Some methods are safer and have fewer side-effects than others. NFP, for instance, is a ‘natural’ method because it doesn’t involve the use of pills, devices, or chemicals; therefore, it doesn’t cause any side-effects or pose any health risks to the women who use it. Sterilization doesn’t physically affect a person’s hormone levels, sex drive, ability to experience orgasm or cause any other side effects. In rare cases there will be surgical complications such as infections or excessive bleeding and a few people find themselves emotionally upset by the loss of their ability to reproduce. Because there are no known long-term risks, sterilization is considered a very safe method.
Methods such as the cap, diaphragm, condom and spermicides are also very safe and have few side-effects. Occasionally, there will be an allergic reaction to the spermicide or the rubber in these devices, which can sometimes be cleared up by switching to another type of device or brand of spermicide. Occasionally, a diaphragm user is troubled by repeated bladder infections (due to the diaphragm’s pressure on the bladder), which can sometimes be cleared up by changing the size or type of diaphragm. Though bothersome, these allergic reactions and bladder infections are not considered serious because they aren’t major or life-threatening medical problems.
Other methods have a greater number of side-effects and are not as safe to use. The IU D, for instance, may cause side-effects such as period pains, heavier periods and bleeding between periods (breakthrough bleeding). These side-effects may disappear after a few months, but sometimes they are so severe that the device must be removed. The IUD may also cause serious, and even life-threatening, problems. The device can perforate (go through) the muscle wall of the uterus, into the pelvic cavity, although this is rare. Having an IUD in the pelvic cavity could lead to serious problems, so an operation is necessary to remove the device. Another serious problem is that women who do get pregnant despite the IU D may have ectopic pregnancies, pregnancies in which the fertilized ovum implants in the Fallopian tube or some other abnormal location instead of in the uterus. Ectopics can burst the tube, creating a medical emergency and requiring an operation to stop the internal bleeding. They can also cause permanent damage to the reproductive organs, causing infertility (difficulty in getting pregnant) or sterility (the inability to become pregnant at all). Fortunately, though, perforations and ectopics are rare.
If a woman already has, or gets, pelvic inflammatory disease (PID) – an infection of the uterus, Fallopian tubes and ovaries – an IUD can make it worse. PID can cause a woman to be hospitalized, damage her reproductive organs so that she’s infertile or sterile, lead to chronic pelvic pain and repeated infections, and in some cases it may be necessary to surgically remove the woman’s reproductive organs. In rare cases, PID can be fatal. Of course, most IUD users don’t ever develop PID. But, because of the risk of infertility, this method is not recommended for young women or any woman who may want to have children in the future. Because the chance of getting PID is also greater if a woman has more than one sexual partner, or a sexual partner who may have other partners, this method is not recommended for such women, regardless of their future childbearing plans.
The pill also causes side-effects in some women. Pill users sometimes experience weight gain, sore breasts, headaches and nausea, especially at first. There are also a number of other side-effects. Luckily, most women don’t have severe side-effects. When they do, switching to another type or brand of pill may help, but some women have to stop using the pill because of the side-effects.
The pill does not have as good a safety record as some of the other methods. For example, the mini-pill sometimes causes ectopic pregnancies in the small number of women who become pregnant while taking it. The combined pill has caused fatal and non-fatal blood clots in the heart or brain in some users. For a healthy, young pill-user who doesn’t smoke, the chances of a blood clot are very small. However, the risk for women over the age of 45 and smokers over 35 is much higher, which is why doctors usually don’t prescribe combined pills for such women.
The pill has also been associated with other fatal and non-fatal medical problems. In addition, some doctors think that the pill may cause certain kinds of cancer in a small number of the women who use it. Other doctors think that the pill doesn’t cause cancer and that it actually protects against certain kinds of cancer. More research is needed before we can say for sure what the long-term effects of the pill are. However, from what we know now, the pill appears to be safe for young, healthy women.
The injectable contraceptive can also cause side effects such as longer periods, spotting between periods, or no periods at all. Some women experience weight gain, headaches, dizziness, decreased sex drive or allergic reactions, though these are rare. It sometimes takes a number of months for women to begin ovulating, menstruating and being fertile again after they stop using this method. There have been some women who never resumed ovulating and menstruating, but it is not clear if the injectable contraceptive was responsible for the problem in these cases. Some doctors have been concerned that some users of this method might have an increased chance of breast cancer because of laboratory studies done on dogs; other experts don’t think there is any risk. Here again, more research is needed. But from what we know, this method is considered a very safe one, safer, in fact, than the pill.
When they hear about the side-effects and safety problems of some methods, the young people in our class often wonder why women don’t just use the safer methods, the ones with fewer side-effects. Some, of course, do choose these methods for just this reason. However, these other methods are often less convenient to use and sometimes less effective as well. Besides, the chances of having a serious or life-threatening medical problem are very small with all of the methods we’ve been discussing. In fact, a woman would be more likely to die from a complication of pregnancy or childbirth than she would from a problem caused by her method of birth control. So, although it’s true that there are risks with certain methods, the risks are relatively small for young, healthy women.
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