What’s in Your Birth Control? The Pros and Cons of Hormonal and Non-Hormonal Methods

When it comes to birth control, I think we can all agree on at least one thing: We’ve come a long way.

These days, a visit to your gynecologist can leave you feeling empowered, in control and confident about your sexual health. Take your pick of the pill, the patch or the ring, or opt for an IUD, diaphragm or condoms. Contraceptive options have never been more plentiful. Moreover, health care reform over the last few years now ensures that many women have access to these types of preventative services, at no added cost.

It’s about time, isn’t it?

Yet, from a health perspective, it’s impossible to have a discussion about most contraceptive birth control methods without talking about what’s going into your body. As a physician  — and a woman — who supports the idea of informed choices, I believe there’s no “right” or “wrong” when it comes to what method you use. However, it is important to be educated about how contraceptives may affect your health, your hormone balance and even things like your energy and mood.

HORMONAL METHODS:

If you’re using a hormone-based birth control method (the pill, the patch, the ring, etc.), the reason you’re (hopefully) not getting pregnant is due to the hormone power couple, estrogen and progesterone. Hormones in birth control pills essentially prevent ovulation, while thickening the lining of the cervix to prevent sperm from reaching any eggs that might have been released and thinning the uterine lining to make it harder for a fertilized egg to attach.

Hormonal birth control effectively “tricks” the female body into not having a normal monthly cycle, which is incredibly effective in preventing unwanted pregnancy – but may pose potential problems for some women.

Let’s review the pros and cons of hormonal contraceptives:

Pros:

• Reliability. If used correctly, these types of methods can prevent pregnancy about 99 percent of the time.
• Cancer prevention. Studies suggest that taking birth control pills long term can reduce your risk for ovarian and thyroid cancer.
• Acne reduction. Since hormonal birth control methods reduce androgen levels, they tend to help clear up acne.
• Accessibility/cost. Birth control pills are among the cheapest types of contraception, making them a viable long-term option for women.

Cons:

• PMS factor. The pill can often make PMS symptoms worse, especially when it comes to emotional symptoms like mood swings or depression.
• Weight gain. The hormones in the pill could make you gain weight.
• Blood clots. Your risk for blood clots can triple, especially if you’re a smoker.
• Decreased sex drive. Low libido is a common side effect of hormonal birth control methods.
• Lowered thyroid hormone. By increasing thyroglobulin, a protein that binds thyroid hormone, the pill can interfere with proper thyroid function.
• Depleted B vitamins. B vitamins keep your neuroendocrine system working, which is the basis for hormone balance.
• Breast cancer. The synthetic progestins in menopausal hormone replacement have been linked to an increased risk of breast cancer. Data are mixed, but there is a possibility of a modest risk from the synthetic progestins in birth control pills.

NON-HORMONAL METHODS:

If you’re happy and healthy on the pill, there’s no need to toss your supply. Yet if you want to explore a non-hormonal method, you can try an IUD (intrauterine device), a diaphragm, the female condom, spermicidal sponges or condoms, along with Natural Family Planning – a method that factors in the rhythm method, the basal body temperature method and the cervical mucus method.

Non-hormonal methods vary in how they work, and offer different benefits and drawbacks than hormonal options:

Pros:

• Versatility. Unlike the pill, you can combine different methods of non-hormonal birth control until you find something you’re comfortable with.
• Family planning transition. If you want to become pregnant, switching from a hormonal to a non-hormonal method can help your body readjust to a normal menstrual cycle, which can improve your chances of an earlier conception.
• Convenience. Most non-hormonal birth control options are fast and fairly convenient.

Cons:

• Reliability. With the exception of the IUD, most options have a lower success rate in preventing unwanted pregnancies than hormonal methods.
• Lack of spontaneity. If you’re using a diaphragm, female condom or sponge, safe intercourse must happen within a certain window of time.
• Irritation. Yeast infections are common in diaphragm users, while some women may have allergic responses to the latex in condoms or the chemicals found in spermicides.

Regardless of your preference, both hormonal and non-hormonal birth control methods can be safe and effective, if you’re using them correctly.  If you’re concerned about specific health issues that relate to birth control, talk to your doctor. There’s nothing wrong with trying a few different methods until you find one that works best for you.