Birth Control

Birth control, also known as contraception, encompasses various methods and techniques used to prevent pregnancy. It plays a crucial role in reproductive health, allowing individuals to exercise control over their fertility and make informed decisions about family planning. This comprehensive article explores different types of birth control, their effectiveness, benefits, considerations, and the importance of open discussions with healthcare providers.

Importance of birth control

Birth control methods, provide individuals and couples with the ability to choose when and if they want to have children. It empowers individuals to plan their families, pursue education and careers, and prioritize their health and well-being. By reducing unintended pregnancies, birth control contributes to improved maternal and child health, social and economic stability, and individual autonomy.

What are the different methods of birth control?

Hormonal Methods

• Oral Contraceptives (birth control or contraceptive pills): These pills contain synthetic hormones (estrogen and progestin) that prevent ovulation, thin the uterine lining, and thicken cervical mucus to inhibit sperm movement
• Hormonal Patch: A thin, adhesive patch worn on the skin that releases hormones to prevent ovulation
• Hormonal Injection: A long-acting injectable contraceptive, commonly known as the birth control shot, which provides protection for several months
• Hormonal Implants: Small, flexible rods inserted under the skin that release hormones to prevent pregnancy for an extended period, usually three to five years
• Hormonal Intrauterine Devices (IUDs): T-shaped devices inserted into the uterus that release hormones to prevent pregnancy for several years

Barrier Methods

• Male Condoms: Sheaths worn over the penis that block sperm from entering the vagina
• Female Condoms: Polyurethane pouches inserted into the vagina to prevent sperm from reaching the uterus
• Diaphragm: A dome-shaped device inserted into the vagina to cover the cervix and block sperm
• Cervical Cap: A smaller, thimble-shaped device placed over the cervix to prevent sperm from entering the uterus
• Spermicides: Chemical substances available as gels, creams, foams, or suppositories that immobilize or kill sperm

Long-Acting Reversible Contraception (LARC)

• Copper IUD: A non-hormonal intrauterine device that releases copper ions, which are toxic to sperm and prevent fertilization
• Hormonal IUD: In addition to providing hormonal contraception, hormonal IUDs also thin the uterine lining, making it less receptive to implantation

Natural Methods

• Fertility Awareness-Based Methods (FABMs): Tracking menstrual cycles, monitoring basal body temperature, and observing cervical mucus changes to identify fertile and infertile periods
• Withdrawal Method (Pulling Out): The male partner withdraws the penis before ejaculation to prevent sperm from entering the vagina

What is the effectiveness of the various birth control methods?

The effectiveness of birth control methods can vary significantly based on the type of method used, the user’s adherence to the method, and individual biological factors.

Long-Acting Reversible Contraceptives (LARCs)

These include intrauterine devices (IUDs) and implants. These methods are more than 99% effective because they require no user action after the initial insertion by a healthcare provider

Sterilization

Surgical sterilization methods, such as a vasectomy for men and tubal ligation for women, are also more than 99% effective at preventing pregnancy

Short-Acting Hormonal Methods

This category includes birth control pills, patches, and vaginal rings. When used perfectly, these methods can be up to 99% effective, but due to the potential for human error (forgetting to take a pill, not replacing patches or rings on time), the typical effectiveness is closer to 91%

Depo-Provera Injections

These injections, which are given every three months, have an effectiveness rate of about 94% with typical use

Barrier Methods including

Male condoms, female condoms, diaphragms, and cervical caps, have effectiveness rates ranging from 71-88% with typical use. Male condoms are about 85% effective with typical use and have the added benefit of preventing the spread of sexually transmitted infections (STIs)

Emergency Contraception

Emergency contraception pills are used after unprotected sex or contraceptive failure (like a condom breaking). They are most effective when taken as soon as possible after the incident, preferably within 72 hours. Their effectiveness can range from 75-89%

Natural Approaches

These include fertility awareness-based methods, withdrawal method (pulling out), and lactational amenorrhea (breastfeeding as birth control). These methods generally have lower effectiveness rates, with the withdrawal method being about 78% effective with typical use, and fertility awareness methods ranging from 76-88% effective depending on the specific method used

It’s crucial to consider that only condoms (both male and female) provide protection against STIs. All other methods listed above are strictly for pregnancy prevention.

What are the different types of birth control pills and how do they work?

Birth control pills, also known as oral contraceptives, come in two main types: combined pills and progestin-only pills.

Combined Oral Contraceptives (COCs)

These contain synthetic versions of both estrogen and progesterone (specifically, a type of progesterone called progestin). These hormones prevent ovulation (the release of an egg during the menstrual cycle). If an egg isn’t released, it can’t be fertilized by sperm, preventing pregnancy. COCs also thicken the mucus at the cervix, making it harder for sperm to reach any eggs that might be released, and thin the lining of the uterus, making it less likely for a fertilized egg to implant and grow.

COCs come in different forms:

• Monophasic pills have the same amount of estrogen and progestin in each pill
• Multiphasic pills have varied amounts of hormones and are designed to be taken at specific times throughout the pill-taking schedule
• Extended-cycle pills are designed to lengthen the time between periods. A person taking extended-cycle pills may only have a few periods a year

Progestin-Only Pills (POPs)

Also known as mini-pills, they contain only progestin. They primarily work by thickening the cervical mucus to prevent sperm from reaching the egg, but they also thin the lining of the uterus to prevent a fertilized egg from implanting. Some women may also stop ovulating while using progestin-only pills, but this isn’t the primary way they prevent pregnancy

POPs are all monophasic and must be taken at the same time every day to maintain the correct hormone levels in the body

It’s important to remember that while birth control pills are effective at preventing pregnancy when used correctly, they do not protect against sexually transmitted infections (STIs). Also, certain medications can make birth control pills less effective, so it’s crucial to discuss medication use with a healthcare provider when considering oral contraceptives.

Before choosing a type of birth control pill, it’s best to discuss with a healthcare provider to consider factors like lifestyle, personal medical history, family medical history, and any potential side effects.

What are the typical side effects of the various birth control methods?

Side effects of birth control methods can vary significantly depending on the method used and the individual’s body. Not all people will experience side effects, but here are some potential side effects for different types of birth control:

Hormonal Birth Control (pills, patches, rings, injections, implants)

Common side effects can include nausea, breast tenderness, weight gain, irregular bleeding, and mood changes. Some people may also experience decreased libido. These side effects often go away after a few months of use. Combined oral contraceptive can also cause blood clots, heart attack or stroke

(IUDs) Intrauterine Devices

There are two types of IUDs: hormonal and copper (non-hormonal). Hormonal IUDs can cause similar side effects to other hormonal methods. Both types can initially cause pain during and after insertion, and some people may experience heavier, painful periods (especially with the copper IUD), or spotting between periods

Barrier Methods (condoms, diaphragms)

These methods are generally low-risk, but some people may be allergic to latex (used in many condoms) or spermicides (used with some condoms and diaphragms). Improper use can also lead to discomfort or reduced effectiveness

Emergency Contraception (morning-after pill)

Potential side effects include nausea, vomiting, fatigue, headache, dizziness, breast tenderness, abdominal pain, and menstrual changes

Fertility Awareness-Based Methods

These methods don’t have physical side effects but require daily tracking and a strong understanding of the menstrual cycle, which some individuals may find stressful or inconvenient

Sterilization (tubal ligation, vasectomy)

These are surgical procedures, so risks can include pain, bleeding, infection, or complications from anesthesia. They’re also considered permanent, and while reversal is sometimes possible, it’s often difficult and not guaranteed to be successful, so regret or a change in childbearing wishes can be a significant “side effect”

It’s important to note that while some birth control methods may have side effects, they also have benefits beyond preventing pregnancy, such as more regular or lighter periods, reduced menstrual cramps, and, in the case of some hormonal methods, reduced risk of certain cancers

What are the different birth control drugs and devices?

There are many drugs used in different forms of birth control. The majority are hormonal contraceptives, which use synthetic forms of hormones to prevent ovulation and/or create other changes that help prevent pregnancy. Here’s a general list of some of the most common types of hormonal contraceptives and the drugs they typically contain:

Combined Oral Contraceptives 

These pills contain synthetic versions of both estrogen and progesterone (specifically, a type of progesterone called progestin). Some common types of estrogen and progestin used in these pills include ethinyl estradiol, levonorgestrel, norethindrone, and drospirenone. Examples of FDA and MHRA approved brands include Yasmin, Ortho Tri-Cyclen, and Loestrin

Progestin-Only Pills

Also known as “mini-pills,” they contain only progestin. The types of progestin can include norethindrone or levonorgestrel. An example of a brand is Micronor

Contraceptive Patch

This is a patch that adheres to the skin and releases ethinyl estradiol and norelgestromin into the bloodstream. An example of a brand is Xulane

Vaginal Contraceptive Ring

This is a small, flexible ring inserted into the vagina that releases ethinyl estradiol and etonogestrel. An example of a brand is NuvaRing

Injectable Contraceptives

These are injections of progestin given by a healthcare provider every three months. The progestin used is typically medroxyprogesterone acetate. An example of a brand is Depo-Provera

Contraceptive Implants

These are small rods implanted under the skin that release a steady dose of progestin (etonogestrel). An example of a brand is Nexplanon

Intrauterine Devices (IUDs)

These devices are inserted into the uterus and can be either hormonal (releasing progestin levonorgestrel) or non-hormonal (copper). Examples of brands are Mirena and ParaGard

It’s crucial to remember that while hormonal contraceptives are generally effective at preventing pregnancy, they don’t protect against sexually transmitted infections (STIs). A healthcare provider can provide the most current, personalized advice on choosing a contraceptive method

Importance of checking blood pressure when taking combined oral contraceptives.

It is essential to measure blood pressure before prescribing Combined Oral Contraceptives (COCs) due to the potential risk of cardiovascular complications associated with these medications.

COCs contain synthetic versions of the hormones estrogen and progestin. While they are effective for contraception and offer some other health benefits, they can also increase the risk of certain health problems. One of these is a slightly increased risk of developing high blood pressure (hypertension).

In some individuals, COCs may cause blood vessels to narrow, which increases the resistance to blood flow and thus the blood pressure. High blood pressure is a major risk factor for cardiovascular diseases like heart attack and stroke.

If a patient already has high blood pressure before starting the COC, taking these medications can further elevate it, increasing the risk of these serious complications. Therefore, it’s crucial to check blood pressure to ensure it’s within a safe range before prescribing these medications.

Also, regular blood pressure monitoring is recommended for individuals taking COCs so that any increase in blood pressure can be detected early and managed appropriately.

COC’s can also increase the risk of deep vein thrombosis (DVT) which are blood clots that occur in the lower leg.

Importance of Open Communication

Open and honest communication with healthcare providers is vital when discussing birth control options. They can provide guidance, address concerns, offer education, and ensure individuals have accurate information to make informed decisions. Regular check-ups allow for method evaluation, monitoring side effects, and adjusting as needed.

STI Prevention

It is important to note that while some birth control methods can prevent pregnancy, they do not provide protection against sexually transmitted infections (STIs). Barrier methods like condoms are effective in reducing the risk of STIs and should be used in conjunction with other birth control methods for comprehensive protection.

What UK Birth Control organisations are there to support me?

In the UK, there are several organizations and services that support birth control, providing information, advice, and services related to contraception and sexual health. Here are some key organizations:

• NHS (National Health Service). The NHS provides a wide range of contraceptive services for free through GP surgeries, sexual health clinics, and certain pharmacies. They offer information on all methods of contraception and help individuals choose the best method for their needs
• Brook. Brook specializes in sexual health services and advice for young people under 25. They provide free and confidential advice on contraception, as well as other sexual health topics
• FPA (Family Planning Association). Although the FPA no longer provides clinical services, they have historically been a leading voice in sexual health and birth control advocacy in the UK. Their website still offers a wealth of information and resources
• Marie Stopes UK. While they are perhaps best known for their abortion services, Marie Stopes also offers contraceptive advice and services
• BPAS (British Pregnancy Advisory Service). BPAS, like Marie Stopes, is more commonly associated with abortion services, but they also provide contraception advice and services
• Sexual Health Clinics. These clinics, often referred to as GUM (genitourinary medicine) clinics, provide free and confidential sexual health advice and services, including contraception
• SH:24.  This is an online sexual health service that provides free STI test kits and some contraceptive options, depending on availability and location
• Pharmacies.  Many pharmacies like NowPatient provide over-the-counter contraceptive options, like condoms, and some also offer emergency contraception. Some local authority areas have schemes where registered pharmacies can provide certain types of contraception for free or at a reduced cost

Remember, the best way to determine which contraceptive method is right for you is to have a consultation with a healthcare professional, who can provide tailored advice based on your health, needs, and circumstances.

What US Birth Control organisations are there to support me?

In the United States, there are numerous organizations and services that support birth control, offering information, services, and advocacy related to contraception and reproductive health. Here are some key organizations:

• Planned Parenthood Federation of America (PPFA). Planned Parenthood is one of the most well-known organizations in the U.S. offering reproductive health services, including a wide range of contraceptive options. They have health centers across the country
• Guttmacher Institute.  This is a research and policy organization committed to advancing sexual and reproductive health and rights in the U.S. and globally. While not a service provider, they offer extensive information and statistics on contraception and reproductive health
• The National Campaign to Prevent Teen and Unplanned Pregnancy. This organization focuses on reducing teen pregnancy rates and unplanned pregnancies among young adults. They provide information, resources, and advocacy
• Bedsider. An online birth control support network for women 18-29, Bedsider provides information on different contraceptive methods, reminders, and a “clinic finder” to locate nearby services
• Reproductive Health Access Project (RHAP). RHAP works to ensure that everyone has access to reproductive health care. They provide training and support for clinicians to make reproductive health care accessible to everyone
• Center for Reproductive Rights. A legal advocacy organization that promotes and defends the reproductive rights of women worldwide
• American Sexual Health Association (ASHA).  The ASHA provides information on sexual health, including birth control options, and promotes sexual health through education, advocacy, and community outreach
• Power to Decide. Formerly known as The National Campaign to Prevent Teen and Unplanned Pregnancy, this organization focuses on preventing unplanned pregnancy and ensuring all young people have access to reproductive health resources
• NARAL Pro-Choice America. NARAL advocates for reproductive freedom, which includes access to contraception

Summary

Birth control methods offer individuals and couples the ability to control their reproductive choices, improve family planning, and enhance overall well-being. From hormonal options to barrier methods and natural techniques, a range of effective choices is available. By understanding the options, considering personal preferences and medical history, and engaging in open conversations with healthcare providers, individuals can make informed decisions and access the most suitable birth control method to meet their reproductive health needs.