You Asked Us How To Not Have Babies. We Have Some Answers
Let's talk about birth control.
Because it's clearly what you want to talk about.
Here at LADYist, birth control is one of the most frequently asked about topics. Below are a handful of the questions we've been getting:
- I would like to learn more about birth control (pros/cons) and different options. --Jessie Kim
- Is there an internal birth control method out there that won't affect my mental health? --Brittany
- Please explain the stigma and controversy over IUD's. Why are they not promoted more as an [alternate] option to the Pill? --Sandra
- What is the impact of long-term (10 or more years) on hormonal contraceptives on fertility? --Monisha Brown
We get SO MANY questions about this, and they tend to fall into a couple of categories: how birth control works, what the options are and which ones will do the job with minimal side effects.
The Affordable Care Act mandates that insurance carriers cover birth control, though the Trump administration recently expanded the law's religious exemption rule.
California is widely considered to be one of the most progressive states when it comes to birth control access. You can even pick up birth control over the counter without a doctor's prescription because of a 2016 state law, but you'll need to find a pharmacy that will offer it.
And while talking about "birth control" may imply that it's just for our heterosexual and men-loving sisters, it goes without saying that many queer-identifying women, transgender men, and non-binary folks use it, too.
That's because it's not just about staying baby-free: hormonal contraception can be used to treat a wide variety of conditions, including acne, fibroids, irregular periods, and (ironically), infertility.
Regardless of the reason, birth control can be complicated. So just sit back and listen to this Loretta Lynn classic, while we take you on a journey through the magical world of contraception:
YOU'VE GOT OPTIONS
There are a few ways you can group contraceptive methods. For our purposes, we will look at them in three distinct groups: barriers; hormonal methods (such as The Pill); and intra-uterine devices, or IUDs.
Keep in mind that we're only talking about temporary forms of birth control, since the only permanent and sure-fire way to prevent conception is to get your tubes tied... we'll come back to that in a moment.
1. WRAP IT UP
We've told you before about how great condoms are at reducing your risk of getting an STI. In fact, they're the only method that can do that AND help prevent pregnancy. What a concept!
However, there are other ways of keeping things under wraps, so to speak. Cervical caps, diaphragms, female condoms, and other barriers can help prevent conception, though it's recommended that you use these along with a spermicide.
And we'd be remiss if we didn't mention the spermicidal sponge. We'll leave it up to you to decide who is or isn't sponge-worthy.
And yes, they're still around.
2. USE HORMONES TO HACK YOUR BODY
Hormonal treatments are by far the most common methods of birth control. Data from the Centers for Disease Control and Prevention shows that about 28% of women who use some form of contraception take the Pill or some variation of it.
And the way it works is actually kind of sneaky.
Over the course of your menstrual cycle (and we're talking about the whole monthly ride, not just your period), your body produces different levels of hormones that go up and down, depending on where you're at in the process. The Pill, and medication like it, evens out that biochemical roller coaster ride, so you stop getting those spikes in your hormonal levels, which is what triggers your body to ovulate.
"It essentially tricks your body into thinking you're menopausal," said Dr. Kris Brandi, an assistant professor of obstetrics and gynecology at Rutgers-New Jersey Medical School.
The only thing is, you need to take it every day at around the same time for it to work.
Fortunately, if you're hopelessly forgetful, you can get the exact same birth control method in the form of a once-a-week patch. There are also longer-term options like vaginal rings (which you'd swap out once a month), an injection (which usually lasts about three months), or even an implant in your arm.
Keep in mind that if you're using hormone-based methods regularly, you're in the clear. But as soon as you stop using them, you're no longer protected.
3. INTRA-UTERINE WHAT, NOW?
IUDs are a longer-term, but 100% reversible solution. They are available with or without hormones, but are quite different from the Pill.
Both types of IUDs are inserted into the wall of your uterus and work by triggering your body's natural inflammatory response mechanism. It's similar to how your skin will slowly push out a splinter.
That inflammatory response, though mild, is effective enough to kill sperm. But IUDs with hormones take it a step further: they help increase your body's natural production of cervical mucus, which in turn creates a barrier to keep sperm from entering the uterus in the first place.
But getting one put in can be a little tricky.
"It's very similar to getting a Pap smear," said Dr. Brandi. However, instead of taking samples of cells outside the cervix, your doctor will use a small plastic tube to insert the IUD through your cervix.
The procedure can cause cramping, and while the risk is very low, an improperly-placed IUD can potentially lead to pelvic inflammation.
Once it's in, though, you can essentially set it and forget it. Modern IUDs can safely stay in your body for years at a time, and they can be removed whenever you choose -- just don't try it at home.
One drawback is that IUDs are typically much more expensive than other forms of birth control and can cause complications for some women. However, keep in mind these are not your mother's IUDs: they've gone through a massive design overhaul through the years, and the ones on the market today have far fewer side-effects than their predecessors.
BONUS Q: BUT WHAT IF I WANT KIDS SOMEDAY?
Never fear. Everything we've covered here is 100% reversible. The idea that oral contraception or that having an IUD will eventually make you sterile is a persistent myth.
Numerous studies show that birth control does not decrease your chances of getting pregnant after you stop taking it. As we mentioned above, it can even be used to kick-start the ovulation process to help women conceive.
BONUS Q: WHY AM I SO DOWN WHEN I'M ON BIRTH CONTROL?
Like nearly all medical treatments, every form of contraception has its own side effects and drawbacks.
Case in point, several loyal LADYist readers have specifically asked about the link between birth control and changes in mood -- specifically, feeling depressed.
Unfortunately, there isn't enough reliable data to make a direct correlation between hormonal birth control and depression. Although a 2016 study from Denmark concluded that there is a connection (particularly among young women), a separate study from Ohio State University did not.
The disagreement may be over what we're talking about when we say "depression." The lead researcher from the Ohio State study told CNN that they did not look at changes in mood or the state of simply "feeling down." Instead, they looked at instances of clinical depression, which is a persistent mental illness.
But that doesn't mean that whatever you're feeling isn't real.
Generally speaking, everyone will react differently to birth control. Some women report feeling anxiety, or losing their libidos. Others report unexpected weight gain or loss.
"There's this disconnect between what science shows and what real people are experiencing every day," said Dr. Brandi. "My general sense is to trust my patients when they tell me about any side effects."
Keep in mind that if something isn't working for you, you should talk to your doctor to try something different. Just make sure to switch it up on time, so that you don't have any gaps in your protection.
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