A lot of people, sexually active or not, think that contraceptive methods are “common sense” and that there’s nothing new to learn. Well, guess again. There are a lot of “common sense” things about contraceptives that some people don’t know, and with technology rapidly evolving, there’s always new things to learn and become aware of when it comes to your sexual health. Before we get into it, let’s first identify the different methods of contraceptives: barrier, hormonal, long-acting, and permanent. There’s also nonmedical (which is withdrawal, basically removing the penis from the vagina before ejaculation, but this is never a safe idea and not effective) and emergency contraceptives, both of which won’t be touched on in this article.
- Barrier Method
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Condoms and the diaphragm are types of barrier methods, and work to prevent pregnancy by blocking the sperm and have a bonus of protecting against STIs. This method also doesn’t have as many side effects as others since it doesn’t directly interact with our bodies, like the bloodstream.
Most people know about male condoms, but did you know there are internal condoms, too? These used to be called “female” condoms, and they work in the same way as male condoms but instead go inside the vagina. This is a great alternative for women who don’t wish to rely on a male partner to bring the condoms, and gives women more agency in their sexual health. One thing this condom does that the male condom can’t is provide additional protection against STIs that can be contracted through skin-to-skin contact, such as herpes and genital warts, as it has broader coverage over the labia, perineal region, and the base of the penis. Condoms can also be used with spermicide and lubricants, but it’s really important to make sure you pick up a water-based lubricant instead of an oil-based one, as the oil-based will cause the condom to break, making your contraceptive method ineffective. And please, don’t ever use two barrier methods together, as you risk breaking them and making them ineffective.
- Hormonal Method
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Most hormonal methods need a prescription from a doctor, whereas barrier methods are often found over-the-counter. Hormonal methods also prevent pregnancy, but they do not protect against STIs, and for this reason should be used with a barrier method for ultimate protection. Hormonal methods are so often used for more than just pregnancy prevention: to control acne, regulate periods, control the growth of ovarian cysts and fibrocystic breast changes, lessen the intense pain of cramping, and so many other wonderful benefits. However, because hormonal methods directly interact with our bodies through the bloodstream, you may experience unpleasant side effects, such as change in mood or the development of depression, change in libido, an increased risk of blood clots and breast cancer, migraines, high blood pressure, and even liver and kidney disease. Hormonal methods can interact with certain drugs, too, so it’s important to be honest with any healthcare provider about what medications you’re taking. For example, some antibiotics interact with hormonal methods and actually make them ineffective while taking the antibiotics.
I’ve heard a lot about the Pill and the Depo-Provera shot, but did you know there’s also a patch and a vaginal ring? The patch is exactly what it sounds like: a patch that you can stick on your arm or shoulder, and change once a week for three weeks, with the fourth week patch-free. The ring works in a similar fashion, except this doesn’t need to be changed every week. Instead, it fits inside the vagina and stays there for three weeks before being removed for the fourth week.
- Long-Acting Method
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This includes the implant and intrauterine devices (IUDs), and prevents pregnancy but not STIs, so this method should also be used with a barrier method. The long-acting method requires a visit to a clinic or your doctor, but it has some great benefits unique to this method: the implant can last for up to three years and IUDs last 5-12 years. They are also the most effective reversible contraceptive method. IUDs are inserted into the uterus, while the implant is inserted into the upper arm. Both can also be removed before their scheduled expiration, so if you want it out sooner than you thought, no problem! Just book an appointment with your doctor. IUDs can also include hormones; however, if you found that you experienced some unsavory side effects from the hormonal method, you can get a copper IUD that is still just as effective, but doesn’t have any hormones. However, these long-acting methods can sometimes cause irregular or heavy bleeding, an increase in ovarian cysts, and can be very expensive if not covered by insurance.
- Permanent Method
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This is often called “sterilization.” A lot of people are familiar with the permanent method for males (the vasectomy) and it should be noted that after getting this procedure, the male is not infertile right away, so another method should be used until a visit to the doctor confirms the surgery has been successful. There are a couple different permanent methods for women, such as tubal ligation, which closes the fallopian tubes, and a hysterectomy, where the uterus is removed (you can also remove the ovaries in this surgery, but keeping them allows you not to have to take hormones). Unfortunately, women have to be persistent with a lot of doctors if this is the method they are truly set on, as a lot of doctors will try to push them towards a non-permanent method “just in case” they want children later on in life. However, it is really important that you talk to multiple doctors and do your research before investing in a permanent (or any!) method.
Essure was a permanent method that didn’t require invasive surgery, and instead saw a metal, flexible spring inserted into each fallopian tube. The springs expanded, causing scar tissue to close the tubes. Unfortunately, Essure had horrible side effects for the majority of women who underwent this procedure, and what’s even more unfortunate is that these women were not believed by healthcare workers for years when they came forward with their experiences. Finally, Essure was taken off the market thanks to the dedication of thousands of women whose lives have never been the same since. Want to know more about Essure? Check out the documentary The Bleeding Edge on Netflix.
When considering a contraceptive method, either for the first time or switching from one to another, it’s vital that you talk to a trusted doctor or your OBGYN and do your own research. Each type and method has its own benefits, risks, and effective rates — many of which weren’t mentioned in this article. There are even different brands that may be more cost effective or have a lower instance of certain side effects than others.
I cannot stress how important it is for you to find the right fit that makes you feel comfortable and in control. Afterall, this is your health; you should be the one making the (informed) decisions.
Resources:
Planned Parenthood. Birth Control. https://www.plannedparenthood.org/learn/birth-control
“Birth control.” Our Bodies, Ourselves, edited by The Boston Women’s Health Collective, Touchstone, 2011, pp. 201-256.