New birth control and old favourites

All you ladies on birth control pay close attention. With newer products showing up on the Canadian birth control market, such as the NuvaRing and the patch, the focus has shifted to a new ideal, replacing the need for daily doses of drugs.

Birth control has been around for centuries, but options for females did not exist until the ’60s, when the first birth control pill, Evonid, was introduced. Today the pill is a far cry from its ancestor in both form and function. Two types are currently available, a mini-pill containing the hormone progestin and the progestin and estrogen combination pill. The mini-pill only caters to certain women.

“For women who are breast-feeding, estrogen may affect the production of breast milk,” said Dr. Brian Hauck, a private practitioner and Calgary Health Region employee. “The mini-pill is better for women after pregnancy who are breast feeding.”

The mini-pill does not control the occurrence of menstruation and has a five per cent or greater failure rate, as compared to the failure rate of one per cent in the combination pill–under ideal conditions.

The combination pill has two forms. Triphasic pills have different levels of hormones every week unlike monophasic pills, which only have a single dose for the entire cycle.

“The rationale behind triphasic pills is they should mimic the menstruation cycle,” said Dr. Lois Milne from University of Calgary Health Services, who added that changes in hormone levels occur naturally.

“Triphasic pills have no advantage over monophasic pills,” said Dr. Hauck. “This is because the dose of progestin is so low in the first week that a missed pill early in the cycle leads to greater susceptibility to pregnancy.”

Similar to the pill, the patch is a thin paper-like bandage that sticks to the skin and releases hormones that is replaced weekly. Although the patch can be used in four main areas, Dr. Milne said there may be a problem when placed on the buttocks, where the patch can move around causing the hormones to fluctuate and reducing the patch’s effectiveness. Side effects are similar to the pill with the additional possibility of a minor rash occurring where the patch is applied.

An uncommon option is the intrauterine device. There are two types of IUDs available today, the Mirena and the Copper-T IUD. These are implanted into the uterus by a doctor in a 15-minute procedure.

“The Copper-T IUD makes the uterus an unfavourable area for implantation,” said Dr. Milne. “This means that a fertilized egg does not implant.”

Although the IUD promises a life free of pill-popping, there are some risks attached. There is a slight risk of cervical or uterine infection which may be caused by the implantation of the device or the device itself. In some extremely severe–and rare–cases, it can cause sterility. However, Dr. Milne assured this is not a common occurrence.

“In terms of an ideal person, women who have children and don’t want to consider [tubal sterilization] or a vasectomy in their partner may choose this option,” said Dr. Milne. “It is also for younger women who cannot use hormone contraceptives who are in a monogamous relationship. Fewer partners means less risk of infection.”

Another non-pill option is Depo Provera, a shot that is administered every three months. It has a very high rate of effectiveness but will not suit a needlephobe. There are also many side effects such as acne, weight gain, bone loss and excessive bleeding during the first year of use.

“[Another] concern we have with Depo Provera is the development of osteoporosis,” said Dr. Milne. “There are studies that suggest a higher incidence of it occurring in women who use Depo for two or more years. This may be due to lack of estrogen.”

So what about the new NuvaRing? It may cater to serial pill-missers and it is better-suited for those who experience problems with high estrogen levels. The ring releases a smaller amount of estrogen into the blood than the lowest dosage in the pill. This lower dose alleviates some side effects associated with estrogen, such as nausea and migraine headaches.

The ring is also simple to use. It is a clear plastic ring with a two-inch diameter. To place it into the vagina, it is folded and pushed in place. If it is not placed properly it can be pushed in further until it sits comfortably. The ring is meant to be used over a period of three weeks, but can remain in the vagina for five and still be effective.

Many women still prefer to stick with the pill or their preferred choice of birth control, and both Dr. Hauck and Dr. Milne said options simply allow women to find what is best for their bodies and personal lives. Both doctors also mentioned condoms.

“There are lots of options out there–latex condoms, non-latex and non-spermicide,” said Dr. Hauck. “There isn’t much of a difference between different brands, condoms are all made the same.”

The Students’ Union has been offering free condoms for seven years. This is a very successful service and SU Vice-President Events Alex Vyskocil wants to keep it that way.

“Students have the opportunity to have safe sex if they choose to have sex at all,” said Vyskocil. “It is a low profile program we offer, because we do not embarrass or even notice a student when they come into the office to grab condoms. I think students appreciate the chance to get free condoms–I have to order a new batch every couple months.”

Sexual Awareness week is a way the SU educates students about sexual well-being.

“Many people in university are exposed to sex during these important years in their life,” said Vyskocil. “It is important to have the opportunity to discuss it.”

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