Birth Control Methods Explained

With so many birth control options out there, choosing which birth control method is right for you can be a daunting task...and choosing the wrong one can actually cause some very dangerous side effects. Along with health risks, birth control can also have some very annoying complications, such as weight gain, nausea, varied failure rates, etc. To decide which birth control is right for you at this point in your life, you need to know first what is available and what risks you are taking, if any, by choosing any one method. Typically when a woman decides to initially start birth control it is for one of two reasons...either she is sexually active and does not want to become pregnant or she has a medical issue that certain types of birth control can address. Both problems are usually solved by temporary forms of birth control:

1 The Pill: The Pill is probably the most widely used form of birth control other than condoms. There are many different types of pills, all of which have different side effects and failure rates. These include the progestin-only pills, combination pills (which include mono and multi-phasic pills) and the emergency contraceptive pill. The progestin-only pill is usually used by women who are breastfeeding or who have medical issues that prevent them from taking the traditional combination pill. This pill does not contain estrogen and works by thickening the cervical wall thereby preventing sperm from entering the uterus. Because it doesn't contain estrogen, it doesn't prevent ovulation like the combination pill and are therefore less effective in preventing pregnancy. They must be taken on a very strict 24-hr schedule and can easily fail if not taken correctly. Still, other than spotting, they have fewer side effects than any other pill on the market and the normal side effects, such as headache, nausea, etc. are minimal.

The most common form of the pill is the combination pill. They contain both estrogen and progestin and prevent a woman from ovulating. They also thing the lining of the uterus and thicken the cervical wall, all of which prevent sperm from entering and fertilizing an egg. The combination pill, however, has many side effects because of its addition of estrogen and has to be taken on a strict 24-hour schedule as well. Effects range from headaches and nausea to weight gain, depression, spotting, change in vision, loss of hair, vaginal infections, darkening of the skin and increased risk for heart attack and breast cancer. The failure rate is lower than that of the progestin only pill, but is still higher than some forms of birth control because women have to remember to take it everyday at the exact time which is many times difficult. Its effectiveness is also decreased anytime a woman takes antibiotics. Still, there are some good side effects, which can include (but are not gauranteed) reduced bleeding and mood swings during periods, reduced pain during ovulation (less cramping) and sometimes reduced acne.

The emergency contraceptive pill is not a contraceptive but rather a pregnancy preventative. It is taken after sex when a woman has taken no other precaution and thinks she may have put herself at risk for pregnancy. It must be taken within 120 hours of sex and is more effective the sooner it is taken. It works by thinning the uterine lining and preventing an already fertilized egg from attaching to the uterine wall. Taking this form of birth control can be complicated by the question of ethics on when life happens, whether at initial conception (the sperm meeting the egg) or implantation (when the egg attaches to the uterine wall) for many women and has been a very controversial form of birth control since its release. It can cause some very intense side effects, including severe abdominal pain, chest pains, shortness of breath, severe headache, blurred vision, and numbness which are all signs that would need to be reported to a doctor. More common side effects include nausea, vomiting, headache, dizziness, fluid retention, abdominal pain and bleeding that can last from 1 to 2 days. The ECP is also less effective than most other forms of birth control (75-89%) and should therefore not be used as a regular form of contraceptive. When coming off the shot, it can sometimes take up to 18 months for a woman to become fertile enough to conceive again.

2. Contraceptive rings, patches and shots: Contraceptive rings work in the same way as a pill, but come in a plastic ring that is inserted in the vagina and left there to release hormones for an entire cycle (typically three weeks). It is then removed for one week to allow a woman to have her period before a new ring is inserted. Having used a ring myself, I would say their side effects, though similar to the pill, tend to be more mild thanks to the constant release of hormones. They also provide the added benefit of not having to remember to take a pill everyday. They come with some added side effects however, including discomfort if felt by the man during intercourse (which rarely happens) and increased risk of failure as the ring can be expelled if a woman pushes too hard with her muscles during a bowel movement, etc. Like the ring, the birth control patch releases a constant stream of hormones, but has to be changed once a week rather than once a month. The downside to the patch is that it has to be placed and kept on the body to be effective and its visibility can provide for some awkwardness in certain situations. The birth control shot also works similarly to the pill, but has the added benefit of only having to be administered once every three months. It tends to have a higher frequency of side effects and contains only progesterine. It requires a doctor's visit every three months and like the pill, does not protect against STDs. Unfortunately the shot has been associated with many harmful side effects including loss of bone density, which can continue to effect a woman after she stops taking it and can lead to osteoporosis. It is not recommended as a long-term form of birth control or to be taken by women who are not finished growing. Some women also have allergic reactions to the shot and almost seventy percent of women taking it will gain a minimum of five pounds within a year or more. Each consecutive year they will continue to gain at a rate of five pounds a year. Irregular periods, heavy bleeding, headache, nausea, nervousness, bloating, hot flashes, acne (and back acne) hair loss and decreased sex drive are all possible side effects as well.

3. Condoms: Condoms are probably the most widely used form of birth control, both due to their convenience and their widespread availability. Unlike the pill, they not only can prevent pregnancy, but can also protect against STDs. Used in combination with other female contraceptives, they can be very effective. Most condoms are made from latex, which is fine for most people but can cause bad reactions in people with latex allergies. However, they are also available in other forms, including lamb intestine. There is also a female form of the condom that inserts inside the vagina and acts as a bag for catching sperm. It too protects against STDs and carries some of the same risks as a male condom. Generally, apart from allergic reactions, reduced sensation and irritation, condoms carry very few side effects. However, they have a higher rate of failure in highly sexually active people due to the risk of slippage or breakage. When used correctly they have a failure rate of only 2%, but with typical usage they fail 15% of the time due to user error.

3. Less Common Forms of Temporary Contraceptives: Less common forms of contraception include spermacide which is a gel-like liquid that is inserted in the vagina to kill sperm and prevent them from reaching the egg. Spermacide is not a very reliable form of birth control (it has a typical failure rate of 28%) and can cause irritation and increased risk of transmitting HIV. It is not recommended as a form of birth control by the CDC. Another less common form is a vaginal sponge. The sponge is inserted into the vagina and contains a spermacide. It works by both blocking and killing sperm, but is also highly ineffective as it has to be placed perfectly over the cervix and has a typical failure rate of 32%. A diaphragm is another alternate form of birth control. Much like a female condom, it is inserted into the vagina to act as a barrier against sperm. It has very few side effects but is very unreliable and is usually used in combination with spermacide. It must be fitted by a doctor and many women find it difficult to insert.

4. IUD: An IUD, or Intrauterine Device, is a longer term form of birth control than most typical methods and can only be used in women who have already given birth to at least one child. There are two different types of IUDs, copper and hormonal. An IUD is a small t-shaped device that is inserted by a doctor into a woman's uterus. They typically last for five to ten years and are generally very effective. Copper IUDs do not contain any hormones. They work by releasing copper which blocks sperm from entering into the fallopian tubes. In a situation where sperm does manage to fertilize an egg, the copper also helps to prevent the egg from implanting in the uterus, thus preventing pregnancy. Hormonal IUDs work in a similar manner but rather than releasing copper, they release progestin, which helps to prevent pregnancy by thickening the cervical mucus like the progestin pill. Hormonal IUDs carry similar side effects as other forms of hormonal birth control. Both Copper and Hormonal IUDs carry an increased risk of Ectopic pregnancy, which can be extremely dangerous for the mother and always requires a termination of the pregnancy upon discovery. And Ectopic pregnancy is when a fertilized egg implants somewhere other than the uterus, often times in the fallopian tubes themselves.

Once you have given birth to all the children you desire, you may want a more effective form of birth control. There are two options when it comes to permanent birth control, one for women and one for men.

1. Vascetomy: A vascetomy is the most reliable form of permanent birth control. A vascetomy is an out patient surgery where the tube connecting a man's testicals to his semen. If successful, the surgery is relatively painless, but symptoms can vary and some possible side effects include bruising and bleeding and in some cases, a condition known as Post-Vascetomy Pain Syndrome. PVPS is a chronic pain condition that can occur either right after surgery or years down the road. It can cause extreme constant pain or pain that occurs only during sexual activity or other strenuous physical activity. Vascetomys fail once in every 4,000 surgerys and generally occur within the first year (which means my son is 1 in 4,000!). Doctors usually suggest you continue to use another form of birth control after surgery until the patient has received three negative fertility tests.

2. Tubal Ligation: Tubal Ligation, or "getting your tubes tied" is when a woman's fallopian tubes are either cut and cauterized or tied in order to block the flow of sperm to the ovaries. Unlike a vascetomy, tubal ligation surgery is inpatient surgery and comes with all the normal risks of any major surgery, including internal damage to other organs, wound infection, reactions to anesthesia (which can result in death) and general pain of recovery. Having one's tubes tied is also less effective than a vascetomy (about 1 in every 100 fail) and the younger a woman at the time of surgery, the more likely it is to reverse itself. A tubal ligation may be a good option for someone who does not plan on being with the same partner for an extended period of time but is done having children, or a woman who is already planning on undergoing a abdominal procedure (such as a c-section) in which it does not add any extra recovery time or strain. Having a tubal ligation raises your chances of having an ectopic pregnancy in the case that the procedure fails and is not a good method for women who have previous health issues such as diabetes, obesity, heart problems or issues with blood clotting.

Along with the aforementioned side effects, there are a few other things a woman should take into account before choosing a method of birth control. One needs to consider the cost, availability, time, and what to do if birth control, in the end, is ineffective. Even the most reliable forms of birth control can fail. I personally have gotten pregnant after my husband had a vasectomy and I have also known many women who have gotten pregnant while on other forms of birth control, including the pill, the shot, the ring and during condom usage. In the end, the only way to completely prevent yourself from becoming pregnant is not to have sex at all until you are prepared to take care of a child.

Along with the risk of failure, there is also a risk of damage to one's body if you constantly switch between methods or if you choose the incorrect method. I made this mistake in my early twenties and ended up having to undergo a DNC in order to stop three months of continous internal bleeding. Switching between three different methods had caused my uterine lining to shed itself in three different cycles, which basically meant I was experiencing a period that never stopped. By the time I had my DNC, I was so anemic from my blood loss that I could not stand for more than a few hours without feeling faint. Had my doctor not found the cause of my bleeding I may very well have died from extreme blood loss. It is very important that whatever method you choose, you make sure you use it correctly and take all of the side effects listed very seriously. Good luck to everyone reading this...I hope it has been both informative and helpful!