Diabetes

The birth control pill may be safely taken by women with either a personal history or family history of diabetes melitus.

Women who have diabetes often find taking BCPs has either no effect on their diabetic control or else improves their control. Some women find they need more insulin while taking BCPs, but are otherwise satisfied with the pill and these women may safely take it. A few women find their diabetic control is adversely affected by the BCP. For those women, changing the pill may be tried, but often the BCP must be discontinued.

Women with a family history of diabetes generally have no trouble taking BCPs.  Very rarely, the BCPs may provoke diabetes (or unmask it). If this happens, alternative BCPs may be tried but usually the BCPs will be discontinued.

The reason for this generally stabilizing effect of birth control pills on diabetes is related to the ovarian suppression that is usually found. With ovarian suppression (caused by the progestin half of the BCP), the normal monthly wide swings in female hormones is suppressed. Instead, the pill substitutes its own hormones, providing typically lower and much more stable levels than if the woman didn't use the pill at all. This increased stability and lower overall hormone levels contribute to the stabilization of blood glucose so often seen among diabetic women taking birth control pills.

However, if the birth control pill fails to suppress ovarian function, then lower, more stable hormone levels do not occur...in fact, it's worse. This woman will still have the wide monthly fluctuations of her own hormones, plus the pill hormones which will aggravate the hormonal peaks. These women will probably not experience much in the way of glucose stabilization, and sometimes it becomes even less stable. Switching to a more powerful pill (low dose, stronger progestin with a longer half life) may be effective in controlling ovarian function.