February 12 was Sexual and Reproductive Health Awareness Day. We celebrate it annually to raise awareness about sexual and reproductive health. In honor of the day, we wrote this post to raise awareness of the contraceptive measures you can take to plan and or prevent pregnancy.
With technological advancements, there are a myriad of birth control options. However, more choices mean more factors to consider when choosing a method that is specifically right for you. Several factors include allergies, current and future menstrual cycle, length of protection, discreetness, etc. This post will explore different contraceptive methods and provide an overview of using them and what to expect. We recommend discussing what works best for you with your healthcare provider at your next doctor’s visit or annual pap smear.
The Pill
Oral contraceptive pills (OCP), more commonly known as “the pill,” are among the most popular forms of birth control used today. There are many formulations of birth-control pills with various levels of synthetic hormones, and for the sake of clarity, we will break down the intricate details of the pill.
How does it work?
The birth control pill is made with one or two different chemicals that mimic pregnancy hormones – estrogen and progesterone. In pregnancy, the combination of estrogen and progesterone suppresses your ovaries from ovulating (releasing eggs for fertilization), and this is the aim of combination pills (those comprised of synthetic estrogen and progesterone.) So basically, the pill “tricks” your body into believing it’s pregnant. Some pills, often called “mini-pills,” only contain progesterone, which does not inhibit ovulation; instead, it makes the uterus a hostile environment for sperm, which thins the lining of the uterus to make it more difficult for a fertilized egg to implant.
How do I take the pill?
Oral contraceptives need to be taken every day at the same time to be most effective. Therefore, it is strongly recommended that patients set a daily alarm so that any disruption to their usual routine does not hinder them from taking their pill at the right time. Many apps, gadgets, and websites help in this time-sensitive ritual, such as Bedsider, Spot On, Flo, Eve, Clue, and Popit Sense.
Now, imagine the simple graph below illustrates what happens when you take a single OCP once – your hormone levels spike and then drop again because you didn’t take any additional pills. If taking the pill “tricks” your body into thinking it’s pregnant, the drop in hormones will “trick” your body into thinking you have ended a pregnancy and need to empty your uterus, causing you to bleed.
What are the possible side effects?
The pill mimics the hormones that your body produces during pregnancy. Therefore, many women experience similar symptoms, such as nausea, breast tenderness (and breast enlargement), mood swings, weight gain, spotting, decreased sex drive, headaches* (more on this later), and changes in vaginal discharge. Light bleeding or spotting, along with the side effects mentioned above, is entirely normal for the first three months of taking the pill, as your body adjusts to the alterations in hormones. However, contact your healthcare provider if you are still experiencing symptoms that are disruptive to your everyday routine after three months.
There are a few severe side effects to look out for, indicating you should stop taking the pill and seek medical attention. Here is an easy way to remember what to look out for:
A – abdominal pain
C – chest pain
H – (severe) headaches
E – eye problems (blurred vision, loss of vision)
S – swelling/aching pain in legs
Who shouldn’t take the pill?
If you have experienced any of the above symptoms, or ACHES, during pregnancy or previous OCP’s use, then avoid the pill and consider alternative forms of birth control. Also, if you’ve been diagnosed with thrombosis – or blood clots – in the veins, lungs, brain, or heart, then OCP’s is not for you due to the hormones causing an increased risk of developing blood clots. If you are over the age of 35 and smoke, there is also a higher risk of developing blood clots with OCP’s and a different form of birth control is recommended. Lastly, you are also not a candidate for the birth-control pill if you have a personal history of liver or heart disease, breast or uterine cancer, uncontrolled blood pressure, or migraines with auras.
How much does the pill cost?
This frequently asked question is essential to consider when deciding what birth control is right for you. Many insurance plans cover all or most of the cost of birth control, but those who are uninsured or under-insured may be surprised to learn how expensive the pill can be. In addition, some pills are newer to the market and therefore do not have any generic forms available, which often means they cost more. If you are concerned about birth control being cost-prohibitive, mention it to your health care provider because they may be able to start you off with a sample, prescribe a generic brand, or suggest where you might find coupons. In addition, GoodRx can often compare the costs of medications at various pharmacies and provide links to coupons if any are available.
Other Forms of Contraception
Birth Control Implant
The birth control implant, also known as Nexplanon, is a thin, tiny rod that releases progestin into the body to prevent pregnancy. Progestin works by thickening your cervix’s mucus, which prevents the sperm from swimming to your egg. The hormone can also stop eggs from releasing from your ovaries, so when the sperm can’t meet the eggs, pregnancy can’t occur.
How does Nexplanon work? A doctor inserts the implant directly under the skin of your upper arm. Although it’s one of the more invasive forms of birth control, it’s 99% effective and can last up to five years. If you decide to get pregnant before the five years is up, you have the option to remove it.
The cost for the birth control implant depends on your insurance plan and clinic but can range from $0 to $1,300.
IUD
An IUD is a tiny plastic device shaped like a T and inserted into the uterus to prevent pregnancy. There are two different types of IUDs: copper and hormonal. The copper IUDs don’t have hormones. Instead, they’re wrapped in a copper, which deters the sperm away. Copper IUDs can last for up to 12 years.
On the other hand, hormonal IUDs (Mirena, Kyleena, Liletta, and Skyla) use progestin to thicken the cervical mucus and trap the sperm. Like Nexplanon, if you decide you want to become pregnant, your doctor can take it out. Another benefit of using an IUD is that it can be used as a form of emergency contraception. For example, an IUD can be put in five days after unprotected sex and is considered 99% effective. Cost varies but ranges between $0 and $1,300.
Birth Control Shot
The birth control shot, also known as depo-provera, is a shot that contains progestin to prevent the egg from releasing. It’s 94% effective and costs up to $150. Shots last between 12 and 13 weeks and must be injected every three months. Because they need to be administered by your provider, this option may not be suitable for you if you cannot make doctor visits. Shots taken within the first seven days after the start of your period can protect you from pregnancy.
Birth Control Vaginal Ring
As the name implies, the birth control ring (NuvaRing and Anoovera) is a vaginal ring that’s inserted inside the vagina. It works by releasing hormones into the body to stop the sperm in its tracks and prevents the sperm from reaching the egg. The NuvaRing lasts up to five weeks, and you must put a new one in once a month. Another type of vaginal ring, the Annovera ring, is placed inside the vagina for 21 days before it’s taken out for seven days. After seven days, the Annovera is put back in. The ring requires precise use so that any mistakes may lead to pregnancy. It’s 91% effective and can cost up to $200.
Birth Control Patch
The least invasive birth control option, the birth control patch, is similar to a bandaid but is worn to stop pregnancy. Like birth control pills, the patch is infused with hormones, such as estrogen and progestin, and absorbed through the skin. The culmination of these hormones stops ovulation by preventing ovulation and thickening the cervical mucus. There are two different patches: Xulane and Twirla. The Xulane and Twirla patches can be worn on your belly, back, or butt. You can also wear the Xulane patch on the upper arm. You must change birth control patches once every week. However, on the fourth week of every month, you don’t have to wear a patch because that signals to your body that you’ll get your period. The patch is 91% effective at preventing pregnancy and costs up to $150.