Can contraception make you tired?

Some menstruators have noticed that they feel tired when using hormonal contraceptives such as birth control pills. Fatigue and menstruation are indeed linked, but it’s more complicated than simple cause and effect.

Read on to learn more about how hormones, menstruation, and birth control can affect sleep and fatigue.

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What the research shows

There is conflicting research on how hormonal birth control pills affect sleep and fatigue.

A 2020 study found that people who used hormonal birth control had subjectively worse sleep and more self-reported sleep problems, including insomnia and daytime sleepiness, than those who didn’t use them.

Progestogen-only contraceptives have been shown to be worse for sleep than combined hormonal contraceptives.

The authors of this study noted that these results contradict evidence showing female sex hormones in particular progesterone, have hypnogenic effects (falling asleep). They hypothesized that the timing of taking the pill might play a role, suggesting that taking it in the morning may induce daytime sleepiness, while taking it at night could promote sleep. They note that this is highly speculative and would need research to confirm.

In contrast, a 2012 study found that hormonal birth control was associated with improved sleep efficiency and reduced severity of sleep apnea (a sleep disorder that causes breathing problems during sleep).

Many organizations, including Planned Parenthood and the FDA, do not include fatigue in their list of the most common side effects of hormonal birth control. The FDA mentions fatigue as a side effect of emergency contraception (the “morning after pill”).

Progestin vs Progesterone

Although the terms sound similar, progestin and progesterone are not the same:

  • progesterone: A hormone produced in the ovaries
  • progestin: A synthetic form of progesterone

Hormonal birth control may be the culprit

How can hormonal birth control cause fatigue?

The two most important female sex hormones estrogen and progesterone are believed to affect sleep. Progesterone is considered to be particularly sleep-inducing. Estrogen, although less studied in this area, may also have a sleep-promoting effect, as suggested by estrogen replacement therapy, which improves sleep-related symptoms perimenopausal People.

The use of hormonal birth control can also indirectly affect sleep and wakefulness. Although more research is needed, hormonal birth control use has been linked to depression. Fatigue is a well-known symptom of depression.

While the research is conflicting, some people who are menstruating report fatigue while using hormonal birth control, which improves when they stop using that particular method.

Do you tend to get tired during your period?

If you tend to get tired during your menstrual cycle, discuss this with your doctor before starting hormonal birth control.

Types of hormonal contraception

Types of hormonal contraceptives include:

How to switch birth control

If you want to switch birth control pills, talk to your doctor. Depending on the type of pills you use, there are different strategies to choose from.

Options to switch between combination pills:

  1. Complete the entire pack, including week 4 placebos, using your old method. Start the new method pack on the day you would have started the first day of the old pack. Or,
  2. Start the new COC right away, but if it has been more than five days since the menstrual period started, use a backup method (such as a condom) or refrain from sex for the next seven days.

Switching from the combination pill to the minipill:

  1. If there has been no menstrual bleeding for more than five days, take your minipill right away, refrain from sex, or use a backup method for the next two days.

Switching from the minipill to the combination pill:

  1. Start the COC immediately, but if it has been more than five days since your menstrual period, do not have sex for the next seven days or use an alternative method (e.g. a condom).

Premenstrual Syndrome (PMS)

The menstrual cycle can also affect sleep and wakefulness. People who are menstruating may experience increased sleepiness and insomnia during the premenstrual period (also called the luteal phase).

People with premenstrual syndrome (PMS) may experience the following symptoms:

  • depression
  • irritability
  • difficulty concentrating
  • fear
  • social retreat
  • insomnia
  • fatigue
  • breast tenderness
  • gas
  • headache
  • swelling of hands/feet
  • discomfort and pain
  • Changes in thirst and appetite
  • Gastrointestinal complaints and abdominal pain

Premenstrual dysphoria (PMDD), a more serious and bothersome form of PMS, can occur in addition to the symptoms seen in PMS, including:

  • nervousness
  • agitation
  • anger
  • Severe tiredness
  • bad sleep
  • confusion
  • memory problems
  • moodiness
  • paranoia
  • Emotional Sensitivity
  • crying episodes

Other reasons for fatigue

Whether or not you use hormonal birth control, fatigue that is recurrent, intrusive, or not relieved by rest should be taken seriously and discussed with a doctor.

Fatigue can be a sign of a number of conditions, including:

Summary

Some people who have their periods report feeling tired or fatigued while using hormonal birth control pills.

Research is divided on whether or not hormonal birth control pills can cause fatigue. Possible reasons for this are sleep disorders, associations with depression and the sleep-promoting effect of sex hormones such as progesterone.

Fatigue can be a symptom of many other conditions, including PMS, anemia, hypothyroidism, depression, and sleep disorders like sleep apnea.

A word from Verywell

Birth control is not a one-size-fits-all. If you feel like your birth control is making you feel tired, talk to your doctor about other options available. Whether you’re using hormonal birth control or not, it’s important to talk to your doctor if you’re experiencing fatigue just in case it’s a symptom of something more serious.

frequently asked Questions

  • How does hormonal contraception work?

    The birth control pill prevents pregnancy by:

    • Changing hormone levels to prevent the release of an egg (ovulation).
    • Thickening of cervical mucus, making it difficult for sperm to enter the uterus
    • Thinning of the womb lining, which reduces the chance of a fertilized egg implanting

  • What are the side effects of contraception?

    Some common side effects of hormonal birth control are:

    • Spotting/bleeding between periods
    • breast tenderness
    • nausea
    • headache

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