Contraception is widely thought of just as a form of preventing pregnancy. But what many people don't know are the various reasons as to why a gynecologist could prescribe birth control. Ozarks at Large's Eva Mundo reports.
Dr. Luann Racher is an OB-GYN and associate professor at the University of Arkansas for Medical Sciences. She says the two main reasons that women go on birth control beyond preventing pregnancies are to lighten periods or reduce pain.
"For women who have conditions that cause pain, suppressing their period or lightening it when they're on some kind of hormonal contraception can be really beneficial. Some women can actually bleed so much that they become anemic. And that can even be severe anemia to the point of needing a blood transfusion. So if periods are very heavy, we put them on hormonal contraception. And that reduces the amount of bleeding that they have."
Racher says that birth control can help treat hormone-related headaches and premenstrual dysphoric disorder, which can cause severe mood disorders and even suicidal thoughts. She also says there can be a reduction in breast cancer and endometrial cancer with long-term use.
"Especially for women who have PCOS or very irregular periods where they go for months and months without having a period, that can increase your risk of cancer in the uterus, and treating that with a progesterone, which is a hormone in contraceptives, then that can reduce that risk."
To taking hormonal contraception can vary greatly from person to person. There are two different types, one which has the hormones estrogen and progesterone in it, typically found in the birth control pills, patches or rings. There are also options with progesterone only. IUD devices are inserted in the uterus, where some can remain for up to eight years. Another option is to receive shots of the hormone, which are given every three months. A third option is Nexplanon implants, which are inserted in the arm, lasting up to five years.
Providers take into consideration a patient's preferences when picking a form of contraception, like if someone is forgetful about taking pills. They also consider the given patient's specific health needs. For example, Racher says that women with histories of cardiovascular disease, blood clots or other high-risk conditions shouldn't take estrogen because it increases risks of having a stroke or heart attack. But there are also negative connotations that surround birth control, especially for teenage girls.
"So let's say we have a teenager who comes in, she's not sexually active. Or maybe she is. She's, we could say, 14 and her parents bring her in and she's having very heavy, painful periods. It's causing her to miss school. And they want to talk about what options are. Sometimes we hear that parents will be a little bit nervous to put their adolescent on birth control pills because they feel like it's opening the door for sexual activity, something like that. So we go through that a lot. This is a medication. It has more than one use. It's not just a permission slip to go out and have sex. It is to treat a problem that is going on and it's the best way to treat it."
Dr. Nirvana Manning is an OB-GYN and chair of the Department of Obstetrics and Gynecology at UAMS. She says that controlling period cycles is a major reason why gynecologists may recommend birth control to teenage girls. However, common misconceptions lead patients to be hesitant, with one of the biggest worries being weight gain.
"That's one of the misconceptions that we try to dispel really early. And I always joke that it's not our parents' birth control. The doses which these birth controls now come are so low, and the risk of weight gain is so small. A lot of parents also are very concerned about the hormonal aspect of it. And the way these work is, essentially, we give them a steady state of hormonal stimulation that allows, in many cases, their ovaries to not ovulate. So we kind of take over for their ovaries. So the amount of hormones that they're receiving is significantly lower than what their body would receive otherwise."
Manning says that a decrease in ovulation in a lifetime leads to decreased risk of ovarian cancer. Birth control can also help treat higher-risk patients, including obese patients, who are at risk of endometrial cancer.
"I've seen endometrial cancer as young as in their late 20s, with women that are morbidly obese using a progesterone-only birth control, and whether that be in the form of a pill or a long-acting reversible contraception such as a Mirena or a Nexplanon, that actually can reduce their risk of endometrial cancer."
She also says that for patients wanting to maintain fertility, they were able to use an IUD to treat something called endometrial hyperplasia, a precursor to endometrial cancer. But Manning says that age-related misconceptions are still holding some women back from using some forms of contraception. She says that women around 22 and younger tend to opt for Nexplanon devices rather than IUDs if they are choosing a long-acting reversible contraception. This is opposed to women in their mid to late 20s who lean more towards IUDs.
"I think some of those as cultural, some of it is just kind of what you've been grown up with. When you do a Google search and you look up some of these things, many of the people have negative connotations or negative comments to say that. What I remind them is that most people that are happy with their products are not going online and writing soliloquies. I think the take home is talk to your provider. And if you do research and your provider doesn't offer the kind of contraception you think you want, find someone that will talk to you."
Manning says that dispelling these misconceptions comes down to talking with trusted individuals, peers or family members, and going over the safest, most effective options. For more resources and information about contraception, go here.
Ozarks at Large transcripts are created on a rush deadline and edited for length and clarity. Copy editors utilize AI tools to review work. KUAF does not publish content created by AI. Please reach out to kuafinfo@uark.edu to report an issue. The audio version is the authoritative record of KUAF programming.
