How to Choose Birth Control for Side Effects
Choosing a contraceptive can seem intimidating, especially if you’re worried about more serious side effects. You may have heard horror stories about the risks of organ perforation when using an intrauterine device, or that contraception is associated with migraines . However, extreme side effects are rare and usually only occur if you have a pre-existing medical condition that could cause them.
As far as common side effects go, the good news is that since there are so many options on the market, there is likely a form of birth control that minimizes the effects that worry you the most. The bad news is that there is no hard science to predict how certain birth control will affect anyone.
The likelihood of side effects
Lists of side effects on packages can look long and intimidating, as are 21 possible side effects listed on the label of the popular Yaz birth control pill: irregular periods, headaches, menstrual changes, fatigue, nausea, bloating, mood swings. breast tenderness, cramps, weight changes, and avoiding serious side effects such as depression, blood clots, strokes, and heart attack. Other common side effects for most forms of hormonal contraception include the possibility of changes in your appearance, such as worsening (or improving) acne, changes in hair growth, or swelling of your hands and feet.
“More serious side effects, such as blood clots and an increased risk of deep vein thrombosis or stroke, are usually associated with previous risk factors such as smoking, obesity, or family history,” says Brett Worley, MD, assistant professor of obstetrics and gynecology. Ohio State University.
Fortunately, doctors agree that current research refutes two often-cited associations with birth control: that it causes depression in people who weren’t previously depressed, and weight gain.
“I’ve tried my best to find out if hormonal contraception causes depression,” says Worley, author of a 2018 meta-analysis on the topic. “I could not find anything that would be a convincing assumption that one directly causes the other.”
Current research similarly refutes the link between hormonal birth control and weight gain, with the exception of the Depo-Provera vaccine.
“Most of the studies that have been done show that there is no difference in weight among women using hormonal methods of contraception,” says Amy Bryant, M.D., assistant professor of obstetrics and gynecology at the University of North Carolina at Chapel Hill. “People in this country gain weight over time.”
However, this does not mean that you should ignore the other side effects of contraception. If you are unhappy with how you are feeling after 3-4 months, Bryant recommends that you visit your doctor again to find the best solution.
“Unfortunately, despite years and years of research and significant progress, we do not have an ideal birth control method that works for everyone or works equally well for everyone,” she says. “I try to emphasize that none of these options are permanent, so if that doesn’t work for you, we’ll try something else.”
Bryant adds that the key to choosing the best birth control is knowing what you want from the product – be it more regular periods, better skin, or a pregnancy prevention method you don’t even need to think about.
Here’s a breakdown of what we know about the side effects of popular hormonal contraceptives on the market to make this choice a little easier.
Tablet
There are several brands of oral contraceptives , but they all work in the same way. Combination pills contain both estrogen and progestin – a synthetic version of the hormone progesterone – but you can also opt for “mini pills,” which only contain progestin. When taken correctly, the pill is 99 percent effective , but when taken intermittently, it drops to 91 percent.
Why you might choose them : Many women choose pills because of their lightness, reliability and the fact that they regulate the menstrual cycle, says Bryant. Combination birth control pills are also the only FDA-approved hormonal treatment for acne. You can get pregnant right after you stop taking the pills.
Why not choose it: the tablet is user-dependent, which means you must remember to take it every 24 hours for it to be fully effective. According to Bryant, people whose lifestyles do not fit this model may want to explore other options for birth control. Patients who smoke or are at risk of heart attack, liver disease, or breast cancer should also consult with their doctor before taking estrogen pills.
Long-acting reversible contraceptives (LARCS)
The popularity of the Nexplanon intrauterine device (IUD) and hand implant has increased over the past decade as device technology has improved, from 3.7 percent of contraceptive users in 2007 to 10.6 percent in 2017 . Both are progestin-only contraceptive options, but the amount varies by device.
Nexplanon is the only arm implant currently on the market and releases 35-45 micrograms (mcg) of progestin per day in the first year, but IUDs come in different sizes and release different levels of progestin. The most common are:
- Mirena , which secretes 20 mcg of progestin per day.
- Kilina , releasing 17.5 mcg per day
- Liletta , which releases 18.6 mcg per day
- Skyla , releasing 14 mcg per day
- ParaGard is a copper IUD and the only non-hormonal IUD on the market
Why You Can Choose It : The IUD and Nexplanon are 99 percent effective for the first few years of use (LARCS lasts between three and twelve years, depending on the brand). People who choose LARC often want to “set and forget,” Worley said. After removal, you can get pregnant right away.
Why not choose it: To insert the IUD, the doctor or nurse must pass the applicator tube through the cervix and into the uterus. It can cause mild to severe cramping. One in 20 IUD users also experience expulsion when the IUD leaves the uterus on its own. ParaGard users also often experience more profuse periods and cramps, and hormonal IUD users usually find that their bleeding pattern changes – for an easier period, more frequent bleeding, or no menses at all.
Depo-Provera Shot
The Depo-Provera shot is an injection of progestin given by a nurse or doctor every 12-14 weeks to prevent pregnancy. As long as doses are given regularly, the shot is 99 percent effective. But since some people skip appointments, the overall effectiveness is 94 percent.
Why you might choose it: The shot is popular with people who want long-term contraception to be effective but don’t want the device inserted, says Bryant.
Why not choose it: If you don’t like needles or think you can keep making appointments for re-insertion, you might want to consider other options, Bryant said. In addition, she added, due to the high influx of hormones, the shot is the only hormonal birth control option that correlates with some weight gain .
Patch and ring
Although the patch and NuvaRing are not as popular as other hormonal contraceptives, they are available as alternatives to hormonal contraceptives. Both deliver a combination of estrogen and progestin. The patch is changed once a week, NuvaRing – every three weeks. The efficiency is 99 percent for both the patch and ring when used correctly, but user error brings that overall figure down to 91 percent for each.
Why you might choose it: Both are effective alternatives to pills that are still short-acting but require less involvement than oral contraceptives, says Bryant.
Why not choose it: since both of them are not permanent fixtures, you must remember to change them in time and double check so that neither of them falls or moves prior to intercourse.