So you want to know which birth control is right for you. Thanks to medical advancements, you now have multiple choices for birth control. You might or might not be sexually active, you might want to use birth control to help you with your acne, or if you're like me, you started birth control to regulate your periods. Whatever your reason may be, it's important to be well educated about the decisions you make when it comes to starting birth control.
I want to share my experiences with the pill, patch, and ring as a woman in my mid-20's who has tried all three. I've also invited Dr. Sophia Yen (Pandia Health's founder and a birth control specialist) to give her two cents on what she recommends. After all, she is the goddess of birth control and has spent a good portion of her life (20+ yrs) getting really educated in the space.
Keep in mind that everybody is different and that while one has worked for me, it might not work for you. With that being said, let's start with the pill.
I started the pill when I was 13 years old and kept taking it until I was 18. My pediatrician prescribed this to me because I rarely got my period. It arrived for 2 days in the 6th grade and then it never came back until I was in the 8th grade and even then it would come every 3-4 months... talk about irregular, right? I was not sexually active, but my mom was mortified to hear that I was taking such medication simply because of the name and the social stigma behind it - after all, aren't birth control pills the medication you take to control your chances of having birth which means that you are doing something that could result in having birth??? No mom wants to know or admit that their child is having sex despite the fact that 30% of high school freshmen in the US have had sexual intercourse... However, because my doctor prescribed them to me and explained the reasons behind it, my mom reluctantly agreed to let me use them.
+ My period came! And they came regularly.
+ I wasn't going to get pregnant IF I were going to be sexually active.
- Many different formulations exist so it might take some trial and error to figure out which one works best for your body. However, most people do well on the 1st one they try.
- Hormones made me more easily annoyed and cranky, especially during the week before my period came.
- Since you are consuming these pills, the hormones go all throughout your body.
- I had such a hard time remembering to take these pills everyday! TBH I probably skipped 2-3 days and just thought I could pop two in the next day. I wasn't sexually active so I thought it wouldn't be a big deal. However, if you are sexually active, this is quite a big deal.
I "upgraded" to the patch in college because I didn't want to take those pills everyday. I just could not for the life of me remember to take them, even though I had an alarm for it and had multiple packages in different bags. It was just always a huge inconvenience for me. So I discovered the patch and found how convenient it was to stick the patches on and only change very week, except the fourth week when I'd get my period.
My college health center had me sign up for Family PACT which stands for Family Planning, Access, Care, and Treatment and is California’s "innovative approach to provide comprehensive family planning services to eligible low income (under 200% federal poverty level) men and women". The physician at school prescribed OrthoEvra to me and thankfully, I had a pharmacy at school that would dispense them to me 3 months' supply at one time.
Those are the 4 locations that you could put the patch on and because I'm such a sweaty mess, I found that the arm and stomach are the best places I could put them on without them falling off. They are like a bandaid to your skin.
I used this method for about 5 years, until I went abroad and could no longer get my hands on these. It also turns out that OrthoEvra is no longer being made and is replaced by the generic Xulane. From their page, this is how the patches work - "Hormones from Xulane get into the blood stream and are processed by the body differently than hormones from birth control pills. You will be exposed to about 60% more estrogen if you use the patch than if you use a typical birth control pill containing 35 micrograms of estrogen."
+ Convenient - I only changed these sticky patches once a week (I changed every Sunday)!
+ No changes to my mood.
+ No more worrying about forgetting to take pills.
+ You can put this on yourself.
- When placed on my arm, people thought they were nicotine patches which implies that I'm a smoker...
- Because of its adhesive nature, I would get skin irritation and left over marks from constantly putting the patches on my belly or arm.
- The hormones are absorbed into the body through the skin.
I'm just kidding. Not this one.
This one (the contraceptive ring): where you have to insert this gel ring inside the vajayjay and leave it in there for 3 weeks. Now this one I used for 3 months and I did not like it at all. I had thought it would be even MORE convenient than the patch because I just stick it in there and leave it in there for 3 weeks without having to worry about it. HOWEVER the hormones in this did not work well with my body. I became super cranky and ultra snappy and extra sassy... and no one likes a cranky snappy sassy diva.
+ SUPER convenient - you put it in and leave it in the for 3 weeks.
+ You don't feel anything. Absolutely no pain.
+ You can put this on yourself.
+ It releases a continuous low dose of hormones centralized in your abdomen.
- You have to stick something in your vagina.
- Your partner does feel this swimming around inside. (Dr. Yen says only 10% of men notice and only 10% of them care to ask their partner to remove it)
- There's only one brand so there's only this specific type of hormone.
- Expensive if you don't have insurance.
At the end of the day, it's your body. And every body is unique and beautiful in their own ways. You know your body best. And it does take some trial and error to figure out which hormones work best for you. Speak to your doctor to get started. Or if you want to do things from the convenience and privacy of your own home, you can go to pandiahealth.com and one of our doctors to prescribe you birth control for $39.
Here are Dr. Yen's thoughts about the pill, patch, and ring:
In general, we recommend that young women consider LARC (long-acting reversible contraceptives) before the ring/patch/pill because they are more effective.
Check out this chart that shows the different efficacy of the methods:
But if you don't like the idea of something in your uterus or arm or a shot every 12 weeks, then the ring, patch, and pill are your next best options.
For the pill or patch or ring, they are basically the same drugs. Just depends how you want to take them (by mouth, by patch, or by vagina) and how often you want to worry about it (every day, once a week or once a month). Unfortunately, for the patch and ring, if your body doesn't like the progesterone in them, there is only 1 choice for each of those forms (etonogestrel, the active metabolite of desogestrel for the ring and norelgestromin for the patch). For the pill, there are about 30 different options. And as noted above, the patch has about 60% more estrogen than the other methods which can increase your risk of blood clots.
Each person responds differently to the pill, patch, or ring. Most women do just fine on them and love the benefits of having absolute control over your periods.
Once you are on the pill or ring, you can decide when and if you have periods. If you want, you can skip periods altogether. Unfortunately with the patch, you cannot skip your periods. Read my blog piece about that coming up next week ;) Some women respond poorly to the different hormones and we can try different pills (There are like 30 different pills to try!)
This is how the pills, patch, and ring work. The hormones in these methods work mainly by blocking your body from releasing eggs each month. For 3 weeks you have hormones, and the last week you can take sugar pills or go off the patch/ring and then you get a withdrawal bleed. This bleed is purely optional. Read my piece on periods are optional to learn why. You can skip that week and just go on to the next active pill and ring.