Episode Transcript
Interviewer: You might be having an allergic reaction to your birth control, but maybe you're not. Let's find out next on The Scope.
Announcer: Questions every woman wonders about her health, body and mind. This is "Am I Normal?" on The Scope.
Interviewer: We're talking to Dr. Kirtly Parker Jones. She's our expert on all things women. So, Dr. Jones, we've been getting a lot of emails about women who are having "allergies" with their birth control, they're just having some sort of reaction to it and they're thinking its allergies. Is it even possible to have allergies with your birth control?
Dr. Jones: Okay, well, let's talk about what an allergy is. An allergy, or an allergic reaction, is where your body recognizes a substance as foreign, makes an antibody to it, and that causes a process, an allergic reaction, that can cause itching, hives, can cause swelling of your throat, difficulty breathing, low blood pressure and passing out. Not necessarily all of those, but it could be. In reality with respect to birth control it is rare for someone to be truly allergic to birth control. The reason is, with respect to birth control hormones, is the hormones are very much like your own hormones and it's unlikely that you're going to be allergic to it.
Now, sometimes birth control pills have dye, have colors in it, so you know when you open your pack there some blue ones or pink ones, so some people are allergic to the dye, probably not so much the hormones. In birth control shots like Depo-Provera, that's a brand, the carrier or the liquid that's in there you may be allergic to that. There are women who actually have allergy to nickel, that's pretty common, but in fact there aren't any birth control methods with nickel and the copper IUD is copper and it is rare to have someone truly allergic to copper because we all need copper in our body, so we're not allergic to it.
There are people who are truly allergic to latex, as in condoms. So yes, that can cause shortness of breath and hives and itching and all those things, so some people are allergic to latex condoms and some people are allergic to that foreign substances, of which there are quite a few, in spermicides. So when you're using a foam or a gel or something which is a spermicide in conjunction with your condom some people are allergic to those. But in terms of birth control pills or birth control shots or birth control implants or IUD's, true allergies are very rare, meaning less than maybe 1 in a 1,000.
Interviewer: So then is it normal?
Dr. Jones: To be allergic? It is not normal. To have side effects? Yes. Let's go back to that normal thing. So something is not normal if it happens to less than 5% of women and side effects happen to more than 5% of women. Now, side effects happen to women because the hormones in either the pill or the hormonal IUD changes some parts of their bodies. So remember estrogens and progestins, the other hormone that is often in birth control methods, they change your body. That happens to you in your natural hormonal cycle and it may change your body when you use them in birth control. So when people say, "I have breast tenderness," or, "I have nausea," or, "I got some acne from that pill."
Interviewer: That's a side effect.
Dr. Jones: That's a side effect, and a side effect isn't an allergy. The other thing is that life happens and some people have things happen concurrently when they're starting a new birth control method. When people say, "Oh, I must be having a side effect from my IUD because I'm crying all the time." "Well, how long have you had that IUD?" "Over four years." Well, in fact, that's not your IUD. What else is happening in your life?
So when you do studies of birth control methods, you often do a placebo-controlled trial. So when you're looking at things like headache and nausea and breast tenderness, you often find that those happen in people who were given a placebo. It's clear that the real attributable number of people who have a side effect would be the number of people who had it with the real drug minus the number of people who had it with the placebo. So headaches, nausea, not feeling well, mood, those can change just because and you just happen to be on birth control at the same time.
So side effects from birth control pills are common and I consider them normal. In fact, some side effects of something like the levonorgestrel IUD, the hormonal IUD of irregular bleeding or very light periods or no periods, that's actually not a side effect. That's a direct cause and some people are annoyed by the irregular bleeding but some people really like the little light periods.
Interviewer: You're still okay.
Dr. Jones: You're still okay. Now if it turns out . . . so when you first start something like birth control pills, headache, nausea, and breast tenderness may be very common side effects, they tend to go away though. So if it's persisted over three cycles, if you can hang out with it, it actually tends to get better.
Interviewer: If you can hang out with it?
Dr. Jones: Yeah, if you can hang out with it. But remember when you say allergy you're really talking about a very specific set of symptoms which are quite rare with birth control methods except latex condoms and some spermicidal gels, but talk to your doctor about it, talk to your doctor. Hopefully they're experienced enough about it or they can call an expert.
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updated: October 4, 2018
originally published: April 22, 2016