Over the years we’ve learned more and more about the pros and cons of taking the birth control pill. And after finding out that it has the potential to negatively affect your libido, digestion, weight, and mood, it’s no surprise many women are thinking twice about oral contraceptives. But where do you turn? Natural family-planning apps, the hormonal IUD, the copper IUD—or condoms alone? The birth control pill is so popular and frequently used, it can push us way out of our comfort zones to even think about trusting anything else.
If you can relate to this, don’t worry because we’ve got your back. We asked some of our favorite doctors—experts on all things hormonal health and integrative wellness—what type of birth control they’ve decided is the best choice for them. Here’s how the pros are preventing pregnancy:
1. I decided I no longer felt good about the pill or the IUD, and then I discovered the Fertility Awareness Method.
“I’ve been on a long journey to arrive at the right birth control method for myself. I never tolerated the birth control pill well (it caused mood, gut, and libido changes for me), though I didn’t know any better, so that didn’t stop me from being on it for seven long years. Sigh. Back in my 20s I did some research, decided I didn’t want to be on exogenous hormones, and switched to the copper IUD. This was better for me than the pill, but as I got even more conscious and in tune with my body in my 30s, I decided I no longer felt good about having a foreign object causing chronic low-grade inflammation in such a tender and sacred part of my body. That’s when I learned about the Fertility Awareness Method. This is the method I use to this day. I like it because a) it works for contraception and fertility planning, b) it requires no exogenous hormones or foreign objects and c) it enables women to get intimately acquainted with their bodies and attuned to their cycle. It’s a beautiful practice. I learned the art of charting from an über-goddess named Katinka Locascio. My only words of caution would be: Do it right by having a consultation with someone who can teach you how to chart, and then chart meticulously. If you do it halfheartedly, side effects may include babies.” —Ellen Vora, M.D.
2. The IUD is the best for my system, and you still ovulate regularly.
“I highly recommend IUDs for my patients. They are low-hormone or hormone-free and are more ‘set it and forget it’ than any other form of birth control. I personally found the IUD reliable and the best for my system. I like IUDs because unlike the pill they don’t interrupt the menstrual cycle—you still ovulate regularly. This means you aren’t masking any deeper hormonal imbalances while on birth control.” —Robin Berzin, M.D.
3. I weighed the pros and cons and decided that the pill was still a good option for me.
“When it comes to birth control, there are many new options that make the oral contraceptive a good choice for many women (and what I use). New formulas have lower hormone levels of both progesterone and estrogen, which lowers the risk of side effects and complications, such as blood clots. Of course, they’re still a hormone medication, so as a physician (and for myself as well), I advise any woman taking them to avoid smoking altogether, and if you take a long plane or car ride, to get up and walk frequently to reduce any clot risk. When it comes to preventing pregnancy, oral contraceptives are very effective when taken as instructed (in fact, having to remember to take them daily is one of the disadvantages). They also have an added benefit in that they can have advantages for some women that are not pregnancy-related: less pelvic pain, lighter periods, reduced risk for ovarian cysts (something I’ve had in the past myself, so I pay attention to that!), improved skin clarity and less acne, and reduced menstrual migraines and PMS.” —Darria Long Gillespie, M.D.
4. I’m tempted to get an IUD but plan on sticking to condoms for now.
“I used the birth control pill and condoms for many years and stopped around age 32. Since I started down the functional medicine path, I’ve been reluctant to use them again. So, for the past 15 years we’ve used condoms for contraception. I’m now perimenopausal, and at times my periods are irregular, so it’s been tempting to get a Mirena IUD, which has a form of progesterone in it and can lessen menses. However, I still don’t want to have the synthetic hormones in me and have refrained. Instead, to manage my cycles, the PMS, and skin changes I use the following supplements. I take CDG EstroBal (it’s got the cruciferous vegetable metabolites I3C and DIM in it), chasteberry tree extract (Vitex), evening primrose oil, and to support the second half of my cycle, I use a progesterone lotion derived from yams (so that I don’t get a period every 20 days!). Additionally, since I went about six weeks a few years ago without a period, I use a period tracker app, which helps me remember when I had my last menses.” —Wendie Trubow, M.D., MBA