It seems like birth control is always under attack. Should women have a right to it? Should they pay for it? Despite the sheer number of people who use some sort of birth control, misinformation spreads like wild fire. Birth control is obviously primarily for avoiding pregnancy, but it is also used in the treatment of several disorders such as polycystic ovary syndrome, endometriosis, amenorrhea, premenstrual syndrome and others. It can also be used in cases of heavy acne to help rebalance the contributing hormones. For this article, I would like to focus on the goal of preventing pregnancy. There are several types of prevention ranging from medications to implants to barrier methods. Each method comes with different benefits and risks, and it’s important to understand how each works so you can make educated decisions about your health. Most of this information can be found on the Planned Parenthood website, but I’ve taken highlights of some of the key qualities.
Hormonal Methods
The birth control pill (oral contraceptive) is one of the most commonly used forms of preventing pregnancy. These pills must be taken every day. According to Planned Parenthood, if used perfectly, the pill is 99% effective, but as most people don’t use it absolutely perfectly, it may actually be around 91% effective.
There are two main types of pills: the more common combination pill and a progesterone-only pill (mini-pill). Some people may not do well on a combination pill, so the mini-pill is a better option for them. Both pills typically come in a package of 28 days laid out in four weeks. The combination pill contains three weeks of active pills and one week of sugar pills that should correspond with your period. The mini-pill does not have an off week so you take an active pill every day. You should try to take your pill around the same time every day, but this is slightly more important for the mini-pill.
Birth control pills come in many doses and formulations. Each formulation, while it may contain the active compound, has slightly different inactive components that may affect each person differently. Because of this, many women have to try different pills until they find one that agrees with their body.
The pill is convenient because it is easy to carry around the pack and as long as you take it every day, there is little concern about pregnancy. If you wish to become pregnant, all you have to do is stop taking the pill. Birth control pills are very effective at regulating hormones, which can lead to more consistent periods that are often shorter and less intense. All medications have the potential for side effects, and these will vary between formulations. One major drawback to the pill is that you have to take it every day. Missing a pill increases your risk of pregnancy. If you are someone who has a hard time remembering to take a daily pill, there are apps you can download to help remind you, but a different birth control method may be better for you.
The patch is not as common as the birth control pill. The patch typically contains both estrogen and progesterone, just like combination pills. You wear it on your skin and you must change it every week. You wear a patch while changing it weekly for three weeks, and then get a week off. Just like the pill, the patch ranges from 91-99% effective based on how well you use it.
The patch boasts many of the same benefits as the pill, but you don’t have to remember to take it every day. You still have to remember to change it once week, but you can use an app or calendar to help keep track of when to change it. Some women may feel self-conscious having the patch visible on their skin during sex, so it may not be the best option if that is a problem for you.
Nuvaring is a hormonal contraceptive that is worn in the vagina. It stops ovulation, and if no egg is released, there cannot be pregnancy. You can wear the ring continuously, changing it once every 28 days, to skip your period. If you’d prefer to have your period, you can wear it for three weeks and take a week off. Like the other methods above, if you wish to become pregnant, you just have to stop use. The ring is a very convenient form of birth control because you only have to change it once a month and it isn’t visible to partners. The only downside? It may be more expensive depending on your insurance.
The shot, which typically contains only progesterone, is highly effective at preventing pregnancy. Once every 12 weeks, you must go get a shot that will protect you until the next dose is needed. With perfect use, the should is more than 99% effective. If you account for people who miss doses, the shot is, overall, around 94% effective. The shot is best known for its ability to stop menstrual cycles. You only have to remember it once every three months and usually requires making an appointment, so it’s a good option for people who are more forgetful. There is more research coming out about the shot, and they point to a high potential for side effects. Many women report continuous spotting for up to the first 12 months of use. Weight gain and loss of bone density are major concerns when using Depo-Provera. If you wish to become pregnant, it may take an upwards of 10 months for fertility to return after stopping the shot.
The implant is another good option for women who have difficulty remember a daily pill or to change other methods. The implant, which is about the size of matchstick, contains progestin which may stop ovulation, but primarily thickens the cervical membrane so that sperm can’t reach the egg. The implant is good for up to five years and is more than 99% effective. Because the implant is a one-time insertion, it’s nearly fool-proof. The implant reduces or may totally eliminate periods. You can get pregnant immediately after removing the implant. The side effects are similar to the other methods, but the weight gain is less of a concern compared to the shot. While most insurances cover the insertion and removal of the implant, it can be very expensive without coverage. The insertion of the implant does include the administration of a numbing agent to the arm and a small incision.
IUDs are very effective (nearly 100%). They can be costly and the insertion is known to be painful. In addition, there are known cases of the IUD moving which can require surgery. Despite this, the IUD is a great choice for women who are not interested in becoming pregnant in the next few years. There are five different IUDs available in the United States.
Hormonal: All the hormonal IUDs use the same hormone (progestin) but are effective for different times. In addition, some IUDs are better suited to women with specific anatomical features.
1) Mirena: 7 years
2) Kyleena: 5 years
3) Liletta: 7 years
4) Skyla: 3 years
Nonhormonal: There is currently one option for a nonhormonal IUD. The Paraguard IUD contains copper, which makes it impossible for sperm to move toward the egg (sperm and copper really don’t get along). The copper IUD is good for 10-12 years. You can get pregnant immediately upon removal. This is a great option for women who cannot use a hormonal form of birth control. In addition, the copper IUD can be used as emergency contraception if placed within five days (120 hours) of unprotected sex.
Of course, none of the options above protect against STDs. It is recommended, therefore, to use a condom (either male or female) every time you have sex, regardless of the use of another contraceptive. In addition, regular STD screenings are a majorly important part of sexual health.
Hopefully this information can help you make more informed decisions regarding your body and lead to better discussions with your healthcare provider.
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