What birth control should you take?

Holistic v. hormonal 

Written by Jennifer Hanson
Birth control has evolved in many ways since its inception in 1960. Contraception now comes in all shapes and sizes but everyone's body is different, and what works for one person may not work for another. Whether hormonal or holistic, it’s crucial to find the birth control method works best for your body.

Your cycle affects your life

Any person with ovaries knows that period symptoms can wreak havoc on your life. Mood, pain or flow issues at the wrong time are bound to cause unintended consequences. Indeed, a 1995 study showed that menstrual issues significantly impacted the well-being of the women studied. A similar study concluded that the number and severity of menstrual symptoms negatively affected the participant's mood. As such, these symptoms are a form of continuing stress and can impact quality of life over time. While some of these symptoms cannot be fully erased, there are some ways to effectively mitigate them so that their effects aren’t as severe.
Although severe symptoms are not necessarily common among people who have periods, they are still prevalent enough to mention. Dysmenorrhea, the scientific name for excessively painful periods, occurs for 2-9% of people, while about 8% of people report regular heavy bleeding. 

Amenorrhea, or absent periods accounts for about 1% of period issues. But absent periods can also be a side effect of disordered eating patterns or excessive athletic activity, and these instances aren’t always included in the 1% metric. A more common issue is irregular periods, which happen for about 14% of adults ages 19-54 but can fluctuate between 5-36% depending on a person’s occupation, age and country of residence.

If you’re looking to mediate pain or effects in a holistic way, there’s good news: yoga and aerobic exercise have been shown to help with menstrual pain and cycle regulation. Really any sort of positive health or lifestyle change will benefit your body if it’s a continued habit. This includes good nutrition, taking vitamins, limiting alcohol, staying hydrated and getting exercise. Some research shows that taking ginger can have a positive effect on cycle issues as well. Limited research has also indicated obesity can impact your cycle via hormonal regulation, so maintaining a healthy body weight may have some effect on symptoms.

Holistic birth control

Now that we’ve talked about how your cycle can affect your life, let’s talk about how you can understand and control your cycle.  

The least invasive method of holistic birth control is “natural” birth control. This involves monitoring your cycle and temperature to know when you’re ovulating. Going natural is around 75% effective, and can be even more effective when you take the life cycle of sperm into account (remember, sperm can live inside for five days!). But it won’t work for everyone, especially if you’re prone to stress, which can throw your cycle out of whack. Disordered eating or switching medications can have a similar effect. All of these changes can alter your menstrual cycle and make it harder to track, so make sure to carefully consider whether going natural is the right method for you. 
Some folks who are certain they will never want children opt for permanent sterilization. This can involve tubal ligation (having your tubes tied) if you have a uterus. The pros of TL are that the procedure doesn't affect your body's hormones, which means that libido and menstruation remain unchanged. The cons are that the procedure is irreversible and some folks may regret the decision afterwards. It's also a major surgery that requires general anesthesia. 
If you’re looking for a less permanent and involved form of birth control, you might want to check out the copper IUD. Copper acts like a spermicide in the uterus, and Paragard (one of the most popular copper IUDs) is safe to be implanted for ten years. This is a great option if you don’t have any serious issues with your cycle, since it can make periods more intense for some.
In addition to the options above, don’t forget about the tried and true condom. Condoms are effective anywhere from 87-98% of the time if used correctly, and they are the most inexpensive method of birth control. Similarly, the internal condom has a similar success rate of 79-95% and allow the wearer to protect themselves ahead of time instead of relying on their partner to be prepared. 

Diaphragms need to be used with spermicide and are effective around 84% of the time. Diaphragms also require a prescription and possibly a fitting depending on which brand you get. Spermicide is accessible and inexpensive, but it shouldn’t be used alone since it only has an effectiveness rating of around 21%.
The sponge is inserted before sex and can be effective around 73-91% of the time if used regularly. Sponges block sperm from entering the uterus and release spermicide simultaneously. Cervical caps work similarly, but spermicide has to be applied to them. Caps are also more expensive since they require a fitting. 

Finally, the withdrawal (pull-out) method is effective anywhere from 78-96% of the time depending on how often it’s executed correctly.

Hormonal birth control

If you’re in the unfortunate position of having unpleasant or excruciating periods, hormonal birth control might help you more than wearing a condom or monitoring your cycle. But everyone has different bodies and different needs, so no one hormonal method will work for all. Luckily, there are many options.
Hormonal IUDs like Mirena or Skyla are at least 99.2% effective at prohibiting pregnancy. The device releases progesterone to thicken cervical mucus, thus keeping sperm from accessing the uterus. It also helps thin the menstrual lining that usually gets shed during a period. Some users report eliminating periods altogether after a few years of having a hormonal IUD. However, there are some drawbacks: insertion can be painful, and they can be expensive depending on your insurance. 

Another insertion option is the implant. This matchstick-sized device is inserted into the skin of the upper arm and is 99.9% effective for up to four years. The implant uses progestin, the same hormone as an IUD. The shot has the same effect and will keep you safe for three years as opposed to four, with a 96-99.8% effectiveness range. Cost wise, shots are somewhere in the middle ground between pills and the implant.
Not excited about inserting a birth control method into your body? You don’t have to! The patch is 93-99.7% effective. Just stick it on and you’re ready to go, as long as you remember to switch it out once a week. Rings provide a similar level of protection and are only slightly more costly. Similar to the cadence of birth control pills, you insert the ring in your vagina for three weeks and take it out the fourth, or skip your period altogether by leaving it in.
Birth control pills are another non-invasive option. New pills come out all the time, and they are available in an estrogen-progestin combination or progestin only. The pill ranges from being 93-99.7% effective depending on how good you are at taking it at the same time each day. The cost of birth control pills can vary depending on your situation, so this might be an important point to bring up with your doctor.

Emergency contraception

Forget to take your pills or insert your device? Emergency contraception is available to make sure you’re covered. Having a copper IUD inserted within five days of your mishap can have the same 99.9% effectiveness the IUD offers normally. If you’re not ready to fork over that cash or make an implant decision, there are a few different brands of "morning-after" pills to consider. These levonorgestrel-based pills can lower your chance of getting pregnant by 75-89% if you take it within three days after unprotected sex, but some brands (such as Plan B) may not work if you weigh 155 pounds or more. Planned Parenthood has a handy quiz to determine which form of emergency contraception you should take. 

Keep it steady

Lastly, switching birth control methods is occasionally necessary if you’re not satisfied with the method you’re using. However, unplanned pregnancy can be an unintended consequence of switching methods, so it’s important to talk to your doctor before you switch to make sure you’re covered throughout. Despite people with ovaries making many of the contraception choices, female sex or pleasure isn’t considered when developing methods of birth control. While this is unfortunate, it doesn’t mean you should stop looking for the method that works best for you!

Still weighing your options? This reliable guide can help you compare and contrast methods in detail so you can make sure you get the birth control that’s best for you. Finding the right birth control can be frustrating, but making sure you’re covered will benefit you in the long run.

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