A Lesson In Birth Control Methods

What’s Best For You?

The Different Types of Birth Control
From abstention to the “Morning After” pill, birth control is any means used by a woman or a couple to determine when they will have a child.

Sometimes a birth control method can be used to help with a physical pain or medical problem.

For instance over 90% of women get some premenstrual symptoms (PMS). These can take the form of bloating, headaches, mood swings, acne, or abdominal pain. Some women are not much bothered by these symptoms, while others suffer so badly they miss work or school one or more days per month.

Contraception Methods graphic

Oral contraceptive pills can even out the hormone fluctuations that come with the menstrual cycle and by doing so provide relief from many of the symptoms of PMS.

Endometriosis is another medical condition that can be helped by using one of several birth control methods. Endometriosis is a frequently painful disorder in which tissue that normally lines the inside of your uterus grows outside your uterus commonly in the ovaries, fallopian tubes and the tissue lining your pelvis.

By controlling the hormones responsible for the buildup of endometrial tissue each month, birth control pills, patches, and vaginal rings help may reduce or eliminate the pain of endometriosis.

An additional benefit sometimes found with taking the pill is that it may help treat a type of skin inflammation (dermatitis) that seems to be related to your menstrual cycle.

However, the primary use for birth control is to prevent pregnancy. Many different methods are available that work well, each has its own particular benefits and risks.

Forms of Birth Control

Birth control methods that prevent sperm from reaching the egg are known as barrier methods. Then there are those methods of birth control that prevent ovulation and those that prevent the fertilized egg from getting implanted into the uterus. Finally, for individuals who are certain they no longer desire having children, there are permanent, surgical methods of birth control.

Birth Control Pills
One of the most well-known methods of birth control is the oral contraceptive known as “The Pill”. Birth control pills are a hormonal contraceptive which contains a small amount of man-made estrogen and progestin hormones. These hormones inhibit the woman’s natural cycle, preventing ovulation and altering the lining of the womb.

Birth Control Pills in package

There are a few different types of birth control pills, Each must be taken as directed by your doctor and the materials provided in the package.

Combination Pills
Birth control pills containing two hormones – estrogen and progestin – are called combination pills. These are the most common type of oral contraceptive. These usually come in 21-day or 28-day packs.

As long as you take one pill every day you’re protected from pregnancy while taking this form of contraception. (taken correctly oral contraceptives are over 99% effective.)

21-Day Packs
Take 1 pill every day for 21 days (three weeks) in a row. Then take no pills for seven days (the fourth week). You’ll get your period during the fourth week when you aren’t taking any pills. It’s important to take every pill in this type of pack because there are no hormone-free reminder pills like there are in the 28-day pack. Note that you are protected from pregnancy even during the week that you are not taking the pills.

28-Day Packs
Take 1 pill every day for 28 days (four weeks), and then start a new pack on the 29th day. The last pills in the 28-day pack are hormone-free pills (how many will depend on the brand). To stay on track, make sure you take all the pills provided.

91-Day Packs
Some combination pills have 12 weeks’ worth of hormone pills in a row, followed by up to a week of hormone-free reminder pills. When you take this type of pill, you will only have your period once every three months.

Progestin-Only Pills (Mini-Pills)
If you’re breastfeeding, have certain health problems, or don’t want to take estrogen, your doctor may recommend you take progestin-only pills for birth control. As the name implies, these pills contain only progestin.

Unlike combination contraceptive pills, these mini-pills must be taken within the same three hours every day in order to be effective.

Progestin-only pills come only in 28-day (four-week) packs. All 28 pills have hormones. And you must take every pill in a progestin-only pack to be protected from pregnancy — there is no hormone-free week. You may get your period during the fourth week. You could also have bleeding on and off throughout the month (spotting) or get no period at all.

An important factor to be aware of with the mini-pill is that it does not have as high a level of effectiveness as other contraceptive pills. It’s estimated that as many as 13 out of 100 women who use the mini-pill will get pregnant in a year of use.

Who shouldn’t take the pill?

Most women have no problem when taking birth control pills, but this form of contraception isn’t right for everyone.

If you smoke and are over 35 years old, you shouldn’t take the pill or use any other kind of birth control that contains estrogen.

  • Also, avoid using combination pills (those with estrogen) if you have any of these health problems:
  • Breast cancer
  • Heart problems, including heart attack, stroke, or angina
  • Blood clots, an inherited blood-clotting disorder, or vein inflammation
  • Uncontrolled high blood pressure
  • Migraine headaches with aura (seeing flashing, zigzag lines)
  • Liver disease
  • Severe diabetes

It’s important to go over your medical history with your doctor before taking any medications, including birth control pills.

Additional Benefits of Taking Birth Control Pills

Acne – Taking the pill can prevent the pimples that often accompany the menstrual cycle.

Cramps – The most common menstrual problem, cramps are caused by too much prostaglandin, a hormone that makes the uterus contract. The pill can eliminate this issue.

Endometriosis – Birth control pills help control estrogen, which is the hormone causing the buildup of endometrial tissue each month. The exact dose of progesterone in the pill helps reduce or eliminate endometriosis and the pain it causes.

Heavy or Irregular Periods – The progesterone in the pill makes the menstrual cycle regular and thins out the uterine lining, making your periods lighter.

Mood Swings – The steady hormones in the pills tend to lessen the emotional problems and mood swings come with PMS in some women.

Risks Associated with Taking Oral Contraceptives (The Pill)
Complications from taking the pill aren’t common, but they can be serious. Risks include heart attack, stroke, blood clots, and liver tumors. In rare cases, these risks can lead to death. For the most part, progestin-only pills avoid these risks.

Side Effects Related to Taking Oral Contraceptives (The Pill)
Possible side effects from taking oral contraceptives include: nausea, spotting, breast tenderness, weight gain, headaches and migraines, missed periods, mood changes, decreased libido, skin discoloration, changes to eyesight for those using contact lenses, and vaginal discharge.

IUD (Intrauterine Device)
An IUD is basically a small piece of flexible plastic, shaped like a T that is placed inside the uterus by a doctor.

IUDs are divided into 2 types: copper IUDs and hormonal IUDs. Both the copper IUDs and the hormonal IUDs prevent pregnancy by changing the way sperm cells move so they can’t get to the egg.

IUD shown in hand

The copper IUD works because sperm doesn’t like copper, so the copper in the IUD makes it almost impossible for sperm to get to the egg.

The hormones in a hormonal IUD prevent pregnancy in two ways: by thickening the mucus that lives on the cervix, which blocks and traps the sperm, and by stopping eggs from leaving the ovaries and coming in contact with a sperm.

Benefits of using an IUD
With an IUD you don’t have to remember to take a pill or to do anything special for birth control before having sex.

IUDs last for years but are not permanent. If you decide you want to get pregnant or you just don’t want your IUD anymore, your doctor or nurse can quickly and easily remove it. There are no after-effects and you’ll be able to get pregnant right after the IUD is removed.

The copper IUD also works as emergency contraception. If you get it put in within 5 days after having unprotected sex, it’s more than 99% effective.

Risks and Side Effects of using an IUD
Some women experience side effects from getting an IUD. These normally go away within a few months.

  • Side effects can include:
  • Pain when the IUD is put in
  • Cramping for a few days after the IUD is put in
  • Backaches for a few days after the IUD is put in
  • Spotting between periods
  • Irregular periods
  • Heavier periods
  • Worse menstrual cramps

The diaphragm looks like a shallow cup or a saucer with a rim around the edge. It’s made of latex or silicone placed inside the vagina, over the cervix to block the entry of sperm. The rim of a diaphragm is squeezed into an oval or arc shape for insertion. A water-based lubricant (usually spermicide) may be applied to the rim of the diaphragm to aid insertion. Spermicide is placed in the dome of the diaphragm before insertion, or with an applicator after insertion.

Diaphragm shown

The diaphragm must be in place before intercourse and remain there for 6 hours following. Fitting for a diaphragm is done by a doctor or nurse.

Risks and Side Effects Associated with the Diaphragm

The woman must remember to put the diaphragm in place before having sex and it has to be used correctly in order for it to work. The diaphragm has a one-year failure rate of around 12% with typical use.

Some people using diaphragms get urinary tract infections. Some women are sensitive to the spermicide or to the material the diaphragm is made from.

Vaginal Ring
A vaginal birth control ring is commonly known by the brand name NuvaRing. It’s a small, flexible ring that a woman inserts into her vagina once a month to prevent pregnancy. It remains in place for three weeks and is taken out for the last week of the month.

Vaginal Ring in hand

The vaginal ring, just like many other hormone based birth control methods, releases hormones such as estrogen and progestin. These hormones make the cervical mucus thicker, which prevents sperm from getting to the eggs. It also prevents the eggs from leaving the ovaries and joining up with the sperm.

Benefits of Using the Vaginal Ring

The vaginal ring is a simple and effective way to prevent pregnancy. There is no preparation required before intercourse. Man women using the vaginal ring have shorter, lighter periods.

The ring can also help to protect against: Acne Menstrual cramps Ovarian and endometrial cancers Non-cancerous breast growths Bone thinning Headaches related to PMS Depression related to PMS Premenstrual symptoms (headaches/depression) Infection of ovaries, uterus, and tubes Ovarian cysts Pelvic inflammatory disease Irregular/heavy periods Iron deficiency anemia

Risks and Side Effects of Using the Vaginal Ring
There are some undesirable side effects associated with the Vaginal Ring.

These include:

  • Vomiting or nausea
  • Bleeding between periods
  • Breast Tenderness

Long-lasting Side Effects Can Include:

  • Vaginal irritation
  • Increased vaginal discharge
  • Infection
  • Changes in sex drive

Morning After Pill
Used only for emergency contraception, the morning after pill can prevent pregnancy when taken within 5 days of having unprotected sex. These pills work by preventing or delaying ovulation or fertilization and therefore preventing pregnancy. The morning-after pill is intended for backup contraception only, not as a primary method of birth control.

Morning After Pill in box

Benefits of the Morning After Pill
They can be used to prevent pregnancy after having had unprotected sex.

Risks Associated with The Morning After Pill
There’s some indication that the morning-after pill won’t be as effective in preventing pregnancy on women who are overweight as it is for women who aren’t overweight.

Do not take if you are pregnant or breastfeeding. The effects of The Morning After pill on a developing baby are unknown.

Side effects of the morning-after pill, which typically last only a few days, might include:

  • Nausea or vomiting
  • Dizziness
  • Fatigue
  • Headache
  • Spotting
  • Heavier than usual period
  • Breast tenderness
  • Lower abdominal pain or cramping

Implant Birth Control
Nexplanon, the birth control implant is a small, thin rod about the size of a matchstick. A doctor or nurse places the implant into your arm and for four years it releases the hormone progestin into your body.

Birth Control Implant in arm

The hormones in the implant prevent pregnancy in two ways:

  • Progestin thickens the mucus on the cervix, preventing the sperm from swimming through to the egg.
  • Progestin can also stop the eggs from leaving the ovaries, so there are no eggs to fertilize.

The implant is not permanent and can be removed by your doctor or nurse at any time. You will soon after be able to get pregnant again.

Benefits of Implant Birth Control
This method of birth control lasts 4 years.

Side Effects Connected with Implant Birth Control

  • Breast Pain
  • Headaches
  • Infection in the Location of the Implant
  • Nausea
  • Ovarian Cysts
  • Pain or Bruising in the Location of the Implant
  • Periods that are longer and heavier
  • Spotting
  • Weight Gain

Depo-Provera Birth Control
Depo-Provera (AKA The Depo Shot) is an injection of the hormone progestin you get from a doctor or nurse once every three months. Progestin stops you from getting pregnant by preventing ovulation. When there is no egg available to meet up with the sperm, pregnancy cannot happen. The Depo Shot also works by making the cervical mucus thicker so the sperm cannot get through.

Birth Control Shot shown

To make sure you retain the full power of Depo-Provera birth control shots you have to remember to go back to the doctor for a new shot every three months.

Benefits of Depo-Provera
The main benefit of the Depo-Provera shot over other birth control methods is that it lasts three months, so you don’t have to remember to take it when you’re supposed to, as with the pill or interrupt intercourse to put it on like you do a condom.

Side Effects and Risks Associate with Depo-Provera
Some people get side effects when using Depo-Provera. These can include:

  • Bleeding more days than usual, spotting between periods, or no periods
  • Breast tenderness
  • Bruising where the shot was given
  • Depression
  • Headaches
  • Nausea
  • A small, permanent dent where the shot was given (very rarely)
  • Weight gain

It may take up to 10 months to get pregnant after stopping Depo-Provera.

One of the oldest and most popular methods of birth control is the condom. Condoms slip over the penis to prevent pregnancy and lower the risk of STIs by keeping sperm inside the condom and out of the vagina. There are also internal condoms that go inside the vagina.

Condom in hand

Benefits of a Condom
The main benefit is that, other than abstinence, using a condom is the only form of birth control that protects you from HIV and STDs.

Side Effects and Risks of Using a Condom
There are little to no side effects of using condoms. Some people might feel irritation caused by the latex, but condoms come in other materials such as nitrile, polyisoprene, polyurethane and lambskin.

The only real risks are forgetting to put it on or having it break during intercourse.

Permanent Birth Control
Permanent birth control should obviously, only be considered by individuals or couples who are through having children.

Surgical sterilization is a form of permanent birth control available for both women (tubal ligation) and men (vasectomy).

Benefits of Permanent Birth Control
The benefit of this birth control method is that it is permanent and no other contraception is needed.

Risks Associated with a Vasectomy or Tubal Ligation
Although women who have had tubal ligation do not have side effects after recovering from the procedure, any surgery itself carries a small risk of infection or bleeding as well as complications from the anesthetic agents.

A vasectomy is associated with small risks from the procedure as well as some swelling and pain in the days following the procedure.

The birth control method you choose is a personal decision and one that should not be made without sufficient information. There is no single choice that’s best and safest for everyone. You need to weigh carefully the risks and the benefits and the effectiveness of each method before choosing which form of birth control to use. An open discussion with your physician must be part of the decision-making process. A doctor can guide you through the maze of information and help you find the birth control method that best suits your health, age, and lifestyle.