Your birth control FAQs answered

By Kristen Plastino, MD

If you are thinking about starting birth control, you may have questions about which methods are most effective, or what side effects you might experience. Dr. Kristen Plastino is a professor at UT Health San Antonio and an OB/GYN at University Health and answers your questions here.

Q: What types of birth control are there for men and women?

A: Men are pretty limited in their options. Right now their options are condoms and vasectomy. Women have hormonal and non-hormonal options. Everything from IUDs to implants, shots, pills, patches, rings and tubal ligation, also called getting your tubes tied.

Q: How do you help people find the best birth control option for their lifestyle?

A: The important thing to do is to get a comprehensive medical history because some methods are not the best for them. For example, if they have high blood pressure or blood clotting, their birth control could impact that condition. Then, we ask questions to understand their lifestyle, such as:

  • What other pills do you take every day?
  • Do you want to have a regular menstrual cycle, or would you rather not have one?
  • Do you have painful or heavy periods?
  • What are your reproductive life goals?
  • When do you want to have children (if at all)?

Once we get all of that information, then we can make a medical recommendation, working with you to ensure the best match.

Q: What is the most effective method for reducing my risk of getting pregnant?

A: The most effective methods are the IUD and implant. There are two types of IUDs (intrauterine devices), hormonal and non-hormonal. It is placed into your uterus through your vagina and up through your cervix during an office visit. Depending on the type of IUD you request, it can last for 3 to 10 years. The implant is a small device that contains hormones. During an office visit, the implant is placed under the skin in your upper arm using a small amount of numbing medicine. The implant lasts three years. Both the IUD and implant can be removed sooner than when they expire if you are ready to get pregnant.

Q: What are the side effects of birth control for women? What about for men?

A: The most common side effect of hormonal birth control is irregular bleeding and spotting. It doesn’t signal a problem, though, it’s just a hormonal side effect.

The most serious side effects, specifically with estrogen-containing products, are blood clots and stroke. Blood clots are the one that we educate on the most. They’re still very rare, and there’s less risk of getting a blood clot with hormonal contraception than if you get pregnant. If you get pregnant, you have a higher risk of developing a blood clot than if you use hormonal contraception.

Some people report weight gain, but that’s not the birth control itself. You have probably changed your eating or exercise habits.  Some of these medications may make you hungrier and if you eat more, you will gain weight. I often check to see if women have healthy eating habits before starting contraception, then they don’t gain weight. If they did not have those healthy eating and exercise habits when starting the contraceptive method, they may gain weight.

Acne, bloating, nausea, vomiting and headaches are also possible side effects, but not everyone experiences them.

Since men are limited on their birth control options with only non-hormonal methods such as condoms, there are no serious side effects, however, it is important to be aware of any latex allergies.

Q: Does female birth control, like the pill, increase your risk for uterine or ovarian cancer?

A: No. In fact, the pill has been shown to be protective against developing certain types of cancer. In the normal female cycle, you ovulate every month and make an egg. When the egg comes out of the ovary, it pops out and breaks the outside layer of the ovary, and it causes a little damage.

As we’ve delayed childbearing until later in life, we ovulate more times before going through menopause. That constant pop of the egg through the ovary causes damage and increases your risk of ovarian cancer. That’s why women who’ve never had babies are at a higher risk of ovarian cancer, because they never stopped ovulating. But the pill has been shown to decrease the risk of ovarian cancer because it inhibits that over and over ovulation during a woman’s reproductive years.

Q: Does female birth control increase my risk of breast cancer?

A: There’s a lot of data with mixed results. Currently, data shows that estrogen-containing birth control neither increases nor decreases your risk of breast cancer.  

And when you’re talking about risks associated with estrogen-containing methods of birth control, we are discussing not only the pill, that also includes the patch and the ring. The pill, patch and the ring are all hormonal birth control methods that inhibit ovulation, thicken cervical mucus and thin the endometrial lining.

Q: How can I get birth control if I don’t have a primary care provider?

A: Did you know that OB/GYNs (obstetricians/gynecologists) can be considered primary care doctors, too? Often, we are the only doctor taking care of a woman in her reproductive years and most insurances let you see an OB/GYN without a referral.

Q: How do I pay for birth control?

A: Most insurances cover birth control and make it very affordable. If you don’t have insurance, the state of Texas has multiple grant programs to help with that:

All of these funding options are available for uninsured or underinsured people. Also at University Health, we can help you see if you qualify for any of the grant programs.

Q: How else can birth control be used besides reducing the risk for pregnancy?

A: Birth control is not just used to prevent pregnancy. Hormonal and non-hormonal birth control can decrease heavy menstrual bleeding and painful periods. It can also help with acne and signs of PCOS (polycystic ovarian syndrome).

Q: Do any of the birth control methods prevent me from getting a sexually transmitted infection (STI)?

A: No, however, using a dual method of contraception is highly recommend for STI and pregnancy reduction – this means using both a condom and a hormonal or non-hormonal birth control method. Condoms, used consistently and correctly with every act of vaginal or anal sex, can reduce the risk of many STDs, especially HIV. 

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