Dear Alice,

I am seeing a guy I love and we are both thinking of consummating our relationship soon. We are both adults and this will be the first time for both of us. This is great, but also a bit scary in terms of the necessary protection.

To add to that, I have Hashimoto's, a reason why I am a bit worried about taking birth control pills. I would seriously prefer birth control pills (while using the condoms of course), but friends who have had hypothyroidism have warned me against birth control unless I begin taking thyroid supplements (which i have been advised are premature at this stage). I would really like to know if this is a valid concern and in which case, what I should do.

Hope to hear from you,

Dear xoxo,

Kudos to you for being so thoughtful and intentional about birth control and STI prevention as you approach your first time! For readers less familiar with Hashimoto’s, it’s a disease in which a person’s immune system attacks the thyroid gland. The disease has no symptoms initially, but progresses slowly and usually results in hypothyroidism, a drop in thyroid hormone levels. Thyroid hormones are essential in influencing heart rate, regulating the use of fats, the production or protein, and other functions. Symptoms of hypothyroid can include weight gain, dry skin, puffiness in the face, joint and muscle pain, constipation, and sluggishness. In more severe cases, untreated hypothyroidism can cause depression, birth defects, and coma if sedatives are taken.

As for taking birth control, this shouldn’t present a problem, but check with your health care provider just to be sure. For someone on hormone replacement therapy, certain medications (including some forms of birth control) can interact with the synthetic thyroid hormone in such a way that a higher than normal dose of thyroid may need to be prescribed. Your friends with hypothyroidism may already be on this medication, but since your Hashimoto’s has not progressed to the stage of needing hormone replacement, this should not be an issue. A health care provider, however, will know for certain if birth control is 100% for you to use or not.

If taking birth control does present a problem, know that condoms are very effective forms of birth control and safer sex. When used properly, they are 98% effective against pregnancy (see the related questions below for more information).

Here’s to happy firsts and thinking ahead!


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