Preconception

Finding birth control that’s right for you

By Gina Roberts-Grey

Choosing birth control is a very personal decision. Some women rely on their partner to prevent an unplanned pregnancy while others look to birth control as an added layer of protection against sexually transmitted diseases. Thankfully, women today have far more choices of birth control methods than our mothers and grandmothers ever did.

Flexibility. Comfort. Effectiveness. Side-effects. Just a few of the factors that woman consider when looking to implement or change a birth control regimen. Understanding how birth control can affect your health, relationship and lifestyle empowers you to make a choice that suits you best.

Timing can be everything

Just because you want birth control today, doesn’t mean you might want it next month or next year. Ask yourself ‘when might I want to begin trying to conceive’ and talk to your health care provider about the short and long term affects of your choice.

Dr. Tommaso Falcone, M.D., Chairman of the Department of Obstetrics & Gynecology at the Cleveland Clinic, whose specialties include infertility, in vitro fertilization, microsurgery for tubal ligation reversal, surgery for endometriosis and infertility surgery cautions that women need to define their future reproductive aspirations. “Some options have lingering effects that may slow the chances of conception within the first year of ceasing usage,” Dr. Falcone explains.

Fitting into your life

Scheduling an appointment to receive a birth control injection once every three months may be easier than visiting the pharmacy once a month. Sticking on a patch and having spontaneity may feel more comfortable than inserting a diaphragm and risking a lack of intimacy. Birth control should be something that fits discreetly into your life, not complicate it. “Regardless of the method, a woman must be comfortable with her form of birth control or it will not work into her life,” adds Dr. Falcone.

“I couldn’t remember to take a pill every morning so switching to one that I only have to take once a day was more convenient,” says Vivian Moffet of Huntington, New York. If you have trouble remembering to take your daily vitamins, opting for extended use birth control methods might better compliment your schedule. Birth control patches can be worn for one week at a time where as internal birth control such as Nuvaring only needs to be replaced once a month. “Women wanting long term birth control also have intrauterine devices implanted that can provide birth control for up to five years at a time,” says Dr. Mary Jane Minkin, M.D., clinical professor of Obstetrics and Gynecology at Yale University School of Medicine in New Haven, Connecticut.

“In my younger years, I was on the pill because it was convenient and effective. Then midwife that attended my daughter’s birth offered to fit me with a diaphragm and I took her up on it,’ explains Joanna Strong-Millsap of Redlands, CA. Concerned about use of synthetic hormones, Millsap is one of many who are willing to trade a bit of spontaneity for peace of mind or a lower risk of physical side effects as a result of birth control. Cervical caps, male or female condoms, and spermicides or foams are also choices that do not introduce hormones into your body nor do they impact fertility in the weeks and months after discontinuing use.

The added benefits

Relief from heavy menstrual cycles or the emotional and physical symptoms of premenstrual dysphoric disorder, or PMDD, prompts the decision to opt for a birth control method for many women.

“Many oral contraceptives can help a woman suffering from heavy periods or irregularity,” notes Dr. Minkin. A 24 day regimen, YAZ offers women less fluctuation in their monthly cycles than traditional 21 day birth control options. “The Mirena 5 year IUD can also produce a reduction in flow of up to nearly 90 percent six months to a year after insertion,” says Dr. Minkin.

Switching methods

Some find that their first choice in birth control doesn’t fit into their lives as they’d expected. “We though condoms were a great form of birth control, but it turned out that we didn’t like them and didn't bother using them!” says Katie-Anne Gustafsson of Sweden. After a few weeks of vacillating between using something that didn’t fit their lifestyle, Gustafsson and her husband knew they needed to make another choice. “I opted to go for 1 shot every 3 months,” Gustafsson adds.

Know the risks

Although the chances are slim, someone has to be in that one percent to get pregnant despite using one or perhaps a combination of birth control methods. “We used multiple forms at one time,” says Diana Crabb of Crystal Lake, Illinois describing the birth control practices used during the few months between her going off of birth control pills and her husband having his vasectomy. “Nine months later, our daughter was born,” adds the mother of four.

Pay attention to increased headaches, nausea, breast tenderness, acne or other potential side effects to help you and your health care provider fine tune the hormonal dosage and find the best birth control method for you. Ask questions to understand the effectiveness of your method as well as risks for physical and emotional side effects. Discuss smoking, medications, allergies, health conditions and history with your health care professional before starting or changing your birth control to ensure maximum potential effectiveness as well as prevent potential drug interaction.

Health experts also caution that there is a very definite difference between birth control and prevention of contracting sexually transmitted diseases. Dr. Minkin explains, “The only birth control options that also help to protect against the transmission of disease are condoms and abstinence.”