Birth Control Options

Birth Control.  Contraception.  Pregnancy Prevention.  It’s a vital concept for most sexually actively women.  And while we appreciate the varied birth control methods available to us, we can be overwhelmed with choosing which method may be best.

Barrier Methods:

Male condom:

How it works: A thin covering, usually made of latex is unrolled over an erect penis to prevent the entry of sperm into the vaginal canal during ejaculation.

Pros: Also protects against STDs.  Inexpensive.  Can be found at most pharmacies, grocery stores, big box stores, etc.

Cons:  Must be used during each sexual encounter.  Can break or slip off during rough sex.  Human error (i.e. incorrect application) can impact its effectiveness.

Effectiveness: 82-98%

Female Condom:

How it works: A loose pouch is placed inside the vagina, held in place by flexible rings.   During intercourse, the penis goes inside of the pouch, and sperm is trapped during ejaculation.  (NOTE: a female condom and male condom should not be used at the same time).

Pros: Also protects against STDs.  Can be inserted up to 8 hours before intercourse.

Cons: Must be used during each sexual encounter.  Noticeable during sex.  Can break or slip off during rough sex.  Human error (i.e. incorrect insertion) can impact its effectiveness.  About 3x more expensive than male condoms.

Effectiveness: 79-95%

Spermicide:

How it works: Chemicals that immobilize or kill sperm are mixed into foams, gels, creams, films, suppositories, and sponges.  The products are then applied to the vagina.

Pros: Easy to buy at any pharmacy or online retailer.

Cons:  Some people may be allergic to one or more of the ingredients in the product.  Only work during a narrow time window–most types must be applied at least 10 minutes before intercourse, and only work for an hour.  Must be left on the vagina for 8 hours after intercourse.  Again, human error during the application process can affect effectiveness.  Does not protect against STDs.

Effectiveness: 72-91%

Diaphragm:

How it works:  A soft silicone dome holds spermicide, and is placed against the cervix.

Pros: Can be inserted up to 2 hours before intercourse.

Cons: Recommended to use with spermicide.  Does not prevent STDs. You must go the the doctor to be properly fit for one, and get refitted after childbirth or if you gain or lose more than 10 pounds.  Needs to stay in place at least 6 hours after sex.  May become dislodged during sex.  Must be washed after each use.  May cause bladder infections

Effectiveness: 88-94%

Cervical Cap:

How it works: Very similar to a diaphragm.

Pros: Keeps working for up to 48 hours after insertion.

Cons: Recommended to use concurrently with spermicide.  Can become dislodged during sex.  You must go the the doctor to be properly fit for one, and get refitted after childbirth.  Needs to stay in place 6-8 hours after sex.  Must be washed after each use.  Does not  protect against STDs.

Effectiveness: 68-91% (effectiveness decreases after childbirth)

Hormonal Methods:

Emergency Contraception: 

How it works: Taken after unprotected sex to prevent pregnancy, these pills work by giving you a short burst of hormone-like substances, which mimic progestin, to prevent pregnancy.  They may affect ovulation, movement of sperm, or interrupt other processes necessary for fertilization of the egg.  Note, these pills will not abort a currently existing pregnancy.

**Emergency contraception should not used as a regular form of birth control**

Pros: May be effective up to 5 days after intercourse (but most effective within the first 24 hours).  Available over-the-counter to adults over the age of 17.

Cons: May cause side effects such as abdominal pain, chest pain, shortness of breath, headache, blurred vision, and severe leg/arm pain or numbness.

Effectiveness: Depends on the type you take, and how soon you take it after intercourse.

Birth Control Pills:

How it works: Synthetic hormones release estrogen and progestin in your body.  This stops pregnancy by preventing ovulation and thickening the cervical mucus to make it more difficult for sperm to enter the uterus.

Pros: Can regulate or lighten periods.  Easy to use.  May protect against uterine and ovarian cancers.  May reduce acne.

Cons: Must be taken daily.  Does not prevent against STDs.  May cause several side effects, the most severe of which is increased risk of stroke, blood clots, and certain cancers. May be less effective when taken with certain medications, such as antibiotics.  Requires a prescription.

Effectiveness: 91-99%

The Patch:

How it works: A bandage-like patch that sticks to your skin, and releases estrogen and progestin.  It can be applied to the abdomen, buttocks, upper arm, or upper torso.

Pros: Only needs to be applied once weekly.  Easy to use.  May regulate or lighten periods.

Cons: Does not prevent STDs.  May cause skin irritation.  Less effective for women >198 pounds.  May increase risk of blood clots, heart attack, and stroke.  Requires a prescription.  Effectiveness may be lowered when taken with certain medications.

Effectiveness: 91-99%

Vaginal Ring:

How it works: Your body absorbs hormones through a clear, soft, flexible ring that is inserted into your vagina.  Your body absorbs the estrogen and progestin through your vaginal wall.

Pros: Only requires once monthly insertion.

Cons: Does not protect against STDs.  May cause vaginal discharge/irritation, headache, weight gain, nausea, irregular bleeding, breast tenderness or mood changes.  Its effectiveness may be altered by other medications.  May increase risk of blood clots, heart attack or stroke.  Requires a prescription.

Effectiveness: 91-99%

The Shot:

How it works: A long-acting injection of synthetic progestin, which stops the ovaries from releasing eggs and also thickens the cervical mucus.

Pros: Low-maintenance.  Each injection lasts 3 months.  Decreases risk of endometrial cancer, ovarian cancer, uterine cancer and pelvic inflammatory disease.  May decrease menstrual cramping and frequency of periods.

Cons: Does not prevent against STDs.  May increase risk of weight gain and osteoporosis (due to loss of bone density).  Requires a doctor’s visit for each injection.  May alter your menstrual cycle, including breakthrough bleeding and the absence of periods altogether.  Not recommended for women who may want to get pregnant in the near future, as it can take up to 18 months for the body’s hormonal cycle to normalize.

Effectiveness: 94-99%

Long-Term Methods:

Implant:

How it works: A soft rod that releases artificial progestin hormone into your body is placed under the skin in your upper arm .

Pros: Low maintenance.  Lasts 3 years.

Cons: Does not protect against STDs.  Insertion site may get infected.  May cause irregular breakthrough bleeding, heavy bleeding, or the absence of periods.  Serious side effects may include allergic reaction, infection, weight gain, or mood changes.  Effectiveness may be decreased by certain medications.

Effectiveness: 99%

Intrauterine Device (IUD)-cooper:

How it works: A small T-shaped device is inserted into the uterus through the cervix.  It changes the cervical mucus, fallopian tubes, and lining of the uterus.  These changes stop the fertilization of the egg.

Pros: Low maintenance.  Lasts 10+ years.  Does not contain artificial hormones.

Cons:  Does not protect against STDs.  Requires a doctor’s visit for insertion and removal.  May cause heavier, more painful periods.  Can occasionally be felt during sex.

Effectiveness: 99%

IUD-progesterone:

How it works: Same as the copper IUD,  but it releases synthetic progestin.  This makes egg fertilization harder.

Pros: Low maintenance.  Lasts 5 years.  May cause lighter, less painful periods for some.

Cons: Does not protect against STDs.  Sometimes causes cramping.  May cause breakthrough bleeding, or the absence of periods.  Some women experience mood changes, less pleasure while having sex, and headaches.  Is sometimes felt during sex.  Clinic visit required for insertion and removal.

Effectiveness: 99%

Sterilization (i.e. getting your “tubes tied”):

How it works: The follopian tubes are burned, tied, blocked with a substance, or cut with a small incision.

Pros: Effective immediately, and has a low failure rate.  Requires no further action.

Cons: Irreversible, completely permanent.  Does not protect against STDs.

Effectiveness: 99%

Knowledge-Based Methods:

Withdrawal (i.e. Pulling Out): 

How it works: During intercourse, the male partner pulls his penis out of the female partner’s vagina prior to ejaculation.

Pros: Free, and available anytime.  No hormonal-related side effects.

Cons: Does not protect against STDs.  Requires special attention, and is completely dependent on the man’s  self-knowledge and self-control.  It is important that the male ejaculate away from the woman’s body, as even sperm left on the female’s legs or vaginal lips can travel into the vagina.  Less effective than other forms of birth control.

Effectiveness: 77%

Fertility Awareness:

How it works: The female sexual partner becomes highly aware of her menstrual cycle.  She then avoids sex, or uses a barrier method of protection, on the days that she is ovulating.

Pros: No health risks or hormonal side effects.  In addition to preventing unwanted pregnancy, can also be used to improve your chances of getting pregnant when ready.  Alternative means of pregnancy prevention for religious couples opposed to other methods.

Cons: Takes time, effort, and meticulous record-keeping…especially in the beginning.

Effectiveness: 76-99%

Abstinence:

How it works: Sexual intercourse is avoided.

Pros: The only completely fail-proof method to avoiding pregnancy.

Cons: Requires self-control to be effective.

Effectiveness: 100%

You are in control of your body, and are best qualified to determine what birth control method is best for you.  For more information, and the ability to actually do a head-to-head comparison of up to 3 methods, click here: http://www.birth-control-comparison.info/

Yeast Infections

“Yeast infection” is a phrase commonly used to describe a vaginal infection caused by candida albicans, a type of fungus.  Seventy-five percent of women will experience a yeast infection at least once in their lifetime.  While they may cause significant discomfort, yeast infections are usually minor and can be treated in just a few days.  Additionally, unlike other vaginal infections, a yeast infection is generally not considered to be an STD, though it is possible to transmit the infection to your partner during intercourse.

Cause.  Our vaginas are very delicate organs.  A healthy vagina has a certain amount of bacteria and fungus present.  Yet when something throws off the balance of these organisms, the fungus can overgrow and cause painful symptoms.  Antibiotics, high estrogen levels, and a weakened immune system caused by a condition such as cancer or HIV can all negatively alter the balance of the organisms present in our vaginas.

Symptoms.  Someone with a vaginal yeast infection may experience inflammation, burning, itchiness, soreness (especially during intercourse) and the presence of a thick white odorless discharge.

Treatment.  Minor yeast infections can be self-diagnosed and treated with OTC products such as Monistat (miconazole), Gyne-Lotrimin (clotrimazole), and Terzol (terconazole).  OTC options are available as tablets, suppositories, and creams, and their duration of treatment may last 1-7 days.  Please note, if you are using a antifungal cream, you should avoid using latex-based contraceptive products (i.e. condoms) as the oils in some topical products can weaken the latex.

If you have repeated infections (>4 within a year), you should visit your doctor.  He/she may recommend a prescription product such as Diflucan (fluconazole).

Prevention.  You can reduce your risk of yeast infection by practicing good vaginal hygiene:

  • Avoid exposing your vagina to unnecessary chemicals.  Your vagina is a self-cleaning organism.  It does not require fancy lotions, creams, douches and deodorants.  Mild unscented soap and water should be sufficient.  Unwanted discharges or odors are likely indicative of a more serious problem.
  • After using the bathroom, always wipe from front to back to avoid transferring unhealthy organisms from your anus to your vagina.
  • Wear cotton underwear.  Cotton allows your vagina to breath, keeping it dry and cool.
  • Avoid tight-fitting clothes, as they may make your vagina too warm.
  • Change out of wet clothes and swimsuits immediately.  Moisture allows for bacterial and fungal growth.
  • Frequently change your pads and tampons.  Consider using pantyliners even on days you are not menstruating as they help absorb any extra moisture.  Again, unscented products are likely best and some fragrances and other added chemicals may lead to vaginal irritation and/or alter your vaginal pH.