We’re bringing Sexy Mac: Learning about your contraception options


Many are making the great leap from contraceptive pills to IUDs. Photo coursey of creative Commons.

Delanee Hawkins

Welcome to a new year of sex advice and conversation! For an introduction on me, why I use the language I do and the mission of this column, go check out The Mac Weekly archives available online. I’m hoping to debut a physical box for questions and comments somewhere in the campus center, so stay tuned for exciting updates. Let’s start the year out with a bang (pun intended) and talk about the wide world of contraceptive devices. Hurray!

Many are making the great leap from contraceptive pills to IUDs. Photo coursey of creative Commons.
Many are making the great leap from contraceptive pills to IUDs. Photo coursey of creative Commons.

Everyone loves condoms. Even if you’re not interested in sex or penises, condoms make fabulous balloons or dorm decor. Unfortunately for many of us educated in the United States, our first experience with sex education involved a semester-long advertisement for abstinence, with condoms mentioned in the last ten minutes of class as a desperate measure only. Now, sex educators often hold up external condoms as the gold standard of contraception, perpetuating the idea that if you just use a condom during sexual intercourse, you won’t get pregnant or contract an STI (sexually transmitted infection). In pamphlets of birth control options, condoms occupy the space at the top of the page, proudly boasting a 98 percent success rate against pregnancy. This number is often quoted to discount other methods of birth control and continue the idealization of condoms. The truth is not so shimmering.

The typical use failure rate of condoms hovers around 20 percent per year. This means that, out of a sample size of 100 people, 15-20 people with uteruses will become pregnant within a calendar year. Yikes! That wasn’t in the curriculum! The message here is not that condoms are bad, unnecessary or ineffective, but that educating oneself about the correct use of condoms is of paramount importance. I’m looking at you, first-years: go to SEXY Training! Or at least spend a few minutes of procrastination time watching videos on how to use a condom effectively, so that that ideal 98 percent success rate applies to you. Additionally, it’s important for every sexually active person to research and decide on a birth control method that is right for them and not just trust in the dominant narrative.

I’m sure by now you or someone you know have made the great leap from contraceptive pills to IUDs (intrauterine devices). Just to get this out of the way: I am biased toward IUDs. Mirena has made this gender-bender stop bleeding out the wazoo without starting T (testosterone) and as anyone who has experienced gender dysphoria knows, the less body horror the better. However, I also know people whose experiences with IUDs were the polar opposite of mine. Bodies react to identical stimuli in startlingly different ways, and any discussion or suggestion of contraceptive methods should be taken with a grain of salt. Nobody, not even your doctor, knows your body better than you.

There are four types of IUD approved for use in the United States: three hormonal and one non-hormonal. The non-hormonal IUD, which works by emitting copper into the uterus to prevent fertilization, is generally the least popular because for some people. Side effects include monstrously heavy and frequent menstruation. Fun times. The other three IUDs, Mirena, Liletta and Skyla, use the hormone progestin to thicken cervical mucus and prevent ovulation. Pregnancy is thus prevented by decreasing both sperm and egg mobility; the sperm can’t make it up past the cervix, and the egg can’t make it down from the ovaries. All four IUDS are about 99 percent effective, in large part because there is no difference between typical and ideal use. You can’t forget to take an IUD or get carried away and decide not to use one. In fact, you shouldn’t have to think about the presence of an IUD at all for at least five years. For those worried about using hormonal contraception, the amount of progestin is so insignificant that over-the-counter menopausal skin creams often contain more hormones than IUDs. This is not so with daily contraceptive pills, which have a typical usage failure rate of around 10 percent, but unfortunately are often accompnied by a host of side effects ranging from weight loss/gain, migraines and feelings of depression.

After that brief (and decidedly non-exhaustive) discussion of hormonal contraception, I’ll wrap up this week’s column by mentioning non-hormonal birth control. My research on the “new” CycleBeads method of birth control actually inspired the column’s theme this week. CycleBeads are the newest evolution of the literally ancient rhythm method of birth control. The rhythm method has previously lurked only in the realm of the conservative religious, many of whom believe that using other types of birth control is analogous to abortion. I predict a trend toward the rhythm method as technology improves and more people realize the high risk, low reward contradiction that often accompanies the contraceptive pill. CycleBeads have a typical use failure rate of 5 percent for those whose menstrual cycles are between 26 and 32 days. The method involves using colored beads to keep track of the days in which pregnancy is most likely, based on when one’s period starts. The high success rate of this method shocked me, since I had always been taught that the rhythm method of birth control was as ineffective as withdrawal. Apparently it can take a bit of tweaking to get the hang of it, but this method may be the non-hormonal solution for those who want an alternative to typical external condoms.

A closing note: condoms are the only method mentioned in this column that are effective in the prevention of STIs. If you are having sex with a penis involved, condoms are necessary not just for preventing pregnancy, but for preventing the spread of disease. In the state of Minnesota since the roll-out of Obamacare and the subsequent increased access to birth control, unplanned pregnancy rates have gone down but STI rates have gone up. Many are theorizing that this trend is a result of free IUDS (with some insurance plans), which have convinced people that they don’t need to use a condom. If you take nothing else from this column this week: learn how to use a condom correctly, and then show off your knowledge.

Every time.