Many women who use birth control choose hormonal methods, like the pill, hormonal intrauterine device (IUD), implant, patch, and vaginal ring. Depending on the specific method, hormonal birth control usually is made up of forms of estrogen and/or progesterone. These powerful hormones can potentially wreak havoc on a body’s immune system.

Different hormones affect the body in different ways. Estrogen, for example, can cause cells to grow and make it easier to produce antibodies, while progesterone can affect T-cells. T-cells help the body respond to different invaders, like bacteria and viruses. Additionally, hormonal birth control can suppress the gonadotropins, hormones secreted in the pituitary gland. All of this can mean chaos for your immune system.

Read on to learn how some of the most common autoimmune diseases and birth control may interact.

Research has found an association between risk of Crohn’s disease and a history of using birth control pills. Studies showed current birth control pill use increased the risk the most, and the risk was higher if you had used them for more than six years.

Ulcerative colitis (UC) is more common in people who use birth control pills. You are also at a greater risk of ulcerative colitis if you use birth control pills and smoke. While the length of time people used birth control pills did not alter their risk of UC, the higher the dose of estrogen, the more likely the patients were to have issues.

The risks associated with combined hormonal birth control pill use and systemic lupus erythematosus are well-documented. What different studies disagree on is when you are most at risk from birth control use. For example, one study found that women were at the highest risk of developing lupus when they first started taking the pills, while another found the risk was raised throughout the use of birth control pills. Another showed any history of birth control pills to be a risk factor.

The links between hyperthyroid and hypothyroid disease and birth control use vary. Interestingly enough, combined hormonal birth control pills seem to protect you against the risk of developing hyperthyroid disease. However, combined hormonal birth control pill use does not appear to alter hypothyroid risk.

When it comes to multiple sclerosis (MS), it can be tricky to understand the risks associated with birth control use. For example, one study showed a significant increase in risk of developing MS in people who used birth control, but this increase could also be attributed to lifestyle (e.g., smoking status, what you eat, and environmental hazards, etc.). Another study also showed that using birth control pills is one factor that may increase the risk of MS.

Some research has found an association between the risk of developing eczema and current use of combined hormonal birth control pills. There may also be an increased risk of developing the skin disorders pemphigus and vulval lichen sclerosis. The good news is that there appears to be no increased risk of scleroderma or psoriasis when you use combined hormonal birth control pills or have previously used them. If you currently use progesterone-only birth control methods, one study found, your risk of eczema and contact dermatitis, pruritis and related conditions, alopecia, acne, and urticaria” may be higher, too.

Whether you already have an autoimmune disease diagnosis or not, it’s important to have a conversation with your doctor about birth control’s potential impact on your risk. For example, you might ask: Does this medication increase my risk of developing autoimmune disease? If yes, how much should I take that risk into account when making birth control decisions? Is there anything I can do to mitigate that risk? Is there an alternate form of birth control that might be better for my situation?

While the hormonal influences of birth control could potentially impact your autoimmune disease risk, it’s important to keep in mind that birth control can have many benefits, too — and that goes beyond pregnancy prevention. Many women decide these benfeits outweight any risks. Additionally, changing your birth control method does not guarantee that you won’t develop an autoimmune disease. Having a thorough discussion with your doctor about your personal health history, risk factors, and birth control needs can help you find the safest way forward for your situation.