Kiska (ifritah) wrote in sexuality101,

Birth Control Methods, Part One

This being the first entry in the community, I considered a few different ways to start things off. I finally decided to go with a topic that seemed to be getting brought up left and right around me at the moment - contraception.

Considering that discussing birth control in one big entry would take a long time (not to mention be a huge bit of text), I thought breaking the topic up into it's four subcategories would be more appropriate. And how handy is it that there are four Thursdays this month? Quite handy, I'd say. So, every Thursday, I'll go into a new subcategory.

But let's not beat around the bush, shall we? The four subcategories of birth control are:

* Hormonal Methods
* Barrier Methods
* Sterilization
* Periodic Abstinence

Today, I'm going to talk about hormonal methods. That would be any method of birth control that prevents pregnancy through increasing hormones in a woman's body. Now, let me tell you, there's a LOT of information on this topic alone. Talking about it in detail would kill my typing fingers (and likely put you to sleep). So, I'm going to briefly touch on each type. If you have any questions on something I didn't cover, please email me at Every Sunday I'll post answers to questions (anonymously) about whatever you want to know.

Okay, let's get to it!

There are two different types of birth control pills - Combination pills (containing both synthetic estrogen and progestin hormones) and "mini-pills" (containing only progestin). What does an increase in these hormones do? To put it simply, the estrogen boost prevents ovulation (tricking the body into thinking it's pregnant, basically), while progestin thickens the cervical mucus so sperm are cut off from their goal, and also has a hand in preventing ovulation as well.

The pills come in a pack of either 21 pills or 28. For 21 consecutive days, a woman takes one pill at the same time every day, and in the case of 28 pills, takes 7 placebo pills (which contain nothing in them, but are there to help keep a woman on track of taking the pill on a regular schedule) after the first 21 pills. In other words, while on the pill, you're in a 28-day cycle. 21 days with increased progestin (and with combo pills, estrogen), 7 days hormone free. Those seven days are when a woman most often has her break-through bleed (her period), though in some cases women have reported spotting (a small amount of blood present during non-period days of the month).

Interesting tidbit: When a woman is taking birth control pills, her break-through bleed is not blood. The cervical mucus that thickened due to progestin sheds, and well, it had to go somewhere.

A bit of history: In 1959, the U.S. Food and Drug Administration gave its first approval to the birth control pill. (This also is considered to be the event that jump-started the sexual revolution.) As with most products first on the market, the pill in its early stages had a lot of faults. Luckily for us, modern science discovered the big issues, fixed 'em up pretty, and got us some much better pills on today's market. (In other words, they found out that increasing estrogen too much was related to cardiovascular problems.) The pill on the market now is not your mom's pill.

Sidenote: The pill is not just for women not wanting to get pregnant. It also has some really great advantages that can help those that are not sexually active:

* More regular periods
* Less menstrual flow
* Less menstrual cramping
* Less iron deficiency anemia
* Fewer ectopic pregnancies (fertilized egg implanted outside of the uterus)
* Less pelvic inflammatory diseases
* Less acne
* Less premenstrual pain/tension
* Less rheumatoid arthritis
* Decline in the risk of endometrial and ovarian cancer

(Note: Not all brands of pills give every advantage (and some may even give advantages I didn't bring up). Talk to your doctor or nurse practitioner about what you're interested in and they can help you get a good fit.)

Like any birth control method, there's disadvantages as well. Taking the pill means you have to be very strict about when you take your pill every day. The body's not waiting for your next shipment of hormones. If the shipment's late, the boat heads off to it's next destination. (Meaning, your body will begin to go through it's natural daily progression if pills are missed or taken at drastic different times of the day.) It also does not protect against sexually transmitted infections.

Effectiveness: If used perfectly - 99.9%. Actually reported as 99.5% effective due to error on the part of the pill taker.

Depo-provera is a shot containing the hormone progestin (synthetic progestorone) given every three months by a healthcare professional. (Note: Read first paragraph in birth control pills cut to read explanation of progestin's role in preventing pregnancy.)

Advantages: No ability to use method incorrectly.

Disadvantages: If undesirable side-effects occur (such as frequent bleeding), the woman must wait out the three months before changing to a different method. Like the pill, it also does not protect against sexually transmitted infections.

Effectiveness: 99.7%

The Nuva-ring is a small, flexible ring that is manually inserted into the vagina once every three weeks by the woman herself, not a healthcare professional. In the fourth week, the woman removes and disposes of the ring for her break-through bleed. After the last day of the fourth week, a new ring is inserted. It contains both synthetic estrogen and progestin, but at much lower dosage due to it's close proximity to the cervix. (Note: Read first paragraph in birth control pills cut to read explanation of estrogen and progestin's role in preventing pregnancy.)


* No worries of forgetting a pill or taking it at a specific time of day
* For women who have negative results with higher dosage hormonal methods, the lower dosage of the ring is a nice alternative


* Possible forgetfulness of the ring's presence causing un-timely changing of the ring
* Long-term results will not be available for some time, due to being only recently a birth control method option.
* Does not protect against sexually transmitted infections

Effectivness: As stated above, no studies have yet been published (that I know of), but the industry is predicting the effectivness to be higher than that of the birth control pill.

The Intrauterine Device (IUD) is a small, T-shaped device inserted into the uterus by a medical professional. Currently, there are two different types of IUDs offered in the US - ParaGard, or Copper T 380, and Mirena (previously known as Progesterone T).

The ParaGard contains copper and is not a hormonal method of birth control, as it does not contain any hormones. However, since it doesn't really fit in either of the other three types of birth control (and since it's sister IUD fits here just fine), here is where it will be explained. A lot of sources don't really go into how exactly the non-hormonal IUD works, but let me try to give it a shot as best as I can with the little information I've heard over the years. Basically, the non-hormonal IUD creates a negative environment for sperm, where they don't want to roam anywhere near the IUD.

The Mirena continuously releases a small dose of the synthetic progestin hormone. (Note: Read first paragraph in birth control pills cut to read explanation of progestin's role in preventing pregnancy.)

Advantages: IUDs are kept inside the uterus for years, instead of weeks or months. (For ParaGard, up to ten years, Mirena - three to five; some devices recommend year by year changes.)


* Women who have never had children are not recommended to have the device implanted. This is mostly due to the device not fitting in the uterus the same as it would for a woman that has already given birth. As well, a lot of healthcare professionals are wary because of the length of preventing pregnancy (though the device can be removed early).
* Increases the risk of pelvic inflammatory disease (another reason women who have never given birth are usually turned away from the procedure)
* IUDs can be unknowingly discharged (a string attached to the IUD goes through the cervix, into the vagina, and can be checked to ensure the IUD is in place)
* There is a small chance pregnancy can occur while the device is in place. If the IUD is removed, there is a 25% chance the pregnancy will end spontaneously. If the IUD is not removed, severe results can occur (such as ectopic pregnancy, infection, blood poisoning, bleeding, or premature labor).

Effectiveness: 97-99%

Norplant is a form of implant no longer available as a birth control method, however, women who still have the implants are still able to be treated by medical professionals. Since it's no longer on the market, I'm just going to make a small note of what it is.

Norplant uses the synthetic hormone levonorgestrel, which is put inside six soft capsules (about the size of a matchstick) and inserted under the skin of the upper arm. Levonorgestrel creates the same end result of that of estrogen and progestin (thickens the cervical mucus and prevents ovulation). The implant was kept in place for up to five years (could be removed by a professional any time the woman desired).

Emergency contraception (also referred to as the "morning-after" pill) is used for when unprotected sex occurs (or when another method fails that you are aware of). Like birth control pills, there are two different types -pills that contain estrogen and progestin, and those that only contain progestin (called "Plan B").

Plan B and other progestin-only ECP are taken in either one or two doses, 12 hours apart. Combined pills are taken in two doses, 12 hours apart.

Important Note: Emergency contraception will NOT affect an existing pregnancy.

Effectiveness: 75-89% when taken up to 72 hours after intercourse (effectiveness increases depending on when the ECP is taken in that 72-hour period - the earlier the better).

A couple of sites that I've found to have excellent information on these topics are:

Planned Parenthood
Contraceptive Information Source
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