Can Urine Testing Detect Birth Control Use?

Can Urine Testing Detect Birth Control Use?
Page content

Do Urine Tests Detect Birth Control?

There are quite a few choices for family planning open to men or women. Men’s choices for active contraception come down to the use of a condom or a vasectomy, although research is being conducted into an oral contraceptive for men. Women have a wider range of alternatives from surgical interventions where the fallopian tubes are tied-off, through intrauterine devices (the coil, or IUD), female barrier techniques (Femidom or cap) or the contraceptive pill. For religious reasons, some couples will practice the “rhythm method” where sexual activity is avoided during the woman’s period of maximum fertility. Abstinence isn’t really a birth control mechanism since it precludes sexual activity altogether.

Oral Contraceptives

In the Western world, many women choose to use oral contraceptives to control their fertility. Oral contraceptives offer women assurance over their birth control since they do not need to rely on a partner to take responsibility for ensuring that they don’t fall pregnant. This can be particularly valuable to younger women who are sexually active, but not in a long-term monogamous relationship. These days, it is also possible to administer such contraception via implants and injections which release the contraceptives over time, thereby freeing the patient from having to remember to take them.

Female contraceptive pills work by causing the cervical mucus to thicken, thereby making the environment hostile for sperm and preventing conception (progestin only pills, or POPs) or by inhibiting the production of follicle stimulating hormone (FSH) and luteinizing hormone, preventing ovulation, together with thickening of the cervical mucus in the combined oral contraceptive. Progestin is a synthetic form of the hormone progesterone.

Urine Tests - What Can They Measure?

Some young women may be concerned that if they take a routine urine test the results could reveal that they are on the pill and therefore are likely to be sexually active. This may be a personal fact that they do not wish their parents to know of. Do urine tests detect birth control? Well, clearly the answer to this question will depend upon the birth control choice that the individual is using. A physical method of birth control such as an IUD or a barrier technique will not show up in the urine, obviously. The components used in oral contraceptives are synthetic versions of natural hormones which are produced by the body (estrogen and progesterone) and can be detected. Indeed, progesterone levels may need to be monitored in early pregnancy to evaluate placenta and foetal health (low progesterone is associated with miscarriages and ectopic pregnancy) and measurement of estrogens may provide a wealth of valuable medical information. Knowledge of both hormones is vital in a successful IVF treatment.

A better question than “do urine tests detect birth control?” would be could can a urine test detect the presence of birth control substances? The answer to this question is plainly, yes, they can. Although a wide range of substances and their metabolites can be detected in urine, the testing procedure used is specific to a certain set of substances that are of relevance to the patient’s circumstances (i.e. why the urine is being analysed in the first place). However, the hormones used for contraception are not routinely measured when urine is analysed for insurance purposes or routine medical testing. Urine is routinely tested to screen for diabetes, kidney disease, the presence of blood or a urinary tract infection, but it can provide information on a whole host of other conditions (see reference 3 for more details).

A young woman can rest assured that taking a urine test will not be used to show that they are taking oral contraceptives - there is no reason for it to be screened for. In most jurisdictions, doctors would not be allowed to discuss the results of a urine test with parents unless given the patient’s prior consent. An unwanted pregnancy would be much more difficult to keep from your family; so sexually active women should use contraception, or ensure that their partner does.

References

  1. Systematic review of contraceptive medicines “Does choice make a difference?” RHRU, University of the Witwatersrand, South Africa:. https://archives.who.int/eml/expcom/expcom15/applications/sections/ContraChoiceReview.pdf
  2. Mechanisms of the Contraceptive Action of Hormonal Methods and Intrauterine Devices (IUDs), Family Health International: https://www.fhi.org/en/rh/pubs/factsheets/mechact.htm
  3. Medline Plus, National Library of Medicine and the National Institutes of Health: https://www.nlm.nih.gov/medlineplus/ency/article/003579.htm