Hi,

I may be getting married soon and was wondering what types of birth control are better for a woman as far as a woman's overall health is concerned? For instance, I have heard that the pill has alot of potential bad side effects....if that is the case, I would not want my wife to be on it if it will harm her. On the other hand, condoms and diaphrams are probably not effective on their own, so outside of any vasectomy or tube-tying, what are the best options or combinations thereof? What have been some of your more successful (or unsuccessful) experiences with particular forms of birth control? Thanks, I will look forward to your responses.

OK, here is what I can tell you (just my opinions, of course, and I don't have any statistics to give you as far as how effective each one is).

Hormonal B/C (pill, patch, shot, etc.)- Yes, these can have bad side effects...alot of it has to do with the individual who is using it (does she smoke, have high blood pressure, a blood clotting disorder, etc). This are probably the most reliable form of b/c if used properly. A doctor should be consulted regarding the health risks.

Condom-fairly reliable, more so if used with spermicide. Not usually the 1st choice for married couples as condoms can decrease feeling and sensivity.

Diaphram-these are used in conjunction with spermacide. They can be messy and difficult to insert and remove and sometimes they can be uncomfortable for both people. Not very spontaneous. Worked well for me for preventing pregnancy.

Cervical Cap-similiar to the diaphram but smaller. Also used with spermicide. Not as cumbersome as the diaphram. Not very spontaneous. Probably works as well as the diaphram, although I have never used one.

Spermicide-used alone it is not as effective as when used with the condom, diaphram or cervical cap. It's also messy. Worked well for me for preventing pregnancy.

IUD-These are quite effective and do not interfere with spontaniaty since it is always inside the woman. Do some research as these have changed alot since I had one. Worked well for me for preventing pregnancy.

Rhythm Method-This involves charting the woman cycle and determining when she ovulates and when it's "safe" to have sex without using any b/c. During the unsafe times you can abstain or use birth control. Worked well for me for preventing pregnancy, but it can be risky and should not be used if you absolutely don't want kids.

I can't think of anymore....hope I've helped.

Well there are a couple things to say here. I have been on BC for about two years on and off and if you take care of yourself and don't have any allergy it is a really great method. As with any medication there are side affects but not as bad as having a child. I have found ortho-tri-cyclen to be very effective. Also I thought you would find this funny. My grandfather who recently passed away gave me a sure fire method. He said "Just stick it in a tomato." http://www.healthboards.com/ubb/biggrin.gif But don't eat it after ward. lOl. He was a funny man! Much love Sunnie

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You alone can decide your destiny!

No matter what method you choose, there's going to be some kind of inconvenience, short of surgical sterilization. Most people on this board will warn you off the Shot (depo-provera) because of suspected ties to infertility, and just general bad-experience with side-effects. I honestly don't know a single person who got on depo and hasn't had a problem with it.

Norplant is somethign that's been around for years and is a rather permanent type of solution. They last 5 years, I believe, and are slow-release capsules that release the same hormones found in most birth control pills without having to remember to take them.

There's two kinds of IUDs, each with different risks and benefits. There's the copper one and the hormone-impregnated plastic one. The copper one doesn't have to be replaced more often than once every three years, but can cause heavier periods, cramping, and a higher risk of ectopic pregnancies. (My mother had a tubal pregnancy while she was using one.) The hormone-impregnated version is slightly more modern, as it works the same way taking the pill every day would, and it's made of plastic so the irritation isn't as likely to be so pronounced, though you'll probably still get a heavier period and some cramping. The IUD is generally recommended for people who've already had kids since it makes insertion easier, but this by no means means that you can't get one unless you've had kids.

There's Nuvaring, which is a ring you replace once a month that just sits on the cervix and slow-releases hormones a la birth control pill. You wear it for three weeks and take it out for the fourth week to have a period, then put in a fresh one.

There's also a patch you replace once a week.

No barrier method is fool-proof, and hormonal methods are generally regarded as the most reliable, but because of an increased incidence of user error, they can actually average out similarly. (Since it's harder to forget to put on a condom than it is to forget to take a pill.)

I've been on the birth control pill for, oh, like two and a half years now. I haven't had a single one of the side-effects, well, aside from a shorter, lighter period and decreased menstrual cramps. I'm taking Alesse, which is a low-dose monophasic pill, and because of the low levels of hormones may not be effective for everyone, especially people who don't own as slim a frame as mine.

The Planned Parenthood site has a lot of awesome information about methods I haven't even mentioned, and her doctor will be able to help her decide on a method that's safest and easiest for her.

Wow, many thanks for all of this valuable info! This is very educational for me, I really appreciate all the effort that went into these replies. I will re-read them again tomorrow.....Thanks, Al

i have been on BC for about 4 yrs now and haven't ran into any problems of course it's different for every woman. there are a lot of side effects but then again mostly everything these days comes along with those kind of suprises....in my opinion starting out i'd recommend the pill and then maybe later switch

I have been on the pill for 11 years straight and have never fallen pregnant and I'm only 24.

I would start off on the pill as its the simpliest and then maybe switch.

There are heaps of different pills out there so it really does depend on the individual and how they react to them.

If one talks in terms of "evidence-based medicine", that is, actual studies of women using one form of contraception versus another, the general answer is that the "pill" is responsible for a huge improvement in general health.

There are a few categories here:

Iron deficiency: Women who are not on the "pill", generally get heavier periods and are much more likely to suffer from both anaemia (tiredness, lethargy, depression), and the effects of iron deficiency aside from anaemia, which are often quite subtle "un-well-ness".

Debility from menstruation: In the same manner as the previous, women on the "pill" are much less likely to lose time from work and from recreational activities, and have somewhat less domestic difficulties.

Endometriosis and fertility: Endometriosis is a major risk to "delayed" fertility - deferring childbearing to the late twenties or beyond. The "pill", as well as making periods lighter, reduces the risk of development of endometriosis and the consequent risk of infertility.

Of course, the "urban myths" are that it causes infertility, but in reality, "post-pill infertility" is the result of aging and the "pill" does the very opposite - it tends to preserve fertility as compared to barrier methods.

And it even has some protective effect against STDs (including cervical cancer), by improving the cervical mucous barrier, though of course, condoms are more effective on this score. http://www.healthboards.com/ubb/smile.gif

Ovarian cancer: Risk is reduced because the "pill" reduces the stimulation of growth to the ovaries. Of course, infertility treatments have the very opposite effect - they increase the risk by over-stimulating the ovaries. This effect (risk reduction) persists for many years.

Endometrial cancer: Risk is reduced because growth of the lining of the uterus is suppressed. In fact, this is extremely rare in women on the "pill".

Pregnancy: To the extent that the "pill" is more effective as a contraceptive than other methods (the injection and implants are much more effective again), fewer pregnancies means a much reduced risk of pregnancy complications such as blood clots (and stroke), high blood pressure and eclampsia, diabetes and Lupus.

And in general, all the other hormonal (progestagenic) contraceptives, Depo-MPA, Implanon®, the progestagen IUD and vaginal ring, would have the same or better benefits, compared to barrier methods, periodic abstinence, and sterilisation!

In summary, the "pill" is one of the most, no, in all likelihood, the most important contribution to women's health over the last forty years!

You forgot to mention however, that taking the pill also interferes directly with your hormones.

You mention that you get lighter periods and less debility? Well, this is actually because if you are on the pill you are not having a proper period. The pill stops you ovulating and you have to stop taking the pill to allow your body to have an artificial bleed. No wonder.

The pill also carries increased risks of developing DVTs in some cases.

Also, not all women who do not take the pill have problems with heavy periods, pain and debility. If they do, there are things that they can do to help that does not include taking the pill as a solution.

I think your best bet is to see your doctor and discuss your options with him or her. They'll know your history and possibly your family history so if you decide to use a pill, they can advice you on what would be best for you.

Originally posted by Sarah68:
You forgot to mention however, that taking the pill also interferes directly with your hormones.

Well, It's not as if I forgot to mention it - all the consequences I mentioned, are the consequences of altering hormone levels. I was merely pointing out that the concept that what the "pill" does to the hormones is not necessarily a bad thing at all.

You need to remember - the natural object of the menstrual cycle is to result in pregnancy. Now whilst pregnancy is quite advantageous for the continuation of the "species", or family line, it is very much at the expense of the individual. What people conveniently fail to recall in discussions such as these, is that only a hundred years ago, the greatest risk for a young woman of dying - was pregnancy.

Medical science has without doubt, improved on a "woman's lot" immensely during that time, and the "pill" has played a major part in this in more recent times.

if you are on the pill you are not having a proper period.

And just what is a "proper period"? Menstruation is the consequence of growth of the uterine lining (endometrium) as a result of the action of hormones (oestrogen), followed by its sudden necrosis and shedding as a result of the withdrawal of such hormones. The endometrium has no way of distinguishing hormones ingested in a pill, from those produced by the ovaries.

(Not quite true, but I invite you to demonstrate a rational argument as to why? Obviously the effects of the "pill" are quantitatively different as I have just pointed out that periods are lighter.)

This is a common example of mythical thinking. There is the concept that menstruation is necessary to "rid the body of toxins" or some such. Well, I for one, have never had a period, and though I may be a bit eccentric, it isn't because of an accumulation of "toxins"! They haven't done me any harm.

Simply put, what is passed in a "period" is no more and no less than what uterine lining grows as a result of the hormones. If a period is lighter, it is simply because there is less growth, less to be "got rid of" in the first place, not because "toxins" are accumulating.

The pill stops you ovulating and you have to stop taking the pill to allow your body to have an artificial bleed.

Just as your follicle has to die each month to "allow" your body to have a "non-artificial" bleed. The point of this statement?

No wonder.

No wonder nowadays, just pure science.

The pill also carries increased risks of developing DVTs in some cases.

In some cases it does, and those women had better be very worried, as the risk of developing DVTs should they become pregnant (which is itself much more likely because the non-hormonal contraceptives are simply less effective), is hundreds-fold higher - indeed, a virtual certainty.

Also, not all women who do not take the pill have problems with heavy periods, pain and debility. If they do, there are things that they can do to help that does not include taking the pill as a solution.

There are. Unfortunately, the "pill" tends to be far more effective!

here are a few things to think about. the pill can work in 3 ways. usually the first way works, but if the first and second fail, the third was is to prevent the fertilized egg from attaching to the uterine lining. that is something that you and your wife should be comfortable with if that is what you decide to use. i mention it because i was not comfortable with it, but it was never explained to me before i started the pill.
condoms are pretty darn effective. as long as you have the willpower to use them every time and provided neither one of you are allergic to them, you don't have to worry about side effects.
last, if you decide to explore natural family planning, i know many Catholic churches offer free classes taught by those who have had success this way. that is certainly not a method i would rely on unless i was really informed! good luck!

Sarah68 or PaulB,

I'm sorry, one of the terms you used I am not familiar with...i.e what is a "DVT"?

- Al

"Deep vein thrombosis" or "Deep venous thrombosis" - a clot in the veins right inside the leg, not just the ones on the surface.

You've heard all about this in the last year or so in respect of airline travel. The danger, is that such clots can break loose and travel to the lung, clogging it to a greater (fatal) or lesser degree. In very rare cases where someone has a hole in the heart, it can travel elsewhere, such as to the brain causing a "stroke".

The female hormones affect the blood clotting system. Normal women are not affected, but some have a fault in that system, so that extra hormones cause an excess clotting tendency. They are a "walking time bomb" and unfortunately more likely to come to grief under two circumstances of which the most risky is pregnancy, because the amount of hormones produced then is dozens if not hundreds of times as much as during a normal cycle.

The other risk factor, the "pill" (or more particularly, the higher oestrogen ones used to treat acne), causes the hormone levels to be perhaps, twice normal.

Originally posted by paulb:
There are. Unfortunately, the "pill" tends to be far more effective!

Paul, I thought IUDs were pretty effective too? Equally if not more effective than the Pill, perhaps?

[This message has been edited by Ravenna (edited 02-04-2003).]

Raveena, Paul was referring to the pill's ability to influence the period for the more comfortable, not so much the prevention of pregnancy.

In this sense, no, the IUD would not be more effective -- in fact, the IUD can actually cause MORE problems with a woman's period. More painful cramping, heavier periods, that sort of thing.

Hmm. I didn't read it closely enough. Sorry. The lady at Planned Parenthood was quite enthusiastic about IUDs, only mentioning the period problems under her breath. Sneaky.

Originally posted by Ravenna:
Paul, I thought IUDs were pretty effective too? Equally if not more effective than the Pill, perhaps?

OK, I have to say that IUDs are nowadays not popular (I haven't put one in for over 13 years as far as I recall - well, maybe just one!) and I just tend to forget about them.

They certainly are effective contraceptives, comparable to the "pill". The hormone-containing ones are equivalent to an implant, so whatever is said (I didn't really go into detail) about implants, holds for those as well. There are perhaps four problems, or at least four things to be said about them:

The non-hormonal ones effectively align with "barrier" methods - they have none of the advantages that I mentioned for the pill except prevention of pregnancy.

They do tend to increase cramping - and blood loss - with periods (and occasionally between), though the hormone-containing ones counter these effects.

There is no doubt that they increase the risk of PID - Pelvic Inflammatory Disease - by providing a path and lodging place for bacteria to enter. As such they are still not recommended for women with multiple partners, or women who are concerned about future fertility. Remember that medically, the term "multiple partners" means in a lifetime, not just at once, or within a particular time frame. http://www.healthboards.com/ubb/wink.gif

And, perhaps less so with the hormone-loaded ones, but they have a problem that whilst they prevent pregnancy in the uterus, they do not as other methods do, prevent ectopic pregnancy, and since the user is essentially "trying" to get pregnant with enthusiasm, http://www.healthboards.com/ubb/wink.gif the risk of ectopic pregnancy is significant - relatively greater than it otherwise might be.

I can't take the pill because I have a clotting disorder. I developed clots in my legs once and they took me off the pill so fast it wasn't funny. After several miscarriages it was determined that I have Factor V Leiden, which makes my blood clot quicker than someone without this disorder.

Originally posted by Lady^:
I can't take the pill because I have a clotting disorder. ... I have Factor V Leiden, which makes my blood clot quicker than someone without this disorder.

So, what did they advise you about the risks of getting pregnant?

I think the pill is great if you can find one that works for you. I had a hard time finding one that really worked for me. I do have endometriosis (spelling sorry) and when i am not on the pill I am in worse shape then the pill causes. I was never really advised of any other meathod to take care of it. I also had cervical cancer and i was advised to get on the pill again. I finally tried Yasmin and i have lighter periods, NO cramping, and i am protected against pregnancy. I think the pill would be your best bet......

I'm 24 years old.....I have been on birth control since I was 19 years old. I have two children, 4 years old and 3 1/2 months old, both were accidentally conceived while on the pill. I know several women who have also gotten pregnant while on the pill

paulb, I have other problems so I am no longer trying to get pregnant. I've had 3 ectopics including a rupture and 3 miscarriages, one of them confirmed uterine. I have Factor V Leiden, I'm Type II diabetic and rh negative. And almost 39 years old.

paulb, if you're interest there is another thread where I was talking to someone about all this. Most of my info in the last post of the thread.
http://www.healthboards.com/ubb/Forum71/HTML/001016.html

Now I am confused. Planned Parenthood says there are NO implants available on the market. Yet my mother's doctor says that there ARE. What??

In the one response I read that being on the pill reduces the risk of several forms of cancer. I find this quite interesting - because - my doctor refused to put me on the pill because it would increase my chances of getting cancer. (my mother has already had cancer once, and several aunts have died from it) But the kind my mother had was endometrio......one of the ones said to be reduced in risk.

Thoughts??

Depends on the cancer. Everyone is different. And the BCPill does actually increase the risk of other types of cancers.

It's a risk-factor, and I'm pretty sure it's a risk-factor your doctor would rather not have on his head in a malpractice suit, no matter how small the risk.

"Hmm, let her have birth control, potentially get sued. Let me think."