As a young teenager, I had a really cheesy poster on my bedroom wall entitled "How to Be a Fabulous Feminist." One of the items on the list was "Visualize perfect birth control." At the age of 14, this confounded me. Weren't the pill and condoms supposed to work pretty much perfectly?
Of course, adults learn that no birth control method is without its flaws. One of the most common methods used by adult couples -- the birth control pill -- is also the one most fraught for many women. The pill can be expensive, and it has many noticeable side effects, ranging from dry eyes and weight gain to blood clots, headaches, and even anxiety and depression. Birth control pills are serious medication that fool a woman's body into thinking and acting as if it were pregnant. Going on or coming off the pill creates a massive change in hormonal body chemistry, affecting one's mood and sense of physical well-being.
Are there "more perfect" options out there -- perhaps non-hormonal options? Today on the main site, I report on a new paper, published in the journal Contraception, arguing that sex-educators and medical researchers give the withdrawal method another look. Yep, that's "pulling out," and although it provides no protection against STIs, one study found couples who use the method perfectly experience only a four percent failure rate in terms of unintended pregnancies, compared to a 2 percent failure rate for the male condom. Of "typical" withdrawal users (those who sometimes mess up), 18 percent will become pregnant over the course of a year, compared to 17 percent of "typical" condom users.
As I write, the implications of all this for sex-education are far from clear. Teenagers are a special demographic group with their own set of risk factors. But what should adults take away from these numbers? According to one study, 56 percent of women rely, at least occasionally, on withdrawal. There is a real desire out there for non-condom, non-hormonal birth control. Monogamous couples do want to prevent pregnancy, but many simply aren't sold on either of the two most popular methods. And withdrawal is not the only -- and probably not the best -- of the alternatives.
"The whole group of non-hormonal options does tend to be treated with a bias," sex-educator Heather Corinna told me. "You do have a lot of reporting from patients saying it’s hard for them to get support from their health care providers against hormonal methods, including diaphragms and cervical caps. Any approach like that from any health care provider is really inappropriate."
It's anecdotal, but it seems true to me. I, for example, am a migraine sufferer who has had trouble finding a birth control pill that doesn't give me more headaches, yet no doctor has ever encouraged me to consider an IUD, cervical cap, or diaphragm. What's to blame? Pharmaceutical companies are highly invested in marketing birth control pills to women and doctors, of course. But it's also a question of simple consumer education -- until women and men are encouraged in school, by their partners, and by the medical profession to visualize birth control that truly works for them, they may not realize there are decent options out there other than the pill. Have we found the "perfect" birth control? Not yet. But there's no reason to stop looking.
--Dana Goldstein
