Birth control, like many other aspects of women's health, still has a long way to come. If you're a straight, born female you've probably used it as a contraceptive, and possibly for other reasons, too, but the side effects are abundant and some more severe than others. There's also a plethora of types these days: pills, IUD's, arm implants, condoms, patches, shots. How do you choose? What is the safest option? Unfortunately, there's no easy answer to these questions. It all depends on the person and what you're trying to achieve.
What if I am just looking to prevent pregnancy? In terms of not allowing his sperm to fertilize your egg, your safest bet is an IUD or implant, coming in at 99% effective. Next is the shot, coming in at 94% effective. Following that is the vaginal ring, the patch, and the pill, which are 91% (only if used correctly, not missing doses and taken at the same time everyday). Coming in at the end is the condom, at 90%, mainly because they break easily with thrusting or if they are too tight for the particular wearer.
What if I have other issues, like an unpredictable cycle due to a hormone imbalance? Like many others, I started on the pill quite young (14) to try to manage my crazy period. Back then it was just Ortho Tri Cyclen Lo, and in just 3 short months I gained 20 lbs and felt awful. I had mood swings like no other, a new splattering of acne in addition to the moderate level I had before, and in general felt a different person, but I had already tried 2 other medications to treat what was obviously PCOS. It was either this or I bled for 2 weeks street, leading me to develop anemia. In 2020, there are many different hormone combinations you can take besides just ethinyl estradiol (man made estrogen). There is drospirenone and progestin (man made progesterone). There is also a mini pill that has progestin only for people who are more sensitive, but of course this means that in turn it is less effective.
What's the deal with IUD's? While I can't get one put in, I totally see the appeal for others. The concept of put it in and go about your life is great since we've been so used to having to dwell on taking a pill daily, but doesn't it hurt? From what I've been told by the many women who've gotten one, it isn't comfortable having an IUD inserted into your uterus through your cervix by your gynecologist, but as long as you aren't someone who has pelvic pain issues it shouldn't necessarily hurt. You can experience cramping and possibly spotting afterwards. Sometimes they give you a medicine to open up your cervix (if you haven't had children) to allow for easier entry and a local numbing agent to make it more tolerable. If you do have pain already in the area then, depending on the level of severity, it may not be possible to have this procedure done without being put under first, which is expensive. IUD's themselves are covered by insurance in the US, due to the Affordable Care Act put in place by Obama, but their cost varies from $0-$1,300. In the long run, it is still often cheaper than buying boxes of condoms or pill packs every month. The string that hangs down from the IUD is much like a tampon string and meant for the dr to remove it when the time is right. Make sure you don't tug on it yourself because you move the IUD out of place and cause yourself pain. If your partner complains of it poking him then the string was not trimmed short enough and you should go back to your doctor to have this corrected. It's important to note that there is the hormonal type, which often makes your periods lighter or disappear, and the copper type, which can make them heavier. From what I've read, more complications occur with the copper kind so they appear to be less safe for your body. The various types also all have a different length of time they can stay inside the body before needing to be replaced. The Paragard IUD should be replaced after 12 years, Mirena after 7, Kyleena after 5 years, Liletta after 7, and Skyla after 3 years. These options allow you to choose what works best for your future, which is why many young women get them in college, since they know they won't want a baby for at least several years.
What prevents STD's? If you are having sex with multiple partners it may be your best option to stick with female or male condoms. These are the only birth control methods which stop the spread of a sexual transmitted infection (STD's have been updated to STI's since they are typically a treatable infection and not an actual disease). These may also be your best bet if you don't feel comfortable having a plastic object attached to your body or have sensitivity to hormonal birth control. Having a condom by the bedside is a pretty easy way to be prepared for PIV sex, but some guys complain about feeling less with one on and some girls have sensitivity to the material, latex or not.
What's the most common type of birth control? The pill is the most frequently used for lots of reasons: it's the least invasive option, it's easy to carry with you everywhere in a purse, and it's a tried and true method women have been using for decades so we trust it. Your mom most likely suggested it to you as the best option when you were a teen because that's what she used. If that's the case, then why are so many women moving away from the pill to opt for something to wear inside of the body at all times? One reason is because remembering to take the pill is very annoying, even if you set an alarm like I do, and if you lose it or leave it somewhere, not only can you not have PIV sex but it really fucks with your hormones. When you have to double up the next day you can become nauseous, headachey, and develop sore breasts for the extra dose of hormones you're feeding your body to make up for the previous day. So having something inserted into your cervix that stays there for years and consistently provides the same amount of hormones (or not) is a way simpler option, especially considering you have to go to the gyno for a pelvic exam every year to renew your birth control prescription and pick it up from the pharmacy every month. New research is revealing that the pill is believe to give some women Vulvodynia, the longer you've been on it and the younger you were when you started, the more likely this is to be the case. It certainly checks out for me. So if you suffer from some kind of pain in the vulva, whether it be Clitodynia or Vestibulodynia, you may want to consider stopping the pill and switching to another method. We're learning that using all of these artificial hormones in our bodies for years trains them to not be able to produce the real thing anymore, which can cause all kinds of issues. The pill can also cause blood clots due to its constricting the blood flow and even cancer. I was advised a long time ago to take a break from it every couple of years to give my body some relief before I get back on again. Now that I'm nearing 35 I'm staying off for good.