Good morning, Disruptors!
We get to talk about my VERY FAVORITE TOPIC today. No, it’s not egg sandwiches or Buffy the Vampire Slayer, but those are very great guesses. It’s BIRTH CONTROL!
Why am I so irrationally excited about birth control?
Because, like many great things in our time, it has multiple hidden talents and is deeply misunderstood by the general public. Did you know you can use birth control for:
- Pregnancy prevention
- Menstrual cycle regulation
- Alleviation of menstrual cramps and other PMS symptoms
- (Barrier methods only!) STI prevention
- (Barrier methods again!) Protection for your sex toys
- Hormonal treatment of PCOS symptoms, should you choose to do so
- Treatment of PMDD
- Treatment of uterine fibroids
- Jump-starting your fertility like a friggin’ jumper cable to the ovaries (bodies! So cool!)
What do you mean by birth control?
In this post, I’m going to discuss the following methods in varying degrees of depth: pills, the patch (Ortho Evra RTM), NuvaRing RTM, birth control injections (DepoProvera RTM), the implant (Implanon or Nexplanon), IUDs (Mirena, Paragard, and Skyla), male and female condoms, sterilization, and fertility awareness (also known as natural family planning). I won’t be focusing on diaphragms, cervical caps, foams, films, and jellies because they’ve drastically fallen in use. That being said, I’m happy to discuss them further in the comments below.
Choosing a Method
Now, when choosing a method, it’s important to think about you want out of a contraceptive method. There’s lots of things to consider and Bedsider, Planned Parenthood, and Sex, Etc. all have wonderful charts and interactive tools to help you make your decision. Rather than give you another, not-as-awesome chart, I’m instead going to focus on choosing methods based on common concerns people have when selecting a method.
Important caveat: my advice to you comes from three years as a sex educator and my academic background in sexual and reproductive health. I am not a doctor and I cannot give you medical advice. However, I can share my knowledge from extensive research and training on birth control methods and my conversations with hundreds of people about their birth control experiences. Also remember that every person’s body is different and can experience each method in a different way.
- Intended use. Are you using this for pregnancy prevention? Period suppression? Hormone therapy? Acne prevention? Some combination of the above? Depending on what you’re looking for, there will be different methods that work better for you.
- Hormones. Hormonal birth control methods (pills, patches, NuvaRing, injections, implants, and certain IUDs) all contain progestin, estrogen, or a combination of the two. There are many variations in terms of the types of estrogen/progestin involved and it may take some time to find the right combination for you. Some people, such as smokers, breastfeeding parents, and people with certain medical conditions, may not be able to use estrogen methods. Here’s how the different methods size up in terms of hormones:
- The pill, patch, and NuvaRing are all combined hormonal contraceptives, meaning they contain estrogen and progestin.The only exception is the mini-pill, a progestin-only pill that is not commonly prescribed because it can be tricky to use correctly.
- Depo-Provera, the implant, and hormonal IUDs (Mirena, Skyla) are all progestin-only. They’re safe to use while breast feeding, and carry a lower risk of clotting and strokes for smokers.
- Paragard, male condoms, female condoms, diafragms, cervical caps, and spermicides are all hormone-free methods.
- If you are using a method for pregnancy prevention, think about your risk-tolerance for a pregnancy. Some methods are more effective than others. Before choosing a method such as withdrawal or natural family planning, consider: how high of a failure risk are you willing to accept? Real-world effectiveness of withdrawal and natural family planning varies: 73-88%. For some couples, that’s an acceptable risk. Others might feel uncomfortable taking on as much as a 27% risk of pregnancy.
- Discretion. Some methods are easier to hide than others. If no one in your life knows you’re on birth control, peach-colored patches or a ring your partner can feel are probably not the way to go. Depo Provera is perhaps the most discrete birth control method available; only the health practicioner giving you the injections will know you’re using it. Other more discrete methods include IUDs and implants.
- STI protection. Only two methods provide STI protection as well as pregnancy preventions: male and female condoms. If you and your partner have not been tested (and even if you have!), I would strongly recommend adding condoms to your routine. They can be used with every other method of birth control and they serve as a great back-up method in case your primary method fails. If you’re unfamiliar with the female condom, get super familiar with the help of these amazing short films, including my favorite one here:
- Partner cooperation. Some methods (fertility awareness methods, condoms, and vaginal rings to a degree) require a certain level of partner cooperation. If you have a partner/partners willing to work with you to make those methods successful, you’re golden. If not, it’s best to add another method that requires less participation from your partner(s).
- Level of responsibility. Birth control methods only work when you remember to use them. Some people are very regimented and enjoy a daily pill. Other people (myself included) are lucky if they remember their keys on the way out of the house. If you belong to the latter category, consider a longer-acting method. You’ll save yourself a mountain of pregnancy scares, hormonal irregularities, and anxiety. Your feelings on this might change if you’re using the method for non-contraceptive reasons.
- Short-term, medium-term, or long-term. This mainly pertains to pregnancy prevention, but can also apply to those using birth control methods for other reasons as well. Think about how long you would like to be using this method.
- On the flip side, there are lots of methods that are over 99% effective! These include:
- All IUDs including Skyla, Mirena, and Paragard
- Implanon and Nexplanon, the birth control implants
- Long term. Are you looking for a permanent, baby-free solution? Maybe sterilization is for you. Keep in mind: if you’re young/have never had children before, you may have a hard time finding a doctor willing to perform the procedure.
- Medium term. Long-acting reversible contraceptives (LARCS) are your best bet. These methods include IUDs (3, 5, and 12 years) and implants (3 years). As a bonus, those methods are either hormone-free or just contain progestin, so they’re safe for people with estrogen sensitivities.
- Short term. Are you nervous about how you’ll react to a hormonal method? Maybe unsure how long you’ll need to use it for medical purposes? Shorter term methods such as pills, patches, or Nuvaring might be more your speed. If you decide to stop using any of these methods, the hormones leave your body within a week and you have a speedy return to fertility. As I alluded to above, this return to fertility is so fast that some doctors will even prescribe 1-3 months birth control pills to people looking to get pregnant in order to jump start fertilty and increase the chances of success.
As you continue on your research, it’s important to remember that your body is unique; meaning, your experiences may be different from what your friends/family members/doctors/Google searches tell you. It may require some trial and error, which will possibly suck in the short term. However, it’s my hope in providing this information that I can help you make a more informed decision for yourself and your relationships.
Now, dear readers, I want to hear from you. If you or a friend/partner has searched for a birth control method, what factors motivated your decisions? How did you figure out whats best for you?