If you have ulcerative colitis (UC), you may be wondering whether birth control is right for you.

When living with inflammatory bowel disease (IBD) — which can cause painful inflammation in your digestive system — it’s important to understand how the condition impacts things like your period, hormones, and of course, different options for birth control like oral contraceptives, barrier methods, or IUDs.

Don’t let UC stop you from being safe. Here’s everything you should know about UC, birth control, and how the condition affects your menstrual cycle.

Oral forms of birth control and hormonal therapy have been linked to a higher risk of inflammatory bowel disease, which can present itself in the form of Crohn’s disease or UC. Whether taking oral hormones actually contributes to disease development or relapse, though, is still up for debate.

Most women with IBD can safely take different forms of birth control, but those with more severe forms of UC should consider steering clear of contraceptive methods that contain estrogen, like combination pills, the patch, or the vaginal ring.

That’s because birth control with estrogen can increase the risk of blood clots, which women with more aggressive forms of IBD or UC are already at risk for.

However, it’s important to keep in mind that pregnancy actually poses a greater risk of blood clots than birth control, meaning avoiding unintended pregnancy may have more benefits in the long run.

Women with IBD, especially in severe forms, can consider an intrauterine device (IUD) as a safe form of birth control. IUDs and UC are a good match, since studies show that IUDs don’t have any effect on the condition.

An IUD is a small, T-shaped, plastic or copper frame that’s inserted into your uterus. It can help prevent pregnancy and offer long-term birth control. With more than 99% effectiveness and lasting anywhere from 3 to 6 years, IUD and UC work together well thanks to the device’s minimal side effects.

The way IUDs work is by preventing sperm from connecting with an egg. Some versions release a hormone called progestin, which prevents ovulation (a window during your menstrual cycle with the highest risk of getting pregnant).

Plus, an IUD can easily be taken out, meaning that if it causes you discomfort or you simply want to stop using it, it is a reversible option.

Yet IUDs aren’t the only option for people living with UC.

Barrier contraception is a smart choice for a one-time use during sex to help prevent pregnancy. These options create a “barrier,” keeping sperm from reaching an egg. Condoms, sponges, diaphragms, cervical caps, and spermicide are all good choices for barrier birth control that won’t negatively impact UC.

Emergency contraception, more commonly known as “the morning after pill,” can also be purchased over-the-counter or prescribed in the event that your original birth control method doesn’t work (such as a condom breaking). This form of birth control, though, should only be used as a backup.

Birth control pills, vaginal rings, patches, or birth control shots offer short-acting protection as well. By adjusting the natural levels of estrogen and progestin in your body, these birth controls make it much less likely for you to get pregnant.

Women with severe forms of UC, however, should ask their doctor about blood clot risks before considering birth control that contains estrogen.

Fluctuating hormones can impact IBD symptoms during your period. In fact, more than half of women in a study of 1,203 female patients with Crohn’s disease and UC reported worsening symptoms during menstruation.

Since hormones can create spikes in inflammation and sensitivity, they may cause more painful gastrointestinal symptoms for those with IBD.

Pregnancy and UC have a complicated relationship as well. Studies show that women who get pregnant during an active flare have double the risk for disease flares during pregnancy, compared to women who get pregnant at a time of remission from ulcerative colitis.

Whether this is due to hormones or abstaining from medication during pregnancy is up for debate, though.

So far, no direct link has been found between IBD and menopause. Menopause should occur on its own if UC is in remission and periods are regular, however surgical menopause may actually improve symptoms of IBD, according to the Crohn’s & Colitis Foundation.

In addition to fluctuating hormones potentially making UC symptoms more challenging, it’s important to factor in how you manage period pain.

Since common over-the-counter medications for menstrual cramps like Aleve, Motrin, and Advil can cause flares or symptoms such as diarrhea, abdominal pain, and bloody stools, these should be avoided.

Instead, consider Tylenol to help manage period pain or symptoms of PMS. The Crohn’s & Colitis Foundation recommends using up to 3,000 milligrams per day if needed to keep pain at bay.

Stress can also potentially trigger worsening ulcerative colitis, so practicing self-care and relaxation during your period can go a long way in keeping the disease manageable and symptom-free.

Birth control should continue during your period unless stated otherwise by your doctor.

You can safely use birth control if you have ulcerative colitis, and one of the best options may be IUDs. IUDs and ulcerative colitis are a smart choice, since the device is widely recognized for its safety in those with chronic illnesses like IBD.

To learn more about birth control options and which plan of action is right for your needs, connect with your OB-GYN to discuss the pros and cons of different contraceptives and determine the best choice for you.