Know Your Birth Control Options
Oral contraceptives contain synthetic versions of the hormones estrogen and progesterone to prevent ovulation. “They mimic the hormones produced by your ovaries,” says Cindy Basinski, a gynecologic surgeon in Newburgh, Indiana. “So your brain doesn’t signal your ovary to produce an egg.” Most pills contain both hormones. Several contain only progesterone; they’re often prescribed to women who can’t take estrogen or who are breast-feeding. Typically, you take pills that contain hormones (called “active” pills) for 21 to 24 days and placebos for four to seven days. The placebos trigger the body to bleed, as if you’re having a period (you aren’t, because you haven’t ovulated). “Continuous cycle” pills, like Seasonale, all but eliminate this pseudo-period. You take active pills for three months at a time and get a “period” four times a year. “This is safe—there’s no medical need to have a period on the Pill,” says Lauren Streicher, an assistant professor of obstetrics and gynecology at Northwestern University, in Chicago. Some women are wary of taking the Pill long-term in light of its purported link with breast cancer. But “the Pill does not appear to significantly increase your risk,” says Basinski. And those containing both estrogen and progesterone may reduce your risk of ovarian and uterine cancers.
Benefits: Lighter, regular periods (ideal for women with a history of heavy bleeding) and restored fertility as soon as you stop taking it. So, contrary to popular belief, you don’t have to be off the Pill for a few months before trying to conceive.
Downsides: The Pill can sometimes produce side effects, such as headaches or nausea, and it’s not recommended for women who have a history of blood clots or who are over 35 and smoke or are obese. And—obviously—you need to remember to take it every day.
Cost: $10 a month for a generic to $75 for a brand name; may be covered by insurance. (In August 2012, health plans will be required to cover prescription contraceptives approved by the Food and Drug Administration.)
This low-tech method can prevent pregnancy—when used perfectly, that is. And therein lies the problem: “The fact is that condoms have a 20 percent failure rate,” says Eve Espey, a professor in the department of obstetrics and gynecology at the University of New Mexico, in Albuquerque. Remember the lessons from high school health class: Latex, the only material recommended for condoms, is fragile, and condoms have to be put on and taken off carefully.
Benefits: Condoms are inexpensive and don’t require a visit to the doctor’s office. They’re also the most effective way to prevent sexually transmitted diseases.
Downsides: Most experts don’t recommend them as a primary method of birth control (see: failure rate). They’re best used in tandem with another option, like the Pill.
Cost: About $8 for a pack of 12.