Last week, my mom called me when I was walking around TJ Maxx at 3pm. “I have good news!” she proclaimed. “You can get an IUD for only $400 with a prescription in Canada, and my Canadian friend is trying to get you one, and then my friend said she’ll put it in for free!”
Okay, back up. Why is my mom trying to smuggle a long-term contraceptive across the border for me?
I’m 21, I’m getting married in 6 months, and I don’t have health insurance – a concoction that makes me desperate for affordable birth control. I’ve spent the last six weeks looking up birth control methods on my phone at work, and I’m now here to impart that wisdom to you. Well, that and the insight of my gynecologist mom.
As we begin this conversation, it’s vital that we remember a few things. You, and you alone, are living in your body. You know what you’re feeling and how your body is responding, and if that doesn’t line up with what friends, doctors, or signifcant others are saying, you need to trust yourself. If a birth control method doesn’t work for you, then it doesn’t work for you. Just because your roommate is having the time of her life on NuvaRing doesn’t mean you’re broken if it’s making you hella depressed.
It’s completely normal to try a few different methods before you nd one that works, and it can feel like a roulette of side effects as you try to decide which ones you can you live with instead of, you know, getting pregnant. That doesn’t trouble my mom; she believes rmly in the idea that you can’t get something for nothing. I, on the other hand, am more idealistic and think it’s hellish and dumb that we have to gain weight
or have acne or be moody or slip into an actual depression just so we don’t accidentally give birth. Regardless, please don’t be afraid to say enough is enough and move on to something else.
I’m dwelling on this because I’ve heard 1,000 horror stories and I DON’T WANT YOU TO BE ONE. “Gaslighting” is a form of psychological abuse that happens a lot in women’s health, especially when it comes to birth control. A victim is made to question her own sanity, perception, or memory. This can be someone telling you that your side effects aren’t a big deal, or that they’re worth not getting pregnant, or that you’re just emotional and it has no connection to birth control. Keep your eye out for this.
I also think it’s really important to talk about the depression issue here. A recent study found that women on any form of hormonal contracep- tion (including things like the IUD, Depo shot, and implants) are 30% more likely to be depressed or taking antidepressants. THAT IS AN ENORMOUS NUMBER. Almost one third of women are experiencing depression from something that 62% of reproductive-age women are using. I don’t mean to be rash, but that is kind of like ibuprofen causing depression. This medicine that everyone is using is screwing with everyone’s heads, and we haven’t found a way around it. It’s frus- trating and not okay, but we are lucky to live in a time when
studies are being done to prove that these side effects exist, and it’s no longer taboo to talk about these issues publicly and loudly.
At the end of the day, it is amazing that we have the ability to control our fertility inexpensively and relatively safely. That isn’t something to be taken for granted. It’s something our mothers and grandmothers fought for. But please do so in the most informed and healthy way possible.
Birth control comes in a lot of different methods, but it’s all based in two different hormones that try to mimic your body’s natural rhythms. When you’re evaluating whether a birth control method is going to work for you, seeing what hormone it relies on is a great place to start.
Estrogen — You can’t take estrogen if you’re at risk for a blood clot, smoke, breastfeeding, migraine-prone, or older (35 is the suggested age cut-off). It can cause nausea and weight gain. Taking estrogen can reduce the risk of ovarian cancer; women who are at risk often take it for preventative treatment.
Progesterone — Effectiveness can be a little lower. It can be more likely to cause birth-control-induced depression. It can increase your libido. You can take it if you’re breastfeeding, migraine-prone, older, or at risk for a blood clot.
Many birth control methods are a combination of the two hormones, but rely more heavily on one than the other. Those side effects and lists are in no way exhaustive, so please do research on the hormones and effects of birth control methods before you commit!
On to our methods:
Birth control pills: 97% effective (Combination – mostly) —
Easy to find, normally pretty inexpensive, and not very intrusive.
Enough variations that theoretically, anyone can find something that works for them. Theoretically.
92% is not a great effectiveness rate.
You have to take the pill at the same time every day in order for them to be effective.
My doctors told me never to go on birth control pills because I get migraines, but I tried them anyway and gained 15 pounds and got migraines so bad even Vicodin didn’t help. I don’t recommend this.
IUD: 99.7% effective (Progesterone) —
It’s pretty darn effective.
Set it and forget it: you can have it inserted and not worry about getting pregnant for the next ve years or so. Can stop your period entirely or make it really light.
It hurts like hell to get it put in.
I will never get back the hours I lost reading about people’s experiences with IUDs.
If your body doesn’t react well to it, the monster is literally inside you. You’ll have to go back to a doctor to get it removed and, depending on your gyno, they might make you wait a while because “those side effects are probably all in your head.”
Can increase your risk of STDs because it’s basically putting a window into your cervix.
Depo Provera (Depo Shot): 97% effective (Progesterone) —
Often used for underserved populations. Only need one shot every three months. Can still breastfeed while using it.
Can cause irregular bleeding for a while, but then can cause amenorrhea (ending your period) Causes weight gain in most cases
Can deplete the minerals in your bones (say what?!)
My mom (the gynecologist) said she wouldn’t put someone in her family on this one.
Patch: 92% effective (Estrogen-based; maybe combo) —
I can’t imagine anything more convenient than putting a sticker on your arm that stops pregnancy.
This can cause nausea, breast pain and tenderness, and bleeding between periods.
This one is estrogen-based, so it’s loosely linked to all of the scary things estrogen is, such as heart attack and blood clots.
Condoms: 86% effective —
No hormones!!!!!!!! NO HORMONES.
You constantly have to buy condoms.
This one has the largest chance of user error.
It interrupts your *moment*.
I cannot comment on the feeling because I know nothing about it.
Implant: 99.7% effective (Progesterone-based) —
Continuous, long-lasting birth control with nothing to remember or worry about It’s easily removable and reversible
Irregular bleeding, especially within the rst 6-12 months
It’s inserted in your arm, so you have to visit a doctor to make any changes or remove it
Birth Control for Men —
You are putting safety on the gun instead of just wearing a bulletproof vest and hoping for the best.
It is so much safer for fertility and there are less risks of complications (that are sometimes fatal for women).
Men are babies so they won’t actually work on creating it.
Example: There was recently a study that you probably read about in which they stopped a trial for male birth control because 3% of participants were experiencing mood swings and depression.
(Remember that gaslighting thing we were talking about? And how the number is 30% for women? Society has a lot of work to do here).
NuvaRing: 98% effective (Estrogen-based) —
There’s nothing to remember or keep track of
Many women have more regular, shorter, lighter periods
This works like the birth control pill, and can help with the same things, like heavy cramping, acne, and PMS symptoms
This is linked to breast tenderness, nausea and vomiting, and bleeding between periods
After you stop using the ring it can take a few months for your body to go back to normal
It’s estrogen-based – you know what that means. Even Vicodin didn’t help. I don’t recommend this.