Alternatives to Hormonal Birth Control

Photo by Reproductive Health Supplies Coalition on Unsplash

For those seeking contraceptives purely as a form of pregnancy prevention, there are a few options that don’t include synthetic hormones (I’ll save my speech on synthetic hormones for another post). It’s important to realize that you must do what’s best for YOUR body. For some, hormonal contraceptives may be the best choice due to various medical conditions. What worked for some may not work for you, what works for you may not work for others.

This blog post is for informational purposes only, I do not guarantee the efficacy of these methods nor am I formerly educated on the use of any of the following. Please speak to your medical doctor or seek further guidance to find a contraceptive that works best for you and for proper education on the use of the chosen method. Your doctor should be supportive and open to discussing your options, please do not feel pressured in to choosing any options you are not 100% certain of or comfortable with.


Copper IUD

The copper IUD is a small t-shaped device that is inserted into the uterus by a doctor. It works by increasing copper ions, prostaglandins and white blood cells within the uterine and tubal fluids. Changing the lining of the uterus, slowing the transport of the egg and inhibiting the sperm's motility and viability in cervical mucus.  Copper IUD’s do not impact ovulation and can be left in for up to 10 years.

Copper IUD’s do not appear to affect fertility or the ability to conceive once removed and are over 99% effective.  The most common side effects include spotting between periods, heavier, longer bleeding that seems to level out within 12 months of insertion in most and cramping or discomfort during periods. Pain during periods tends to be the #1 reason women remove the device.

 There is a small but very serious risk of perforation by the device which can lead to damage of the uterus or infection, resulting in the need for surgery. An IUD may fall out or become displaced.

IUD’s should not be used if you have a copper allergy, Wilson’s disease or a
bleeding disorder.  While there have been reports of copper toxicity, there is currently no research to support this.  Currently only 1 study has linked the copper IUD to depression, although there have been quite a few reports from women noticing a change in their mood. As mentioned above, everyone will react differently so it is important that you pay attention and take note of any changes that arise. Your doctor will remove the device should you decide it is not right for you.

The IUD does not protect against STI’s.


Fertility Awareness Method

Fertility Awareness based methods are a number of tools one can use to track ovulation and therefore prevent pregnancy (or can be used when trying to get pregnant.) Despite what school programs may have had you believe, you cannot get pregnant every day of your cycle.  Once an egg is released from an ovary it will survive for 12-24 hours. Sperm can survive for roughly 5 days as your cervical mucus has the correct pH level and consistency to help keep the sperm alive and travel to the egg. Making you fertile approximately 6 days of the month. The failure rate of these methods is dependant on a number of things like the users skill at tracking, and the methods used. Rhythm methods, which rely on previous cycles to determine your typical fertile days are less reliable as cycles are rarely consistent throughout ones life. Tracking signs such as cervical mucus and basal body temperature have the lowest failure rate when tracked together and used perfectly, and can be up to 99% effective.

It takes a few cycles to get these methods down, and as there is a steep learning curve it is best to work with a certified fertility awareness method educator if you are trying to avoid pregnancy. (Many have instagram pages full of useful information.)

Tracking your menstrual cycles not only promotes body awareness but allows you to take note of any irregularities that may signal an underlying health condition.

Certain lifestyle events may make tracking fertility signs more difficult. If you recently gave birth, are approaching menopause, recently came off of hormonal birth control or recently started menstruating, you may want to use other methods of birth control.

These methods do not protect against STI’s

Condoms

Condoms don’t seem to get a whole lot of love these days. Some people may feel uncomfortable purchasing them, others complain about lack of sensation or intimacy while using them and for others latex can cause irritations or allergic reactions. But when used perfectly condoms have a 2% failure rate and have the added bonus of protection against STI’s and HIV. However, condoms can rip, leak or slip off. It is important that the condom fits the user properly and so it is recommended to take measurements and find the correct sizing.

If you have a latex allergy, polyurethane or lambskin condoms can be used. Natural material condoms, like lambskin, do not provide protection against all types of STI’s 

Always check the expiry date before using condoms.

Please note, the use of oil-based lubricants can cause damage to latex, causing it to split or break.

Diaphragm & Cervical Cap

A diaphragm and cervical cap is a circular dome made out of latex or silicone that fits over the cervix and surrounding area (diaphragm) or the cervix only (cap) and is typically used in conjunction with spermicide (a gel that kills sperm). Neither is one size fits all, so you must visit a health professional to be correctly fitted at which point they will write you a prescription. Insertion may take some getting used to and if you have a weight change of more than 10 lbs you will need to be refitted.  With perfect use it is around 94% effective, and closer to 88% effective when user error is accounted for. It does not protect against STI’s.

The Diaphragm or Cap must be inserted before you plan to have vaginal intercourse as spermicide can take up to 30 minutes to work and must be left in for at least 6 hours after sex. Prescriptions for diaphragms are relatively hard to obtain in Canada as other options like the IUD are in much higher demand. 

The use of spermicide increases the risk of vaginal irritation, STI’s and urinary tract of vaginal infections. 

Sponge

The sponge is a soft disc shape, made of polyurethane foam. Like the diaphragm and cap it works by blocking the cervix so sperm cannot pass. The sponge also contains spermicide. Sponge failure rates range from 9-12% however increase to 20-24% in women who have given birth by vaginal delivery. 

 It can be inserted immediately before vaginal intercourse, or up to 24 hours prior to. It must be left in place for at least 6 hours afterward.

The use of spermicides in the sponge may increase the risk of getting HIV from an infected partner. Allergic reactions may occur due to the active ingredient nonoxynol-9. The sponge does not protect against STI and there have been studies showing irritation of the vagina from sponge use. 

Spermicides 

Vaginal spermicides are inserted into the vagina prior to vaginal intercourse. They are thought to be around 80% effective with perfect use, and around 70% effective with typical use. It is best when used with another barrier method.

Spermicides do not protect against STI’s and may increase the risk of getting HIV from an infected partner. Allergic reactions may occur due to the active ingredient nonoxynol-9.

The Withdrawal Method

While the withdrawal method (withdrawing the penis from the vagina prior to ejaculation) may seem like a last minute, often unplanned form of birth control, when used perfectly it has a 4% failure rate. However, perfection rarely exists in the real world. Typical use sees around 27/100 women becoming unintentionally pregnant. As comforting as it is to know that this method can provide protection should you get caught up in the moment or other methods fail, it takes a lot of self-control to work efficiently. 

This method does not protect against STI’s and is not recommended as a main form of pregnancy prevention.

Remember, there is no perfect form of birth control. Find the option that works best for you

Have fun, stay safe.