Table of ContentsView AllTable of ContentsEffects on the ThyroidEffects on TestsEffects on Birth ControlStopping Birth ControlFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Effects on the Thyroid
Effects on Tests
Effects on Birth Control
Stopping Birth Control
Frequently Asked Questions
Thethyroid glandis a butterfly-shaped organ located in the lower part of your neck. It sits a little below the Adam’s apple (the laryngeal prominence) and above the collarbone (clavicle). This gland is part of the endocrine system and plays an essential role in women’s health. It produces just the right amount oftriiodothyronine(T3) andthyroxine(T4) hormones that are critical for:
Hypothyroidismoccurs when the thyroid is underactive and doesn’t produce enough hormones.It affects 1 in 300 people in the United States and is most common among people assigned female at birth and older adults.Alternatively,hyperthyroidismoccurs when the thyroid is overactive and produces too many hormones.
This article reviews the link between birth control and hypothyroidism, including how birth control affects the thyroid and lab test results and what to expect when you go off birth control.
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How to Tell the Difference Between Hyperthyroidism and Hypothyroidism
How Does Birth Control Affect the Thyroid?
Hormonal birth controlcontains reproductive hormones, including estrogen,progesterone, or a combination of both, and comes in various forms including:
An Overview of Birth Control
Reproductive hormones, includingestrogen, work closely withthyroidhormones. The estrogen in most hormonal birth control can alter how thyroid hormones are made, used, and converted.
Estrogen increasesthyroid-binding globulins(TBG), which prevents thyroid hormones from freely circulating in your blood. It can also influence iodine uptake. This is significant becauseiodine deficiencyis the leading cause of hypothyroidism.
Research suggests that longtime use of hormonal birth control is strongly associated with hypothyroidism. This is especially true for those who have taken hormonal birth control for over 10 years.
A healthcare provider may still advise you to take hormonal birth control if you have hypothyroidism. However, they may want to increase your dose of thyroid medication and monitor you more closely.
Nonhormonal Birth Control MethodsA healthcare provider may recommend birth control methods that don’t include hormones. Examples are:Internal condomsExternal condomsSpermicidesPhexxi(hormone-free gel inserted into the vagina before sex)DiaphragmBirth controlspongeCervical capsNonhormonal intrauterine device (IUD)Family planningTubal ligation(surgery to clip fallopian tubes)Vasectomy(surgery to close the tube that stores and carries sperm cells in a testicle)
Nonhormonal Birth Control Methods
A healthcare provider may recommend birth control methods that don’t include hormones. Examples are:Internal condomsExternal condomsSpermicidesPhexxi(hormone-free gel inserted into the vagina before sex)DiaphragmBirth controlspongeCervical capsNonhormonal intrauterine device (IUD)Family planningTubal ligation(surgery to clip fallopian tubes)Vasectomy(surgery to close the tube that stores and carries sperm cells in a testicle)
A healthcare provider may recommend birth control methods that don’t include hormones. Examples are:
Drugs, including hormonal birth control, can affect how thyroid medication is absorbed and can decrease its effectiveness.This doesn’t mean you can’t take these medications, but it’s important to provide healthcare providers with a current medication list. This way, they can check for drug interactions, monitor you more closely, and adjust medications' dosages and timing as needed.
Medication InteractionsWhile this is not a complete list, examples of medications that affect absorption include:Hormonal birth controlEstrogen replacementTestosterone replacementSomeseizure medicationsCertain antidepressants, includingProzac(fluoxetine)Some barbiturates (mild sedatives that reduce anxiety and are used in seizure prevention)Cholesterol medications including statins such as Lipitor (atorvastatin)Rifadin or Rimactane (rifampicin) (an antibiotic used totreat tuberculosis)For best absorption of your thyroid medication, it’s best to avoid taking the following medications within four hours of taking your thyroid medication:AntacidsCalciumCholesterol medication such as Colestid (colestipol)IronMultivitamins
Medication Interactions
While this is not a complete list, examples of medications that affect absorption include:Hormonal birth controlEstrogen replacementTestosterone replacementSomeseizure medicationsCertain antidepressants, includingProzac(fluoxetine)Some barbiturates (mild sedatives that reduce anxiety and are used in seizure prevention)Cholesterol medications including statins such as Lipitor (atorvastatin)Rifadin or Rimactane (rifampicin) (an antibiotic used totreat tuberculosis)For best absorption of your thyroid medication, it’s best to avoid taking the following medications within four hours of taking your thyroid medication:AntacidsCalciumCholesterol medication such as Colestid (colestipol)IronMultivitamins
While this is not a complete list, examples of medications that affect absorption include:
For best absorption of your thyroid medication, it’s best to avoid taking the following medications within four hours of taking your thyroid medication:
Can Birth Control Alter Thyroid Test Results?
Thepituitary glandproduces the TSH that helps your thyroid gland release T3 and T4. When T3 and T4 levels are low, the pituitary makes more TSH. High levels of TSH and low levels of T4 often indicate hypothyroidism.
The estrogen in hormonal birth control can affect thyroid test results even if you do not have a thyroid disorder. Estrogen can increase the T3 and T4 levels. However, the TSH typically stays within the normal range.
T3 LevelsT3 levels are the last to become abnormal. They are more useful when diagnosing hyperthyroidism rather than hypothyroidism.
T3 Levels
T3 levels are the last to become abnormal. They are more useful when diagnosing hyperthyroidism rather than hypothyroidism.
Can Hypothyroidism Affect the Effectiveness of Birth Control?
While there is no evidence that abnormal thyroid function or thyroid medications affect the performance of birth control, it’s always best to speak to a healthcare provider about your specific situation.
The best way to ensure oral birth control pills are 99%effectiveatsuppressing ovulationis to take them consistently and correctly. When not taken consistently at the same time each day, the failure or pregnancy rate is about 4% to 7%.
Tips for Taking Thyroid MedicationThyroid medications are prescribed in tiny doses. Small changes, including switching brands, can affect how they work. Simultaneously taking other medications or eating can decrease absorption. The following tips can help you avoid some of these concerns:Take your thyroid medication on an empty stomach and avoid food for 45 minutes to an hour.Take it at the same time each day.Let a healthcare provider know if you wish to change brands, switch to generic, or stop the medication.Notify a healthcare provider if you have any of the following symptoms. They may indicate your dose is too high:Heart palpitationsAnxiety or restlessnessShakinessSweatingRapid weight changes
Tips for Taking Thyroid Medication
Thyroid medications are prescribed in tiny doses. Small changes, including switching brands, can affect how they work. Simultaneously taking other medications or eating can decrease absorption. The following tips can help you avoid some of these concerns:Take your thyroid medication on an empty stomach and avoid food for 45 minutes to an hour.Take it at the same time each day.Let a healthcare provider know if you wish to change brands, switch to generic, or stop the medication.Notify a healthcare provider if you have any of the following symptoms. They may indicate your dose is too high:Heart palpitationsAnxiety or restlessnessShakinessSweatingRapid weight changes
Thyroid medications are prescribed in tiny doses. Small changes, including switching brands, can affect how they work. Simultaneously taking other medications or eating can decrease absorption. The following tips can help you avoid some of these concerns:
Notify a healthcare provider if you have any of the following symptoms. They may indicate your dose is too high:
How to Take Thyroid Medication Including Levothyroxine
What to Expect When Going Off Birth Control
Talk with a healthcare provider if you stop taking hormonal birth control. If you take thyroid medication, your provider may need to decrease your dose as the thyroid medication should work more efficiently once you’re off hormones.
A healthcare provider will also want to monitor your TSH blood levels regularly to ensure you get the correct thyroid medication dose.
Otherwise,stopping birth controlcan be done safely at any time. You may notice some menstrual irregularities or spotting between periods. This is typically temporary and resolves within a few months.
Remember that you can get pregnant as soon as you stop taking birth control. If you are not planning to get pregnant, use another form of birth control, such as condoms or a diaphragm.
If you do become pregnant, notify a healthcare provider. They may want to adjust your thyroid medication dose and monitor thyroid levels to promote a healthy pregnancy.
Hypothyroidism and Infertility
In one study, 76.6% of women with infertility due to hypothyroidism got pregnant within six weeks to a year after starting thyroid medication.Another smaller study showed that 33% of women got pregnant six weeks to two years after starting thyroid medication.
Summary
Hypothyroidism is a disorder where the thyroid doesn’t produce enough hormones. Estrogen, a hormone in most hormonal birth control, can alter how thyroid hormones are produced and work. Long-term use (over 10 years) of hormonal birth control increases your risk of hypothyroidism.
Estrogen can also affect the T3 and T4 thyroid blood test results, even if you do not have a thyroid disorder. However, it does not typically affect TSH levels.
You can still take birth control if you have hypothyroidism. However, a healthcare provider may want to increase your dose of thyroid medication and monitor you more closely. Talk with a healthcare provider if you decide to stop taking hormonal birth control; they may want to decrease your dose.
A Word From Verywell
Many women take hormonal birth control at some point in their life. The thought of it leading to hypothyroidism can be concerning. Keep in mind that the risk is small and usually only results from long-term use.
Talk with a healthcare provider if you are concerned about your specific situation. They can also discuss nonhormonal birth control options if that is best for you.
Frequently Asked QuestionsYou can take birth control and thyroid medication on the same day but not simultaneously. It’s best to leave a four-hour window between them. Many women take thyroid medicine in the morning, wait 45 minutes to eat breakfast, and then take birth control in the evening. A healthcare provider may want to adjust your thyroid medication when you start or stop hormonal birth control.Untreated hypothyroidism can increase your risk of infertility (not getting pregnant). However, your chances of getting pregnant increase when thyroid levels are corrected through medication.One study found that 76.6% of women got pregnant within six weeks to a year of starting thyroid medication.Another smaller study showed that 33% of women got pregnant six weeks to two years after starting thyroid medication.Infertility is a common problem for women with hypothyroidism, especially when untreated. One study showed a 23.9% rate of infertility among women who had hypothyroidism. However, many of these women got pregnant six weeks to a year after starting thyroid medication.
You can take birth control and thyroid medication on the same day but not simultaneously. It’s best to leave a four-hour window between them. Many women take thyroid medicine in the morning, wait 45 minutes to eat breakfast, and then take birth control in the evening. A healthcare provider may want to adjust your thyroid medication when you start or stop hormonal birth control.
Untreated hypothyroidism can increase your risk of infertility (not getting pregnant). However, your chances of getting pregnant increase when thyroid levels are corrected through medication.One study found that 76.6% of women got pregnant within six weeks to a year of starting thyroid medication.Another smaller study showed that 33% of women got pregnant six weeks to two years after starting thyroid medication.
Untreated hypothyroidism can increase your risk of infertility (not getting pregnant). However, your chances of getting pregnant increase when thyroid levels are corrected through medication.
One study found that 76.6% of women got pregnant within six weeks to a year of starting thyroid medication.Another smaller study showed that 33% of women got pregnant six weeks to two years after starting thyroid medication.
Infertility is a common problem for women with hypothyroidism, especially when untreated. One study showed a 23.9% rate of infertility among women who had hypothyroidism. However, many of these women got pregnant six weeks to a year after starting thyroid medication.
17 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Qiu Y, Hu Y, Xing Z, et al.Birth control pills and risk of hypothyroidism: a cross-sectional study of the national health and nutrition examination survey, 2007-2012.BMJ Open. 2021;11(6):e046607. doi:10.1136/bmjopen-2020-046607MedlinePlus.Thyroid tests.Wilson S, Stem L, Bruehlman R.Hypothyroidism: diagnosis and treatment.Am Fam Physician. 2021;103(10):605-613.Britton L, Alspaugh A, Greene M, et al.Ce: an evidence-based update on contraception.Am J Nurs. 2020;120(2):22-33. doi:10.1097/01.NAJ.0000654304.29632.a7Planned Parenthood.Birth control.Torre F, Calogero A, Condorelli R, et al.Effects of oral contraceptives on thyroid function and vice versa.J Endocrinol Invest. 2020;43(9):1181-1188. doi: 10.1007/s40618-020-01230-8The American College of Obstetricians and Gynecologists.Combined hormonal birth control: pill, patch, and ring.Johns Hopkins Medicine.Thyroid medication.The Pharmaceutical Journal.Thyroid dysfunction and drug interactions.Lai J, Xu D, Peterson B, et al.Reversible fluoxetine-induced hyperthyroidism: a case report.Clin Neuropharmacol. 2016;39(1):60-61. doi:10.1097/WNF.0000000000000116MedlinePlus.Hypothyroidism.American Thyroid Association.Thyroid function tests.Teal S, Edelman A.Contraception selection, effectiveness, and adverse effects: a review.JAMA. 2021;326(24):2507-2518. doi: 10.1001/jama.2021.21392Planned Parenthood.How do you stop taking birth control pills?Koyyada A, Orsu P.Role of hypothyroidism and associated pathways in pregnancy and infertility: clinical insights.Tzu Chi Med J. 2020;32(4):312-317. doi:10.4103/tcmj.tcmj_255_19Verma I, Sood R, Juneja S, et al.Prevalence of hypothyroidism in infertile women and evaluation of response of treatment for hypothyroidism on infertility.Int J Appl Basic Med Res. 2012;2(1):17-19. doi:10.4103/2229-516X.96795Priya D, Akhtar N, Ahmad J.Prevalence of hypothyroidism in infertile women and evaluation of response of treatment for hypothyroidism on infertility.Indian J Endocrinol Metab. 2015;19(4):504-506. doi:10.4103/2230-8210.159058
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Qiu Y, Hu Y, Xing Z, et al.Birth control pills and risk of hypothyroidism: a cross-sectional study of the national health and nutrition examination survey, 2007-2012.BMJ Open. 2021;11(6):e046607. doi:10.1136/bmjopen-2020-046607MedlinePlus.Thyroid tests.Wilson S, Stem L, Bruehlman R.Hypothyroidism: diagnosis and treatment.Am Fam Physician. 2021;103(10):605-613.Britton L, Alspaugh A, Greene M, et al.Ce: an evidence-based update on contraception.Am J Nurs. 2020;120(2):22-33. doi:10.1097/01.NAJ.0000654304.29632.a7Planned Parenthood.Birth control.Torre F, Calogero A, Condorelli R, et al.Effects of oral contraceptives on thyroid function and vice versa.J Endocrinol Invest. 2020;43(9):1181-1188. doi: 10.1007/s40618-020-01230-8The American College of Obstetricians and Gynecologists.Combined hormonal birth control: pill, patch, and ring.Johns Hopkins Medicine.Thyroid medication.The Pharmaceutical Journal.Thyroid dysfunction and drug interactions.Lai J, Xu D, Peterson B, et al.Reversible fluoxetine-induced hyperthyroidism: a case report.Clin Neuropharmacol. 2016;39(1):60-61. doi:10.1097/WNF.0000000000000116MedlinePlus.Hypothyroidism.American Thyroid Association.Thyroid function tests.Teal S, Edelman A.Contraception selection, effectiveness, and adverse effects: a review.JAMA. 2021;326(24):2507-2518. doi: 10.1001/jama.2021.21392Planned Parenthood.How do you stop taking birth control pills?Koyyada A, Orsu P.Role of hypothyroidism and associated pathways in pregnancy and infertility: clinical insights.Tzu Chi Med J. 2020;32(4):312-317. doi:10.4103/tcmj.tcmj_255_19Verma I, Sood R, Juneja S, et al.Prevalence of hypothyroidism in infertile women and evaluation of response of treatment for hypothyroidism on infertility.Int J Appl Basic Med Res. 2012;2(1):17-19. doi:10.4103/2229-516X.96795Priya D, Akhtar N, Ahmad J.Prevalence of hypothyroidism in infertile women and evaluation of response of treatment for hypothyroidism on infertility.Indian J Endocrinol Metab. 2015;19(4):504-506. doi:10.4103/2230-8210.159058
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Qiu Y, Hu Y, Xing Z, et al.Birth control pills and risk of hypothyroidism: a cross-sectional study of the national health and nutrition examination survey, 2007-2012.BMJ Open. 2021;11(6):e046607. doi:10.1136/bmjopen-2020-046607MedlinePlus.Thyroid tests.Wilson S, Stem L, Bruehlman R.Hypothyroidism: diagnosis and treatment.Am Fam Physician. 2021;103(10):605-613.Britton L, Alspaugh A, Greene M, et al.Ce: an evidence-based update on contraception.Am J Nurs. 2020;120(2):22-33. doi:10.1097/01.NAJ.0000654304.29632.a7Planned Parenthood.Birth control.Torre F, Calogero A, Condorelli R, et al.Effects of oral contraceptives on thyroid function and vice versa.J Endocrinol Invest. 2020;43(9):1181-1188. doi: 10.1007/s40618-020-01230-8The American College of Obstetricians and Gynecologists.Combined hormonal birth control: pill, patch, and ring.Johns Hopkins Medicine.Thyroid medication.The Pharmaceutical Journal.Thyroid dysfunction and drug interactions.Lai J, Xu D, Peterson B, et al.Reversible fluoxetine-induced hyperthyroidism: a case report.Clin Neuropharmacol. 2016;39(1):60-61. doi:10.1097/WNF.0000000000000116MedlinePlus.Hypothyroidism.American Thyroid Association.Thyroid function tests.Teal S, Edelman A.Contraception selection, effectiveness, and adverse effects: a review.JAMA. 2021;326(24):2507-2518. doi: 10.1001/jama.2021.21392Planned Parenthood.How do you stop taking birth control pills?Koyyada A, Orsu P.Role of hypothyroidism and associated pathways in pregnancy and infertility: clinical insights.Tzu Chi Med J. 2020;32(4):312-317. doi:10.4103/tcmj.tcmj_255_19Verma I, Sood R, Juneja S, et al.Prevalence of hypothyroidism in infertile women and evaluation of response of treatment for hypothyroidism on infertility.Int J Appl Basic Med Res. 2012;2(1):17-19. doi:10.4103/2229-516X.96795Priya D, Akhtar N, Ahmad J.Prevalence of hypothyroidism in infertile women and evaluation of response of treatment for hypothyroidism on infertility.Indian J Endocrinol Metab. 2015;19(4):504-506. doi:10.4103/2230-8210.159058
Qiu Y, Hu Y, Xing Z, et al.Birth control pills and risk of hypothyroidism: a cross-sectional study of the national health and nutrition examination survey, 2007-2012.BMJ Open. 2021;11(6):e046607. doi:10.1136/bmjopen-2020-046607
MedlinePlus.Thyroid tests.
Wilson S, Stem L, Bruehlman R.Hypothyroidism: diagnosis and treatment.Am Fam Physician. 2021;103(10):605-613.
Britton L, Alspaugh A, Greene M, et al.Ce: an evidence-based update on contraception.Am J Nurs. 2020;120(2):22-33. doi:10.1097/01.NAJ.0000654304.29632.a7
Planned Parenthood.Birth control.
Torre F, Calogero A, Condorelli R, et al.Effects of oral contraceptives on thyroid function and vice versa.J Endocrinol Invest. 2020;43(9):1181-1188. doi: 10.1007/s40618-020-01230-8
The American College of Obstetricians and Gynecologists.Combined hormonal birth control: pill, patch, and ring.
Johns Hopkins Medicine.Thyroid medication.
The Pharmaceutical Journal.Thyroid dysfunction and drug interactions.
Lai J, Xu D, Peterson B, et al.Reversible fluoxetine-induced hyperthyroidism: a case report.Clin Neuropharmacol. 2016;39(1):60-61. doi:10.1097/WNF.0000000000000116
MedlinePlus.Hypothyroidism.
American Thyroid Association.Thyroid function tests.
Teal S, Edelman A.Contraception selection, effectiveness, and adverse effects: a review.JAMA. 2021;326(24):2507-2518. doi: 10.1001/jama.2021.21392
Planned Parenthood.How do you stop taking birth control pills?
Koyyada A, Orsu P.Role of hypothyroidism and associated pathways in pregnancy and infertility: clinical insights.Tzu Chi Med J. 2020;32(4):312-317. doi:10.4103/tcmj.tcmj_255_19
Verma I, Sood R, Juneja S, et al.Prevalence of hypothyroidism in infertile women and evaluation of response of treatment for hypothyroidism on infertility.Int J Appl Basic Med Res. 2012;2(1):17-19. doi:10.4103/2229-516X.96795
Priya D, Akhtar N, Ahmad J.Prevalence of hypothyroidism in infertile women and evaluation of response of treatment for hypothyroidism on infertility.Indian J Endocrinol Metab. 2015;19(4):504-506. doi:10.4103/2230-8210.159058
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