Birth control is one of the most challenging decisions women have to make. Choosing which contraceptive method to use can be overwhelming. There is so much information, and scientific advances regarding hormonal contraception can change very quickly leaving women and their partners with more doubts than clarity. Before making a decision, women must be well-informed about the advantages, disadvantages, and contraindications of the different methods.
To have a holistic approach and make an informed choice, women must also have information about what is happening in their bodies during their menstrual cycle and learn to listen to the signals the body constantly sends throughout the month.
Talking about a holistic approach to birth control is not the same as discussing a natural approach. A natural approach refers to methods that do not involve allopathic medication. A holistic perspective is when a women and her partner choose the most suitable method specifically for them. In order to do this they must take into account several things:
- Their age
- Health problems
- Habits (like drinking or smoking)
- Type or stage of their relationship
- Concerns about sexually transmitted diseases
- Effectiveness or pregnancy rates of the different methods available, as some methods are more effective than others.
The best approach is to make this decision together with your partner and your doctor, so that you can clarify all doubts you have regarding contraception.
Contraceptive methods can be divided into two large groups: barrier and hormonal.
Barrier methods can be permanent or temporary. Today, so-called permanent methods for both men and women—such as vasectomies and tubal ligation—can be reversed with medical treatments, most of which imply surgery or invasive treatments. It’s important for couples to really inform themselves of the reversibility implications and be positively sure about the decision, this way you won’t have any regrets. These methods have different pregnancy rates. For vasectomy, the pregnancy rate is 0.15 percent and tubal ligation has a rate of 0.5 percent.
Temporary Barrier Methods
Temporary barrier methods include condoms, diaphragms, and sponges. Male condoms, for example, have a use-related pregnancy rate of 18 percent and a method-related rate of 2 percent (see author’s note). These methods do not interfere with your hormones or with your own communication with your body. You can still observe and be aware of the changes that occur in your body throughout the menstrual cycle. This awareness is necessary in order to control symptoms associated with hormonal variations, like PMS.
The copper intrauterine device, or IUD, is also a temporary barrier method. Before choosing this alternative, be sure to ask your doctor about the consequences and side effects of using IUD, common issues include heavy menstrual bleeding and increased risk in pelvic pain and ectopic pregnancy.
Hormonal methods like the pill, monthly injectable hormones, patch, and vaginal ring all interfere with ovulation. This is why these methods are among the most effective in preventing unwanted pregnancies. Nevertheless, there is a considerable difference between the use-related and the method-related pregnancy rates (9 percent versus 0.3 percent).
Hormonal methods alter the normal flow of hormonal production and variations in your body, making awareness of your internal signals almost impossible. Another disadvantage is that they have contraindications and health risks that you must be aware of before taking them, ranging from gastrointestinal side effects like nausea to more serious threats like blood clotting and liver problems. Always consult with your doctor first to make sure a hormonal birth control is safe for you.
Other hormonal methods like implants (subdermal devices inserted in the arm) and the hormonal intrauterine device do not interfere with ovulation, but they do have an impact on your hormones and may also have side effects that you must be informed of, like migraines and absence of menstrual flow. This makes you lose track of what is happening in your body. They do, however, have a very low pregnancy rate, both method and use-related, and have the advantage of long-term use.
Some hormonal methods, specifically some of the first pills that were introduced to the market, can interfere with your libido. This side effect is not seen when women choose some of the newer pills.
Natural methods are based on being aware of the changes your body experiences during the menstrual cycle. The Billings Method is one of the best known. It involves observing the changes in female mucus secretions that occur throughout the month. During ovulation, there is an increase in vaginal secretions that can be recognized by the patient, helping her to identify her fertile days.
Method-related pregnancy rates with natural methods range from 0.5 to 5 percent, which means that if the couple uses the method with conscious awareness, they are very safe. However, the use-related failure rate is as high as 24 percent. The reason for this is that these methods require that you have a regular menstrual cycle, and that there isn’t any infection that may interfere with interpretation of the mucus.
Advantages of natural methods are that they have no side effects, you stay in tune with your body by preserving the natural rhythms of your hormones, they’re easy to use, they’re free, and the best part is that birth control becomes a shared responsibility because partners can participate, enhancing intimacy.
When you choose a natural method, you won't be concerned about hormones being present in your system when you decide it's the right time. Although hormonal methods are not related to higher infertility rates, you do have to wait one or two months after you stop taking the pill in order to get pregnant.
Sometimes your doctor will prescribe a hormonal method because of other existing conditions, like menstrual irregularity, PMS, or even acne. But most of the time, the decision to take the pill is not accompanied by medical advice. Remember that taking a hormonal method like the pill may seem easier, but it may not be safe for you. Always consult with your physician to ensure you don’t have any contraindications before starting hormonal birth control.
Ultimately, any of the methods can fail, but combining two of them may lower the risk of becoming pregnant. I recommend using the condom even if you choose another method; you can lower unwanted pregnancy risk and also prevent sexually transmitted diseases.
Remember that everybody is different, and one method may be an excellent choice for one woman, but not for you. Before deciding which method to choose, talk to your doctor, get informed, discuss it with your partner, and don’t hesitate to ask questions to find out what will likely work best for you. This is the only true holistic approach.
Author’s note: “Method-related pregnancy rate” refers to rates based on a perfect use of each method. The “use-related pregnancy rate” refers to statistics obtained when a mistake is made by the user (for example, forgetting to take a pill). This is why failure rates may vary according to the source. Data was obtained from The National Center for Biotechnology Information studies. Additional use-related data was obtained from the Reproductive Health Department of the Centers for Disease Control and Prevention (CDC)
*Editor’s Note: The information in this article is intended for your educational use only; does not necessarily reflect the opinions of the Chopra Center's Mind-Body Medical Group; and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition and before undertaking any diet, supplement, fitness, or other health program.