Birth control, although many believe it is primarily for preventing pregnancy, can also be used for a variety of conditions as well. Throughout the past few years, more options have become available for birth control. There are several different dosage forms available ranging from oral, transdermal, intravaginal, and intrauterine devices. Each woman will prefer a birth control method based on their daily life and their co-existing health conditions.
Disease Synthesis:
There are 3 main phases of the menstrual cycle, the follicular phase, ovulation, and the luteal phase. During the follicular phase follicles develop and there is a secretion of estrogen. Then there is one dominant follicle that releases the ova. Once the ova is released LH is stimulated in the luteal phase. This causes the release of estrogen and progesterone which in return decreases the levels of LH and FSH. When the levels of LH and FSH are low the woman begins her period. Most women start their menstrual cycle around age 12 and have their menstrual cycle until about their late 40s or early 50s.
Signs & Symptoms:
There are no specific underlying signs and symptoms that contribute to the use or need of birth control. However, many women start to utilize birth control to prevent pregnancy once they become sexually active. Other women may utilize birth control to help cure acne or painful periods in addition to premenstrual syndrome symptoms (PMS).
Contributing Factors & those at risk:
Almost all women will have a menstrual cycle every month. Although there is nobody at risk for needing birth control more than others, those individuals who are engaging in risky sexual behaviors may be more inclined to utilize birth control. Women who have bad acne or PMS symptoms may also be more inclined to use birth control as these assist with those conditions. Some birth control methods can also eliminate a period together from happening each month.
Holistic Treatments:
The most effective holistic treatment is abstinence, but most people will not be abstinent for their entire lives, so there are alternative methods.
Barrier methods must be used every time you have sex, and these include condoms, cervical caps, sponges, and diaphragms. The other holistic treatment method for birth control involves avoiding sex on days when the woman is most fertile and most likely to become pregnant. This method heavily relies on the ovulation cycle, which can be hard to track and is not the most effective birth control method.
Treatments:
There are several different types of birth control options, and these choices rely heavily on patient preferences. These choices are listed below along with some of the more common side effects of each option.
Hormonal Pills
- Combined oral contraceptive (COC)
- Desogestrel-containing pills may reduce acne, fluid retention, and lipid levels in the blood
- Side effects: increased risk for blood clots, bleeding, nausea, headache
- Not recommended in women who smoke
Progestin-only
- Can be used in women who smoke or are breastfeeding
- May be less effective than COC
- Side effects: Bleeding, nausea, weight gain, menstrual irregularity
Emergency Contraception: Ulipristal (Ella)
- Can be used up to 5 days after unprotected sex
- Can also be used to treat uterine fibroids
- Side effects: abdominal pain, loss of period, headache, nausea, breakthrough bleeding
Patch (COC)
- Applied and changed weekly for 3 weeks, then not used one week and restart cycle after week off
- Depending on the brand, might improve acne, fluid retention, and lipid levels
- Side effects: increased risk for blood clots, bleeding, nausea, headache
Ring (COC)
- Used for 3 weeks then taken out for one week, then replaced
- Depending on the brand, might improve acne, fluid retention, and lipid levels
- Side effects: increased risk for blood clots, bleeding, nausea, headache, weight gain
Injectable
- Can treat loss of period, abnormal uterine bleeding, hot flashes, endometriosis
- Injected every 3 months; must be given within 5 days of period onset or birth (unless breastfeeding, then wait 6 weeks after birth)
- Side effects: abdominal pain, headache, weight gain, irregular periods, increased risk of blood clots
Intrauterine Device (IUD)- Both types are highly effective at preventing pregnancy and reversible
Hormonal (Levonorgestrel)
- Must be inserted by a physician
- Last 3-6 years
- Works by making a less hospitable environment for pregnancy, thickens cervical mucus
- Side effects: uncommon, but risk for cervical or uterine perforation, vaginal discharge, pain upon insertion, pelvic inflammatory disease
Non-Hormonal (Copper)
- Makes the uterus produce fluid that kills sperm
- Lasts 10 years
- Doesn’t interfere with natural hormones
- Can make period heavier and more painful, uterine perforation, pelvic inflammatory disease
Implant (Etonogestrel)
- Placed in the upper arm, up to 3 years of use
- Progestin only, very effective, reversible
- Must be implanted by a physician
- Can be used in women over 40
- Does not protect against STDs
- Side effects injection site pain, allergic reaction, changes in menstrual bleeding, spotting, weight gain, nausea, infection after insertion
Surgery
- Surgical removal of the fallopian tubes and/or uterus is the only form of guaranteed, permanent birth control
Adverse Effects of Treatments:
The most common adverse effects of taking birth control include headaches, irregular bleeding, nausea, and weight gain. Some women may have venous thromboembolism as a result of taking birth control.
References:
- Takahashi TA, Johnson KM. Menopause. Med Clin North Am. 2015 May;99(3):521-34. doi: 10.1016/j.mcna.2015.01.006. PMID: 25841598.
- Martin Lopez JE. Candidiasis (vulvovaginal). BMJ Clin Evid. 2015 Mar 16;2015:0815. PMID: 25775428; PMCID: PMC4360556.
- Belayneh M, Sehn E, Korownyk C. Recurrent vulvovaginal candidiasis. Can Fam Physician. 2017 Jun;63(6):455. PMID: 28615397; PMCID: PMC5471085.
- Donders GG, Mertens I, Bellen G, Pelckmans S. Self-elimination of risk factors for recurrent vaginal candidosis. Mycoses. 2011 Jan;54(1):39-45. doi: 10.1111/j.1439-0507.2009.01754.x. PMID: 19780979.
- InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Vaginal yeast infection (thrush): Overview. 2019 Jun 19.Available from: https://www.ncbi.nlm.nih.gov/books/NBK543220/
Mac Bride, M. B., Rhodes, D. J., & Shuster, L. T. (2010). Vulvovaginal atrophy. Mayo Clinic proceedings, 85(1), 87–94. https://doi.org/10.4065/mcp.2009.0413
