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Birth Control Pills: Pro’s, Cons, and other options

Being such a well known and used method of contraception for reproductive women and people with vaginas all around the world, we must ask ourselves about the pros and cons of this method – do the pros really outweigh the cons? Or are we being sold into something by our GPs that could potentially be detrimental to our health? Also, what are some of our other options?!

Here’s some food for thought: Information obtained by the Guardian has discovered that a huge 9 in 10 women who receive contraception from a Pharmacist or General Practitioner take a form of contraceptive pill, which totals to over 3 million women in England. Also, a whopping 49.9% of reproductive women in Portugal take a form of contraceptive pill, which is the second highest % for one birth control method within a country around the entire world. The contraceptive pill is also the most commonly used birth control method for reproductive women in Europe, Asia, and Oceana, which has not changed since before 1994!

The most common contraceptive pill: the combined pill (COC)

The most common contraceptive pill: the combined pill.

The combined pill (or combined oral contraceptive/COC) is generally a really simple method of contraception if you’re a relatively organised or habitual person, because all you need to do is remember to take your COC at the same time every day.

It’s also really effective – over 99% to be precise, meaning that under 1 in 100 women and people with vaginas who take the COC will get pregnant in one year. This works by preventing ovulation each month through the prevention of egg release, thickening the mucus of the womb making it more difficult for sperm to penetrate, and also thinning the lining of the womb making it more difficult for a fertilised egg to attach itself into the womb.

The different types

Monophasic pills are the most commonly used within the UK, whereby a pill is taken for 21 days straight and after this you take a 7 day break. Phasic pills have a few different types of pill within each pack with different levels of hormones in each one, and are needed to be taken in the correct order. Finally, Everyday pills work the exact same as the Monophasic pills, except there are 7 inactive pills in each pack – this helps with remembering to take the pill and helping it to become a daily habit, without the need to take a 7 day break in between.

Advantages

Some listed advantages of taking COC are that it can help regularity and heaviness of periods, it does not interrup sex in any way, it can reduce symptoms of PMS, and it can reduce acne.

Disadvantages

COC can increase blood pressure, it does not protect you or any sexual partner against STI’s (sexually transmitted infections), and it has also been linked to serious health conditions such a breast cancer, and blood clots.The COC is also actually not recommended for use by just anyone either.

For example if you take certain medications, if you have high blood pressure, if you have any disease that narrows arteries, if you suffer from severe migraines, or if you are over 35 and a smoker, the COC is not recommended as the best method for you.

OUR HORMONES

If you suffer from severe migraines, or if you are over 35 and a smoker, the contraceptive pill is not recommended as the best method for you.

Ιt is only right that we should be fully aware of all of the information we might need to know about how this could affects us, and one thing that we see a lot of women reporting on is how the COC, containing hormones, can alter our mental health in a detrimental way – but is this actually the case?

In a recent Danish study, it was found that individuals taking a contraceptive pill were statistically significantly more likely to be either diagnosed with depression, or prescribed antidepressants for the first time in comparison to a population of individuals who do not take the pill. This was even more significant for the population of adolescents in relation to adults too- and these results were mirrored in another Finnish study on the same topic.

If you’re able to dig deep enough online, and in scholarly articles, you will be able to find lots of varied reports on the relationship between the COC and mental health – some will say that yes it does have an impact, specifically with the diagnosis of depression, however many have also found no statistically significant results to back this up.

Having said this, even looking at the vast amount of research and debate on this topic, many reproductive women and people with vaginas are starting to think that perhaps taking a COC might not be worth the right after all, and are moving to safer alternatives.

Alternatives to Contraceptive Pills

Male Condom

External Male condoms are an example of a barrier method that protects against pregnancy. An added bonus of using condoms is that they can also prevent STIs! There are 2 main types: Latex (the most common type) or, Plastic (good for those with allergies).

Sponge

This is another example of a barrier method that is placed inside the vagina before sex, and must left inside the vagina at least 6 hours after sex to be effective. It contains spermicide (kills sperm!), and can be used alongside condoms.

Copper IUD

The IUD is a small T-shaped contraceptive made of plastic and copper, which may or may not contain progesterone. There are two types of IUDs: pharmaceutical (containing hormones) and mechanical (not containing hormones) and which one a person will use has to do with their medical history and preferences. The IUD causes the reduction of motility and fertility of sperm, as well as their destruction, while making the uterus unsuitable for implantation of the fertilized egg as a target of the fertilization environment, inhibiting the implantation of the fetus in the uterus.The IUD prevents the uterine mucosa from preparing to receive the fertilized egg not only as a foreign body into the uterus, but also causing locally aseptic inflammation. It also causes the fallopian tubes to contract, which are shaken by these rapid movements, making the egg less functional the moment it meets the sperm. The effectiveness of the IUD reaches 97-99% making it a very reliable means of contraception. It lasts about 10 years and can also be used as an emergency contraceptive if needed.

Withdrawal

Otherwise known as the glamorous ‘pull out method’, withdrawal essentially means to remove the penis from the inside of the vagina before male ejaculation. It should be noted here that sometimes pre-ejaculative material can enter the vagina during sexual intercourse before male ejaculation, which can also cause pregnancy!

Diaphragm

This is a rubber capsule that is placed in the vagina in a way that covers the cervix, preventing the entry of sperm into the uterus. It has the shape of a dome with an inner ring that supports the wall of the bay. It is designed to hold spermicide cream or gel in the cervix. It is placed up to 6 hours before sexual intercourse and can remain up to 6 hours after, but in no case should it remain for more than 24 hours.

Cervical Cap

The cervical cap is a birth control (contraceptive) device that prevents sperm from entering the uterus. The cervical cap is a reusable, deep silicone cup that is inserted into the vagina and fits tightly over the cervix. The cervical cap is held in place by suction and has a strap to help with removal. The cervical cap is effective at preventing pregnancy only when used with spermicide. It doesn’t offer protection from STIs.

Rhythm method

Also known as the calendar method, involves you being able to track your own menstrual cycle and cycle history so you’re able to determine when you’re most and least likely to be fertile. You can download apps on your phone for support with this, for example Clue Birth Control, which has been found to be effective at preventing pregnancy.

One final note – Please make sure to do your own research to make sure that you’re making the right decision for yourself and for your body. Some of the alternative methods do also have side effects and should be well researched or discussed with your GP before making the decision on which method of contraception to go for. Alternatively, if you’re in a heterosexual relationship, why not try to encourage your partner to research male contraception?!

Words by: Sophie Simmonds

Sophie Simmonds is the Client Engagement Lead at Matchable Volunteering – who support Impact Organisations & Non Profits to find skilled volunteers where they need it most. Sophie is currently volunteering with Omgyno to support with content creation

Resources

https://onlinedoctor.superdrug.com/birth-control-around-the-world/
https://www.theguardian.com/uk-news/2019/mar/07/revealed-pill-still-most-popular-prescribed-contraceptive-in-england#:~:text=Figures%20obtained%20by%20the%20Guardian,similar%20for%20the%20past%20three
https://www.nhs.uk/conditions/contraception/combined-contraceptive-pill/
Skovlund CW, Morch LS, Kessing LV, Lidegaard O. Association of hormonal contraception with depression. JAMA Psychiatry. 2016;73(11):1154-62.
Lindberg M, Foldemo A, Josefsson A, Wiréhn AB. Differences in prescription rates and odds ratios of antidepressant drugs in relation to individual hormonal contraceptives: a nationwide population-based study with age-specific analyses. Eur J Contracept Reprod Health Care. 2012;17(2):106-18.
Hatcher RA. Contraceptive technology 20th edition. 2015.USA: Bridging the Gap Foundation and Mimi Zeiman.
Food and Drug Administration. Paragard prescribing info [Internet]. 2019. [cited 2022 Feb 23] Available from https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/018680s069s070lbl.pdf
Hatcher RA. Contraceptive technology 20th edition. 2015.USA: Bridging the Gap Foundation and Mimi Zeiman.
Food and Drug Administration. BioWink GmbH – Clue Birth Control: Prescribing information [Internet]. 2021 Feb. 18. [cited 2022 Feb 22]. Available from https://www.accessdata.fda.gov/cdrh_docs/pdf19/K193330.pdf