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Contraceptives: Methods, Types, and Potential Side Effects

April 16, 2021

By Dr. Leila Turner

Today we’re talking about contraceptives, the different types, and which ones we recommend. Unfortunately, there aren’t a lot of great options. Most of them are on the woman to make a decision about what she wants to do with her body.

Contraceptives.
Reproductive Health Supplies Coalition on Unsplash

Some of the things that you want to think about before you choose a form of contraception are:

  • Are you also in need of protection from sexually transmitted diseases? Because if you are also in need of that, then your options are much fewer.
  • Is the relationship that you’re in monogamous?
  • Do you trust your partner?
  • How long have you been with your partner?
  • Do they want to be a part of the decision-making process with you?
Chart of comparative contraception options

Above is a picture of all of the different types of contraception. Starting with the least effective: spermicides are not that effective; most women are sensitive to them; they can burn, they can cause irritation. It’ll often throw off the pH of the vagina, and then you’ll be more prone to getting vaginal infections, yeast infections, and urinary tract infections. There’s the withdrawal method, which we all know how effective that is.

And then, there are fertility awareness methods. These are pretty effective. The challenge with them is that they require extreme tracking and documentation from the woman to keep track of her periods, and she has to make sure that her cycles are normal and regular. Suppose she sometimes has a 21-day cycle, and sometimes her cycles are 28 days, and she’s fluctuating between shorter cycles and longer cycles. In that case, the fertility awareness methods are not that accurate, and she’s much more likely to get accidentally pregnant.

Then there are other barrier methods like the cervical cap, sponges, diaphragms, male condoms, and female condoms. I think if you’re going to bother using a female condom, you might as well use a male condom because they’re much easier and they’re cheaper to deal with.

Another method is the lactational amenorrhea method. This is when if a woman is nursing, then she hypothetically is not going to start ovulating again; however, this is not always the case. Many women will start their periods within a few months after having their child. So assuming that you are not going to get pregnant because you’re nursing is not a good form of contraception.

Moving into the hormonal options, we have pills. These are the conventional birth control pill options. Other hormonal options are the patch, which is put on the skin, and these are slowly releasing hormones into the skin. Then, there is the vaginal ring, which is placed inside vaginally, and that’s usually left in there for a few weeks. As well, there are hormonal injectables and implants.

And, of course, the non-reversible options like tube tying, which is female sterilization. This is when you have a tubal ligation. Or there’s a vasectomy, which is when the man has a snip of his tubes.

There’s also an IUD. An IUD is an insertion of a little plastic piece; it’s this little tiny T-shaped thing. There are a few different types of IUDs, some of them are hormonal, and there’s one that is non-hormonal called Paraguard.

Paraguard is my preference because this is one of the most effective forms of birth control that’s not hormonal. One of the problems with many hormonal contraceptives is that they’re non-bioidentical hormones, and non-bioidentical hormones can have hormonal consequences. There are estrogen and progesterone hormonal contraceptives, and then there’s progesterone-only contraceptives, but all of the hormones are non-bioidentical, which means that the hormones that the woman is taking are stronger than what our body naturally makes. 

Dr. Watkins talked a lot about estrogen dominance in the previous articles. And when you’re taking a non-bioidentical estrogen, they’re much stronger than our natural production, and so the side effects of these hormonal contraceptives can get out of control. Often, women are put on hormonal contraception to treat something like painful periods or PCOS. PCOS is commonly treated with the birth control pill. The problem is that it’s not treating the hormonal disorder. It’s just a band-aid. Women are often put on hormonal contraceptives, and there was a hormonal disorder to start with that they never really addressed. 

The hormone contraceptive is going to kind of band-aid and mask the underlying hormonal problem, but they’re still having hormone imbalance underneath. With PCOS, if the underlying hormonal problem is pre-diabetes, insulin resistance, or problems with blood sugar, then all those problems are going to continue to happen in the background. She’s probably going to gain weight on the pill; acne could be a problem. It’s going to be much more difficult for her to get pregnant later because when she stops the pill, those hormonal imbalances were never addressed.

So there’s not a lot of great options because we’ve got our condoms and sponges and in caps and diaphragms, which are all barrier methods, those can be irritating, they can throw off the pH, increasing the likelihood of getting an infection or a vaginal irritation, and then there are the hormonal options. So you can see why the IUD ends up being one that I do end up recommending.

One of the disadvantages to the IUD is that because it is a physical thing inside of you, irritating the lining of the tissue, one of the side effects is that it can make the periods heavier or more painful than they already were. So one of the times I don’t recommend an IUD is if you already have really severely painful periods or severely heavy periods because you might make those worse. 

When you first have the IUD put in, the first period, I always warn women will be heavier because it’s the body having a shed cycle from this IUD just being inserted in there.

The second period after you have the IUD in is usually much lighter. And then the third period should represent what your subsequent periods will be moving forward on that IUD. And so that’s a good thing to know about that if you want a non-hormonal option, try the IUD and see how the period is, but give it three cycles. You want to see how you tolerate it after the third cycle.

Chart of birth controls, advantages and disadvantages

Here’s a picture of these contraceptives and also a chart. Let me preface it with; I have not updated the efficacy percentages and the costs in some time. I have had this chart for many years, and I have not updated it, so please know that all of these prices are not up to date. But the advantages and disadvantages of each of these options are pretty up to date. So this is for you to reference, there’s the IUD there on the left, and there’s one of them that I mentioned called Paraguard, that’s the non-hormonal one, and there are some other IUDs too like Mirena and Skyla, there’s another one called Kylena, there are now some lower dose hormonal IUDs. My general opinion on a hormonal IUD is that if you’re going to go with hormonal birth control, you might just go with an oral contraceptive pill.

Chart of birth controls, advantages and disadvantages, part 2

Now one thing to also know about these hormonal contraceptives is that they deplete your B vitamins. Whenever I put a patient on a birth control pill, which I do despite not liking them, I do still prescribe them when a patient decides this is the route they want to take. I educate them, I give them all of the options, and it’s their choice. So if they choose to go on the birth control pill, I make sure that they’re also on a good quality B complex because birth control pills deplete B vitamins.

Chart of birth controls, advantages and disadvantages, part 3

I hope that this was helpful and informative. If you’d like a free 10-minute phone consult, where you can tell us a little bit about what’s going on with you and we can tell you what we think maybe our approach might be, or if we think we can help, call 480-588-6856.

Filed Under: Blogs, Hormones

Jill Mapstead
Jill Mapstead
2022-03-22
Can’t say enough about Dr. Marianne Marchese! Her commitment to women’s wellness, calm, knowledgeable, non-judgemental guidance and insightful diagnoses / treatment has me turn to her for all my wellness needs. She takes the time to really listen. I feel heard and valued in her care.
Marc Cohn
Marc Cohn
2022-01-08
We had a great first visit with Dr. Turner and we look forward to continuing to work with her. She provides true support and guidance to better health. Alexandra Cohn
Ivana Kalika
Ivana Kalika
2021-12-24
I'm writing my review for Dr. Sarv Varta Khalsa. I met with her a few months ago to receive treatment for a condition I'd been dealing with for an extensive amount of time. She was incredibly kind and took the time to listen to all the details of the symptoms I was experiencing. The office had the prescriptions I needed on-hand so I didn't need to go off-site to find them. All natural remedies, and at comparatively good prices (I don't remember how much exactly, but if they were up-charging, which I doubt, I didn't notice nor would I have minded for the convenience). I'm still symptom-free now after following her recommendations, so I wanted to write a review to express my gratitude. Even though the appointment was pricey, it was worth every single penny to finally be able to live my life feeling normal again. Thank you so much!!
Irene Nicholas
Irene Nicholas
2021-12-15
What's better than a Naturopathic Dr.... Dr. Olivia Watkins!!! I have been working with her for over a year and have learned so much about myself, she is truly a team partner in my journey. She is experienced in ANYTHING you may be experiencing. I consider her my primary physician... you should too!!!
Stephanie Llamas
Stephanie Llamas
2021-11-29
Dr. Watkins is nothing short of incredible. She is kind and personable, while extremely smart and results driven. I have suffered from digestive and hormonal issues my whole life and it wasn't until I met Dr. Watkins that I finally felt heard by a Dr and saw a difference in my health. I can confidently say that my body has never felt this good and we are still working to be even better. If you are ready to feel better and feel heard from your doctor, then run, don't walk to Living Wellness.
D Bach
D Bach
2021-11-10
Dr Olivia Watkins offers a beautiful aura of sincere loving support that I will forever cherish, as she exudes and radiates a beautiful light towards her patients' health care needs. Also, her staff, Joslyn and Ariana are as sweet as they come and have been as helpful as can be to me. One issue I had (and have had a few) was a lack of nutrient absorption and it was Dr Olivia who helped me change that status (thank God!) which I'm already seeing immediate results from and I've had this issue for years which my nails and hair loss were severely revealing! I've also experienced so much stress in the last year and a half, that having Dr Olivia as part of my healing process has made all the difference in my recovery to a more whole being! At this point, I seriously don't know what I'd do without her, as she is now my go-to health advocate and will be to my end days. Dr Olivia is a GodSend! Don't hesitate to call her office. High fives for the brightest healing light you could ever pray for in life! After eight long years, Dr Olivia just recently finished her GM residency and once again, I must congratulate her on such discipline and hard work as it has obviously paid off in spades! Long live Dr Olivia!
Kristin A
Kristin A
2021-09-19
I love Dr. Marchese and so glad I found her last year. She has helped me so much with my health. I have recommended her to several people and they love her too.
Kelly leibrandt
Kelly leibrandt
2021-07-28
Dr. Watkins is life changing! I am so grateful that I was referred to Living Wellness and her specifically. I’ve been dealing with severe stomach issues for 10 years and have gone through the ringer with the test, labs, and over-the-counter medicine suggested by other doctors. Dr. Watkins is so smart, thoughtful, and attentive to every detail so that she can really get down to the bottom of your problems. She feels like a teammate and a very strong coach and a friend all in one. I’m finally on my way to feeling better and I couldn’t have done this without her. If you’re struggling don’t even hesitate to see her or any of the staff at living wellness. I promise you won’t regret it!
Erica Brunkow
Erica Brunkow
2021-03-19
I saw Dr. Warkins several times and was overly impressed her. I was going through cancer treatments and she was compassionate and resourceful. We connected and I felt at such ease with her. She followed up with me multiple times to see how I was doing and feeling. I will continue to see her for any future Gyn needs.
Carey Miller
Carey Miller
2021-03-18
I began to see Dr. Watkins for some general Women's Health issues and she was incredible to work with. She helped my body become more balanced, pain was relieved naturally, and my body was prepared for a healthy pregnancy. She is kind, knowledgable, and very supportive!
Google rating score: 5 of 5, based on 27 reviews

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