If you want a more reliable form of contraception than you can get over the counter, there are a host of prescription options. Listed in order from most to least effective, you might consider a birth control implant, intrauterine device (IUD), shot, pill, patch, ring or diaphragm. While there are pros and cons to weigh with all of these methods, I’m going to focus on the two most widely-used prescripton methods: oral contraceptives and IUDs.
Oral contraceptives, or birth control pills, are the overall most common form of contraception, according to a 2015 report by the Guttmacher Institute. In fact, a 2013 study by the Centers for Disease Control and Prevention (CDC) said that, when considering all U.S. women of reproductive age who had ever had sex with men, four out of every five women had used the pill at some point. IUDs–which I’ll cover in my next post–are the fourth most common contraceptive method, following tubal sterilization (a permanent surgical operation that blocks a patient’s fallopian tubes) and condoms (an over-the-counter barrier method, which I wrote about last semester).
But regardless of popularity, there’s a lot of confusion surrounding the pill. Just last week, one of my male friends tried to tell me that oral contraceptives prevent pregnancy by continuously shedding a woman’s uterine lining (reality: no, that would mean constant periods). Another friend recently told me she was worried about starting the pill, because if you take it even 15 minutes after you’re “supposed” to, it won’t be effective (reality: no, it’s not that dire).
So: before you head over to the Student Health and Wellness Center (HelWell) to see which pills your insurance will cover, read over these answers to common pill-related questions, so you can make an informed choice about whether oral contraceptives are the best method for you.
How do they work? Birth control pills are a type of hormonal contraception, which involves taking one pill every day. The medication inhibits ovulation, meaning that an egg is not released from the ovary. Only nine percent of women experience an unintended pregnancy within the first year of using the pill, and the failure rate is even lower–at less than 1 percent–if you assume correct usage every time.
What’s in them? Pills are usually distributed in monthly packages of 28 pills. The first 21 or 24 of the 28 are hormonal pills, followed by a few reminder pills at the end of the month, which don’t have any hormones (during these days, you’ll likely get your period). In terms of what the hormonal pills contain, there are two kinds of oral contraceptives: combination pills (which have progestin and estrogen) and progestin-only pills (which, of course, have progestin). Combination pills are the more popular form of the pill, since they’re most effective.
If the pills at the end of the month don’t have hormones, why are they there? A lot of this answer has to do with the history of the pill, and a desire to have a woman’s monthly cycle on the pill mimic a natural menstrual cycle. However, if you’re taking combination pills, you can actually control your menstrual cycle and safely miss your period by skipping the reminder pills and only taking active pills. That being said, doing so may lead to light breakthrough bleeding, especially if you skip your period for more than four months. These pills also remind women to take their pill at the start of the next pack, and sometimes contain minerals like iron.
What if I take a pill late? A major drawback of the pill, of course, is remembering to take it every day. This concern is especially important for progestin-only pills, which need to be taken at the same time every day, and become less effective if taken even three hours past the time you’ve chosen. Combination pills, however, offer a fair amount of flexibility in terms of when you can take them on a day-to-day basis; generally if you take your pill within 24 hours (so once a day) you’re covered, however it is best to check with your pill’s directions. Still, if you do forget, you’ll want to use a secondary method of birth control for the next week to prevent pregnancy.
Outside of contraception, what advantages does the pill offer? The pill can regulate and lighten periods, and can also help to alleviate menstrual cramps. Beyond menstruation, combination pills even help with acne! Many women also prefer the pill because it’s one of the most easily-reversible birth control methods, since all going off oral contraceptives requires is not taking any pills for a few months.
What are its main disadvantages? Most negative side effects take place in the first few months of starting the pill: there’s the potential for breakthrough bleeding and nausea, and, depending on the type you’re taking, the pill may also decrease your sex drive. These are all relatively normal, but you should talk to your doctor if they continue past your first three cycles (or if symptoms are more serious). Also, remember that if anything keeps you from swallowing the pill–for example, vomiting–this upset will affect the medication’s success.
How much does it cost? Depending on the brand, hormonal content and what your insurance covers, the pill can cost anywhere between zero and 50 dollars each month. But before getting a prescription from your health-care provider, you may want to discuss with your parents, too. While some students have concerns about their family’s beliefs about contraception, if you’re using your parents’ insurance, it is possible for the medication to show up on their statement (if confidentiality is still a concern of yours, there are some other steps you can consider).
Photo: marieclaire.com/sex-love/advice/a1404/birth-control-pill-reviews