Birth control pills were revolutionary in the 60’s. Suddenly, women experienced a freedom and independence regarding their sexual activity that they had never had before – and it was all thanks to this little pill they could take once a day and hide in their bedside table. What a seemingly wonderful solution!
However, many women are now recognizing the downsides of ingesting the plethora of synthetic hormones that are present in many birth control methods such as the pill, the patch (Ortho Evra) and the shot (Depo-Provera).
In 2016, there is growing concern for the side effects hormonal contraception can have on the female body; some women say they don’t “feel right” while using hormones – there is an increased awareness of familial clotting disorders where hormones are “contraindicated” or should not be used and breast cancer is becoming a looming concern with questionable ties to hormonal birth control usage.
Hormone-free methods are requested more and more often, and the good news is that there are a variety of effective options available to women who do not wish to use synthetic hormones. Here is a brief rundown of my personal discoveries with regards to hormone-free birth control options:
Natural Family Planning
Natural Family Planning is certainly the most inexpensive form of hormone-free birth control, and it can be a reliable method if your cycle is like clockwork.
Here’s how it works: after menses is over, a woman checks her cervical mucous for thickening, which occurs after ovulation (approximately day 15 or 16 of the cycle). She only has sex after the mucous has become thick and ovulation has passed. This, of course, has the side effect of only being sexually active 2 of 4 weeks. If you want to have sex more often, then condoms offer 88% protection when used correctly (see below for further details on condom use). These days, there are apps and products that support NFP. Here’s one that I like.
A brief note about the withdrawal method: it fails 22% of the time. This probably has to do more with timing of the menstrual cycle than the actual act of pulling out because many sperm escape before ejaculation. However, in a pinch, it may be the best method you’ve got.
Male Condoms
Condoms must be used throughout penetration (and not just for ejaculation) in order for them to be fully effective, as some sperm will escape the penis in early secretions.
Keep your fingers crossed that the condom doesn’t break! If you want to be extra sure, then spermicide can offer additional protection (but not a lot for a determined sperm, and you never know when that guy will show up!). Please also note that doubling up on condoms – that is, using two – can actually make them more prone to breaking as the material rubs against itself and causes friction during sex.
There are many options to choose from and the selection can be overwhelming: Latex, non-latex, with spermicide, without spermicide, natural materials, etc. The spermicide is helpful because it helps damage the sperm as well as offer extra protection against HIV if it has Nonoxynol-9. Spermicides containing Nonoynol-9 should only be used once per 24h because the material may damage vaginal skin making infection transmission easier.
Read More Here
Female Condoms
Female condoms are less popular. They are bigger, more cumbersome and more expensive. They have evolved significantly from their initial introduction to the market and are made of the same material as male condoms and are actually more effective than male condoms, around 79% when used correctly.
Read More Here
Spermicides
You can find spermicide in several forms: film, foam, gel, and cream. The more Nonoynol-9 it contains, the more effective it is. Spermicide alone fails 18-29% of the time (YIKES!), so if you are not into Russian Roulette with parenthood, it is best used with another method.
Here is a “green” gel on the market.
Diaphragm
By popular demand, the diaphragm is back! There were a few dark years after the Ortho company stopped making it’s diaphragm, but thankfully Milex picked it up again. Thank you, Milex, from all of us!
In order to work safely and efficiently, the diaphragm needs to be fitted by a women’s healthcare provider and special-ordered. It works 88% of the time in experienced users. If you are new to using a diaphragm, please use in tandem with a condom until you feel comfortable with insertion and removal. If you lose or gain more than 20 pounds, then have it refit by your provider.
A diaphragm must be put in up to 2 hours before initiating sex and can be left in for up to 6 hours afterward so all the swimmers are dead and gone. Use with spermicide to help it seal around the cervix to the vaginal walls. If it is in more than 2 hours before sex, then insert more spermicide, and if intercourse occurs again before removal of the diaphragm, insert more spermicide.
The diaphragm should not be left in place for more than 24 hours because of the risk of toxic shock syndrome. Additionally, diaphragms can predispose women to urinary tract infections, so be sure to empty the bladder immediately after sex and take vitamin C before bed to decrease, but not remove, this risk.
Here’s a Link
Cervical Caps
Cervical caps were off the market and are back! There are “cervical caps” that are on the market for menstrual protection, and these are not made for birth control, so beware and make sure you select the right product with your doctor. Here is a link to the only cervical cap that is FDA approved for contraception currently available.
Here’s a Link
Again, it needs to be used with spermicide.
Copper IUD
The copper IUD (Paragard) needs to be inserted by a women’s health care professional. It lasts for 10 years and can be removed at anytime for immediate desired pregnancy. It works because the copper coils deactivate sperm and make them allegedly unable to penetrate the egg (unless there is an Olympic swimmer!). They are 99.2% effective in preventing pregnancy. Unfortunately, some women can have heavier, longer and more uncomfortable menses with the IUD (although many women have none of these side effects).
More Information Click Here
Female Sterilization
Female sterilization is the last method. There are a couple of choices, and they are all 99.5% effective. Please note they are permanent, no going back, solutions.
Essure is a method that many gynecologists place in their office. It has recently been under investigation by the FDA for some unfortunate side effects. It consists of coils placed into the opening of the tubes as they enter the uterus. The tissue scars around the coils and blocks the tubes.
More Information Click Here
Tubal Ligation
Last but not least is the option of tubal ligation or removal of the tubes (salpingectomy). A segment of the tubes can be removed, a segment of tubes can be burned, or the tubes can be completely removed. This requires a minor surgical procedure, which is expensive and requires taking time off for recovery. There are varying ranges of effectiveness depending on the technique used, and they are all in the 99.5% range.
Read More About Tubal Ligation Here
Vasectomies provide 99.85% effectiveness. If you find someone with a vasectomy, have fun! Also know he probably doesn’t want to father children. That being said, they are more easily reversible than tubal ligations.
Whatever option is right for you, know your partner and know him well enough to be okay with him fathering your children. Unintended pregnancies account for over 50% of all pregnancies.
Here are some more helpful links:
http://www.cdc.gov/reproductivehealth/unintendedpregnancy/contraception.htm
Happy love-making!
Dr. Beth
