Woo-hoo! We are going one month strong with this blog so far! I want to thank you all for continuing to read my posts each week. When I started this, I really wanted to have a space for women’s health education without the time constraints of the clinic space. I hope that this has been educational and as enjoyable for you as it has been for me so far.
I received some feedback that we want to discuss the different types of birth control. There are SO many, and it can get overwhelming. As I said before, you have to consider your lifestyle and your specific needs to make the best decision.
Combination Birth Control (Estrogen and Progesterone)
Birth Control Pills
There are two types: combined oral contraceptives also known as COCs with estrogen and progesterone and progesterone only pills (POPs).
With both methods you need to take the pill every day. For three weeks, the pills contain active hormones, while the fourth week consists of placebos, which may be sugar or iron pills. The week that you take the placebo pill is the week that you should get your period. It can take three to four months for your period to regulate using this method.
COCs are beneficial when used just as birth control to prevent pregnancy and also for those that want a regular period each month. COCs can also improve acne!
Pills are not a good option if you are unable to or not good at taking pills daily. Set a timer to help you remember.
Vaginal Ring
This is a plastic ring that goes inside of the vagina and stays in the vagina for three weeks. At the start of the fourth week, you remove the ring; this is the week that you get your period. Once your period is over you place a new ring for three weeks. For this form of birth control, you need to feel comfortable with placing the ring into the vagina yourself.
Patch
This is a small patch, or you can think of it as a band-aid that goes on your skin. Each week you will need to change the patch and on week four you do not wear the patch as this is the week of your period. The biggest complaint of this form is that depending on the brand, the patch does not stick well. You can cover the patch with a band-aid if you want to feel more secure with this form of birth control.
**For all the methods of birth control above, you can either start them on the first day of your period, the day you receive the prescription (if you KNOW you aren’t pregnant), OR you can start on a Sunday. I personally think people do well with a Sunday start date so that you know which day you miss, especially if you are using pills as your method.**
Progesterone Only Birth Control
Birth Control Pills
POPs are more finicky than COCs and really need to be taken at the SAME TIME every day.
POPs are a great option for breast feeding women, women with heavy periods or painful periods. With this method you may or may not get a monthly period. If you get your period, it will either be significantly lighter or just spotting. You also can have no period at all with this method. However, if you miss a pill by a day or even a few hours you can start to have spotting, so set that reminder!
Injection
If you are not comfortable with shots, this is not the method for you. This birth control works for three months, meaning four times a year you go to your provider and get the injection. The first three months, it is common to have irregular bleeding while your body is getting used to it. Over time, most women do not have a period at all. Again, you can still have a super light period or spotting, it just all depends on the person. The biggest complaint of this method is weight gain because progesterone makes you hungry. Stick to fiber, protein, and smaller meals more frequently, this can help you to stay full and manage your weight.
This method is only recommended for a maximum of TWO years. After two years, you need to change to another method or take a break. The reason for this is due to the risk of bone loss. Bone loss is not uncommon during pregnancy because of decreased estrogen. Bone loss also occurs once we hit menopause, again because of the lack of estrogen. Pregnancy bone loss typically restores once we have our baby, and this is the same once you stop using a progesterone injection. You just need to give your body time to restore, so even if it is only a couple of months that you take a break from this method, TAKE A BREAK.
**Long term use over two years is only recommended if this is the only method that works well for you**
Implant
The implant is inserted under your skin and is about four centimeters long. You should be able to feel the device under your skin, but it should never interfere with your day to day. The BIGGEST complaint with this method is irregular bleeding. If I’m being realistic, the irregular bleeding or spotting can last up to one year. Not for everyone, but it can. Average is about three to six months. There are things that can help the irregular bleeding if that happens to you, so I would not say to remove it right away if you experience this side effect. This is effective for three years on paper, however recent studies show it is effective for five years, so if you have this method and love this method you can keep it a little longer.
Intrauterine Device (IUD)
This is truly my favorite method, but I realize it is not for everyone. With this method the medication is only going to your uterus, so you typically don’t have a lot of side effects like you would with the other methods because it is not going through your entire system. Depending on the type that you pick, IUDs are effective for three to eight years. The three-year IUD is smaller in size and has a smaller amount of progesterone that releases over the course of three years. You can get a normal period with this method. The five-year IUD has a little more progesterone, and you may or may not get your period. Lastly, the eight-year method has the most amount of progesterone and you are more likely not to get a period, although some women do, but these women usually state their periods are lighter than without an IUD.
All methods are fine to use if you have never had children or have children but did not go through labor (meaning your cervix has never opened). The three and five-year methods would be a good option if your cervix has not opened due to their smaller size, but either is recommended.
Non-Hormonal Options
Intrauterine Device (IUD)
There is a copper IUD that is effective for ten years and is a great option if you are not comfortable with a hormonal form of birth control. I would not recommend this form of IUD if you have irregular, painful, or heavy periods. The reason for this is one of the side effects is heavier periods. Since this has no hormones, you will still have your period, and this adds no benefit if your periods are painful. Additionally, remember the previous post (Understanding Your Period & The Use of Birth Control: Part Two)? If you are not using hormones and you aren’t getting a period, this is harmful to your uterus. It is better to have an option that will provide protection to your uterus than nothing at all.
Barrier Methods
These would be condoms and diaphragms. Diaphragms are not the highest on the effectiveness level on prevention of pregnancy, but they are making a comeback. This needs to be prescribed by your provider.
As we know condoms can be bought over the counter, but you need to wear them every time if you are using them to avoid pregnancy. And honestly, none of the methods above will exempt you from a sexually transmitted infection (STI) so protect yourself.
Natural Family Planning
This is not as easy as it sounds. For natural family planning, you need to track your cycles, cervical mucus, and basal body temperature. When done correctly, this can be a successful method.
Sterilization
This is for someone that knows they do not want children or are finished having children. You need to check your states laws and your insurance because depending on your age you may not be able to get this procedure done. For example, you can be 18 to make this decision in my state of Virginia, but if you have Medicaid, you must be 21 to get the procedure done and covered by the insurance. Additionally, some providers do not feel comfortable with performing this procedure if you are younger because “What if you change your mind?”. However, you need to know the laws so that you can make a decision that is best for YOU.
Remember none of these methods are 100% effective, but the IUDs have the highest rate of effectiveness at over 99%.
One last takeaway, your fertility is determined by your ovaries. Once you stop using birth control, you should be able to get pregnant if that is what your plan is AND if you have nothing that was previously affecting your fertility. The only method that usually takes some time to re-regulate after discontinuing its use is the injection because of the fact that it lasts for three months. Sometimes it takes up to six months to conceive once stopping the injection. If you are having trouble conceiving after stopping birth control, I would seriously consider you get worked up to see if you or your partner has something that is preventing a healthy pregnancy from occurring.
Leave a comment