, Carey N, Shawe J. Preconception care education for women with diabetes: a systematic review of conventional and digital health interventions. J Med Internet Res. 2016;18(11):e291. doi:10.2196/jmir.5615
National Institute of Health. Contraception: hormonal contraceptives.
National Institutes of Health. Contraception and birth control.
Serenity Mirabito, MSN, RN, OCN, advocates for well-being, even in the midst of illness. She believes in arming her readers with the most current and trustworthy information leading to fully informed decision making.
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