Is hormonal birth control going out of style? (Photo: Getty Images)
Ninety-nine percent of women ages 15 to 44 who have ever had sex have something in common (besides being active in the bedroom): They’ve used some form of contraception. And 64 percent choose non-permanent contraceptives — mostly hormonal methods: the Pill, a patch, an injectable, a vaginal ring, or an IUD.
The most popular form, by far, is the Pill. In fact, research suggests that upward of 80 percent of American women using contraceptives choose the Pill.
But research also suggests that 30 percent of them cease use because of side effects: mood swings, irregular periods, weight issues, loss of libido, or sore breasts, according to Centers for Disease Control and Prevention (CDC) research.
And while research is far from conclusive, a recent study from Denmark showed an association between young women’s hormonal contraceptive use (particularly long-term use) and an increased risk of a rare kind of brain tumor called glioma. (However, “a risk-benefit evaluation would still favour the use of hormonal contraceptives in eligible users,” study researcher Dr. David Gaist, of the Odense University Hospital and University of Southern Denmark, said in a statement.)
Plagued By Side Effects
Laura Perry, a 26-year-old alternative therapy student and nanny from Danbury, CT, was one of those women. She first went on the Pill at 18 for an irregular period.
“I was always very active during the first few years of getting my period; my gynecologist concluded that was the reason for my irregularity,” she tells Yahoo Health. And while the Pill did regulate her period, she was left with a slew of unwanted side effects.
“My mood swings were erratic. I would get depressed and emotional. I had terrible yeast infections and struggled with my weight. I changed brands a few times, but either nothing changed or side effects worsened,” she remembers.
Soon, Perry turned to Depo-Provera, the birth control shot, with hopes that an injection every few months would ease her pain. Unfortunately, that wasn’t the case. “Nothing could’ve prepared me for what happened after getting the shot,” she says. Her period didn’t stop for six months post-injection.
“I was even more depressed and emotional. I remember sobbing in the car because of a song that came on the radio on my way to work maybe three times a week. My anxiety levels were out of control. I felt like I had PMS all the time, and I gained 20 pounds in three months even though I worked out regularly and had a healthy diet.”
Perry made appointments with her doctors to see what was wrong. They noted that while extreme, her side effects were normal. She decided against the second round of the shot — and while docs urged her to try the Pill again, she couldn’t do it.
Masking Your Body’s Natural Rhythm
“My body had changed so much from the time I was 18. I wanted to get it back to a natural rhythm,” Perry notes.
That’s an important point considering the Pill shuts down ovulation — leaving many women unaware of their bodies’ natural cycle. Paige Fowler, a freelance writer in Chicago, learned this the hard way when, at 29, she went off the Pill after she and her husband decided to have a baby. She had been on it since age 22.
“When I went off the Pill, I didn’t have a period for 41 days. I learned that my cycles were often long (40+ days) and unpredictable,” she says. “I’m still not sure if my cycles were long and irregular because I’d taken the Pill for so long or whether long cycles are my ‘normal.’ I don’t remember what my cycles were like before I went on the Pill — who pays attention to those things in their early 20s?”
While Fowler notes that she didn’t experience negative side effects — the Pill actually cleared her skin, left her with no cramps, and kept her regular — she wishes she had gone off of it earlier. “I would have had more of a sense of how long my cycles were, so we could time things better when trying to conceive,” she explains. “Instead, every month was a total guessing game as to when ovulation would occur.”
Planning, The Natural Way
In order to gauge when she was ovulating, Fowler turned to ovulation predictor kits — part of something called Natural Family Planning. It’s a form of birth control some women turn to when avoiding hormonal options. The idea: If you’re aware of certain biological processes such as ovulation and basal body temperature, you can know when you’re ovulating and prevent pregnancy (or in Fowler’s case, induce it).
And while this technique may sound promising — it’s been grabbing headlines recently — there’s not a ton of research on it, says Taraneh Shirazian, MD, assistant professor of obstetrics, gynecology, and reproductive science at the Icahn School of Medicine at Mount Sinai. “If the Pill is 99.9 percent effective used correctly, natural family planning is about 40 percent effective done correctly,” she says. “We have to learn from history. And the reason these things fell out of favor is they are not as effective.”
Plus, a lot of women can’t rely on Natural Family Planning because of irregular periods. “You never know when you’re ovulating,” notes Shirazian.
Fowler noticed this when predictor kits failed for her. “I’d get a positive as early as day nine and then would have a 43-day cycle, which would mean that ovulation, if it happened, occurred closer to day 29,” she says.
Choosing A Method That’s Best For You
When Perry stopped the birth control shot, it took three months for her period to stop and she didn’t get it again for three months after that. Today, she has regular periods, has gotten back to her normal weight, doesn’t have mood swings or crying jags, and feels happy and healthy. It took almost two years.
For now, both Fowler and Perry have given up the Pill for good — turning to condoms. “I think the Pill is great — and whoever wants access to it should have access to it, especially for preventing unwanted pregnancies,” says Fowler. “But I’ve seen how much the chemicals controlled my body and I really dislike that.”
If you’re struggling to find the right birth control, talk with your doc. “There are more options than ever,” says Shirazian. And if hormonal contraception isn’t your thing, she says it’s OK to use natural fertility methods — if you’re not concerned about pregnancy. You can also take some measures to minimize side effects:
Take it right before bed. “A lot of times when I ask people when they take the Pill, many say they take it first thing in the morning,” says Shirazian. “That is not a good time to take it, especially if you have a sensitive stomach.”
Check your dose. You want to be on a low dose if you are experiencing side effects, says Shirazian. “And there are some very low, low doses to consider.”
Change your delivery method. There are other ways to get the hormones that the Pill delivers. For example, instead of the Pill, you could try Nuvaring, which delivers hormones vaginally. “You might have less side effects that way since hormones are then absorbed locally rather than orally,” she says.
Consider a non-hormonal IUD. “The copper T doesn’t secrete hormones — it’s been around forever and is highly effective,” she says. “For a lot of women who don’t want hormones, I will suggest that.”
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