Girl Talk: Birth Control

Hey girl, hey. Welcome to Girl Talk, birth control edition, the information I wish I had. I’m the oldest in my family and I don’t have a sister. I know some of you are in the same boat, so my hope with this is to give you all big sister advice, grounded in science, so you can make the best decisions for yourself and get the answers you need. 

There are seemingly infinite options for birth control, or contraceptives. With that being said, everyone is different and what works for one person may not for another. There are two broad categories of reversible birth control: hormonal or barrier [1]. Generally, hormonal methods have a lower failure rate (i.e less chance of unplanned pregnancy), but they do not protect against sexually transmitted infections, including HIV. This is an important distinction because if you use a hormonal method, you will need to use an additional barrier to protect yourself and your partner. 

Hormonal birth control options include intrauterine devices (IUDs), implants, injections, oral contraceptives, patches, and vaginal rings. 

Barrier methods include male condoms, dental dams, and diaphragms. 

While choosing a hormonal birth control method is a decision that requires conversation and thought between you and your health care provider, hearing other women’s experiences with various methods helped me decide what was best for me. Let’s break down my own experience with birth control: 

The Patch: When I first began my birth control journey, I was recommended the birth control patch. Like all hormonal birth control, Xulane required a prescription by a health care provider. The patches use a combination of progesterone and estrogen (like birth control pills) to thicken cervical music, stop ovulation, and prevent pregnancy [2]. They are worn on your skin, which absorbs the hormones into your body. Patches are 91% effective, which is fairly low compared to other birth control methods, mostly due to user error. Mistakes, like forgetting to change the patch or refill the prescription, are mainly the reason users get pregnant unexpectedly. For me, the patches worked great because I was able to easily regulate my periods. I changed my patch every week on Sundays. After three weeks, I skipped a week, got my period, and started a new cycle. With that being said, I only used the patch for a few months. Anytime I sweat, got in the pool, etc., my patch lost stickiness and came off. This threw off my whole prescription cycle which caused some problems with my insurance. Eventually, it became too much to deal with, and I sought a different method. 

The Implant: After I tried the patch, I moved onto the implant. The Implant (AKA Nexplanon) is a tiny rod (think match stick size) that is inserted underneath the skin on the inside of your arm [3]. Once inserted, the Nexplanon releases progesterone, a naturally occurring hormone, into your body which thicken cervical mucus, stop ovulation, and prevent pregnancy. This method is highly effective (99%), requires low maintenance, and is approved for 5 years. As Planned Parenthood likes to say, it is a “set it and forget it” method of birth control. I loved that the Nexplanon was easy to use. The insertion process was super straight forward and pain free, save the pinch of the numbing medication. My problem came when I got my period. For 9 months straight. Nightmare, right? So I went to a gynecologist (BTW, gynecologists rock! Go see one!) and she recommended I take out the implant and try an IUD. The removal process was just as easy and pain free as the insertion. 

The IUD: There are two major kinds of IUD, copper or hormonal [4]. No matter what type, they are both structured like little Ts and are inserted into the uterus via the cervix using a small insertion device. Copper IUDs are approved to last 12 years. Hormonal IUDs, which contain progesterone (the same hormone as the implant), last anywhere from 3-7 years depending on the brand. Both types of IUDs prevent the sperm from getting to the egg and therefore prevent pregnancy. The copper IUD deters sperm because sperm simply does not like copper. Hormonal IUDs are a little more complication and prevents pregnancy in two ways. One way they do this is by thickening the cervical mucus which traps sperm and prevents it from getting to the egg, and the other is by preventing an egg from being released from the ovaries (i.e. preventing ovulation). The IUD is also considered a “set it and forget it” method and is highly effective (99% effective). I received the hormonal IUD called Mirena. I’ve had my IUD for 6 months now and I love it! I won’t lie, the insertion was very cramp-y but my gynecologist walked me through every step, and once in place, my IUD has been the best method yet. 

This is a lot of information, and it barely scratches the surface. There are countless other contraception methods that I don’t have experience with. Your gynecologist will have a lot more details and be able to talk with you about all your options. Through all this, remember that what didn’t work for me may work for you, and vice versa. As I said before, every body is different, but this is my story and I hope it gives you some big sister advice! Always remember, you’re amazing!

• birth control
• contraception
• healthy living
• sex ed
• sexual health