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Weighing the Pros and Con(traceptives): A Period Piece

Forty-seven percent of women who have used at least one method of contraception have discontinued using a method due to dissatisfaction, according to the Center for Disease Control. Many young women have been using a birth control method for a number of years, and most young women begin with the birth control pill. Every woman’s body is affected differently by the available doses and contraceptive methods, but women are not always aware of all their possible contraceptive options.

Sophomore Mary Sobran temporarily stopped taking the birth control pill after having a scary reaction to it her senior year of high school when she took two pills to get back on schedule. 

“Probably six months into using it I passed out and threw up while unconscious,” she said. “I was having seizure-like movements.  I had to stop taking it.  I felt like I couldn’t do it anymore.”

She said that her doctor was not a gynecologist and had not talked to her about the prescription before writing it nor knew that her symptoms were a problem.

Forty-seven percent of women who have used at least one method of contraception have discontinued using a method due to dissatisfaction, according to the Center for Disease Control.

Desiree Francis, an advanced practice clinician at American University’s Student Health Center, explained that although everyone’s response to birth control is different, Sobran’s reaction was not a normal case. She said that before prescribing a method of birth control, the clinicians at the health center and most gynecologists consider a woman’s family history, her typical period and other aspects of her health.

“Any time you start birth control it can take up to three months for your body to acclimate to the hormones,” Francis said. “We always say try to bear it through three months.”  

According to Francis, patients usually discuss alternative options if the side effects are undesirable or persist after three months. These alternative options include the IUD, or intrauterine device, which has increased in popularity among younger women in recent years.

The IUD is a small contraceptive that is inserted into the uterus by a healthcare provider.  Its failure rate is less than one percent. According to AU professor Melissa Hawkins, the percentage of women aged 15 to 20 using the IUD is currently six to eight percent and is expected to increase to about 25 percent in the next decade.  Hawkins is a faculty member of the Health Science Department and an expert in public health, maternal and child health and perinatal reproductive epidemiology.

“We have a problem in our country of unintended pregnancy,” Hawkins said. “We can really make an impact by providing particularly young women with safe and effective contraception that is completely in their control.”

Maile Young, a sophomore who has never taken the birth control pill, chose to get a newer form of the IUD called Skyla.  Hawkins explains that Skyla is being marketed toward younger women because it lasts three to five years and is safe and effective.  Young, a public health student who teaches sex education to DC public school students, said this helped her make her decision considering her body’s history of bad reactions to hormones.

“A lot of people I know are scared away from it because it’s inserted,” Young said of the IUD. “It’s not a super comfortable procedure…but it’s manageable.”  She tells the students she teaches that the IUD is an option.

Hawkins said that in the United States there is memory of a dangerous IUD available in the 1970s and '80s called the Dalkon Shield that caused infections, pelvic inflammatory disease and ectopic pregnancies in a number of women.  The memory of this failure may contribute to the country’s previous hesitance to promote the IUD. But research has come a long way.

“This new generation of IUDs is completely safe, and we have peer reviewed articles and rigorous studies that have shown again and again the effectiveness of these IUDs,” Hawkins said.

The CDC found that 50 percent of all pregnancies are unwanted, with the majority of those pregnancies occurring in adolescents and younger women. Hawkins said that this is due to a lack of birth control or a lack of reliable birth control.

She said that IUDs are more common globally, and that there may be a cultural shift in the U.S. that will increase IUD use.  Other countries are typically more positive in approaching sexuality in the younger population.  This could be where the U.S. is headed.

“So part of the conversation – and I think part of the shift – is acknowledging that it is important to provide a safe and effective birth control method for young women,” Hawkins said.

According to Francis, to be a candidate for the IUD in previous years, a woman had to be in her 20s or 30s, engaged or married and have no history of STIs.  Now, healthcare providers prefer to stress efficacy.

“The research has shown that those issues aren’t as important, and that the efficacy rates are so high,” Francis said. “We prefer to prevent unwanted pregnancies.”

Along with efficacy, Francis believes that convenience is another draw of the IUD for young women.  Young agrees.

“There’s less human error,” Young said. “You don’t need to remember to take a pill every day.”

Like the birth control pill, a woman’s body needs time to adjust to the IUD. Young experienced severe cramping early on. Francis and Hawkins said that in addition to cramping, other early side effects of the IUD are spotting or bleeding; some women do not like the idea of not having a period.

Various forums and health websites explain that every woman’s body is different. Certain types of birth control pills may not necessarily be “right” for them, but it is important for young women to understand that the options have broadened to methods other than the pill. Choosing to use a form of birth control may be about staying safe, regulating the period, lessening the severity of cramps or another personal reason. In the end it is always about what is best for one's body.

“I feel like people suffer through it because they think they have to,” Sobran said about the birth control pill. Younger American women should be informed that there are other contraceptive options available that may suit them better. 

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