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What Do Women Really Want to Know About Birth Control?

Cheryl Lathrop

Last updated: October 20, 2016 7:44 pm

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What do women really want to know about birth control? Listen up health care professionals—it may not be what you think!

Women know what matters most to them and physicians think they know what matters most to women. However, a recent study from Dartmouth 1 says that patients and their physicians were sometimes on the same page. But, at other times they were not! But, you already knew that, didn’t you!

This study gave an online poll to 417 women and 188 healthcare providers. Each participant rated and ranked 34 questions about birth control. Questions were things like: How does it work? Is it safe? How is it used? Does it hurt to use it? How often is it used?

And the results? A little more than half of the 34 questions were similar in importance for both women and their doctors (18 questions). But, for the lesser half, the questions were not similar in importance (16 questions).

Choosing to Use Birth Control

Why is this an issue? Well, with the many choices women have for birth control 2 —permanent vs. reversible, pills vs. IUDs, etc.—you need to discuss your options with your doctor to make an informed choice.

However, it seems doctors tend to think it’s most important to discuss how to use birth control and which methods are most effective at preventing pregnancy—and not safety (maybe because they already know that birth control for a healthy woman is usually safer than pregnancy).

It seems women are more often concerned about safety, side effects, and how the birth control works. In the study, the question rated most important for women was “How does it work to prevent pregnancy?”

Actual ob-gyn practice seems to back up this study. Alyssa Dweck, M.D., coauthor of V is for Vagina 3, finds that her patients most often ask about side effects and effectiveness 4.

Since this study highlights the importance of patient-centered information (what you want to know), and not physician-centered information (what the doctor thinks you should want to know), if your physician is not giving you the information you need, then be proactive and ask questions.

Appointments are short nowadays, so this may be difficult. Go to your appointment with a list so you don’t forget your questions—and also so you don’t get rattled and sidetracked. Keep asking until you get what you need.

It’s important that your doctor answers the questions that are most important to you, whether or not he/she thinks they’re major concerns. So if your doctor isn’t answering all your questions, it might be time to find one that will.

An NPR article quotes Kyla Donnelly, a reproductive health researcher at the Dartmouth’s Institute for Health Policy and Clinical Practice, who led the study: “The main takeaway is really that it’s very important for providers to speak about what’s most important to women.” 5

The study authors say that this research provides insights into what women and their doctors should be discussing. Donnelly is currently working with other researchers to develop guides to help doctors and patients better discuss birth control options.

Methods of Birth Control

Reversible methods include:

(1) Hormonal methods—Prevent ovulation (releasing an egg) in the female. Very reliable. Can be delivered in several ways: via pill, injection (shot), patch, implant, and vaginal ring. Hormonal methods use two basic formulas:

  • Combined (“the pill”): Contains the hormones estrogen and progestin. If you are older than 35 years and smoke, have a history of blood clots or breast cancer, your doctor may advise you not to take the pill. Failure rate 9%.
  • Progestin-only pills (POPs): Contains the hormone progestin for women who can’t take estrogen. Failure rate 9%.

(2) Barrier methods—Keep sperm and egg from uniting. Risks for all these methods include incorrect and inconsistent use.

  • Diaphragm: Placed inside the vagina to cover the cervix to block sperm. Failure rate 12%.
  • Cervical cap: Silicone cup placed inside the vagina to cover the cervix to block sperm. Failure rate 12%.
  • Male condom: Keeps sperm from getting into a woman’s body (worn by men). Failure rate 18%.
  • Female condom: Keeps sperm from getting into a woman’s body (worn by women). Failure rate 21%.
  • Spermacide: Foam, gel, film, suppository, sponge, or tablet placed in the vagina to kill sperm. Also added to other devices to increase effectiveness (e.g., diaphragm). Failure rate 28%.

(3) Intrauterine contraception—An intrauterine device (IUD) is placed inside the female uterus to prevent pregnancy. It can cause increased blood flow and cramping. Less than 1% of users get a serious infection called pelvic inflammatory disease (PID).

  • Copper IUD (hormone free): It can stay in the uterus for up to 10 years. Failure rate: is 0.8%.
  • Progestin-only IUD (releases the hormone progestin): It can stay in the uterus for up to 5 years. Failure rate 0.2%.

(4) Natural methods to prevent pregnancy

  • Abstinence (not having sex): Most effective way to prevent pregnancy. 100% effective! Requires will power.
  • Fertility-awareness method (rhythm): Not having sex on the calendar days that the female is fertile (able to get pregnant). Failure rate 24%.
  • Withdrawal (pull out): Removing the penis before ejaculation. Failure rate 22%.
  • Lactational Amenorrhea Method (breastfeeding): Continuous breastfeeding prevents making a hormone necessary for ovulation. Pregnancy cannot happen if an egg is not released. Highly effective, but temporary.

Irreversible methods include:

(1) Female sterilization—Female tubes are tied, clipped, or blocked so sperm and eggs cannot meet. Surgical risk. Post-sterilization regret. Failure rate 0.5%.

(2) Male sterilization—Vasectomy prevents sperm from reaching the penis. Surgical risk. Post-sterilization regret. Failure rate 0.15%.

A summary chart of effectiveness is available from the CDC.

Questions to ask when considering a birth control method

Your choice of birth control depends on: overall health, age, frequency of sexual activity, number of sexual partners, desire to have children in the future, and family history of certain diseases. Planned Parenthood has a comprehensive FAQ. At the very least, you should ask:

  • Is it reversible or irreversible?
  • Who does the work; who remembers—the male or the female?
  • What are the risks to my health (side effects) with this method?
  • What is the failure rate (percentage) of this method?
  • How do I use this method correctly—what happens if I forget?
  • How often do I have to worry about this method (e.g., take a pill every day vs. replace a device every 10 years)?

NOTE: The best way to reduce the risk of unintended pregnancy is to use effective birth control correctly and consistently. Birth control does not protect against HIV infection and other sexually transmitted diseases (STDs); only a condom will help protect you from STDs. 6

  1. Donnelly KZ, Foster TC, Thompson R. What matters most? The content and concordance of patients’ and providers’ information priorities for contraceptive decision making. Contraception. 2014 Apr 30. doi: 10.1016/j.contraception.2014.04.012. (http://www.ncbi.nlm.nih.gov/pubmed/24863169)  

  2. http://www.healthline.com/health-slideshow/birth-control-methods#1 

  3. http://drdweck.com/the-book-2/ 

  4. http://www.womenshealthmag.com/sex-and-relationships/birth-control-concerns 

  5. http://www.npr.org/blogs/health/2014/06/10/320641019/doctors-dont-know-what-women-want-to-know-about-birth-control 

  6. http://www.webmd.com/sex/birth-control/birth-control-birth-control-methods