Jeff Abel

How Does My Birth Control Work?

How Does My Birth Control Work

Maybe you’re already using some form of birth control. Or maybe you’re researching different kinds, trying to decide what’s best for you. So maybe you are wondering – How does birth control work anyway?

Not all methods of birth control work the same way.

Let’s look at the different categories of contraceptives (birth control), how they work, how effective they are and what risks they carry. This is going to be a lot of information, so let’s break it down.

Barrier Methods of Birth Control

These methods create a barrier to prevent the sperm from getting to the egg.

Male condoms
Female condoms
Diaphragms
Cervical caps
Contraceptive sponges
Spermicides

How effective are barrier methods in preventing pregnancy?

For the most part, these methods are considered the least effective at preventing pregnancy.

Type of birth control and percentage of users who have an unintended pregnancy each year

Male condom – 18%

Female condom – 21%

Diaphragm – 12%

Sponge – 24%

Spermicide – 28%

Statistics from CDC.

What are the risks of barrier methods?

Some women have allergic reactions to barrier birth control – vaginal irritation and burning according to the American Congress of Obstetricians and Gynecologists. Spermicides (including the spermicide in sponges) can increase the risk of HIV. Doctors recommend that sponges, diaphragms and any kind of spermicide are used only in mutually monogamous relationships (you each are having sex only with each other).

Hormonal Methods

These methods use hormones to regulate or stop ovulation (release of an egg) and prevent pregnancy. The hormones can prevent ovulation, thicken the mucus on the cervix – which helps keep the sperm from getting to an egg, or thin the lining of the uterus.

The pill (combined estrogen and progestin)
Progestin-only pill
The patch
Injectable
Vaginal ring
Implantable rod

How effective are hormonal methods?

Type of birth control and percentage of users who have an unintended pregnancy each year

Pills – 9%

Patch – 9%

Injectable – 6%

Vaginal rings – 9%

Implantable rods – .05%

Statistics from CDC.

What are the possible risks of hormonal birth control?

These methods are associated with a small increased risk of deep vein thrombosis (DVT)/blood clots, heart attack and stroke. Some women complain of headaches, acne, depression, mood changes and breakthrough bleeding. The serious risks are greater in some women than in others, so it is very important to discuss all risks with your doctor before starting any hormonal birth control according to the American Congress of Obstetricians and Gynecologists.

A recent study in Denmark suggests that women who take hormonal forms of birth control can be up to 70% more likely to be on antidepressants. Teenagers who use the combined pill were 80% more likely to be depressed and teenagers using the progestin-only pill were 120% more likely to need antidepressants.

Intrauterine (IUD) Methods

This kind of birth control is inserted into the uterus.

Copper IUD – This releases a small amount of copper into the body. This causes an inflammation that can keep the sperm from getting to the egg and fertilizing it. If the egg does get fertilized, the device in the uterus keeps the fertilized egg from implanting into the lining of the uterus.
Hormonal IUD – This released a progestin hormone that works similarly to the progestin-only pills. It causes the mucus on the cervix to thicken to prevent the sperm from getting to the egg. It thins the lining of the uterus, and it may prevent ovulation. The presence of the IUD in the uterus can also prevent a fertilized egg from implanting into the lining of the uterus.

How effective are IUDs?

Type of birth control and percentage of users who have an unintended pregnancy each year

Copper – .8%

Hormonal – .2%

Statistics from CDC.

What are the risks of IUDs?

According to the American Congress of Obstetricians and Gynecologists Menstrual (period) pain and bleeding may get worse at first. Some women have bleeding between periods, headaches, nausea and depression. The IUD may come out of the uterus. It could tear the wall of the uterus. Some women experience Pelvic Inflammatory Disease (PID), which is an infection of the uterus and the fallopian tubes. The risk for ectopic pregnancy increases with an IUD.

That’s a lot of information to digest!

The bottom line —

Not all birth control works the same way.
Not all birth control has the same level of effectiveness.
No birth control is 100% effective in preventing pregnancy.
No birth control is free of risks or side effects. (And, if you’re a teenager, you may be at much greater risk for some of those side effects.)

If you want to talk through your birth control options, LivingWell is here to answer your questions or help you sort through all this information. Give us a call 530-272-6800 to schedule a free and confidential appointment.

Eva Fisher

Nursing Director

The content on this page has been reviewed and approved by our Nursing Director.

Medical, Pregnancy, Sexual Health, STIs

Is Using Condoms Practicing Safe Sex?

Is Using Condoms Practicing Safe Sex

When most people think of safe sex, they think of condoms or rubbers. Don’t you? But maybe you’re wondering if using a condom is really practicing safe sex. Do they protect you from pregnancy and sexually transmitted infections (STIs)?

Condoms and Pregnancy

Most any resource you find states that condoms, when used consistently and correctly, are 98% effective in preventing pregnancy. The problem is that not everyone uses them consistently and correctly. According to the Center for Disease Control and Prevention (CDC) [https://www.cdc.gov/reproductivehealth/contraception/unintendedpregnancy/pdf/contraceptive_methods_508.pdf], 18% of women (18 out of every 100 women) experiences an unintended pregnancy within the first year when using a condom. That means almost 1 out of every 5 couples who use condoms experience an unintended pregnancy.

Condoms and STIs

Specific statistics about the effectiveness of condoms in preventing STIs are difficult to find. Most sources say that when used consistently and correctly, they are highly effective. But we know that they aren’t used consistently and correctly all the time. The pregnancy prevention rate is reduced from 98% to 82% because of user error. So, though they are highly effective at preventing STIs in theory, user error reduces that effectiveness as well. Probably the most important step is the most often overlooked step: a condom must be put on before any sexual contact.

Different types of male condoms offer different levels of STI protection. Latex condom use is 98-99% effective in preventing HIV transmission, when used correctly and consistently. Some STIs, like herpes, syphilis and HPV can be transmitted by sores on areas of the body not covered by a condom. That means even when used completely correctly and consistently, condoms cannot totally prevent transmission of those infections. Remember that STI’s do not always have physical signs.

Counseling and Complimentary Testing

Unless you are in a mutually monogamous relationship and you each have only ever had sex with each other, you may be at risk for an STI. And, any time you have sex, you could become pregnant.

We care about you and want you to enjoy relationships that are healthy physically and emotionally. If you want to talk about reducing your risk for unintended pregnancy or STIs or if you are interested in complimentary testing for pregnancy or STIs, we are here for you. Please call us to set up an appointment.

Neva Monigatti-Lake

Medical Director

The content on this page has been reviewed and approved by our Medical Director.

Relationships

Should We Live Together?

Should We Live Together Maybe you’ve been dating awhile and you want to try out living together before you take the marriage plunge. Maybe you spend so much time together already that you think moving in together will save some money. Or maybe it’s just what the people you know do – they date, then live together, then think about marriage.

Whatever the reason – you’re wondering if maybe you and your partner should live together.

You aren’t alone. According to a report by the National Marriage Project at the University of Virginia, living together, or cohabitation, has increased by more than 1,500% since the 1960’s. Census data from 2012 shows that 7.8 million couples chose to live together before marriage compared to 2.9 million in 1996.

This is a big decision. And a lot of people have really strong opinions about whether living together is right or wrong. Let’s look at some information and data that can help you decide if living together is the best choice for you.

The Why Matters

According to a study in the Journal of Family Issues ¹, couples have very different reasons for living together without being married. Some (18.5%) live together for financial reasons. Some (14.3%) want to test out the relationship. A few (6%) don’t believe in the institution of marriage. Most (61.2%) want to live together so they can spend more time with the person they are dating. The study cited in the Journal of Family Issues¹ suggests that when couples live together because of convenience (like financial reasons) or to test out a relationship, the couple is more likely to have relationship problems down the road. In these circumstances, both men and women report more negative interactions, less relationship confidence, more psychological aggression and less dedication to the relationship.

Easy Slide-In, Harder Slide-Out

Researchers call it the “cohabitation effect.”² It’s easy to slide into living together. The convenience of the decision may not require any huge discussions about the future. And the standards for a live-in partner are not the same as for a husband or wife. But a shared lease, shared furniture, shared pets, or even shared children make getting out of a live-in relationship more challenging than most people imagine when sliding into the arrangement.

Effect on Relationship Success

A study published in 2009³ compared married couples and non-married couples who lived together. These researchers found that the unmarried couples who lived together had more arguments and more trouble resolving conflict, were more insecure about their partner’s feelings and had more problems related to future goals. Some studies indicate that couples who live together before marriage are 46% more likely to get divorced.⁴ After 5 to 7 years, 39% of all couples who live together have broken their relationship, 40% have married (although the marriage might not have lasted) and only 21% are still living together.⁵

Living Together vs. Marriage

Many studies over the years have shown that marriage offers a lot of physical and health benefits. Married people tend to live longer, have fewer strokes and heart attacks, have a lower risk for depression, are more likely to survive cancer and are more likely to survive a major surgery than those who aren’t married.⁶But research indicates that unmarried couples who live together do not enjoy all of those same benefits.⁷Marriage is a signal to our brains and our bodies that sends messages of dependability and security. Because cohabitation, or living together, does not have the same commitment level, our brains and bodies don’t receive the same message of security, so our bodies do not respond with the same health benefits.

A Big Decision

Living together is a huge decision and there are more factors to consider than the information we mentioned. If you’re thinking about moving in together and you want to talk to someone about it, we’d love to sit down and listen and help you work through all the pros and cons.

What if you’ve already moved in together and you’re having second thoughts? We’re here for you too.

We care about you and we want to help you have healthy relationships. If we can help you, leave us a comment or give us a call.

¹Rhoades, G. K., Stanley, S. M., & Markman, H. J. (2009a). Couples’ reasons for cohabitation associations with individual well-being and relationship quality. Journal of Family Issues, 30(2), 233-258.

²Jay, M. (2012). The downside of cohabiting before marriage. The New York Times, April 14. Accessed at http://www.nytimes.com/2012/04/15/opinion/sunday/the-downside-of-cohabiting-before-marriage.html?pagewanted=all&_r=0

³Hsueh, A. C., Morrison, K. R., & Doss, B. D. (2009). Qualitative reports of problems in cohabiting relationships: comparisons to married and dating relationships. Journal of Family Psychology, 23(2), 236-246.
⁴ Alfred DeMaris & K. Vaninadha Rao, “Premarital Cohabitation & Subsequent Marital Stability in the U.S.: A Reassessment,” Journal of Marriage and the Family, 54.
⁵ Lynne N. Casper and Suzanne M. Bianchi, Continuity and Change in the American Family (Thousand Oaks, CA: Sage Publications, 2002) Ch. 2.

⁶ Robert H. Shmerling, MD, “The Health Advantages of Marriage,” Harvard Health Blog, http://www.health.harvard.edu/blog/the-health-advantages-of-marriage-2016113010667, November 30, 2016.

⁷ http://www.science20.com/news_articles/living_together_healthy_being_married-129374

Eva Fisher

Nursing Director

The content on this page has been reviewed and approved by our Nursing Director.

Jeff Abel