With my friend Ivy’s sweet baby Mason.
I love snuggling with babies, especially when I can give them back!
Full disclosure: I have never been on birth control in all of my 28 years. There are a few reasons why I’ve chosen not to go on the pill, but, considering having a baby is not in my #3yeargoals plan, I jumped at the opportunity to ask all of the “birth control for dummies” type of questions with an expert. Dr. Palmay was recently given the Reproductive Health Award from the Federation of Medical Women in Canada for her excellence in the field of women’s health, so birth control and reproduction are her specialty! Check out our Q&A below on how to know what birth control is right for you.
1. When and why should a woman consider a birth control option?
The short answer is ANYTIME, but I am guessing you want more specific examples…
This is a very personal decision. As a doctor who sees many young women in various phases of their life, I often open the discussion the moment a young women gets her first period! Although this seems early, it is important as we also prescribe birth control for health issues beyond pregnancy protection, such as irregular periods or painful periods.
If women simply want to address contraception, I think it is essential to think about birth control options if a women plans to be sexually active. The selection of birth control can take some time to make and after, to stabilize in your system. Give enough time prior to having sex so that you can make the most informed choice that is most suitable for you.
2. What are some of the things that a woman should know before going on birth control if she has never been on the pill before?
This is a great question! Firstly, taking a birth control pill requires compliance. Taking the pill late or missing a pill may reduce the efficacy of the pill and open the doors for an unintended pregnancy. Secondly, the birth control pill can take at least 3 months to stabilize in your system and as such, women should not be alarmed with breakthrough bleeding, skin changes, mood fluctuations that may only be temporary. Thirdly the birth control pill does not protect women against STIS. She must use a condom for protection. Finally, it is essential to understand that while the pill is the most commonly used form of birth control, other methods exist that may be more suitable for a women’s lifestyle.
3. Are there different types of birth control that you recommend to women of different ages and in different stages in their lives?
My general approach with patients is not to make assumptions – every woman is unique and has a lifestyle that differs. It is essential for a woman to know ALL of her options prior to making a selection. While the birth control pill is the most routinely prescribed form of birth control in Canada, many other safe and to be frank, more effective options exist. With busy lifestyles, taking a pill the same time every day may not be possible. We have other birth control options known as long acting non daily forms of birth control that are hassle free and do not require having to take a pill the same time every day. I recommend that patients routinely reassess their life and determine if their current choice of birth control is the best suitable option. Things change, life is busy and as such, we need to rethink whether our current status quo is most appropriate.
4. Personally, I’ve always been afraid of experiencing the negative physical side effects of birth control that have happened to my friends. How does one determine which option is best for their body?
Speak to your health care provider re: all the factors I discuss in question 6 below and know that you can always change your mind! In Canada, most women now are eligible for pap smear testing every 3 years and as such, I recommend that at that time, they reassess their contraception choice and update it if needed.
5. What are some of the things that women should look for, and consider, when choosing the best birth control option for them?
1. Health risks that may not make her a candidate – smoking, blood clot history, breast cancer risk – these can be assessed by your health care provider prior to making your selection
2. Lifestyle factors – can you remember to take a pill the same time every day
3. Pregnancy planning – are you planning to get pregnant during the next year, 5 years etc.
6. I’ve never been a fan of taking a lot of prescription drugs or medications, what are the options that will be the least harmful to my body? Is birth control harmful?
This is a difficult question to answer!
Aside from abstinence (not fun!), we must understand that any prescription birth control is a medication and as such, comes with risks and side effects to consider. It is essential to note that not all women should be prescribed hormones. Factors such as risk of blood clots, migraines, smoking status and breast cancer risk are all issues that I discuss with my patients during birth control counseling sessions. Women who have contraindications to using hormones need to rely on other options, but they represent a small portion of my patients. Likewise, side effects such as weight gain, nausea and mood fluctuations may occur. Communicate with your health care provider who can make recommendations to switch your birth control choice. Know that one form is not ideal for every woman and side effects can be minimized or prevented by ensuring that you have an individualized match. Good communication with your health care provider and constant feedback minimizes risks and makes birth control safe.
7. What are some of the birth control options that are currently available that you recommend most?
In Canada, we have a myriad of options:
1. Abstinence (so not fun)!
2. Condoms, diaphragms
3. Birth Control pill – a wide variety of pills that very in composition of estrogen and progesterone
7. IUDs – both copper and hormonal
See www.sexualityandu.ca – great summary!
My personal preference is to recommend alternatives to the pill. I have a young, busy and active patient population and worry that compliance may be an issue. The bottom line is that while I have my own preferences, it is always a patient’s personal choice. My role to ensure that the patient is informed! For a summary of Long Acting Non Daily forms, see www.talkwithyourdoc.ca – I am in a webinar that addresses concerns about the IUD/IUS.
8. Currently, my #3yeargoals do not include getting pregnant or having children, but it is something that fits into where I see myself in five years. What kind of birth control would you recommend for me?
I love it when patients ask my questions after they have reflected on their life goals. This is the best way to make the most informed and best suitable choice for you!
Five years is plenty of time to “pregnancy plan” and really doesn’t limit your birth control choice. Understanding that I know nothing about your health status, of the options available, a pill, patch, ring or 3 year IUS would be appropriate.
9. How quickly does a new birth control take effect?
Once again, this is a great question. If discussing contraception exclusively, given consistent and proper use, most birth control works as contraception within seven days, however I always recommend that patients use a condom for the first month to be safe. Overall, to benefit from other birth control treatments such as cycle regulation, acne reduction, reduced painful periods, I advise patients that these benefits may take up to 3 months to occur.
10. How long does it normally take for a birth control to no longer be effective?
Assume that it is not effective as soon as you stop taking birth control.
11. How much protection does a birth control provide against getting pregnant and STDs? What is the best way to protect your body when you’re sexually active, whether you’re single or in a relationship?
Efficacy in protecting against pregnancy varies depending on the type of birth control selection. The birth control pill is not as effective as commonly believed and other non daily long acting methods may be more suitable if you can’t remember to take a pill the same time every day. Speak to your health care provider regarding statistics or refer to a credible site such as www.sexualityandu.ca.
The only form of birth control that protects against most STIs is a barrier form of contraception such as a condom.
The main point to understand is that no form of birth control is 100% effective and taking control of one’s sexual health means getting informed – ask your health care provider!
12. Is there any other important information that women who are new to birth control should know?
Know that no form of birth control is 100% effective and that various types come with various side effects and failure rates. I often refer patient to a wonderful website (www.sexualityandu.ca) that provides updated Canadian information.
Know that choices exist and that what may be appropriate for your friend, sister or butcher may not be the best choice for you! Update your knowledge from credible sources and start a discussion with your health care provider to ensure that you are making the best choice for you!
Thank you Dr. Palmay!
For more on how to know what birth control is right for you visit BirthControlForMe.ca