Periods and contraception when you have type 1 diabetes

For those who menstruate, the monthly cycle and periods can cause blood glucose to change. Many of the young women we interviewed said that their blood glucose levels tend to fluctuate between low and high before and after their periods.

One young woman was prescribed a contraceptive pill to regulate her periods and she expects to take it until her twenties or when her blood glucose levels become more stable.

Another young woman stopped taking the pill because she found that her blood glucose levels went very high during the time of her period.

Says that her diabetes control has been affected by puberty, she experienced very heavy and…

Age at interview 17

Gender Female

Age at diagnosis 1

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You said that your control is not very good. What did you mean by that?

Well my control, yeah is not very good and it’s mainly because going through puberty your diabetes will go haywire pretty much. And then I had the whole feminine issue to deal with as well. So it wasn’t the best and so on about, when you’re say eighteen, nineteen, twenty your blood sugars sort of just naturally start to level off. Things like that. So yes.

So this is a particular tricky period?

Yeah.

They definitely fluctuate every month to, with my period. It’s strange [laugh]. Yeah they go. Generally I get low, lower when my period comes and then higher afterwards. So I just adjust the insulin, have a bit more to eat, things like that.

Did the diabetes care team tell you about it?

Yeah the diabetes, they have. They’ve helped a lot. Yeah they told me what to expect. How to deal with things like that. That was very good.

I’m on Microginol which is the pill because the diabetes complicated being a teenager. And long story short it mucked up my periods [laugh] and so I’m on the pill just to get that straightened out. And the pills quite good because it’s small and you don’t really notice it. Yeah but Metformin is not so good. I’m not really on anything else I don’t think [laugh].

What do you, when you said that the diabetes sort of had influenced your periods or messed them around what did you mean? What happened?

Well. Ok. First period I had was three, no four weeks long. It wasn’t like what, it was continual but it, it went from like heavy to light and intermittent. And then it stopped. The third period I had was two months long, constant heavy bleeding. Wasn’t the funnest thing ever. And, and that’s when I was just like, ok stop. I can’t take this anymore. So they put me on the pill to sort out my periods which stops long periods and it just makes, it makes it much equal, much more equal because the pill decides when. Well when you take the pill and when you’re off the pill you, you have the periods. So it decides when you have your period and obviously you have to take it every month. You have to take a pill a day for three weeks and then you’re off for a week and then it continues.

How did the doctor explain to you the connection between diabetes and your periods being so, lasting for so long?

I think generally it’s because diabetes just plays havoc with your hormones and also because I’m insulin resistant it didn’t really help and everything.

So you taking the pill [correction]has helped?

Yes definitely [laugh]. Yes. The pill [correction] is good. If they want to put it on it, go on it [laugh]. It’s definitely good. It doesn’t have any side-effects that I know of that affect me whereas Metformin does but I mean it’s ok.

And for how long do they reckon that you need to be on the pill?

Quite a while. They think I should be on it until I’m about mid-twenties just to make sure that I’ve got a steady cycle going and everything.

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All forms of contraception are suitable for people with diabetes.

The combined contraceptive pill (‘the pill’) is one of the most common types of contraception used by young women. It is very good at stopping you getting pregnant as long as it is taken according to the instructions, but it does not stop you getting a sexually transmitted infection. So it is always best to use condoms in addition to whatever other method is used if there is any risk of contracting a sexually transmitted infection. Also, it is important to know what to do if you miss any of the pills, especially pills 1–7 or 14–28 in the pack. If you do miss a pill or pills, check the information on the insert leaflet, or phone and ask your doctor if you are unsure what to do. You might need emergency contraception and/or to use other forms of contraception such as condoms for the next 7 days or it may be necessary to run 2 packets of pills together.

Sometimes women go onto the pill to help regulate their periods and some women do find the pill helps. The mini pill, coils and contraceptive injections can also be used. Your doctor will be happy to tell you more about the various alternatives, their advantages and disadvantages and discuss the best form of contraception for you.

Contraceptives and advice on their use can be obtained from your GP, young persons and family planning clinic. You can hear what other young people say about contraception and sexual health by going to our young people’s sexual health section.

Pregnancy and type 1 diabetes

If you think you might be pregnant, it is very important that you find out and get help straight away, especially if you have diabetes. Your GP, diabetes team or family planning clinic can arrange immediate testing for you.

If you are pregnant and have diabetes, you will have to work really hard to keep your blood glucose under control during the pregnancy. If you are planning a pregnancy, good control before you actually become pregnant is very important.

If an unborn baby is exposed to high blood glucose during the early weeks of development, there is a higher risk of problems such as spinal and heart deformities. Later on in the pregnancy, bad control can lead to problems with the baby controlling their own glucose levels when they are born.

If you are planning to have a baby or think you are pregnant then it is important that you speak to your diabetes care team as soon as possible for advice.