10 Things We Wish People Knew About Birth Control

They *do* ease poverty.
PHOTO: istockphoto

1. Some types of birth control are much more effective than others.

Birth control is any method, medicine, or device that aims to prevent pregnancy. Contraceptives are classified as:

  • Female and male sterilization (female tubal ligation, male vasectomy). This is pretty much a medical procedure that prevents pregnancy for good. With the typical procedure, less than one pregnancy per 100 women happens in a year. To be more exact, one in 2,000 male sterilizations fails, while one in 200 female sterilizations fails.

  • Long-acting reversible contraceptives (intrauterine device, hormonal implant). These are devices that your doctor inserts in your body once every three to 10 years, depending on the brand you get. With these contraceptives, you don’t have to think about using birth control every day or month. Thin rods placed in the arm and containing hormones that inhibit ovulation, hormonal implants have been found to be the most effective temporary birth control all over the world, with less than one pregnancy per 100 women happening in a year. IUDs, which are T-shaped devices containing copper or certain hormones, are just as effective. 
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  • Short-acting hormonal methods (pill, shot). These are contraceptives your doctor prescribes you take every day or every month. The shot is administered every three months, while the pills are to be taken every day. The shot is more effective than the pill; the former has nine pregnancies per 100 women in a year of typical use, while the pill has six pregnancies per 100 women in typical use. (Note that typical use includes imperfect use.) 

  • Barrier methods (condom). These are contraceptives you put on before having sex. Condoms have resulted in 18 pregnancies per 100 women in a year of typical use.
  • Natural rhythm method. This means using birth control or avoiding sex on your fertile days. (A woman knows she’s fertile by tracking her menstrual history to predict when she’ll ovulate.) With typical use, it has resulted in 24 pregnancies per 100 women.
  • Withdrawal. Around 22 out of 100 women who have withdrawal as their only form of birth control for a year will get pregnant. Withdrawal is not a very effective method for a few good reasons. For one, not every guy knows when to pull out or to keep himself from ejaculating. Another is that while pre-seminal fluid (aka, precum) itself does not contain sperm, sperm can be left behind on his penis or on the woman’s urethra from a previous ejaculation. When the sperm comes into contract with the fluid, sperm can be carried by this fluid into the woman’s body.

  • Emergency contraception. It works by preventing or delaying ovulation through a lot of hormones. This prevents 95 percent of pregnancies if it’s taken within five days after sex; your chances are better if you take it as soon as possible after unprotected sex. Note that emergency contraception does not do anything if you’re already pregnant.
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    2. There is a demand for effective birth control.

    Precisely because some contraceptives are more effective than others, women look into the more effective ones when they want to delay pregnancy. In fact, more than 80 percent of married women want effective family planning. That’s also why governments, health care providers, and health organizations such as the World Health Organization and United Nations Population Fund promote some contraceptives (like the implant) more than others, especially when the focus is on safe, effective, and accessible family planning.

    And speaking of implants, more than 150,000 women in the Philippines use the implant Implanon. But the implants were removed and made unavailable by the Department of Health due to the Supreme Court temporary restraining order. According to the Commission on Population, there have been additional 500,000 unintended pregnancies after the removal. As more contraceptives are going off the market and health centers, more than 13 million women will be affected.

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    3. They aren’t taken only by promiscuous girls.

    As said in #2, even married women need effective contraceptives for family planning. Women who are in monogamous relationships also need and use effective contraceptives, like the pill or the implant. And so what if promiscuous girls take them too? At least they know how to take care of themselves and are smart and responsible enough to use safe and effective methods.

    We need to stop stigmatizing contraceptives and the women who take them because women’s and children’s health are put on the line. And failing to recognize the independence and responsibility of women as something valuable is a disservice to society in the short- and long-term. And for what? So people can feel righteous? That ain’t right.

    4. Some contraceptives are NOT abortifacients. Others are still inconclusive.

    The Reproductive Health Law defines “abortifacient” as any drug or device that induces:

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    • Abortion
    • The destruction of a fetus inside the mother’s womb
    • The prevention of the fertilized ovum to reach and be implanted in the mother’s womb

    Contraceptives are designed to prevent conception (the meeting of the egg cell and the sperm cell). But some people think that these are abortifacients because they don’t let a fertilized egg implant in the womb. These people argue that some contraceptives make the uterine lining thin as a side effect, and a thin lining has been found to make implantation difficult, if not impossible.

    But different studies have produced different results, making the matter inconclusive. What’s certain though is that some contraceptives like the implant Implanon are not abortifacients because they work by only preventing ovulation and thickening the cervical mucus. They don’t make the uterine lining thin. They don’t prevent the implantation of a fertilized egg, because fertilization doesn’t even happen.

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    As of now it’s hard to say which contraceptives result in a thinner lining for the user, since there’s no research testing each contraceptive product out there for this side effect.

    As for emergency contraceptives, well, some studies have found these to not be abortifacients either, because they are ineffective after ovulation and don’t interrupt an already established pregnancy or harm a developing embryo. The possibility of the latter has not been ruled out, though.

    5. Like any other medication, they have side effects.

    Side effects are defined as “problems that occur when treatment goes beyond the desired effect,” or as “problems that occur in addition to the desired effect.” Here are the main side effects of contraceptives:

    • Weight gain
    • Decreased libido
    • Moodiness
    • Falling hair
    • Blood clots
    • Nausea
    • Intermenstrual spotting
    • Breast enlargement or tenderness

    IUDs slightly raise your chances of having an ectopic pregnancy in the future. Ectopic pregnancies occur when a fertilized egg implants outside the uterus (usually in the fallopian tube or anywhere else in the abdomen) instead of inside the uterus. It’s a serious problem that should be treated as soon as possible.

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    IUDs also raise your risk of getting an infection or puncture in your uterus.

    Shots, with long-term use, have the side effect of bone loss. If shots are your contraceptives, note that bone loss may be curbed once you stop taking this method.

    If you’re 35 or older and smoke, it’s not recommended that you use hormonal birth control. Smokers who use hormonal birth control have a higher risk of blood clots and high blood pressure. Blood clots and high blood pressure can result in a heart attack or a stroke.

    6. It doesn’t mean you’ll get all the side effects though.

    Side effects vary from drug to drug and depend on person to person. If you want to know the side effects of the contraceptives you’re using on your body, consult your doctor. It’s important to seek medical guidance when it comes to taking contraceptives to make sure you’re taking one that’s suitable for your body and your lifestyle. If you don’t like the side effects or have questions about them, consider lifestyle or dietary changes, or asking your doctor to prescribe another contraceptive.

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    7. They have their benefits or other purposes, too. That’s also why other women take them.

    This is the case, especially for oral contraceptives. Studies have consistently found that oral contraceptives prevent cancer arising from the uterine lining (endometrial cancer) and ovarian cancer. Taking the pill has been seen to reduce the risk of endometrial cancer by approximately 50 percent, and this risk remains low for at least 15 to 20 years after you stop taking the pill. As for ovarian cancer, pill-users’ risk is reduced by 40 percent, and the longer you take the pill, the more you become protected—think 80 percent of risk reduced after more than 10 years on the pill.

    Oral contraceptives also treat dysmenorrhea, which 50 percent of menstruating women (and 90 percent of adolescents) suffer from and result in their absence in work or at school. With reduced pain that comes with menstruation or having no pain at all, girls and women can proceed with their day’s activities when they have their period.

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    Speaking of adolescents, 85 percent of them are affected by the skin disorder acne. Acne, caused by increased sebum production, has negative effects on their self-esteem. Fortunately, it responds well to treatment with most oral contraceptives.

    Oral contraceptives treat polycystic ovary syndrome, too. In fact, they’re the primary treatment for the condition, as they regulate menstruation, reduce testosterone levels produced by the ovaries, and help reduce excess hair growth.

    Other health concerns that oral contraceptives suppress, treat, or alleviate include: endometriosis (a disorder involving the uterine lining) and menorrhagia (abnormally heavy menstrual bleeding).

    8. Some of them don’t mess with your fertility, even if you’re using them for years.

    Short-acting hormonal methods are precisely what their name suggests. The hormones from them will be gone from your body in a few days. When that happens, your body will need to start again, so to speak. Your body will be back to its normal rhythm when you ovulate normally. Women usually ovulate two weeks after they stop taking the pill. It can take some women a month or two also.

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    9. Different women have different budgets for contraceptives.

    It’s unfortunate that there are people whose birth control is no longer on the market. Some are forced to buy more expensive ones (for instance, the price of the pill ranges from P40 to nearly P1,000, depending on the brand), knowing that these are much cheaper than having a baby and raising that child. On the other hand, some have no choice but to stick to condoms (a pack of three ranges from P25 to P80).

    If you’re compelled to switch birth control methods due to the temporary restraining order on contraceptives, or if you’re interested in using hormonal contraceptives for the first time, consult your doctor on the following:

    • When you want to get pregnant
    • How well each method works
    • Possible side effects and the side effects you wish to avoid
    • Number of sex partners you have
    • Your commitment to sticking to the contraceptives’ proper usage (Can you take the pill at the same time every day?)
    • Your budget
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    10. Contraceptives are a key factor in poverty reduction.

    Studies have found that family planning programs reduce the number of people living below the poverty line. By delaying pregnancy, men and women can develop themselves professionally through further education and company training, which give them opportunities for higher wages. As they are not forced to be together to take care of a baby, they can find the right partners for themselves—and having the right partner helps in maintaining or even growing household income.

    In addition, with fewer children, parents are able to invest in the health and education of each child, giving each higher chances of a better quality of life.

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