There are many different reasons why someone might take birth control–preventing pregnancy, balancing hormones (for disorders like Polycystic Ovary Syndrome), and regulating periods, just to name a few. A one-size-fits-all solution doesn’t exist, which is why there are so many different types of birth control. Contraceptives should be prescribed depending on a person’s individual needs, and everyone deserves to make an informed decision that works for them.
With so many uncertainties surrounding the pandemic and the election, more people are reevaluating birth control options available to them out of necessity, since physical and financial access to safe, effective contraception is no longer a guarantee. The popular pill relies on a prescription from a doctor, which could be tricky to obtain if healthcare offices close again due to COVID-19 regulations. And the dismantling of the Affordable Care Act by the current administration could mean that birth control might be unaffordable in the future if employer health insurance plans have the option to deny coverage. The late Justice Ruth Bader Ginsburg fought fiercely for birth control to be provided for workers through their company-sponsored health insurance as a human right. Unfortunately, this may not be the case moving forward.
Before COVID-19, one in three women had issues when it came to obtaining a prescription for birth control. It’s likely even more challenging now with lay-offs, financial insecurity, and limited doctor access.
If you’re currently not taking anything and want to look into birth control options to prevent unplanned pregnancies during the insanity that is 2020, I feel you. If you’re on birth control but want to explore other methods because you’re not happy with what you’re using now, I also feel you. And I understand the urgency. So what is the best birth control solution? I haven’t tried all the different types of contraception out there but I’ve experimented with five before finally finding the one that works for me. Here’s a rundown of my ups and downs so that you, too, can find birth control bliss ASAP.
The trusty condom. The latex armor that we were taught would protect us from all the STDs, STIs, and unwanted babies. When used correctly every time, they’re still only 98% effective. To me, the 2% error rate with perfect use was alarming. But still better than nothing, so I defaulted to the infamous Trojan’s and Durex’s at the start of my foray into sex.
The trifecta of protection was what sealed the deal for me. Lower risk of STD/STIs, pregnancy, and easier clean up! I also didn’t feel the condom at all during sex, which wasn’t the case with my partners. There are also condoms made from alternative materials for people with latex allergies.
In my steady relationships, my partner would always complain how uncomfortable wearing a condom was. Once it was confirmed that neither of us had an STD/STI, I started considering other forms of birth control since pregnancy would be the main concern.
At one point, I decided to try the pull-out method. It turns out that withdrawing right before ejaculation works only 73% of the time, which was 25% less effective than condoms. Still, I was young, broke (condoms are expensive, and I firmly believed costs should be split 50/50), and gave it a go. The 25% sounded pretty marginal at the time.
I saved a ton of money on condoms. There was also a sense of seamlessness when it came to sex–no more scrounging around for the condom, no more running to the store if the box is empty. I know it was all psychological, but I felt closer to my partner too.
It takes A LOT of strength and willpower for the pull-out method to work. Many people time it wrong by mere seconds, significantly increasing the chances of pregnancy. Lastly, the effectiveness rate of 73% is likely unsustainable long term.
Remember when I mentioned that many people don’t have the willpower when it comes to pulling out? Well, I experienced it first hand, which is how I came to familiarize myself with emergency contraception, also known as the morning after pill. When taken within 72 hours of unprotected sex, it’s 87% effective. Right after the pull-out mishap, I went to the pharmacy and picked up Plan B.
A potential solution for your emergency pregnancy scares, though it’s not recommended as a main form of birth control.
Only meant for emergencies, since it does come with risks. I experienced side effects like abdominal pain and some dizziness. Since it works by stopping the release of the egg from the ovary, it could cause menstrual changes, which it did for me. I ended up forming ovarian cysts and having irregular periods not long after I took the pill. My doctor couldn’t definitively say it was caused by the morning after pill, but having a scapegoat made me feel better.
Birth Control Pills
After having surgery twice to remove my huge ovarian cysts (they were the size of tennis balls), my gynecologist recommended that I try birth control pills to balance my hormones in order to regulate my period and ovaries. I voiced concerns about the side effects, so my doctor prescribed Lo Loestrin Fe, which has a lower dosage of estrogen hormones. For pregnancy prevention, the pill is 99% effective with perfect use, which means taking it at the same time every day. Unfortunately, it’s very easy to miss a dose, so in reality the pill is closer to 91% effective.
Lo Loestrin Fe’s lower dose of ethinyl estradiol and a progestin called norethindrone acetate gave me no side effects, which was awesome. My ovarian cysts stopped recurring after I started taking birth control regularly.
Out of pocket costs vary across different pills depending on your insurance provider. Unsurprisingly, my health insurance let me down after a few months and stopped covering Loestrin, which meant I had to start paying $150 per month if I wanted to continue taking it. Hormones affect everyone differently too. My doctor switched me to another brand called Yaz, with hormones that are different than in Loestrin, and my body didn’t react well. Taking the pill at the same time every day proved to be difficult for me, since my schedule wasn’t consistent. The cost of the pill, inconvenience of needing a prescription, and the daily effort of taking the damn thing led me to explore new options.
The last stop for me on the birth control train was the IUD, also known as an intrauterine device. I only started considering it when I researched non-hormonal options, which I found with the Paragard copper IUD. It’s a small T-shaped piece of plastic wrapped in copper coil that’s 100% hormone free and over 99% effective for up to 10 years. At first, I was surprised that it wasn’t more popular than the birth control pill. But then I found out why: the insertion was a huge barrier and not all insurances cover the high cost. An IUD is inserted via a long, thin tube that is threaded into the uterus through the cervix and then removed, leaving the IUD inside. Two threads hang from the IUD, which are self-checked each month to ensure that it’s still in place. Even though the process sounded terrifying, I believed it would be the best choice for me, since I didn’t want to mess with my hormones anymore or deal with taking a pill every day.
I scheduled an appointment to get my IUD at Planned Parenthood, since the $200 cost was less than it would have been with my insurance at the time. I was very nervous and took an Advil beforehand to quell the pain. I was pleasantly surprised at how fast the process was when it was finally inserted. I was in and out in less than 30 minutes and while it was very uncomfortable, it hurt a lot less than I thought it would. My nurse gave me a pantyliner and sent me on my way. That was the last time I worried about birth control.
The >99% effectiveness means I never second-guess the effectiveness of my birth control. Beyond regular PMS, I don’t have to worry about additional hormones affecting my mood or skin. I’m also not a prisoner to a schedule in order for it to work.
The insertion is not pleasant. Heavier blood flow and cramps during the first few period cycles is common. My uterus needed to acclimate to the foreign object in there, but after a few months, everything returned to normal. It can be expensive if your insurance doesn’t cover it, but the cost is well worth it if you don’t plan on having children soon, since you can set it and forget it for 10 years. One thing I’m not looking forward to is the removal process, though it’s expected to be similar to the insertion process.
Everyone’s body is different. One form of birth control could work wonderfully for one person yet cause problems for another. Listen to your body, speak with your doctor, and don’t settle for anything that doesn’t make you feel your best. And if you’re interested in learning about another option called the Nexplanon implant, read about it here.