I get a lot of questions in my practice about birth control. And I will be transparent in saying that, almost %100 of these questions come from women. The reality is, a lot of the responsibility in terms of preventing an un-wanted pregnancy lies on a woman. I used to have quite a frustrated view on this, but I realized fighting against reality wasn’t productive so I tried to get as much information as possible in hopes of giving valuable information to my clients.
The two biggest questions I get are:
“What is the best birth control to go on?”
“What birth control won’t mess with my hormones?”
Now, these two questions are vary vague, so I usually follow up with a few questions myself.
The first thing I ask my clients is “What is the reason you are seeking out contraception?”
This is important because although the answer seems very straight forward, a lot of women believe their only viable option for preventing a pregnancy is a hormonal birth control. Also, hormonal birth control is used for a lot of reasons other than preventing pregnancy. The choice has to be made powerfully and with the information necessary to make a powerful decision. If you are sexually active and wanting to avoid a pregnancy, there are countless options. If you are wanting to regulate your hormones, there are countless options. If you are wanting help to clear up your skin, there are countless options. Whether you are wanting to regulate your cycle, clear up acne or avoid a little one on the way, hormonal birth control is an option just as much as it is not the only option.
I don’t believe that any one suggestion fits for everyone, although there are common trends that seem to happen with birth control methods being used. The one thing that I have noticed with birth control, or contraception, is it seems to be a trend that drives the industry, not necessarily the most productive method for each individual person taking it. As history shows, the status quo seems to choose it’s method of contraception.
But, popular does not always mean best option.
The first ever oral contraceptive pill (OCP) was approved by the US Food and Drug Administration (FDA) in 1960. The Enovid Pill swept the nation after Margaret Sanger spent 10 years putting money and research into this form of contraception for women. It was the 1960’s and the feminist movement was beginning to make serious headway in North America. The birth control pill gave women a sense of sexual liberation and many women felt like it was the first time they were able to enjoy their sex lives the way most men had been for years; With freedom and without heavy consequences. This little pill gave a number of women a different purpose and by 1970 college enrolment was 20% higher among women who had access to birth control.
Fast forward to 2018 and we have turned against the hormone birth control pill for a new invention; the Intrauterine Device (IUD). At this point, everyone and their mother now has a little T shaped device inserted into their uterus to block the fallopian tubes and therefore pregnancy, (myself included, up until a few months ago). It promises a 99% success rate of preventing pregnancy and is a more desirable option for most women as it proves to only release a low dosage of progestin. We are in an era where “hormones” are spoken about often and with strong opinion, so it’s no coincidence that we have opted for a device that barely interferes with them and have boycotted what was once thought to be our liberation.
The point is, just because it is most popular, does not mean it is the right fit for you as an individual. If preventing an unwanted pregnancy is your goal, there are countless options and you do have the power to choose what fits right for you.
Below I have listed all methods of birth control starting from the most effective, to least effective. Take a moment to read and see what feels right for you.
Outercourse / Abstinence – Refraining from sexual intercourse is the only guaranteed method of preventing pregnancy.
Vasectomy – The small tubes in your scrotum (vas deferens) are cut or blocked off so sperm is unable to leave your body. Lasts a lifetime and is performed by a physician and is an outpatient procedure done with local anesthetic to numb the scrotum.
Sterilization (Tubul Ligation) – also known as “getting your tubes tied” is a surgical procedure that permanently blocks the fallopian tubes so an egg is not able to be released each month. Lasts a lifetime and is done by a surgeon while under anesthesia.
IUD (Intrauterine Device) – Brands like Mirena and Jaydess make a small, plastic, flexible T shaped device that is inserted through your uterus that thickens the cervical mucus which blocks and traps sperm from entering the uterus. The use of a low dosage of progestin also stop a females egg from being released from the fallopian tubes. No egg, no sperm, no pregnancy. Can be worn from 3 – 5 years and is inserted by a physician during a small, minimally invasive procedure.
Birth Control Implant – A tiny, thin rod that is implanted into your arm and releases hormones into your body that prevent pregnancy. Can be worn for up to 4 years and is done by a nurse or doctor with a local anesthetic to number the arm.
Breastfeeding – While breastfeeding your body stops ovulating. Your body produces a hormones called “prolactin” which inhibits the hormones needed in order to ovulate.
Birth Control Shot – the Depo-provera shot is an injection that contains progestin which stops ovulation and thickens the cervical mucus so sperm is unable to enter through the cervix. The shot is given by a nurse or doctor and has to be given every 3 months.
Birth Control Vaginal Ring – Nuvaring is a small, flexible ring that sits inside the vagina and contains hormones like estrogen and progestin and stops ovulation. It is changed monthly and inserted yourself
Oral Contraception (OCP) – An oral pill that is taken daily and contains hormones that prevent ovulation and thicken the cervical mucus not allowing sperm to enter. Different birth control pills contain different hormones and different dosage of each hormone – ask your doctor which ones yours contain.
Birth Control Patch – This is a transdermal patch, meaning it is placed on top of the skin either on your belly, upper arm, butt or back and releases hormones through the skin that prevent ovulation. and thicken the cervical mucus. It is worn for 3 weeks and a new patch is changed weekly.
Diaphragm – Is a small, flexible cap that is inserted in the vagina that covers your cervix. This is a non-hormonal barrier option of birth control that blocks the cervical opening and stops sperm from entering. It is inserted up to 2 hours before sex and works best if coated with a. Spermicide prior to inserting.
Condoms – As most people know, condoms are a thin and stretchy dome like material that is placed over the penis prior to sex. It blocks the sperm from being released and is confined in the condom and ejaculation.
76% – 88%
Fertility Awareness Methods (FAMS) – These are methods that involved a woman understanding tracking and being aware of her cycle. This includes ovulation test strips, tracking temperature with a basal body thermometer and tracking cervical mucus. Also using apps to track your cycle and having a body connection in order to detect when a woman is ovulating. To prevent pregnancy this gives you and your partner an idea of when to avoid intercourse (during ovulation) or when to use other birth control methods (ie: condoms, diaphragm etc).
Birth Control Sponge – The sponge is a soft, squishy material that is placed in the vagina before sex. It is covered in spermicide and blocks the cervix. This slows down sperm movement it and blocks sperm from entering the cervix.
71% – 86%
Cervical Cap – Very similar to a diaphragm, a cervical cap is a small device made of silicone that is inserted into the vagina and covers the cervix. Most effective when used with a spermicide, it also blocks the sperm from entering the cervix.
Female Condom – This is an alternative to a male condom, it is a device made of soft plastic that is inserted into he vagina and creates a barrier which stops the sperm from entering the uterus.
Withdrawl (pull out method) – This is when the penis is pulled out right before ejaculation so that no sperm is released into the vagina and into the cervix. This method does not prevent pre-ejaculate from being released into the vagina, which could cause pregnancy.
Spermicide – Using a spermicide can help to prevent pregnancy in two ways. It is a chemical that is placed deep into the vagina before sex and helps to cover the cervix not allot sperm to enter. It also contains ingredients that slow down the movement or sperm which make it difficult for it to move enough to reach an egg.
As I try and relay to all of my clients, get all of the information you can and then make an informed decision that “feels” right for you. Understand the consequences, or potential aftermath, of all your options. If what you are wanting to do is prevent an unwanted pregnancy, there are countless options for you. Weigh out the risk and benefits of each method and you’ll be able to see what option is the best fit for you. If what you are wanting is to help clear up your skin or regulate your hormones or emotions, look into what trends are happening with these methods and ask yourself; “why is it so popular right now and does that mean it will work for me?”