The Basics of Birth Control

Illustration by Maliheh Rahrovan

It's not uncommon for people to beat around the bush when it comes to talking about sex. There seems to be even less talk about the different types of birth control methods.

Betty Vickery, a nurse practitioner with over 35 years of experience and with 20 years of working in the Student Health Center (SHC), discussed a few of the different options available. She cited some of the methods she has found to be the most popular, starting with the pill.

"The most common thing people ask for here are birth control pills," she said. 

Birth Control Pill

One of the more commonly known methods, birth control pills, are an oral contraceptive method taken daily. Combination pills contain the hormones estrogen and progestin that prevent ovulation from occurring. For people who can’t take estrogen, there are progestin-only pills available. 

With typical daily consumption, pills are 91 percent effective. Remembering to take the pill is essential to its success and it must be taken every single day around the same time. 

“The half life of the pills is pretty short, which is kind of nice if you decide you just want to stop them ... On the other hand, if you miss two birth control pills in a row and don’t use a backup method and have sex, you could potentially get pregnant,” Vickery said.

The reasons people go on the pill vary. For Meghan O’Neil, a fourth year Biochemistry major, it was simple.

“I wasn’t getting pregnant,” she said.

The pill isn’t used solely for contraceptive reasons, though. Kelly Hodge, a fourth year International and Global Studies major, started taking the pill when she was 16 years old to regulate her periods. 

“I’ve honestly only noticed pros. When I went on it for the first time, all my acne cleared so that was amazing,” Hodge said. “And I know that it was the pill that did that because I went off of it for a couple months ... and my acne came back and I was like, ‘Gotta go back on.'”

In addition to pregnancy prevention, birth control pills can regulate and lighten periods, reduce cramps and clear up acne. 

Despite the medical benefits and high effectiveness, birth control pills still have their downsides. There are a few side effects, such as nausea, sore breasts or spotting between periods. Dr. Alan Smerbeck, an assistant professor of psychology and Human Sexuality course instructor, also explained why he thought the pills were an inferior birth control method to others, such as IUDs.

“[You] have to remember to take a pill ... To anyone that sounds silly and obvious to, I would challenge you to take one Tic-Tac everyday at exactly 5 p.m. — no earlier no later — every single day for 30 days and see how well you do at it. If you are like most people, you will be imperfect,” Smerbeck said. “With an IUD, it doesn’t matter.”

IUD

An intrauterine device, more commonly referred to as a IUD, requires less effort than taking birth control pills and is one of the most effective kinds of birth control. IUDs live in the uterus and must be inserted by a physician.

“What happens is we have this small device that we use to place it into the uterus. There’s a small string that hangs down into the vagina,” Vickery said. “We trim it; the string is there so that when it’s time to take it out, we just reach in ... and it folds itself right back out — it’s very pliable.”

Hormonal IUDs release a small amount of progestin over long periods of time. Mucus on the cervix thickens to keep sperm from breaking through the barrier and ovulation halts. None of the four hormonal IUDs are permanent, but they can last anywhere from three to seven years. 

“The nice thing about [the IUD] having [a] hormone, is besides preventing pregnancy [is that] this type of IUD causes people’s periods to get lighter, shorter and again over time, some stop having periods completely,” Vickery stated. 

IUDs are especially beneficial for people who lead busy lives and don’t want worry about their birth control. Annika Garbers, a fourth year Industrial and Systems Engineering major, has had her IUD for almost two years. 

“My lifestyle at college is very hectic ... even consistently remembering to take the pill was really hard,” she said. “This [IUD] is easy, I can just get one and not have to remember it.”

O’Neil switched to an IUD back in May 2018 after exploring alternative options to the pill. 

“I went to Planned Parenthood and had discussions with all of the nurse practitioners about what would be a good option; I ultimately decided on an IUD because I didn’t have to worry about it for up to seven years,” she said.

Although there are few side effects, spotting during the first few months and pain upon initial insertion are the most common. 

“A lot of people say that they have really intense pain right after it gets put in for the first time. I didn’t really have that, but it was kind of like a dull aching pain that was there for about a week,” Garbers said.

O’Neil concurred. “It was uncomfortable for the first month ... there was a lot of cramping. But an advantage afterward is that it’s helped with my cramps, so I don’t experience cramps like I used to,” she said.

IUDs are great for those who want a “set-it-and-forget-it” birth control method. But to some, the thought of having a device inside of them may not be appealing.

Depo-Provera Shot

While lesser known, Depo-Provera — commonly called Depo — is a progestin-only birth control shot administered every three months. Jessica McNeely, a second year Applied Mathematics major, has been getting the shot for six months. She took the pill for a short time while when she was younger, but dealt with many negative side effects. 

“When I went this time to go on [birth control] for actually wanting to go on it, it was kind of like, ‘Why would I go back to that [pill], why wouldn’t I just get a shot I can do once every three months and be fine, not have to worry about taking pills?’” McNeely reasoned.

Much like the pill and IUD, Depo stops ovulation. It’s 94 percent effective with average use and only requires a doctor’s visit commitment four times a year.

“I haven’t really had any [side effects] besides the discomfort of [getting] a shot itself,” McNeely said.

Vickery noted that a drawback of Depo is that it can cause bone thinning due to a lack of estrogen — which helps deposit calcium in the bones. To counteract these effects, there are a few things Depo users can do.

“We tell people that they need a certain amount of calcium a day ... And they also need exercise which would involve gravity against the long bones in the legs, so things like walking, running, the elliptical ... are helpful,” Vickery stated.

Belt and Suspenders

Pills, IUDs and Depo shots are just a few of the birth control methods out there. There are many other options available too, like the implant, patch and vaginal ring. 

“We usually give [each method] at least a three month trial because your body needs to get adjusted to whatever we’re using,” Vickery said. “If after that time there’s an issue, I definitely tell people to come back.”

While the main goal of each option is to prevent pregnancy, condoms are the only contraceptive option that help prevent STDs.

“I believe in a belt and suspenders approach — everyone should always be using two kinds of birth control,” Smerbeck said.

The SHC, Center for Women and Gender and Q Center are a few of the places you can find free condoms on campus. In terms of other contraceptive accessibility, the SHC carries a few generic birth control pills. They don’t have Depo or IUDs, however they can write prescriptions and provide referrals to anyone who is interested.

There are many birth control options available to learn about. Each type has its ups and downs, but ultimately it's important to find what works best for your own body. Even though sometimes sex and contraception can be uncomfortable topics, knowing what's out there is important.