Oh yes… we’re going there. On the Full Stop blog we like to demystify the topics no one else will give the gory details on, and this time we’re covering the ‘pull-out method’. We’re breaking down everything you need to know, from how it’s done, to the benefits and drawbacks, and of course its reliability as a method of birth control. 

Let’s dive deep on this confusing and commonly misunderstood form of birth control… completely free from embarrassment or judgement!

The pull-out method, withdrawal method, or if you’re feeling really fancy, coitus interruptus, is a type of contraception where — during penetrative sexual intercourse — the penis is removed from the vagina before ejaculation occurs. Ejaculation may then happen outside the vagina. 

The idea is without semen entering the vagina, pregnancy may be avoided — key word being may. 

It sounds simple, but the pull-out method can be pretty difficult depending on the sensitivity of the penis. In a perfect world, sex would continue until both partners are close to climax, then the person with the penis would withdraw at the last second and continue their ejaculation outside of the vagina… if only it were that simple! 

Fans of the first season of Bridgerton will have seen a perfect pull-out demonstration, but outside of the movies and TV shows where it is depicted (albeit rarely), it’s usually a little messier. It’s important not to feel bad if it doesn’t work the first few times you try. It’s all about figuring out penis sensitivity and the sweet spot between arousal and climax. 

The pull-out method requires the person with the penis to remove it just as ejaculation is about to happen, and letting ejaculation happen elsewhere. You may want to have a conversation with your partner beforehand to discuss where to ‘finish’, i.e. elsewhere on the body, onto bedsheets, or somewhere else. 

Remember, if you’re going to have more sex immediately afterwards, it’s best that the person with the penis urinates and removes any leftover semen from the penis so it doesn’t make its way into the vagina. 

Do people actually use it as a method of contraception?

Yes. Research from the journal titled Contraception found around 60% of Americans aged 15-44 will use the pull-out method at some point in their life. Keep in mind this may be with or without a secondary method of contraception. 

The pull-out method can work. In theory, removing the penis before ejaculation means no semen is left inside, which means no sperm can fertilise an egg. While this is true, even if you do manage to perform a perfectly timed pull-out and think you have avoided internal ejaculation, there’s a spanner in the works called Cowper's fluid. More on this later. 

While the pull-out method can provide some form of protection against pregnancy, it does not protect against sexually transmitted infections (STIs). Condoms are required for this. 

Even though the pull-out method has its disadvantages when used as a method of birth control, it does have some benefits:

It does not require any fitting of a device or a prescription 

It does not affect hormones, like other birth control methods can 

It is a completely free method of contraception 

Like every method of contraception, the pull-out method has its drawbacks too. Here are a few:

It offers no protection against sexually transmitted infections

It is less effective as contraception than other birth control methods 

It can sometimes disrupt enjoyment during sex 

Short answer? Not very. According to the WHO (World Health Organization), the effectiveness of the pull-out method changes drastically depending on how well you use it. With perfect use (i.e. expert timing every single time!) the pull-out method is 96% effective, however with common use its effectiveness falls to just 73%. This is likely the case for two reasons. 

The first is you are relying on you and your partner’s self-control and ability to pull out before any ejaculation takes place. The second is no one can control if they produce Cowper's fluid, otherwise known as pre-cum. 

Cowper’s fluid is sometimes called pre-ejaculate, or pre-cum, and it’s basically a type of semen that leaks from the penis before the main event. There is debate in the science community about whether Cowper’s fluid contains working sperm; one 2003 study found no active sperm in their samples, while a 2010 study found viable sperm in 11 out of 27 samples. 

A person with a penis cannot control whether or not Cowper’s fluid is produced, so this adds another complication for the pull-out method. 

Can I get pregnant while using the pull-out method?

Many a high school rumour says if you just pull-out you can’t get pregnant, so let us make it very clear; this is not true. If you have a uterus, have gone through puberty, and are having sex, you can become pregnant even if your partner pulls out before they ejaculate, and even if you are not ovulating. Remember, sperm can live in the body for several days so you can become pregnant days after having sex. 

OK, so I shouldn’t use the pull-out method? 

The pull-out method offers much less protection against pregnancy than other methods, but it is of course better than having no contraception at all! It may be worthwhile exploring other methods you can double up with to reduce your chances of pregnancy, such as an IUD (intrauterine device), hormonal birth control pills or spermicide. 

If you want to avoid hormonal contraception or you prefer not to have anything interrupt sex, then also incorporating natural temperature-based fertility tracking could offer a good additional form of protection. This means you can still use the pull-out method, but avoid having sex near ovulation. 

Our website has a short Learn Your Phase questionnaire to help you discover more about your cycle. We love to help people tackle the symptoms associated with the entire cycle — not just the bleed days — so whatever your symptoms or cycle goals are, we’ve got you. 

Do you have a question about the pull-out method? Ask in our Full Stop FB group, or reach out to the team on IG at @itsyoppie so we can help. 

The Pull-Out Method: How reliable is it really?

When you start to research birth control, you realise just how many types there are. From condoms to caps and injections to IUDs, there’s certainly no shortage of options when you’re trying out different kinds to see what works for you. 

One of the reasons people struggle to find the right method of birth control is the weight gain it can sometimes cause. While not all types of birth control cause weight fluctuations, and not all people are susceptible to this side effect, it has been known to happen. So we’re digging a little deeper to find out:

What kinds of birth control are out there for you?

Which ones could be causing your weight gain?

What can you do about it if they do cause weight gain? 

…and what else could be causing any weight gain? (Hello PCOS!)

Birth control (sometimes called contraception) is any method implemented to prevent pregnancy. This could be a type of medicine, a device, a procedure or something else. Some types offer more protection than others, and some protect against sexually transmitted infections (STIs) while others do not.  People may choose to take certain methods of birth control for reasons other than preventing pregnancy, such as balancing hormones, improving skin, reducing the intensity of periods, and more. 

Remember, if you have gone through puberty and have not yet reached menopause age, then you could be capable of getting pregnant and therefore should use some sort of birth control if you do not want this to happen. When deciding which type is the right one for you, you may want to ask yourself questions like:

How easy will this be to use, and will I feel comfortable using this?

How effective is this type of birth control?

Will this type of birth control protect me against STIs?

Does this type of birth control interfere with any health concerns I have?

Does this type of birth control suit my lifestyle?

Are there any side effects or risks associated with this? 


What are the most common birth control options?

There are so many options available when it comes to birth control, and many different popular methods around the world to choose from. In the UK however, according to the NHS some of the most popular types of birth control include:

IUD (intrauterine device) or IUS (intrauterine system)

Often referred to as a “coil”, an IUD or IUS is a small T-shaped plastic device inserted into the neck of your womb/uterus by a trained professional. They are two types; the copper coil (IUD) releases copper and the hormonal coil (IUS) releases the hormone progesterone to stop you from getting pregnant. 

Depending on what type you choose, this method of birth control can last anywhere from 3 to 10 years, but always consult your doctor about when you should have it replaced. When inserted correctly, this type of contraception is more than 99% effective.


There are many brands and types of pill you can try, but the main categories are the combined pill, which contains artificial versions of the hormones oestrogen and progesterone, and the progestogen-only pill, which works in the same way but with no oestrogen. Introducing some of the hormones that naturally occur in our system stops ovulation from happening and thickens the cervical mucus to stop sperm reaching an egg. If taken correctly, they can be up to 99% effective. 

For many people, condoms are a go-to because they’re the only type of birth control that also protects against sexually transmitted infections (STIs). There are 2 types; external condoms which are worn on the penis, and internal condoms which are worn inside the vagina. Both are designed to create a barrier so semen can’t get through during sex, and they’re usually made from a thin latex. Condoms are thought to be 98% effective when used correctly. 

Psst! Got a latex allergy? You’ll need to seek out latex-free condoms or use another type of birth control.

The contraceptive injection is exactly what it sounds like; an injection of contraceptives using a needle. The injection introduces the synthetic hormone progestogen into your bloodstream to stop you being able to get pregnant. There are different brands you can discuss with your doctor, lasting anywhere from 8-13 weeks. This method of birth control is thought to be more than 99% effective.

Natural family planning (fertility awareness) 

Natural family planning (sometimes called "fertility awareness") is when you closely monitor and record the symptoms and temperature fluctuations in your body in order to determine where you are in your menstrual cycle. By avoiding your most fertile days of the month, you can prevent a pregnancy. It takes a lot of forward-planning, but if done correctly this method of birth control can be up to 99% effective.

The contraceptive implant is a tiny, flexible plastic stick inserted into the skin of your upper arm by a trained professional. It is designed to release the hormone progestogen into the bloodstream to stop pregnancy occurring, and can last for 3 years before a replacement is needed. This type of contraception is thought to be over 99% effective.

A cap or diaphragm is a small, flexible, silicone dome you can insert into the vagina before sex to form a barrier over the cervix and stop sperm from reaching the uterus to fertilise any eggs. When used correctly with spermicide, this method can be 92-96% effective at preventing pregnancy.

The contraceptive patch is a small patch that sticks to the skin and releases hormones into the body which are absorbed through the skin. Patches must be changed every week for 3 weeks, followed by one week of no patch. When used correctly, they’re over 99% effective at preventing pregnancy. 

Similar to other methods that release the hormones oestrogen and progestogen into the bloodstream to prevent pregnancy, except the vaginal ring is a small, soft plastic ring inserted into the vagina. When used correctly, the ring is over 99% effective.

When deciding which type of contraception may be right for you, be sure to speak to your doctor to learn more about the above methods. 

Why will some types of birth control make me gain weight? 

It’s a commonly held belief that certain types of hormonal birth control can cause weight gain, and it’s a huge reason people avoid them. 

Much of the worry around weight gain with contraception comes from decades-old stories. In years gone by, hormonal contraception used hormones at much higher levels than our birth control methods use today. For example, the first birth control pill (developed in the 1950s) contained 150 micrograms (mcg) of oestrogen, whereas according to a 2012 review, today’s contraception only contains 20 to 50 mcg of oestrogen. So back in the day there was a very good chance if you took hormonal contraception you would put on a few pounds. Today, not so much. 

Studies have looked closely for any correlation between hormonal contraception and weight gain, and the vast majority of these studies came back with limited evidence that the two are related. Some do report gaining a few pounds in the weeks and months after they start taking the pill, but this is often temporary and the result of water retention, not actual weight gain.

It seems more likely users will only experience bloating or changes in body fat distribution around the body, rather than a change in weight. Fluctuating hormone levels during puberty and menopause can also result in changes in body composition, such as when fat begins to grow on the chest, thighs, hips and butt, so it can also be difficult to attribute this to hormonal birth control. 

Research into the subject found some studies were poorly designed and therefore could not draw any solid conclusions without the necessary evidence to suggest a clear link between hormonal birth control and weight gain. 

What else could contribute to my weight gain? 

As above, although hormonal birth control could be indirectly responsible for weight gain, it’s likely other factors are at play such as increased appetite, bloating and water retention which can all cause the appearance of weight gain, if only in the short term. 

Another factor to consider is if you have PCOS, or polycystic ovary syndrome. The exact cause of PCOS is not known, but factors like inflammation in the body, a family history of PCOS, excess androgen hormones, and insulin resistance are all thought to be connected. This common hormonal imbalance presents symptoms like irregular periods, excess body hair, acne, thinning hair on the head, fertility issues, and… drum roll please… weight gain. 

Sometimes those with known or undiagnosed PCOS will start taking hormonal birth control as part of their treatment, which causes their hormones to fluctuate. PCOS makes it harder for the body to utilise the insulin hormone, which normally converts sugar from food into energy. This insulin resistance can cause insulin and sugar to build up in the bloodstream, which can lead to many common PCOS symptoms - like weight gain. 

If you want to learn the first signs of PCOS and how to know if you have it, click here. 

What birth control options could I try to avoid weight gain? 

If you suffer from PCOS, it’s best to speak to your doctor to discuss the best way to manage weight alongside any hormonal birth control you are taking. They may suggest a change in birth control, another medication, or lifestyle changes that could have an impact. 

Regardless of whether you have PCOS or not, you may be interested in some of the research around which types of birth control are more or less likely to cause weight gain. 

While the jury is still out on whether hormonal birth control is in fact the root cause of weight gain, one study found the contraceptive injection seemed to cause more weight variation than other methods, while other studies attributed this to an increase in fat mass. One study found 40% of people taking injections every 3 months noticed this increase in fat mass. 

When it comes to oral contraception (the pill), this low-dose oestrogen study found no difference in weight at the end, while another study with progestogen-only contraceptives found variable weight change in its subjects. And there appeared to be no difference between types of intrauterine devices, according to one study. 

Overall, it seems any weight gain you experience while on hormonal birth control is more likely to be linked to your genetics, your age, your health, and other lifestyle factors. It also matters how your contraception affects you. For example, if you stop getting periods after starting hormonal contraception then you may end up doing more exercise throughout the month than someone who continues to get their period. That said, studies are limited on the topic so always track any variations yourself to get a clearer idea of how your own body is reacting to hormonal birth control. 

Absolutely! If weight gain is a concern you have while on hormonal birth control then we encourage you to speak to your GP who can offer more information on your specific type of contraception, and allow you to try different kinds until you find one that works for you. 

Want to find out more about birth control and weight gain? You can ask questions in our Full Stop FB group, or reach out to the Yoppie team on IG at @itsyoppie so we can help. 

Don't forget that our personalised menstrual cycle subscription box can get organic tampons, PMS supplements and much more delivered easily and regularly through your letterbox, to give you just a bit more peace of mind each cycle.

The best birth control options to avoid weight gain

Natalie Miller (@_healthandhormones) has been taking Yoppie's Poly Complete Support & Endo Complete Support supplements for over 3 months. She uses her personal instagram to share her PCOS & Endometriosis struggles, her fertility friendly lifestyle as well as an honest account of her journey to get pregnant with her followers. Yoppie sat down with her to learn more...

How long have you been suffering from symptoms before you found Yoppie PCOS and what was it like?

My name is Natalie Miller; I'm 30 years old and live and work in Manchester. In 2020 my partner and I had planned to go on our last holiday before we started trying for a baby. However, the pandemic hit and no one was going anywhere, so we thought, why wait, and decided to come off contraception in May 2020 to see what happens. 

After a couple of months, I noticed my period hadn't returned. Although all the doctors reassured me not to worry and that it was expected as I had taken contraception for so long, I could sense something was wrong. I had had this sense even before coming off contraception that something was up as I was losing a lot of hair and had extremely light breakthrough bleeds. 

Something in me felt I needed to push further. As I'm quite petite and exercise a lot, the doctors alluded to me having hypothalamic amenorrhea, but I could feel it wasn't that. I was eventually taken for a blood test and an ultrasound scan, and that was when they found my testosterone levels were through the roof, and my ovaries were polycystic.

I don't look like somebody who has PCOS typically; I'm quite lean, have no acne, and none of the typical PCOS symptoms that you might expect somebody who suffers to have. But I didn't feel right within myself, and it wasn't just my absent periods. Hormonally I could tell something was off, and physically I was in a lot of pain; my whole left side was in debilitating discomfort, especially for somebody who's quite active. However, the doctors tried to write it off as ovulation pain. I thought if this is ovulation pain, how do women do this every single month?



So I just had to keep going back and asking - I had to trust myself; I knew my body and understood that something wasn't right. 

I was finally diagnosed in December of 2020 and was told over the phone that I have polycystic ovaries - it was done in a very flippant way. I had no idea what that meant, and when I put it into Google, all I read was you can't have children. I felt absolutely heartbroken. 

Coming from a psychology background, I'm used to doing my research and needed to channel myself into understanding what it meant to have a polycystic ovary diagnosis. I think the doctors were sick of me, and I'm sure they knew my number by heart with the amount I would call them up.

I wanted to know what holistic remedies were available, and that's when I started looking into diet supplements. With all the supplements I was taking for my PCOS and fertility health, I was taking nearly up to eight pills a morning. I felt like I was rattling around; I even had one of those Monday-Sunday pillboxes.

However, as I was reading up on symptoms, I found that pain was not a PCOS symptom, and I knew something was still up. 

Only last year did I get my endometriosis diagnosis through a specialist, which was after a lot of persistence on my end, as well as going through private healthcare. I don't know how women can suffer for so long! 

The pain was unbearable. I couldn't get up in the morning, I had extreme fatigue during the day, and nights were worse. The only good thing to come from the pandemic was being able to work from home whilst going through all the symptoms. The pain was everywhere; my bowels stuck to the side wall, my colon was twisted, and I had irregular bleeding - nothing was working as it should be.

I went from being someone who was super active and loved to go out and exercise to someone who struggled to get through the day. 

How long have you been using Yoppie and what are the results? 


I love to use my platform to share my journey and was very vocal about all the different supplements I was using, the low-carb diet I was on, and the research I would come across. That's when Yoppie approached me with their Poly Complete Support supplements, which was a game changer. 

Instead of seven or eight pills every morning, I'm now taking one supplement that has it all. Obviously, the supplements I was taking were of my own findings, so I had no clue about the correct dosage, so it was so freeing to know that this one supplement had it all with ingredients that targeted insulin resistance, hormone balance, fatigue, skin and hair health, and most notably for me, reproductive health. 

Everybody's PCOS symptoms are different, so using Yoppie's website for expert advice to accompany the Poly Complete Support supplement was so beneficial. The website helped me understand what each ingredient was explicitly targeting. I found the tailored expert advice on the blog comforting, where doctors who didn't specialise in women's health could have limited knowledge. 

The main benefit I've seen from using Yoppie's Poly Complete Support supplement is that I now have a regular cycle, and I am ovulating every month! This is incredibly impactful for our fertility journey as we continue to try for a baby. To know everything is working as it should makes a huge difference!

After witnessing the positive impact on my PCOS after using Yoppie's supplement, I thought I might as well try the Endo Complete supplement for my endometriosis. I can confidently say it has been worth every penny! 

I thought I'd take it and see what happens, but if I'm honest I was sceptical, but honestly the reduction in pain is unmatched. I was almost scared to say that I'm not in pain, because you think, Oh, it might come tomorrow if I say that. I’m so pleased to say, three months on, I've gone from being in pain every day, to only having the odd day of pain.

I was amazed that only one pill could impact so many different endometriosis symptoms. For example, the turmeric helps to control inflammation in the body, and is packed with broccoli extract (which is hard to get hold of) to eliminate excess hormones. And to top it all off, where PCOS and endometriosis can consume so much of your mind, the subscription means the pills arrive at my door monthly, so I don’t need to spend any time worrying about it. 

I feel so much a part of the Yoppie community, from the IG-lives with specialists in the field to the blogs and even being a part of a WhatsApp group. The community encourages me to continue sharing my experience and story on my platform. I remember feeling so scared and alone, so if I can make sure others don't feel that and know how to advocate for their health, I'm doing something right. 

I want to also share that I did have a miscarriage earlier this year. Many women don't share when they have, but I feel it's important to share. We're continuing to try for a baby, and have since begun taking Yoppie's supplements, so it feels good knowing I'm doing something good for my hormones and knowing that I'm now ovulating every month. We have our fingers crossed, and will continue to share our journey, but we're pleased Yoppie can play a part in that journey.

Got a question about menstrual health, fertility or Yoppie's supplements? Get in touch with us directly on Instagram at @itsyoppie or email hello@yoppie.com. You can also join our private Full Stop FB group. Don't forget our menstrual care subscription can be a good place to start for supplements for your PMS, PCOS or Endometriosis as you can get them delivered easily & regularly through your letterbox. 

Getting to Know : Natalie Miller, Yoppie PCOS & Endometriosis supplement customer

Expanding your family is one of the most exciting things you can look forward to in adulthood. That being said, the fertility journey is not always the easiest and can be different for everyone. Some may be fortunate enough to get pregnant within their first couple of months of trying to conceive. However, for others, after a year of unsuccessful attempts, you may experience feelings of discouragement, failure, worry, and anxiety. This can often leave couples to wonder what’s next, what can we do differently, or are we even able to conceive? Because fertility can be a wild ride and challenging to navigate, let’s dive into some things you and your partner should consider thinking about when trying to conceive. 

Most of the time, we prioritise our physical health more than our mental or reproductive health, for example. But when you are struggling to conceive, it’s important to look into and learn about your reproductive health with the help of your physician. 

Women face difficulty with their menstrual cycles, hormones, reproductive health, and more. On top of this, women can be diagnosed with endometriosis or polycystic ovary syndrome (PCOS), making it even more difficult to conceive. Unfortunately, there is no cure for either of these conditions. These conditions can greatly impact the ability of women to conceive easily and can bring on severe pain, depression, hair loss, and menstrual cycle difficulties. If you experience some of these symptoms, visit your doctor to discuss more and get checked out. While there is currently no cure for either of these, there are ways you can help to manage some of the symptoms and start to live a healthy lifestyle. Try out supplements for PCOS or supplements for endometriosis to start balancing your well-being and maybe start trying to conceive again. 

Because of conditions like PCOS and endometriosis, it’s a common misconception that a couple cannot conceive because of fertility issues from the woman. However, it is possible for both men and women to have fertility problems. Because of this, it’s suggested that both you and your partner schedule a visit with your doctor to talk about all things regarding your reproductive health. Doing this will help get you one step closer to finding out some answers on why you are struggling to conceive. Through this time, remember that you and your partner are a team. Be there for each other through this challenging period and never blame one another. Once you have discussed with your doctor the pinpointed reason you are struggling to conceive, consider coming up with a game plan together. Sitting down and talking through this with your partner can help to decrease any stress or anxious feelings you both may have.

How Can This Effect Your Mental Health? 

Struggling with infertility can have a significant impact on your mental health, especially when your original plan to bring a child into this world has changed. Falling into depression or experiencing anxiety and panic can happen when you have not been successful at trying to conceive. Emotions like hopelessness, frustration, guilt, and worthlessness can commonly be felt when you’re struggling with fertility. The fertility journey is unique for everyone. It is hard to stay positive and always look on the bright side when this situation is challenging and extremely stressful. 

That is why you need to utilise different resources to cope with your emotions. If you are looking for advice or to bond with people going through the same thing, finding a support group near you can be extremely beneficial to you and your partner. This is a great way to talk about your feelings, find out about different treatment options, and socialise. This journey can be isolating, so getting out and having conversations with others can help you feel like you’re not alone in this journey. If your feelings are more serious and are impacting your quality of life, give online treatment for depression and anxiety a try. Talking with a mental health professional will allow you to get an objective point of view, someone to listen to you, give you appropriate support and suggest coping strategies. 

Depending on what your doctor says there are many options for how you can try to have a child. If your doctor has determined that your struggles with conceiving are not related to infertility, they might suggest that you step back and take a look at the lifestyle you are living. After reflecting on your current lifestyle and healthy habits, you can decide what changes need to be made in order to increase your chances of being able to conceive. It is worth discussing these options with your doctor or a medical professional before making any major lifestyle changes. 

For example, it is extremely important for you to stop any and all drug use. Not only is that habit very damaging to your health and body, but it can make it difficult for you to get pregnant. This habit is also not safe and can be damaging to your child if you are able to conceive. Cutting out smoking, drug use and alcohol can be challenging for those who are dependent on them. If this is the case, try finding a program that can help you. 

Other lifestyle habits that might be making it harder to conceive are your eating habits and your weight. Being overweight or underweight can have an impact on your ability to conceive. You can also have a harder time if your eating habits are poor, for example, if your diet is unhealthy or if you are not eating enough. You can follow a fertility diet that will suggest the best foods to eat when you are trying to get pregnant. 

If simple lifestyle changes are not the reason why you are having trouble becoming pregnant but instead your doctor has found a fertility issue, consider your options for other ways you can welcome a child into your life. Discuss with your partner and doctor fertility treatment options like IVF. Fertility treatments can be a struggle and a long process, and might not always work, but it is something you can look into. You can also consider adoption as a way to expand your family. Take your time thinking about this decision and how you and your partner would like to proceed. Get second opinions, read the research, and talk to others who have gone through similar experiences. Find something that is comfortable and fitting for your family. 

Trying to conceive and not being successful can have lasting effects. Not only will you feel the many emotions of going through this journey, but you may also question your worth and the future of what your family could look like. Take these tips into consideration so you aren’t left wondering if you are able to conceive. Determine why you are having difficulties so you can take action. Lean on your partner, your family, friends, and medical professionals during this journey. And most importantly, don’t give up. You are not in this alone and there are many resources for you to utilise and help you through this journey. 

Looking for more advice? Ask away in our Full Stop FB group, or reach out to the team on IG at @itsyoppie so we can help. 

Don't forget that our personalised menstrual cycle subscription box can get organic tampons, PMS supplements and much more delivered easily and regularly through your letterbox, to give you just a bit more peace of mind each cycle.

Struggling to conceive? Here are some things to consider

Been diagnosed with polycystic ovary syndrome, or suspect you might have it? You’re probably wondering what’s going on inside your body. Depending on which type of PCOS you have (yup, there are four) you may experience different symptoms and need to handle them differently. Let’s take a look at their characteristics, and find out which one you have...

PCOS (polycystic ovary syndrome) is common and has all to do with the function of the ovaries. If you have experienced irregular periods, excess body hair, or fertility issues, PCOS could be to blame. Polycystic ovaries hold tiny underdeveloped sacs where eggs develop but are not released. When ovulation doesn’t occur, hormone levels change and PCOS can cause less progesterone and more androgen, causing the symptoms above. 

So, what are the types of PCOS, and what causes them? PCOS has a prevalence of around 2.5% - 11.9%, and of those cases there are four different kinds, with varying causes; 

This is the most common type by far, and affects up to 70% of all people with PCOS. It works in the same way described above. Essentially your cells don’t recognise that insulin exists in the body, causing insulin levels to rise over time and cause the typical PCOS symptoms; irregular periods, fertility issues, excess hair growth, and more. 

This type is driven by chronic inflammation. Studies show it can cause raised levels of CRP, an inflammatory marker also associated with diabetes and heart disease. The cause is believed to be a mix of genetics, stress, environmental toxins, and inflammatory foods. Inflammation happens when the immune system tries to protect against foreign substances in the body. Sometimes the inflammation response overreacts and affects healthy cells, bringing on the symptoms of PCOS. 

This kind is stress-related and causes raised DHEA levels - an androgen hormone produced by the adrenal gland. In this type of PCOS, the ovaries cause excess androgen which can cause adrenal dysfunction. One study tested the adrenal function of 38 patients with PCOS and found that 15 of them produced more adrenal hormones than would be considered normal, and had smaller than average adrenal glands. So, more stress equals more adrenal hormones equals more PCOS symptoms! 

It’s thought that when coming off birth control, some people experience a temporary PCOS-like state. If you had normal periods before you started the pill, but experienced symptoms when you stopped, including weight gain, acne, hair loss or fertility issues, this could be the case for you as your body adjusts to the change in hormones. Usually it resolves itself in a few months, but if you have concerns do speak to your doctor. 

Are there any differences in PCOS symptoms?

Your specific symptoms could be the key to figuring out which type of PCOS you’re dealing with. Here’s what to look out for:

Insulin Resistant PCOS: The most likely symptom is weight gain. You may also have acne, hair growth/loss, irregular periods, and mood and sleep issues. 

Inflammatory PCOS: The most likely symptom is fatigue, but you may notice digestive issues and food sensitivity. You may also suffer from skin issues, headaches or joint pains. One study found those with PCOS had an increased risk of type 2 diabetes and heart disease, so watch for symptoms of these conditions too. 

Adrenal PCOS: The most likely symptom is weight gain, but you may also experience acne, hair growth/loss, and irregular periods. If stress, mood swings, fatigue and sleep problems are recurring for you, this could be a sign of Adrenal PCOS. 

Post-Pill PCOS: The symptoms of this type are the same as in Insulin Resistant PCOS, but they will only come on after you stop taking birth control. 

What happens if you have Insulin Resistant PCOS?

It’s relatively easy to diagnose and treat Insulin Resistant PCOS if your symptoms are clear. Your GP may test your testosterone, insulin, fasting blood glucose, and DHEA, and may suggest medicine to reduce insulin levels and improve blood sugar. Sometimes doctors prescribe medicine that’s primarily used for diabetes, which is normal since both conditions deal with insulin. You may benefit from following a low to moderate carb diet, exercising regularly using diverse workouts, and getting adequate sleep.

What happens if you have Inflammatory PCOS?

If your GP suspects you have Inflammatory PCOS, they may test your CRP, DHEA, and check if you have a vitamin D deficiency. You can try an anti-inflammatory diet, minimise your exposure to environmental toxins, and look for ways to reduce stress. Studies have found those with PCOS who followed a Mediterranean-style anti-inflammatory diet for 3 months showed great improvement in their inflammatory markers.

Between 20 and 30% of patients with PCOS have the kind with adrenal androgen excess, and this is primarily identified through raised DHEA levels. Your doctor may check your prolactin levels first to rule out other conditions, then test your testosterone, your DHEA, your cortisol, and insulin resistance. Consider lifestyle changes like reducing your sugar and processed food intake, reducing stress, and getting more sleep. 

Before you are diagnosed with this type of PCOS, your doctor will likely look at your luteinising hormone (LH) and follicle stimulating hormone (FSH) first, as coming off of birth control pills can cause suppression of these hormones, which leads to symptoms. This is pretty normal, and it will typically be recommended that you wait a few months for symptoms to settle down. 

Got a question about the different types of PCOS? We’re all ears! Ask on our private Full Stop FB group, or DM us on Instagram at @itsyoppie so we can help answer them for you. Don't forget that our personalised period box can get organic tampons, PCOS Supplements and much more delivered easily and regularly through your letterbox, so that's one less thing to worry about each month.

The Four PCOS Types & How To Identify Them

The idea of putting any sort of ‘device’ inside your body can be daunting. It is a temple, after all! So when it comes to birth control, it’s normal to want to know the ins and outs of all the different IUD options there are. Here, we’re pitting the copper and the hormonal IUD against each other, and looking at the pros and cons of each. Let’s get into it...

IUD stands for ‘intrauterine device’, and it’s a small T-shaped instrument that can be inserted into your uterus by a medical professional to help prevent pregnancy. They are typically made of plastic, and release either hormones or copper to protect you against pregnancy for between 3 and 10 years, depending on the type of device. IUDs work by stopping any sperm in their tracks so they can’t reach and fertilise eggs.

What are the general benefits of having an IUD? 

While all birth control methods have their up and down sides, the benefits of the IUD make it a very popular choice for people who wish to avoid pregnancy. 

It's longer lasting than other methods of birth control

Once it’s in, it’s in! You and your partner don’t need to think about it again for years

It’s safe to use when breastfeeding, making it a popular choice for new mums

It’s easy to remove (with a doctor’s help) if you want to try to get pregnant

It could minimise menstrual pain, heavy periods, or pain from endometriosis

Being more than 99% effective at preventing pregnancy, it is one of the most effective methods of birth control available

Unlike condoms, the IUD does not protect against sexually transmitted infections

Insertion and removal requires intervention from a doctor 

Just as some people find their periods get lighter, some also find that periods become heavier, irregular, or more painful 

Hormonal IUDs work by releasing progestin (a synthetic version of progesterone) which thickens cervical mucus in order to stop sperm from reaching and fertilising an egg. As a backup, it also thins the lining of the uterus, so even if any sperm make it to the egg, the thin lining makes implantation extremely difficult. 

In some cases, hormonal IUDs may also stop ovulation, thus effectively preventing pregnancy. There are several brands of hormonal IUD available, lasting anywhere from 3 to 6 years. 

Some people report that the hormones in their IUD make their periods more regular, or they stop altogether

Hormonal IUDs have been linked to reducing the risk of certain cancers, such as cancer of the endometrium (the uterine lining)

If you are unable to use contraceptives that contain estrogen (for example, if you suffer with migraines), hormonal IUDs can be a good alternative

There is some evidence to suggest that hormonal IUDs could be more effective than copper IUDs

They may not be suitable for people with conditions like pelvic infections, or certain types of cancer, such as cervical or endometrial cancer

People with uterine distortions or fibroids may not be able to use a hormonal IUD

If you have dealt with unexplained vaginal bleeding, it is recommended that you don’t use a hormonal IUD

While some people shiver at the thought of having metal inside their body, copper IUDs are actually very safe. They work exactly the same as the hormonal kind, except instead of releasing hormones, they release copper. 

Copper works as a spermicide to damage any sperm, preventing them from reaching the egg. It also generates an immune response to stop eggs developing, and destroy eggs that do develop. 

If you can’t use hormonal birth control, copper IUDs are a safe alternative 

They actually begin working immediately, so can be used as an emergency form of birth control

Copper IUDs can work for up to 10 years, so they’re a great long-term option

Some people report heavier periods, so if you already have heavy or painful periods, or endometriosis, this may not be the best option

People with an allergy to copper or Wilson’s disease cannot use a copper IUD

There is no right answer when it comes to choosing birth control - everyone has different needs and body types, and so both the hormonal and copper IUD will create a unique experience for each person. 

What’s good to know is that in both hormonal and copper IUDs, their safety and effectiveness are pretty much the same. Studies have shown that they are both more effective at preventing pregnancy than almost all other forms of birth control, and are more than 99% effective when used properly. 

As an overview, if you’re looking for an IUD that could lessen period pain then hormonal could be the answer. Alternatively, if you aren’t a fan of adding extra hormones to your body, or you want something super long-lasting, a copper IUD could be the one for you. 

How do I find out more about both options?

Speaking to your GP is always the best way to gather information and find out what might be right for your body. If you have underlying health conditions or already suffer with period problems, your doctor can recommend the kind of IUD that is safest for you, and likely to be most effective for what you’re looking for from your birth control. 

Are you still unsure about which IUD to choose? Pop into our Instagram DMs at @itsyoppie or reach out to our private FB group where no topic is off-limits. Don't forget that our personalised period box can get organic tampons, hormonal supplements and much more delivered easily and regularly through your letterbox, so that's one less thing to worry about each month.

Copper vs Hormonal IUDs: What To Know

Have you had an IUD (intrauterine device) fitted? How did you find the experience? If you experienced pain, you wouldn’t be the first. In recent months, there have been long overdue conversations in the media about women’s pain, with IUD fittings at the heart of the matter. 

Doctors and those in the medical profession are incredible at what they do, but the fact remains; only you know your own pain threshold and levels of discomfort, and if many of those getting IUDs say the pain is intense, isn’t it about time we listened? 

How common are IUDs, and how painful is insertion?  

The UN states around 159 million women have had an IUD fitted (as of 2019), and it remains a convenient and effective method of birth control for those who want something long-term, who struggle to take the pill every day, or who need non-hormonal options. 

For some, the insertion procedure is perhaps a little uncomfortable, but nothing to write home about. In other cases, it can be intensely painful. With more voices weighing in on what an IUD fitting is like, BBC presenter Naga Munchetty called it “one of the most traumatic physical experiences I’ve had”. And it makes sense, since your cervix is designed to have a baby come out, not to have a device go in. It’s no wonder our bodies recoil in pain.

Why is it painful for some but not others? 

Studies have found women who have never given birth vaginally tend to rate their pain level higher (6 out of 10) than those who have (3 out of 10). If your procedure goes smoothly, you could be in and out in 5 minutes feeling barely a twinge. This is the case for many people, and we certainly don’t want to put anyone off of this effective birth control option. That said, pain management for the procedure is typically offered under the assumption that everyone will have a largely pain-free experience. Unfortunately this is not the case. 

Why aren’t we offered more pain relief? 

It can feel a little like gaslighting when - for example - the NHS website claims “It can be uncomfortable when the IUD is put in, but you can take painkillers after, if you need to.” Anyone who’s suffered from intense period cramps will know that sometimes popping a couple of paracetamol won’t always cut the mustard. 

You may experience a difficult insertion, multiple attempts at insertion, cervix spasms, or pain lasting several days after the procedure. In any case, this should not only be made aware to all who opt for an IUD, but they should also be offered adequate pain relief. 

A local anaesthetic injection around the cervix can reduce some pain and discomfort when having an IUD fitted, but it’s not typically offered. While more research is needed, studies suggest this could be helpful for those who have never given birth vaginally.

Women’s pain isn’t always taken seriously for IUD fittings, and for issues such as endometriosis, which research shows takes a staggering 7.5 years to diagnose, on average. 

As author Gabrielle Jackson writes in The Guardian, “Women weren’t included in clinical trials until the 1990s. While we make up 70% of chronic pain patients, 80% of pain medication has been tested only on men.” 

Historically most medical research has been done on males, so there’s room to discover more about women’s bodies, health conditions, and how to treat the ailments many of us live with every day. This has been found in studies on gender stereotypes and pain, where men’s complaints are usually taken more seriously.

Astoundingly, the Harvard blog states that gender biases in medicine can have serious consequences; a 2000 study found women are 7x more likely than men to be misdiagnosed and discharged during a heart attack. While research on disparities is ongoing, it certainly raises questions. 

If you have suffered a horrendous IUD insertion and were told it’s normal, or you live with chronic pain without diagnosis, know that you’re not being “over dramatic” or “emotional”. Communication is often key when you want to voice your concerns. Speak to your GP or nurse about the pain, its intensity, and how it affects your life. 

Getting an IUD and worried about pain? Don’t be afraid or embarrassed to ask questions, voice concerns, or ask to stop at any time. There are often pain relief options available that aren’t immediately offered, so ask the question to prompt a discussion. Doctors and nurses want to help you have a pain-free experience, so give them a chance to do this by effectively communicating your pain. 

A recent uptick in discussion around women’s pain in the media and medical community means we are beginning to take notice of this issue and address it. After her own distressing experience, Lucy Cohen - a small business owner in Wales - began a petition to address women’s pain during IUD procedures. She has had around 1500 people share their stories, and found that on a pain scale of 0-10, 43% of respondents rated their pain as a 7 or higher, describing it as “almost unbearable”, “excruciating”, and a few even likening the pain to childbirth or broken bones. 

The Change.org petition asks for better expectation management of IUD insertion and removal procedures, and more pain relief options as standard, such as gas and air, sedation and muscle relaxants. You can read more about Lucy’s work and sign the petition here. 

Have you experienced a painful IUD procedure? We’d love to hear about your experience, good or bad. Speak about it in our private Facebook group or drop us a note on Insta @itsyoppie. Don't forget that our personalised period box can get organic tampons, PMS supplements and more delivered easily and regularly through your letterbox, so that's one load off your mind about everything that normally goes on down there.

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