Is It a Good Idea to Get on Birth Control?

When it comes to birth control, the 100 percent safe (and 100 percent impractical) method is abstinence.

Beyond abstinence, seven safe birth control methods include:

1. Condom: With about 99 percent efficacy, low cost, and the ability to prevent sexually transmitted infections (STIs), condoms are probably the safest method of contraception. Apart from an individual with latex allergy, condoms are 100 percent safe to use in every age group and with every comorbidity.
2. Oral contraceptive pill (OCP): OCPs come in multiple doses and forms. They have an efficacy of about 98 to 99 percent if used correctly, but these pills may cause side effects in women on long-term use (continuous use for more than five years). Your gynecologist, therefore, advises you to take a pill break every couple of years and use a barrier method of contraception (condom or diaphragm) to help reduce these side effects.
   • Side effects of OCPs may include:
     • Weight gain and unfavorable lipid profile
     • Increased tendency for blood clots
     • Increased blood pressure
     • Increased migraine attacks
     • Theoretically, increased cervical and breast cancer risk that goes back to normal within 10 years of stopping the pill
3. Diaphragm: A diaphragm is a female contraceptive that you can place in your vagina just before intercourse. You must use a lubricant and your fingers to push it up the vagina like a tampon so that it covers the cervix (mouth of the uterus) and snugly fits behind the pubic bone (due to muscles of the pelvis) to stop sperm from entering the uterus. It must be used along with a spermicide to be fully effective. The efficacy of a diaphragm is between 80 and 85 percent. It is important to know that sperms can live for several hours in the vagina, so the diaphragm must be left in place for at least six hours after sex until the sperm in the vagina die. A similar contraption is called a cervical cap. It functions just like a diaphragm, but the shape is different. A diaphragm needs no prescription, can be reused for up to two years, and is generally not felt by either partner during intercourse. It may sometimes irritate the cervical area and requires regular cleaning and drying. The spermicidal gels and pellets are often not effective if used without a diaphragm or cervical cap (efficacy about 70 percent).
4. Intrauterine contraceptive device (IUCD): IUCD is a U.S. Food and Drug Administration (FDA) approved contraception method. The IUCDs are about 99 percent effective. A copper T (Para guard) incites a foreign body reaction in the uterus that makes the local environment for the sperm and implantation hostile. The levonorgestrel-releasing intrauterine systems (Mirena and Skyla) additionally release hormones to prevent implantation if fertilization occurs, which makes them more efficacious. IUCD use may result in severe side effects. These include pelvic inflammatory disease (which may lead to infertility), perforation, increased tendency for ectopic pregnancy, increased bleeding, and long painful periods.
5. Depot injections: Depo-Provera (medroxyprogesterone acetate injection) is administered as an injection every three months. Depo-Provera acts like progesterone and typically suppresses your ovulation. This keeps the ovaries from releasing an egg, causes cervical mucus thickening, and keeps sperm from reaching the egg. Though the idea of not taking daily pills or using condoms seems tempting, the FDA does not advise you to take these injections for more than two years because these can severely affect your bone density and cause osteoporosis at a young age. These may cause weight gain, severe mood swings, migraines, bloating, and delayed return of fertility (up to 10 months after stopping the injections). Similar to injections, there are implantable rods (fixed under the skin) and hormonal patches. Their efficacy ranges from 93 to 99 percent.
6. Emergency contraception methods: Though largely successful at preventing unplanned pregnancy, the efficacy of these methods is often variable. Additionally, these offer no protection from STIs, and these pills contain high levels of hormones, which may negatively affect your hormonal biorhythms if taken too frequently.
7. Vasectomy in men and tubectomy in women: The permanent methods of birth control is only advised to couples who have completed their family and do not want to consider further children. These methods are largely safe and effective and could be irreversible. Reversal often requires major surgery and is often not successful.

There is no minimum age to start using condoms and diaphragm. You must use them as soon as you are sexually active. The pills will require a prescription from your healthcare practitioner.

You can start taking birth control pills as soon as you get them, irrespective of the day of the week and anytime during your menstrual cycle. However, you need to use a backup birth control method (such as condoms) for up to seven days before their effect kicks in.

Emergency contraception needs to be taken within 72 hours of unprotected sex, the sooner the better.

Every birth control comes with its pros and cons, and your doctor can advise you and your partner on the best possible alternative. However, there is no excuse to practice unsafe sex whether you are pro-contraceptive or otherwise.

Even in monogamous couples, an unplanned pregnancy can play havoc with the relationship, strain the finances, and affect the sexual and emotional happiness of the couple.

Additionally, multiple conceptions, which are not far apart, may result in health issues in mothers, such as maternal anemia and fatigue. Hence, consult your doctor and discuss in detail birth control and your plans to have kids.