How did you make your choice for a particular contraceptive? The search for which contraceptive was right for me was mainly a lot of self-study and hours on the internet. After all, there are really many options: a traditional ‘pill’ or a spiral? Or a ring? And is a spiral really a spiral? And how reliable is everything? Which method is most commonly used, and why?
Our questionnaire showed that the traditional contraceptive pill (or combined pill) is still the most popular contraception method for the Isala participants. More than 1,500 women (29%) report using it. Many participants, about 17%, also use a hormone coil, and about the same number of participants (17%) use condoms as a contraceptive. Moreover, participants also indicated that they used a vaginal ring (4%), a copper coil (3%), and a mini-pill (2%). Less popular were the contraceptive injection (0.47%), the hormonal implant (0.45%), and the contraceptive patch (0.25%).
Which method is most suitable for you depends very much on you. Each method has its advantages and disadvantages. The big advantage of the condom, for example, is that it also protects (as the only contraceptive method) against various STIs. It is, therefore, definitely recommended if you have multiple sexual partners. But on the other hand, the condom is not very reliable for preventing pregnancies. The contraceptive pill is much more effective in avoiding them. Also, it allows you to regulate your cycle, and it can have positive effects on any acne or painful lines. But if you are not very punctual (like me) and dare to forget a daily pill, perhaps a combination pill (and the mini pill), it is not suitable for you. In that case, a hormone coil may appeal to you (which actually rather has a T-shape, by the way), which you only have to think about every three to five years. In addition, a hormone coil contains a lower concentration of the hormone. It is very reliable, and your periods become much lighter and less painful, or your period will not last. On the other hand, you need a doctor to insert and remove the spiral. The spiral costs plus the insertion are a lot: about 119 to 149 euros for the spiral, excluding your gynecologist’s fee. However, the hormone coil is ultimately very cheap if you look at the years that it is effective, namely 24 to 29 euros per year. If you are younger than 25, you are also entitled to an increased allowance for contraception (including the most commonly used hormone IUDs). After reimbursement from your health insurance, the final cost will be lower. It used to be stated that you should not have an IUD inserted until after pregnancy. Still, it is also perfectly safe to have them placed if you have never been pregnant. A vaginal ring can also be a solution if you don’t want to think about your contraception too often. It shares many of the benefits of the birth control pill. Still, it is relatively expensive, and you can feel it during sex, which can be a major drawback.
On the other hand, more and more women also prefer non-hormonal contraception and opt for the copper spiral. A copper coil can make your period heavier and prolonged, two important reasons for many not to choose it. Here, of course, we have just mentioned a few aspects of the different forms of contraception.
There are many choices, and it is up to every woman to make a choice. Who knows, our Isala research into the relationship between contraceptive use and the vaginal microbiome may help facilitate the selection. In any case, we were already thrilled with the answers from our Isala questionnaire. Apparently, everyone can choose relatively freely. No one indicated that the partner or their beliefs hindered contraception choice.
Our Isala microbiome data showed that using a birth control methods with extra estrogen (combination pill, vaginal ring or patch) was positively associated with more vaginal lactobacilli such as Lactobacillus crispatus, Lactobacillus jensenii and Limosilactobacillus. Use of a hormonal intra-uterine device (IUD containing only progestin) was associated with more Gardnerella and less lactobacilli, so this method seems a bit less beneficial for your microbiome. But as said before, this is only one aspect of the choice you as a women have to make yourself, taking everything into account.