7 Questions To Ask Before Choosing A Birth Control Method, According To Physicians
From the pill and condoms, to intrauterine devices (IUDs), there are a whole heck of a lot of different birth control methods to choose from — which is seriously awesome. However, it can be an overwhelming process to choose a method if it's your first time using birth control, or even if you're thinking of switching your routine up. Luckily, asking your OB/GYN or GP these seven questions when choosing a birth control can help you find a method that works for you, your health, and your lifestyle.
According to a 2018 report from the Guttmacher Institute, there are 61 million women in the U.S. alone who use some form of contraceptive. (This stat doesn't include the additional men or gender nonconforming people also using birth control methods.) What's more, as NBC News reported in Aug. 2017, a survey from the National Center for Health Statistics revealed one-third of U.S. men regularly use a condom.
It's safe to say that birth control is a mainstay in many people's lives and healthcare. Currently, there are at least a dozen different kinds of birth control to choose from, and researchers are in the process of developing more. Most recently, a male birth control gel has just began clinical trials.
With so many different options, choosing a birth control and understanding the ins and outs of each method will probably require a lengthy conversation with your OB-GYN — one you might not know how to start. These questions can help guide your conversation about choosing a birth control method, so you have all the answers you need before starting.
1. What Birth Control Methods Require A Prescription?
Dr. Beth McAvey, a board certified reproductive endocrinologist and fertility specialist who is a Glow program partner physician, tells Bustle, "Some of [birth control] options are widely available at drug stores, while others require a visit to a physician or a mid-level provider to obtain a prescription or schedule a procedure."
According to Very Well Health, most over-the-counter birth control options are "barrier methods," like condoms and spermicide. Emergency contraceptives like Plan B (aka, the morning after pill) are also available at most drug stores, or pharmacies. Oppositely, hormonal birth control methods like the pill require a prescription, which may require you to see your doctor a certain amount of times per year.
Depending on your access to healthcare, insurance provider, and budget, some forms of birth control may be more cost-prohibitive or accessible than others, so it's important to be aware of those (money and time) costs up front.
2. What Hormones Are In Each Contraceptive?
Not all birth control methods are created equal. They each have their own hormonal makeup, and asking your doctor about the difference is key to choosing the right contraceptive. "The only method that contains both [the hormones] estrogen and progesterone are the combination birth control pills, Nuvaring, and patch," Dr. Sheila Loanzon, a board certified OB-GYN and author of Yes, I Have Herpes, says. "There is availability for a progesterone-only oral pill, and progesterone only is available in the Depo Provera injection, Nexplanon rod, and Mirena IUD."
The reason it's important to be aware of the hormonal affects of birth control is because some people may be more sensitive to hormonal changes than others, especially if you manage mental health issues.
Dr. Loanzon explains that the Paragard copper IUD is hormone-free, as are barrier methods of birth control, so these are options for anyone who want to avoid hormonal methods.
3. What Are The Side Effects?
"[People] should always discuss the specifics of any chosen contraceptive method, including a full discussion of potential side effects," says Dr. McAvey. According to the American College of Obstetricians and Gynecologists (ACOG), certain barrier methods can cause skin irritation, burning, or an allergic reaction (like some people have when using latex condoms). On the other hand, hormonal birth control can cause mood changes, hair loss, vaginal dryness, nausea, pain during sex, and more. Being aware of these potential side effects is key.
4. How Often Does This Birth Control Method Need To Be Taken?
Dr. McAvey explains that another consideration you should discuss with your doc is "how often one needs to remember to use the [birth control] method." Most birth control pills come in either 21-day packs, or 28-day packs that contain placebo pills, which need to be taken at the same time each day. If you have a variable schedule, or otherwise don't think this would agree with your schedule, this kind of birth control might not be the best for you.
Other birth control methods may require fewer reminders. For example, the NuvaRing runs on a four-week cycle similarly to the pill, but after you insert the ring, you don't have to worry about it for three weeks. What's more, Dr. Loanzon adds that, "IUDs can last up to five to 10 years based on which type is chosen." The maintenance required with a certain method could definitely affect your decision.
5. How Are Different Birth Control Methods Processed By The Body?
When weighing the different kinds of contraception, be sure to ask your physician how they are processed by your body. Why? Certain health issues can affect the efficacy of birth control methods. "Some impactful things you provider should be aware of is if you have regular periods, painful periods, self or family history of breast cancer, stroke, blood clots in legs or lungs, liver issues, elevated blood pressure, and many more," Dr. Loanzon says.
She explains that if a person has had issues with their liver, doctors tend to "avoid birth control pills so as not to cause further damage to this vital organ." Furthermore, she says the patch may not work for people with skin sensitivity or allergies, and a long acting reversible contraceptive (LARC) can make it difficult to get pregnant for around six months after an IUD is removed.
Talking openly with your physician about your past medical history, family planning (if that's something you want), and current health issues can be crucial when comparing contraceptives.
6. Will This Birth Control Stop My Period?
This may not be one of your first questions that comes to mind, but Dr. McAvey says it's important to ask your doctor about how different birth control methods affect your menstrual cycle. If you want to get a withdrawal bleed that looks like a period on a monthly basis, an IUD may not be your best option. However, some people also modify their schedules with the pill and NuvaRing to skip their time of the month. Talking to your OB-GYN about your period preference can help you find the right birth control.
7. How Invasive Is This Birth Control Method?
While the pill just needs to be taken once a day by mouth, other contraceptives may require more intrusive procedures.
"If you know that you don't want something invasive for a contraceptive, then an injection or rod placement in your arm may not be a choice for you," explains Dr. Loanzon. "Some patients have issues knowing a foreign retained object is in their body such as the Nexplanon rod or an IUD, so no matter how effective as a contraceptive these methods may be, it may not be a highly reliable choice."
Once you choose a birth control method, Dr. McAvey suggests people "use period tracking apps such as Glow [...] to better understand their cycles and their bodies." That way, if you need to adjust or change your birth control method, you and your OB-GYN have more insight into your menstrual health.
Try to be open with your physician, and definitely don't be afraid to ask as many questions as you need to feel confident about the birth control method you choose. After all, it's your body and your health.