Nine days after 15-year-old Jodi loses her virginity to her high school boyfriend, she realizes her period is a week late. Two weeks later, she and her boyfriend decide to tell both of their moms, who advise them to take a pregnancy test. The test came back negative; however, Jodi had already stressed her body out so much that it took nearly another month for her period to finally start. Because she was so young and did not yet understand her body, the emotional distress that Jodi experienced caused some of her body to shut down – specifically her gallbladder, which she had to get removed later that year due to the immense stress.
“I was so young and confused about sex and pregnancy at the time,” says Jodi, who is now 22. “My mind continued to convince me that I was pregnant, even though I wasn’t.” After the scare, Jodi immediately decided she needed birth control. After discussing it with her mom and her doctor, they decided that Jodi should start with oral contraceptives. However, Jodi soon switched to a long-acting reversible contraceptive, because she learned that they are the most convenient and effective forms of birth control available. “If I would have had that baby when I was 15, I wouldn’t have been able to go to college. I wouldn’t have any of the opportunities I’ve had, friends I’ve made, or memories I’ve gained over the years. Birth control has allowed me to live a healthy lifestyle, free of stress and other negative effects that stem from the fear of an unplanned pregnancy.”
Women that are sexually active, however, are not the only population seeking birth control.
“The two biggest reasons that women begin to use birth control are to prevent pregnancy and to regulate menses, whether that be to control heavy bleeding, irregular bleeding, or painful bleeding,” says Dr. McCarty.
“My youngest patient on birth control was probably fourteen,” says Doctor Susan Emmick, who has been a pediatrician for 22 years. “Anyone who has started menstruating can use birth control.” According to the National Health Statistics Report (NHSR), about 62% of all women of reproductive age are currently using birth control, whether it be for contraceptive reasons or reasons unrelated to pregnancy.
“In addition to preventing pregnancy, I prescribe birth control to my patients to alleviate heavy or painful periods,” says Dr. Emmick. “I also prescribe birth control to patients with severe acne, because it can help with that.”
However, Dr. Emmick notes that because younger teens are not reliable when taking medications, she oftentimes prescribes the less comfortable types of birth control because they do not require everyday attention.
“In regard to my patients, the most common type used in younger girls is Depo-Provera,” says Dr. Emmick. “The second and third most common are probably oral contraceptives and Nexplanon.” So, two out of the three most common birth control methods in Dr. Emmick’s patients involve a typically painful injection or incision. However, according to the National Center for Health Statistics, only 8% of women between the ages of 15 and 44 that are on birth control are currently using LARCs. Despite this statistic, it is evident that users of these methods believe that the temporary pain of the injections and implants is worth it, because it means that they are able to avoid the long-term negative effects of acne, heavy and painful periods, and pregnancy.
21-year-old Carli experiences weakness and lightheadedness every day. She visits her doctor, who performs blood tests and notifies her that she is anemic; on top of this, Carli gets her period twice a month. To regulate it, her doctor suggests that she begin using the 3-month birth control pill, which will minimize her bleeding significantly. The pills helped with her anemia; however, she continued experiencing mood swings, which triggered severe anxiety and depression. Her pills also made her nauseous, and remembering to take her pills every day proved to be challenging to Carli because of her busy lifestyle.
“Missing just one pill would completely mess up my cycle – sometimes my period would last an entire month after I missed a pill. I finally decided to try a long-acting reversible contraceptive, even though I was nervous about it due to the horror stories I have read online,” says Carli. “However, the experience was not nearly as bad as I expected – it was more than worth it, and it has helped so much with my anxiety and depression. Thanks to this type of birth control, I am much healthier, both mentally and physically. I would suggest it to all women who endure the same negative impacts that I did as a result of my period.”
18-year-old Samantha clenches the arms of the gynecological examination chair, her legs spread, exposing her body in a way that is completely unfamiliar to her. The nurse inserts a speculum into her vagina before using a long tube to guide the intrauterine device (IUD) through the opening of Samantha’s cervix and into her uterus. The pain that follows the insertion takes Samantha’s breath away, causing the examination room to spin around her. She closes her eyes for a moment, hoping that the dizzy, nauseating feeling will soon pass.
“It was very much worth it,” Samantha says, despite the painful experience. “As far as pain goes, it was definitely up there in the worst pain I have experienced. But the fact that I don’t have to worry about a period or pregnancy for the next four years, because I have already had it for one year, is like a huge weight off my chest.” Women all over the country endure these painful, and sometimes traumatic, processes every day. Is the pain of the insertion, as well as the pain that ensues the days following the insertion, worth it? Most women would say yes, it is more than worth it.
According to Planned Parenthood, IUDs are one of the most effective birth control methods available to women, being 99% effective. They are long-term, as some types can last up to twelve years, and they are reversible, allowing them to be removed whenever the woman decides to discontinue use. The removal process is typically quick and pain-free; health care providers gently pull the string, and the IUD slips out gently. The various IUD types act as barriers, preventing the sperm from being able to reach and fertilize the egg. IUDs are extremely effective because women cannot forget to take them or use them incorrectly.
“The most common birth control methods are pills, the NuvaRing (a monthly ring placed in the vagina), Depo-Provera (a three-month shot), Nexplanon (a three-year capsule placed underneath the skin of the arm), and the intrauterine device, or IUD,” says Doctor Bob McCarty, who has been an obstetrician-gynecologist for 18 years. “All are great, but I prefer the LARCs (long-acting reversible contraception), which are the Nexplanon and the IUD. I prefer these because they are hard to forget and tend to take away menses, which most women like. Young women who have never had a pelvic exam might struggle with the IUD because of the invasiveness of placement; in these cases, I prefer the Nexplanon.”
Planned Parenthood states that women should not get any type of IUD if they have an STD or other pelvic infection, think they might be pregnant, have untreated cervical cancer, have cancer of the uterus, have vaginal bleeding that is not their period, or have had an abortion in the past three months. Otherwise, symptoms and side effects are rare and not serious. IUDs do not protect against STDs, so it is important for women to pair their IUDs with condoms during sex.
20-year-old Emily cringes as her doctor injects numbing medicine into the tissue of her upper inner arm, only to then gently glide the blade of a scalpel across the skin of her arm, creating a small incision. The doctor then places a matchstick-sized rod in Emily’s arm, which will cause swelling, tenderness, and bruising for the next couple of weeks. Emily also risks developing an infection where the implant is inserted, and she is aware that she must undergo a similar process when the time comes to remove the rod.
“The doctor told me that other types of birth control may put me at a higher risk of developing blood clots,” says Emily, who has a congenital heart defect. “Despite what a lot of women think, Nexplanon is one of the safest birth control methods.”
This is the other type of birth control, aside from the IUD, that Dr. McCarty prefers when prescribing his patients: the Nexplanon, or “the implant.” Like the IUD, the implant is one of the most effective types of birth control, and it is convenient because it is, as Planned Parenthood describes it, a “get-it-and-forget-it” birth control method.
“Nexplanon is totally worth it,” says Emily. “It gives me peace and reassurance, and I don’t have to worry about accidentally missing a pill.” The implant protects 99% of women from pregnancy for up to four years, releasing the hormone progestin to thicken cervical mucus and stop ovulation.
“I had a rough start with birth control just because I wasn’t finding the right method that worked best for me,” says 20-year-old Taylor, who has tried three different types of birth control in the last five years. “When I was 15, I started on the pill, which was too inconsistent for me, so I switched to the patch, which was too complicated for me. Now I’m on the Nexplanon, which has been the most effective for me. I’ve loved it so far.”
The implant is also similar to the IUD in the way that it can be removed whenever a woman wants to get pregnant. It is also safe to use the implant while breastfeeding; however, if a woman has breast cancer or has had breast cancer in the past, she should not use the implant as a birth control method. Possible yet extremely rare side effects of the implant include headaches, breast pain, nausea, weight gain, ovarian cysts, and continuous pain or bruising where the implant was inserted. The implant can cost up to $850; however, most insurance and government plans cover the cost. Because the implant does not prevent STDs, it should be paired with condoms if the woman using it is sexually active.
Birth control is important and should be encouraged as a contraceptive for women that are not prepared for children.
“Birth control allows a woman to have control of her reproductive life,” says Dr. McCarty. “She is able to have sex without the concern regarding unwanted pregnancy.”
“Birth control has given me comfort in knowing I am protecting myself in situations where sex could occur,” says Jodi. “They give me a sort of ‘safety crutch’ if anything is to ever happen, intentional or unintentional.”
“I’m definitely in favor of birth control,” says Taylor. “It can prevent millions of unwanted pregnancies, especially for young teens that are sexually active with someone they may not be spending the rest of their lives with.”
Birth control is important and should be encouraged for reasons other than preventing pregnancy as well.
“There are many uses for birth control aside from contraceptive use,” says Dr. Emmick. “For many of my patients, its use is crucial in order for them to maintain a healthy and comfortable lifestyle.”
Health care providers like Dr. Emmick and Dr. McCarty often suggest LARCs to their patients because of their effectiveness. In terms of reversible contraceptives, IUDs and the Nexplanon are 8% more effective than the next most effective types, which include the patch, vaginal ring, and pill.
“The insertion of LARCs is highly dramatized,” says Dr. Emmick. “The experience is not nearly as scary as most women think, and this leads women to opt for common birth control methods that are less effective. It does depend on the woman; however, many women overlook LARCs, even though they may be the perfect fit for them.”
Women of all ages struggle every day with the negative impacts of menstrual cycles. Many seek help in hopes of gaining a new sense of confidence, preventing an unwanted pregnancy, or attaining a healthy and comfortable lifestyle. Jodi has taken the necessary steps in order to prevent her body from shutting down in the way that it did when she was only 15 years old. Carli is now healthier, both mentally and physically, thanks to her birth control. Emily has gained a new sense of confidence; her implant has reduced the emotional toll of menstruation as well as improving her acne. Taylor no longer experiences frustration regarding her birth control, and she is confident that her IUD will continue to prevent unwanted pregnancy. Sam has attained a healthy and comfortable lifestyle; her IUD has alleviated her excessive and painful bleeding. All of these women hope to share their stories with women who may be questioning LARCs, in hopes of convincing these women to take this necessary step in order to improve their health and happiness.