Hormonal birth control can affect people differently, including people with a history of fibroids or who may be at an increased risk. It’s unclear whether hormonal birth control increases or decreases your fibroid risk, and the impact on existing fibroids varies.

“Fibroids are benign overgrowths in the lining of the smooth muscle uterus,” says Jennifer Makarov, MD, OB-GYN, reproductive endocrinology and infertility specialist at New Hope Fertility Clinic in New York City.

The exact cause of fibroids isn’t currently known. But researchers believe they link to higher levels of certain hormones, such as estrogen and progesterone, says Yan Katsnelson, MD, founder and CEO of USA Clinics Group.

All hormonal contraceptives contain a synthetic form of progesterone called progestin — often alongside a synthetic form of estrogen, like ethinylestradiol — leading some experts to believe they can increase the risk of fibroids.

But current research seems mixed, and there isn’t a clear-cut answer. Whether hormonal contraception is right for you ultimately depends on your overall health, whether you have other underlying conditions or risk factors, and more.

A few studies suggest that birth control pills seem to decrease the risk of developing fibroids — particularly when taken daily over an extended period of time, says Lyndsey Harper, OB-GYN, founder and CEO of Rosy, a sexual wellness platform.

“In one [older] study, women who took birth control pills for more than 10 years reduced their risk of developing fibroids by 31%,” she says.

Researchers in a 2021 study also found hormonal contraception to be a protective factor for fibroids.

But other studies show the opposite. One 2018 study, for example, found that people taking birth control pills were more likely to develop fibroids than people who had never taken oral contraceptives.

Researchers in a 2022 study hypothesized that conflicting research findings could be due to the variability of hormone concentrations across different brands of birth control pills.

There’s no one-size-fits-all rule on which birth control method is right for people with fibroids.

In some cases, hormonal birth control may help regulate the menstrual cycle and prevent extreme fluctuations in progesterone and estrogen levels, explains Katsnelson.

But for others, the influx of additional hormones may actually contribute to fibroid growth.

“Every person needs to discuss their options for birth control with their physician, especially if a diagnosis of fibroids has already been established,” says Katsnelson.

People whose fibroid symptoms worsened when using hormonal birth control or who don’t want to try hormonal contraception may want to explore nonhormonal methods, suggests Harper.

“Nonhormonal contraception such as condoms, a diaphragm, or a sponge would not have any effect, positive or negative, on fibroids or symptoms from fibroids,” she says.

Although a copper intrauterine device (IUD) is a popular choice for nonhormonal contraception, Harper doesn’t recommend it for people who have symptomatic fibroids.

“It can make the bleeding from fibroids heavier and more painful for some people,” she says.

For many people, the presence of fibroids can increase menstrual flow and cause painful cramps, says Katsnelson.

“Hormonal birth control pills, on the other hand, are known to reduce both,” he says. As such, your healthcare professional may suggest taking birth control pills to see whether they reduce your bleeding.

The research on the topic, however, isn’t conclusive. “One [2015 research review] found that it’s not clear whether or not the pill is effective at relieving fibroid symptoms,” says Katsnelson.

“At this point, there isn’t enough scientific research to make widespread recommendations about using birth control pills to treat fibroid symptoms,” he says.

Can certain birth control methods increase your risk of developing fibroids?

There are a number of risk factors for uterine fibroids. Your individual risk of developing fibroids in general and when using hormonal birth control depends on what risk factors you have.

As such, “it’s hard to predict which people will see an increase in the size of their current fibroids when on birth control,” says Makarov.

Broadly speaking, birth control pills with lower doses of synthetic estrogen and progestin-only birth control have the lowest risk of developing fibroids, she says.

Is it safe to use hormonal birth control if you have fibroids?

Hormonal contraception is generally safe for people with fibroids. But some people don’t respond favorably to birth control with high levels of synthetic estrogen.

The best way to determine which birth control is safest for you is to consult a healthcare professional.

Can certain birth control methods trigger or worsen fibroid symptoms?

“Many physicians believe that birth control pills may increase fibroid growth, which can make fibroid symptoms more severe,” says Katsnelson. “There appears to be a connection between fibroids and hormones that affect the uterine lining.”

But some people experience symptom relief when using hormonal birth control because it helps stabilize overall hormone levels.

“More scientific research is needed to make recommendations about whether or not birth control pills can treat fibroid symptoms or make them worse,” he says.

What else increases the risk of fibroids?

According to Makarov, you may be more likely to develop fibroids if you:

What’s the best birth control method for people who are prone to fibroids?

“The best birth control method will be specific for each person and their specific needs and health history,” says Makarov.

The relationship between hormonal birth control and fibroids isn’t clear-cut.

Some studies suggest hormonal contraception can worsen fibroid symptoms and development, while others suggest it promotes symptom relief and slows growth rate.

If you’ve received a fibroids diagnosis or might be at risk of developing fibroids, consult a healthcare professional to learn more.

Gabrielle Kassel (she/her) is a queer sex educator and wellness journalist who is committed to helping people feel the best they can in their bodies. In addition to Healthline, her work has appeared in publications such as Shape, Cosmopolitan, Well+Good, Health, Self, Women’s Health, Greatist, and more! In her free time, Gabrielle can be found coaching CrossFit, reviewing pleasure products, hiking with her border collie, or recording episodes of the podcast she co-hosts called Bad In Bed. Follow her on Instagram @Gabriellekassel.