Non-hormonal birth control - worth trying?

Which non-hormonal birth control is best?

While the pill persists as the most popular contraceptive choice for many women, there are plenty of non-hormonal forms of birth control which may be more appealing or suitable for some. Hormonal contraception can cause side effects and presents possible health risk which means this isn’t an option for some women. Let’s look at some of the alternatives. 

 

What types of non-hormonal birth control are there?

There are four types of non-hormonal birth control: 

  • Barrier methods
  • Natural family planning
  • The copper IUD
  • Sterilisation 

Barrier methods work by stopping sperm from entering the uterus. Natural family planning involves tracking your cycle to be aware of when you are fertile so you can plan around this and the copper IUD becomes toxic to sperm by releasing copper into the womb. Sterilisation is a permanent solution for women who don’t want any more children, or who never want any. 

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Barrier methods 

Barrier methods are convenient and generally easy to use. They include:

  • Male condoms
  • Female condoms
  • Diaphragm or cap
  • Sponges 
  • Spermicide 

 

Condoms

Condoms are the most popular and readily available barrier method and also the easiest to use. They are the only type of contraception which protect against STIs and they are more effective than the other methods in this category. They are a thin, stretchy length of latex which is placed over the man’s penis before sex. Female condoms work in a similar way but they are placed inside the vagina. 

 

Diaphragm or cap

A diaphragm is a small, dome-shaped device made from silicone. It’s placed inside the vagina before sex, creating a barrier in front of the cervix. It should be used with spermicide, a contraceptive gel, in order to be properly effective, and is reusable. Once it’s in place, it needs to be left in for up to six hours after having sex. A cap is a smaller version of a diaphragm and can be left in longer. 

 

Spermicide 

Spermicide is a gel and a chemical which kills off sperm. It’s not overly effective on its own and is usually used in conjunction with something like a diaphragm or sponge. It can cause skin irritation in some people so if you do experience this, it might not be a suitable option. 

 

Sponge

The contraceptive sponge is a soft piece of silicone based material which is inserted into the vagina before sex, in a similar way to a diaphragm. It can be left in for up to 24 hours and should be discarded afterwards. While this is the least effective form of contraception, it is known for being comfortable to use. 

 

Natural family planning

This is also known as fertility awareness and involves using nothing, but monitoring your cycle and signs of fertility to avoid sex during this time. This is a good option for women of certain religious faith and for those who want a natural solution. When followed correctly, this can be 99% effective but it takes time to learn how to do it correctly and involves commitment. 

You’ll need to attend fertility awareness classes, monitor and record your temperature and vaginal discharge daily. During the times when you are fertile, you will either need to abstain from sex or use condoms so that you don’t fall pregnant. 

 

Copper IUD

The IUD (intrauterine device) is more commonly called the coil. It’s a small, t-shaped device made from plastic and copper which is inserted into the base of the womb to prevent pregnancy. It works by releasing copper into the womb which kills off sperm and is very effective. 

Getting it inserted can be an uncomfortable experience. It involves a short procedure which must be undertaken by a doctor. Afterwards, it’s normal to experience cramps and discomfort but this eases off after a day or two. During the first 6 weeks, you’re at a heightened risk of infection and you’ll need to go back for a check-up to make sure that everything is okay.

The coil can cause your periods to become heavier and more painful but it doesn’t cause any of the side effects that you get with hormonal contraception and once it’s in, it lasts for 10 years. You can get it taken out at any time and your fertility will return immediately. 

 

Sterilisation 

Sterilisation involves having your fallopian tubes sealed off so that you can’t become pregnant. This is a permanent solution which involves a surgical procedure and is effective in 99% of cases. It can be difficult to be seen as eligible for this procedure. Many women report that doctors they have seen refuse to consider it if the woman is under 30 or haven’t yet had children. They are also often asked if their husband or partner consents to it. 

 

Which non-hormonal contraceptive is most effective? 

No contraceptive is 100%. Even with sterilisation, there is a possibility that it won’t work properly and in rare cases, the fallopian tubes can rejoin by themselves. There will also be a period of time after the operation when you’ll need to continue using contraception for 1-3 months. 

The effectiveness of each one are as follows:

  • Sterilisation- 99%
  • Copper IUD- 99%
  • Condoms- 96-98%
  • Female condoms- 95%
  • Diaphragm/cap- 92-96%
  • Sponge- 76-85%
  • Spermicide- 70-80%

The copper IUD is the most effective at preventing pregnancy for women who do not want to go through sterilisation, or who are unable to. The IUD can cause some complications, however. These include: 

  • Pelvic infections
  • The device falling out or moving
  • Damage to the womb
  • Ectopic pregnancy should the coil fail

These risks are rare but it’s important to consider all this before deciding to go ahead with it. The coil has two threads attached to it which hang down towards the top of the vagina. This allows you to check it on a regular basis to ensure it’s still in the right place. 

 

Why should I avoid hormonal contraception? 

Hormonal contraception is a valid choice and it works well for many women. However, it’s not suitable for everyone and can pose a health risk for some. It may also not be compatible with certain religious or cultural beliefs. Hormonal contraception is not advised for the following groups: 

  • Smokers over 35
  • Heavy smokers
  • Women who are very overweight
  • Those with high blood pressure
  • Anyone with a blood clot or history of them
  • Those with a family history of blood clots
  • Women with heart problems or a personal or family history of them
  • Diabetic women
  • Women with liver or kidney issues
  • Women with a history or family history of breast cancer 

In these cases, hormonal contraception can increase the risk of experiencing a blood clot or exacerbate existing conditions. It also shouldn’t be taken in conjunction with the following medications:

  • Rifampicin and Rifabutin which are types of antibiotics
  • Epilepsy treatments
  • HIV medications 
  • St John’s wort

Some women experience continued side effects when using hormonal contraception and may wish to switch to a different type of birth control because of this. Common side effects include: 

  • Mood swings
  • Nausea
  • Headaches
  • Bloating
  • Breast tenderness
  • Lack of sex drive 
  • Depression 
  • Anxiety 
  • Breakthrough bleeding and spotting 
  • Weight gain

Overall, it’s best to evaluate the different options that are available so that you can figure out what’s going to be best for you. Everyone’s body is different so your friends’ experiences may be completely different from yours. The important thing is to be comfortable and confident with your choice of birth control. 

 

Sources

Healthline> What are my options for non-hormonal birth control?: https://www.healthline.com/health/birth-control/non-hormonal-birth-control

NHS> Your Contraception Guide: https://www.nhs.uk/conditions/contraception/

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