Contraception - Part 2

Can your chosen method of birth control improve your health or put you at risk? With birth control as with other areas of health and medicine, research is ongoing to develop newer and better options. There have been some recent advances that increase your contraceptive options.

Contraceptives: What about your health?

Your method of birth control can actually do more than just protect against pregnancy. It may also affect things such as your appearance and your risk of certain kinds of cancer.

Health benefits

Some methods of birth control have benefits for your health.

Clearer skin: Studies have shown a connection between the use of the birth control pill and decreased amounts of acne. This is because the pill can moderate levels of hormones called androgens, regulating the production of oil in the skin.

Protection from certain diseases: The birth control pill is associated with protection from some diseases affecting women. These include benign ovarian cysts, endometrial (uterine) cancer, ovarian cancer, iron deficiency (anemia), and pelvic inflammatory disease.

Reduced pain and menstrual flow: Birth control methods that contain hormones are linked to a reduction in the volume of menstrual flow and the painful cramps that often accompany your period.

Protection against STIs: Condoms provide protection against sexually transmitted infections (STIs). Depending on the nature of your sexual relationship, this protection can be vital, even if you use another form of birth control, because the other forms of birth control do not provide protection from diseases such as AIDS/HIV, chlamydia, gonorrhea, genital herpes, human papillomavirus (associated with genital warts and cancer of the cervix), and syphilis.

Things to watch out for

Your state of health is an important consideration when deciding on or during the use of any birth control method. Certain birth control methods may affect some medical conditions, and medication for some conditions may change the effectiveness of some birth control methods.

Antibiotics: The antibiotic rifampin reduces the effectiveness of birth control pills. As for other antibiotics, there is less conclusive evidence that they decrease the effect of oral contraceptives. This effect may only occur in a small number of women. But it's best to err on the side of caution, as more research is needed to determine the effect of antibiotics on the modern low-dose birth control pills used today. Adding a barrier method (e.g., male or female condom) is a good idea if you're taking antibiotics.

Medical conditions: Women with epilepsy need to determine the proper form of birth control with their doctor and neurologist. Many anti-seizure medications may reduce the effectiveness of hormone-based birth control methods by speeding up the breakdown of these hormones in the liver. Including a barrier method will reduce the chance of pregnancy.

Women who have any of the following conditions should talk to their doctor before deciding on a birth control method:

• high blood pressure
• liver disease
• history of blood clots in a vein (deep vein thrombosis) or lung (pulmonary embolism)
• migraine headaches
• family history of stroke

Latex allergy: Most male condoms are made of latex. People who are allergic to latex can consider such options as condoms made from polyurethane and female condoms. Lambskin condoms are also available, but they offer less protection against STIs. If protection from STIs is not an important issue, there are many options, ranging from sponges to IUDs to pills.

What's new in contraception?

Birth control patch: The birth control patch is a convenient alternative to the birth control pill. It is applied directly to the skin and is changed once or twice per week; it delivers the two hormones that are in regular birth control pills through the skin.

Contraceptive rings: Contraceptive rings are made of flexible plastic materials. They are inserted into the top of the vagina and held in place by the muscles there. A ring releases a low dose of hormones over a three-week period and gives a high rate of contraceptive protection.

Non-prescription emergency contraception: Emergency contraception is now available from your pharmacist without a doctor's prescription. The product is called Plan B® and consists of two tablets of a female hormone called levonorgesterol (a progesterone). Plan B must be taken within 72 hours of unprotected sex and is between 95% and 61% effective in preventing pregnancy, depending on when it is taken. Emergency contraception does not protect you from sexually transmitted diseases and is not a reliable form of ongoing birth control.

Continuous birth control pills: For years, women have taken the birth control pill continuously at times in order to adjust the timing of their periods; for example, their wedding day, honeymoon, or a special trip. Research into the safety of extended use of birth control pills has resulted in the introduction of a product in the United States. This product is taken for 84 days in a row, then stopped for 7 days, causing a period. This process is repeated three more times, resulting in four menstrual periods a year. Although this product is not available in Canada, there are contraceptives on the market that contain the identical active ingredients, which could be used similarly, although they are not officially approved for that use.