Did you know that approximately half of all pregnancies are unintended?  Pregnancy and parenthood have a lasting impact on a woman’s emotional, mental, physical, and financial well-being, so it is best to approach the decision to have children seriously. More and more women are postponing childbearing or opting to have a life without children. Careers, relationships, living and financial situations are frequently changing for women of this generation and are common reasons why women are seeking birth control. Being proactive and exploring your options now is key to family planning. So let’s talk birth control!

Hormonal or Non-Hormonal?

There are several non-hormonal methods to prevent pregnancy. Natural family planning or fertility awareness method is a method in which a couple opts to avoid sexual intercourse or use a barrier method during times of ovulation. This requires careful planning and discipline; a woman must have regular menstrual cycles and understand when she is likely to ovulate to be successful in pregnancy prevention. There are various apps for smart phone users that can keep track of cycles and peak ovulatory days. The efficacy of this method largely depends on consistency and vigilance of the couple; it is unclear but suspected that as many as 25% of women experience unintended pregnancy within the first year of typical use of this method.

Other non-hormonal methods work by either creating a physical barrier preventing sperm from reaching the egg  (inhibiting fertilization) or killing sperm altogether. In general, non-hormonal methods tend to be less effective than hormonal methods, with the exception of the Copper-T IUD.  Male and female condoms are the only methods that can decrease the risk of transmission of sexual transmitted infections (STI/STD).  Examples of non-hormonal methods include:

• Male or female condom
• Spermicide
• Diaphragm
• Cervical cap (FemCap)
• Copper – T IUD (Paragard^®)

Hormonal birth control alters the hormone fluctuations in a woman’s body, thereby inhibiting ovulation, thinning the uterine lining, and/or thickening the cervical mucus. Hormonal birth control not only prevents pregnancy but it is also used to control heavy menstrual cycles, improve menstrual cramps, stop PMS, and even treat acne and unwanted hair growth. Studies also prove that prolonged use can decrease the risk of endometrial and ovarian cancer. But hormonal birth control does not come without risks and side effects. Some women may experience side effects including headaches, bloating, and mood changes. Also hormonal birth control may increase blood pressure, lead to migraines with visual disturbances, and carry a slight increased risk for stroke and blood clots, especially in certain health populations. It is also important to note that hormonal birth control does not prevent the transmission of STI’s. If used correctly hormonal methods tend to be more effective than non-hormonal methods. Examples of hormonal birth control include

Oral contraceptives (“birth control pill”) – a pill taken at the same time every day to prevent pregnancy.  There are both estrogen/progestin preparations and progestin-only preparations. It is the most commonly used hormonal method. Side effects may include nausea, bloating, and breast tenderness.

Ortho Evra^® (“The Patch”) – estrogen/progestin containing patch placed on the skin (usually abdomen or buttocks) that is worn for 3 weeks and removed for 1 week to induce a cycle. Side effects are similar to the birth control pill.

NuvaRing^® – estrogen/progestin vaginal ring placed for 3 weeks and removed for 1 week to induce a cycle. Side effects are similar to the birth control pill.

Depo Provera^® (“The Shot”) – progestin-only injection given in office every 3 months. The shot may cause irregular bleeding and weight gain.

Nexplanon^® (“The Implant”)– small, progestin-only rod placed in the upper arm in a quick office procedure. It is effective for 3 years. Most common side effect is irregular bleeding

Levonorgestrel Intrauterine Device (Mirena^®, Skyla^®, Liletta^®) – progestin-only T-shaped device placed in the uterus at a quick office procedure. Approved for use for 3 or 5 years use. Most common side effect is irregular bleeding.

Which Method is Right for Me?

When choosing a birth control method several factors should be considered. Do you plan to have children soon or many years in the future? Does cost matter? How effective is each birth control method? How will a particular method impact my health? There is no perfect form of birth control that fits the needs of every woman, so approach your birth control choice with personal reflection. Speaking with a healthcare provider about what your needs is the best way to start the conversation. We offer various options of birth control at Rittenhouse Women’s Wellness Center. Please contact the office at 215-735-7992 to schedule your appointment and start the path towards taking charge of your reproductive health; your future depends on it.