Birth Control

Okay, this may be a really, really boring for most of you out there with out an excessive x chromosome, but I am really shocked at how little women around me know about birth control options. I know that this is something that is not talked about nearly enough in school, and it's not the easiest thing to research on the internets, but it's important. I mean, the dispersal of birth control is key in feminism. It is how women have been able to delay pregnancy in order to have careers. It's kept women from being under the thumb of their husbands. It's still an important issue. One of the major ways that abusive men* keep control over their victims is through trapping them with children. This can be especially pernicious as many domestic violence shelters do not permit boys over the age of 11. Birth control sabotage is another method of abuse being used by abusers which serves to take away power (usually from the woman) by means of deception. Thus it is important for both men and women to understand different ways that they can prevent pregnancy.

So I propose here to give you a brief summary of those birth control options available to you. This is by no means comprehensive nor is it free of bias, but I think it could be useful for people who are confused about all the different options out there.

Junior Varsity

These are the birth control methods that you've probably heard of/used before. They are common for a reason; they tend to be minimally invasive, simple to use, effective, and generally pretty low risk. So we'll start at the very beginning:

Abstinence: This is the #1 most effective form of birth control if used consistently and properly. Abstinence means many different things to many different people. It could mean refraining from penis-in-vagina intercourse, any penetrative intercourse, oral sex, manual sex, kissing...it's up to you. The best way to prevent pregnancy though is to not allow semen to come near vaginas. So, not having vaginal intercourse is a really good place to start. Remember, though, abstinence is really hard to stick to, and, like all forms of birth control, it only works when used consistently and correctly! See Kidder Kaper's great comic on the benefits of abstinence for more info!

Barrier Methods: These include our friend the condom. Barrier methods work to prevent pregnancy by keeping sperm from getting to the egg by way of a physical barrier. Barrier methods are also the only methods of birth control that can prevent the transmission of HIV and other Sexually Transmitted Infections (STIs). The most common barrier method is the condom which usually refers to the male condom. Most condoms are latex, but you can get polyurethane condoms if you have a latex sensitivity. Lamb skin condoms also exist, but they are generally not effective in preventing STI transmission.  The most awesome part about condoms is that there are so many different kinds: studded, ribbed, lubricated (more on this later), small, large, extra large, colored, flavored, thin, thick...the list goes on. The trick is to find the condom that feels good to you! You don't want one that's too big though or too little as this can increase the chances of failure. Personally, I like the Beyond Seven line. One thing to be careful of in condoms is that some use the spermicide Nonoxynol 9 which used to be thought to prevent HIV infection. While this chemical does kill this virus, it also can be highly irritating and actually increase the possibility of transmission of other STIs.

Other barrier methods include the female condom, cervical cap, diaphragm, and cervical sponge. I listed these in decreasing order of effectiveness in preventing pregnancy and STI transmission. However, they still all work pretty well. These methods are particularly nice because they allow the woman to have control over her birth control options rather than depending upon the man to use a condom. The downside is that some women are a little grossed out by having to put something into their vaginas before sex. This has never squicked me in any way, but I have a very special relationship with my vagina so... Also, note that the diaphragm and cervical cap must be used with spermicidal gel!


Birth Control Pills: or The Pill as many call it. Of course, there is more than one type of pill. In fact, there are SO MANY kinds of birth control pills, it is awe inspiring. Generally, though, these can be divided into three basic types -- triphasic combination pills, monophasic combination pills, and progesterone-only pills.

I know, I know, those are big sciencey words that are not very reader friendly but let's break it down further. So you either have a progesterone-only pill which, surprise surprise, only contains progesterone, or you have a combination pill which contains a combination of progesterone and estrogen. Within the combination pills you either have a pill that is triphasic, meaning that there are three different ratios of estrogen to progesterone for each of the three weeks of active pills, or monophasic meaning all the pills have an identical ratio of estrogen to progesterone in all three weeks of active pills.


So what's the difference? Well, mostly it's a matter of what feels right to your body. Combination pills are slightly more effective at preventing pregnancy than are progesterone-only pills, and they are not quite as finicky when it comes to taking the pill at exactly the same time every day. However, estrogen can have some nasty effects like raising the chance of forming blood clots. This generally isn't a concern unless you have a genetic propensity toword clotting, you're over 30, or you are a smoker.

The differences between monophasic and triphasic methods are a lot more subtle. When I was taking the pill, I really enjoyed monophasics because they really dampened my hormonally related mood swings. Also you can use monophasics continuously and never have periods. It's so civilized. They are also cheaper, but just barely. Triphasics have less breakthrough bleeding and sometimes are more effective in preventing things like cramps and acne.

Other Hormonal Methods: There are other hormonal methods, most famously the NuvaRing, that function similarly to combination pills, but do not require the woman to take the pill every day. The NuvaRing is a small ring that you put in your vagina that stays there for three weeks. You then leave it out for a week, have your period, and replace it with a new one the next week. You can remove it for a few hours at a time to have sex or other things! It's actually a pretty nifty device for a number of reasons. I know a bunch of lesbians who use it to align their menstrual cycles (as pregnancy is obviously not a risk...) and it also can reduce cramping, improve acne, and cause lighter periods. Good things all around. Other hormonal methods include the shot which functions much like birth control pills, but you only need to get one every three months, and Implanon which are small implants in your skin that slowly release hormones.

Varsity:

These methods of birth control are a little less common, but often more effective than the JV methods. They frequently take the factor of human error out of the equation. These are often more invasive, more expensive, or slightly higher risk, though, and are therefore not right for everyone.

IUDs: These little babies get such a bad rap and it is terribly unfortunate. In fact, this is my current method of birth control and I just ADORE it. So the IUD has a long and somewhat spotty history. In the 1970s the Dakon Shield was widely used and, due to it's somewhat porous string, caused some women to get uterine infections which left them sterile. Modern IUDs, however, are free from this problem, and they are a great option for women who have no desire to become pregnant within the next 5 - 10 years.

IUD stands for Intrauterine Device which is exactly what it sounds like. It is a small T-shaped device made of either plastic or copper that is inserted by a gynecologist into your uterus. It is held in place near the top of the uterus by the arms of the T. From the bottom of the T runs a string made of non-porous material that runs out of the cervix. Women with an IUD should check the string monthly to make sure that the IUD is still in place. Honestly, though, I have never been able to feel the string of my IUD, and my gyno said that it's really nothing to worry about.

There are two types of IUDs: copper IUDs and hormonal IUDs. In the United States the copper IUD is marketed as the Paraguard and the hormonal one as Mirena. There are, as always, pluses and minuses to each method. An advantage of the Paraguard is that there are no hormones involved which is great for women who don't like the idea of tricking their bodies into thinking that they are pregnant. Essentially, this IUD makes your body believe that the uterus is injured and thus not a suitable place for baby making. Side effects of the Paraguard are heavy bleeding and cramping, though usually this subsides within a few months. This system also lasts for 10 years, though it is reversible at any time!

The Mirena is a plastic IUD that releases small amounts of progesterone. Since it doesn't contain estrogen, this system, unlike combination pills, does not increase the risk for blood clots. The Mirena, unlike the Paraguard, does not increase bleeding or cramping. In fact, many women stop having periods while using the Mirena. (Again, this is SOOO CIVILIZED!) The levels of hormone released by Mirena are much lower than those seen even in low dose progesterone pills, but it is still present. A downside of Mirena is that if you do contract an STI (and remember this does NOT protect against STIs), you are much more likely to develop Pelvic Inflammatory Disease if you are using the Mirena. This is a disease that you Do Not Want. So, if you do engage in high risk sexual activity, this may not be the method for you.

The major downsides to IUDs are cost and discomfort. If uninsured, IUD insertion can cost upwards of $1,000, though most insurance does cover this at least to a certain extent. The actual insertion of the IUD can be rather uncomfortable especially if you have never had any babies. You see, the cervix has to be dilated in order to shove the damn thing up into the uterus. For me, it felt like the worst menstrual cramps of my life for about a day, but advil really took the edge off. My friend had cramping for a couple weeks. It's really a crap shoot. Also, some women can experience extensive bleeding for up to a month following insertion. Usually it's not a lot of blood, but it's persistent. Buy panty liners before hand!

Tubal Ligation/Vasectomy/Hysterectomy: If you KNOW that you never want to have your own children and you absolutely want to guarantee that you never become pregnant, one of these permanent surgical methods of pregnancy prevention may be for you. These procedures are invasive and surgical, and they are permanent. So if you frequently change your mind about things like your college major, favorite color, or boyfriend, this may not be the right option right now. Or it may be. I know people who are much more sure about their desires to never be parents than they are about their love of purple. I don't have a ton to say about these methods because most people my age don't get them. In fact, many doctors absolutely will not perform these surgeries on young adults because they worry that their patients may someday change their minds. If you are certain, however, there are doctors who will help you out. 

The Future:

The VSF would be so pissed at me if I did not include in here mention of future directions in birth control. Perhaps most notable is the possibility of a birth control pill for men that would essentially disable sperm and prevent them from being able to fertilize eggs. Other methods simply prevent the testes from making sperm. These advances are wonderful as they provide non-barrier methods that are male controlled meaning that men can hold much more responsibility in preventing unwanted pregnancies.



 I hope that was fun and educational for all! A final note (and a somewhat political one at that.) I want to point out that they same people who are trying to take away a woman's right to choose are also trying to discourage information like this from being taught in public schools. Comprehensive knowledge about sexual health and particularly about methods of birth control is the best way to prevent unwanted pregnancies. So, if you really want to reduce the number of abortions in this world, then maybe you should promote comprehensive sex education.






*Of course NEVER to imply that all abusers are men. Not even all heterosexual abusers are men.