Unplanned Pregnancies 20 Times More Likely on Birth Control Pill than IUD
June 21, 2012
By Dr. Mercola
If you think your birth control pill is the best pregnancy prevention tool there is, you may be surprised by new research looking into its failure rates.
Compared to other forms of protection, the Pill failed miserably, which only adds to the myriad of reasons why you should heavily question its use.
The Pill Fails 20 Times More Often
About 99 percent of sexually active women use at least one method of birth control, the most common of which is the birth control pill (oral contraceptives). The Pill was used by nearly 11 million U.S. women from 2006-2008.i
Meanwhile, nearly half of all pregnancies in the United States are unintended.ii Certainly not all of these are due to a birth control failure, but some of them -- estimates suggest about half -- undoubtedly are. Which brings me to a recent study published in the New England Journal of Medicine.iii Out of the 7,500 women in the study, who used various forms of birth control including an intrauterine device (IUD), implant, birth control pills, patch, ring and contraceptive injection, 334 became pregnant, 156 of which were due to birth control failure.
The contraceptive failure rate among pills, patch or ring was 4.55 percent, compared to 0.27 percent among participants using reversible contraception such as intrauterine devices. The effectiveness—or non-effectiveness—was no different in adolescents or young women. The implications—that birth control pills are 20 times more likely to fail than IUDs—should give some women a pause to think about the method of contraception they want to use.
As for the varying degrees of effectiveness, the Pill must be taken daily, preferably around the same time for it to work its best. Study author Dr. Jeffrey Peipert, a professor of obstetrics and gynecology at Washington University School of Medicine in St. Louis, noted:iv
"This study is the best evidence we have that long-acting reversible methods are far superior to the birth control pill, patch and ring. IUDs and implants are more effective because women can forget about them after clinicians put the devices in place ... If there were a drug for cancer, heart disease or diabetes that was 20 times more effective, we would recommend it first."
Hormone-Based Contraceptives Have Steep Risks
Unintended pregnancy is clearly a big one, but artificially manipulating your hormones using oral contraceptives, the patch or ring, or an injection like Depo-Provera is also a very risky proposition. Most birth control pills are a combination of the derivatives of the hormones estrogen and a synthetic progesterone (progestin). They work by disrupting the hormones in your body, essentially fooling your intricate hormonal reproductive system into producing the following effects:
- Preventing your ovaries from releasing eggs
- Thickening your cervical mucus to help block sperm from fertilizing an egg
- Thinning the lining of your uterus, which would make it difficult for an egg to implant, should it become fertilized
However, it is naive to believe that these are the only impacts the synthetic hormones are having. Your reproductive system does not exist in a bubble ... it is connected to all of your other bodily systems as well. The Pill, too, does not only influence your reproductive status; it's capable of altering much more.
Ten years ago, in 2002, one of the largest and best-designed federal studies of hormone replacement therapy was halted because women taking these synthetic hormones had a such a higher risk of breast cancer, heart attack, stroke and blood clots that continuing forward with the study would have been unethical. The news made headlines because millions of women were already taking these synthetic hormones, but fortunately it prompted many of them to quit. And what do you think happened a year after millions of women quit taking hormone replacement therapy? Incidents of breast cancer fell dramatically -- by 7 percent!
What does this have to do with the Pill? Birth control pills contain the SAME type of synthetic hormones -- estrogen and progestin -- that were used in the ill-fated study!
That's just one risk. Oral contraceptives have been linked to more than two dozen conditions, including heart disease, liver cancer, deep vein thrombosis and inflammatory bowel disease.v Research suggests they are not only carcinogenic (cancer-causing) but also cardiotoxic (toxic to your heart) and endocrine disrupting.
Why I Advise Most Women to Stop Hormonal Contraceptives
Birth control pills are rarely, if ever, necessary or beneficial. In exchange for the convenience of preventing pregnancy (which you can do naturally perhaps even more effectively, and I'll explain how below), you are putting yourself at risk of a myriad of health issues.
A new study in the New England Journal of Medicine revealed that several types of hormone-based birth control methods increased women's risk of heart attack and stroke.vi The link was found between oral contraceptives as well as contraceptive patches and the vaginal ring. Women using the ring were found to have a 2.5 times greater risk of stroke compared to those not using hormonal contraceptives, whereas the other methods increased the risk to varying degrees.
Other known health risks of hormone-based birth control include:
|Cancer: Women who take birth control pills increase their risk of cervical and breast cancers, and possibly liver cancer as well.
||Fatal blood clots: All birth control pills increase your risk of blood clots and subsequent stroke.
||Thinner bones: Women who take birth control pills have lower bone mineral density (BMD) than women who have never used oral contraceptives.
||Impaired muscle gains: A study found that oral contraceptive use impairs muscle gains from resistance exercise training in women.vii
|Long-term sexual dysfunction: The Pill may limit the availability and/or action of testosterone, leading to long-term sexual dysfunction, including decreased desire and arousal.
||Heart disease: Long-term use of birth control pills may increase the buildup of arterial plaque, which may raise your risk of heart disease and cardiac mortality.viii
||Migraines and nausea
||Weight gain and mood changes
|Irregular bleeding or spotting
The other hormonal-based options are not much better. Birth control patches (Ortho Evra) have resulted in an avalanche of lawsuits over the past several years due to the overwhelming health problems women have experienced from using them. One of the reasons the patch is so risky is that you absorb up to 60 percent more synthetic estrogen than if you were taking an oral contraceptive. Side effects of the patch include:
|Raised risk of heart attack and stroke
||Problems wearing contact lenses
||Fluid retention or raised blood pressure
||Skin irritation or rashes at site of patch
As far as injections like Depo-Provera, or depo medroxyprogesterone (DMPA), go, this synthetic analogue of natural progesterone known as a progestin interferes with hormone signaling to prevent your ovaries from releasing eggs. Progestins carry with them a vast array of negative side effects, including:
|Side Effects of Depo-Provera
- Weight gain
- Breast swelling and tenderness
- Decreased sexual desire
- Swelling of the hands and feet
- Abdominal cramps
- Weakness of fatigue
- Leg cramps
- Vaginal discharge or irritation
- Pelvic pain
- Lack of hair growth or excessive hair loss
- Hot flashes
- Joint pain
- Urinary tract infections
- Allergic reactions
- Lack of return to fertility
- Deep vein thrombosis
- Pulmonary embolus
- Breast and cervical cancers
- Abnormal menstrual bleeding
- Increased risk for STDs
- Unexpected breast milk production
- Changes in speech, coordination, or vision
- Swelling of face, ankles or feet
- Mood changes
- Unusual fatigue
Is an IUD a Better Option?
Intrauterine devices are small, plastic, T-shaped sticks with a string attached to the end. The IUD is placed inside the uterus and prevents pregnancy by rendering the sperm unable to fertilize an egg, and by changing the lining of the uterus so that it is less supportive for an embryo. It also works by releasing hormones into your body, specifically a progestin hormone called levonorgestrel, which is often used in birth control pills.
One of its major advantages, and what contributes to its increased effectiveness rate, is that it essentially eliminates the compliance failure issue as all you do is insert it once. There is no daily task to remember to do. However, it, too, carries significant risks, including some that are unique to a foreign body being placed inside your uterus. Among them:
- Pelvic infection: IUDs may lead to pelvic inflammatory disease, a serious infection
- The device may attach to or go through the wall of the uterus
- Pregnancy while using an IUD can be life threatening, and may result in loss of the pregnancy or fertility
- Ovarian cysts may occur
- Bleeding and spotting
Take Charge of Your Body Using Natural Birth Control Methods
You may not be aware that there are many effective and safe methods for preventing pregnancy. Some of the more common, barrier methods are:
- Male condoms: Condoms have a 98 percent effectiveness rate when used correctly. A water-based lubricant will increase the effectiveness; do not use an oil-based lubricant, however, as they break the latex and usually are petrochemical in origin.
- Female condoms: These thin, soft polyurethane pouches fitted inside the vagina before sex are 95 percent effective. Female condoms are less likely to tear than male condoms.
- Diaphragm: Diaphragms, which must be fitted by a doctor, act as a barrier to sperm. When used correctly with spermicidal jellies, they are 92 to 98 percent effective.
- Cervical cap: This heavy rubber cap fits tightly against the cervix and can be left in place for 48 hours. Like the diaphragm, a doctor must fit the cap. Proper fitting enhances the effectiveness above 91 percent.
- Cervical sponges: The sponge, made of polyurethane foam, is moistened with water and inserted into the vagina prior to sex. It works as a barrier between sperm and the cervix, both trapping and absorbing sperm and releasing a spermicide to kill them. It can be left in for up to 24 hours at a time. When used correctly, the sponge is about 89-91 percent effective.
Many people are familiar with these barrier methods, and less familiar with natural family planning (NFP) tools, which a woman uses to track when she is ovulating, and then avoid sex during that time (or does so only using a back-up barrier method). Many women feel empowered by NFP because it allows them to get in touch with their fertility cycle.
Some of the most popular methods include:
- Calendar Method: Abstention from sex during the week the woman is ovulating. This technique works best when a woman's menstrual cycle is very regular. The calendar method doesn't work very well for couples who use it by itself (about a 75 percent success rate), but it can be effective when combined with the temperature and mucus methods described below.
- The Temperature Method: This is a way to pinpoint the day of ovulation so that sex can be avoided for a few days before and after. It involves taking your basal body temperature (your temperature upon first waking) each morning with an accurate "basal" thermometer, and noting the rise in temperature that occurs after ovulation.
Illness or lack of sleep can change your body temperature and make this method unreliable by itself, but when it is combined with the mucus method, it can be an accurate way of assessing fertility. The two methods combined can have a success rate as high as 98 percent.
- The Mucus Method: This involves tracking changes in the amount and texture of vaginal discharge, which reflect rising levels of estrogen in your body. For the first few days after your period, there is often no discharge, but there will be a cloudy, tacky mucus as estrogen starts to rise. When the discharge starts to increase in volume and becomes clear and stringy, ovulation is near. A return to the tacky, cloudy mucus or no discharge means that ovulation has passed.
I encourage you to become actively involved in fertility awareness, and embrace natural family planning or barrier methods that will not interfere with your hormones and health. Some excellent reading to get you started on this path include:
- The Ovulation Method: Natural Family Planning, by John J. Billings
- Taking Charge of Your Fertility: The Definitive Guide to Natural Birth Control, Pregnancy Achievement, and Reproductive Health, by Toni Weschler
- Honoring Our Cycles: A Natural Family Planning Workbook, by Katie Singer