No Sex, No Pill?
Should you stay on birth control while he's deployed?
By Josie Cellone
Day after day, pill after pill, taking birth control when your husband is deployed can feel like a constant reminder that you're not having sex.
In the parlance of Carrie Bradshaw, we had to ask: If there's no chance you're going to get pregnant, what's the point of the pill?
Dr. Jacqueline Thompson, an ob/gyn at Womack Army Medical Center in Fort Bragg, N.C., argues that birth control can help regulate other aspects of a woman’s health.
“If you go off of your pill because your husband is in Afghanistan and you don’t need that birth control, your periods can become annoyingly long or annoyingly heavy or simply unpredictable,” said Lt. Col. Thompson, who currently serves with the U.S. Army Reserve Medical Corps.
In Thompson’s opinion, if a woman has been on the pill for as long as six months to a year and she’s comfortable with it, the birth control is almost secondary to the menstrual control.
PRESCRIPTION: LIFESTYLE
Birth control should be about convenience and family planning, said Dr. Vanessa Cullins, vice president for medical affairs with the Planned Parenthood Federation of America. It allows women to get pregnant when they want to get pregnant. Each year, about half of all pregnancies are unintended, Cullins said.
“The best method for the woman is the one she wants and that fits into her lifestyle,” Cullins said. “It’s up to her whether she wants to stop during deployment and whether she can carry out the advance planning in order to start the method before her husband returns.”
PREGNANT PAUSE
Today women have an array of options for birth control, from the 28-day estrogen pill regimen to a progestin-releasing intrauterine device (IUD) that prevents pregnancy for five years.
The IUD, sold under the brand name Mirena, is a flexible T-shaped device that’s inserted into the uterus and suppresses regrowth in the uterine lining. Many women with an IUD stop menstruating. Even though the implant can be as effective as sterilization, women can become pregnant within one month of removing it, Thompson said.
“Women who already have an IUD in place when their spouse deploys don’t have to think about changing their birth control method,” Thompson said. “It can be taken out at any time and you can return to ovulation within the first month after you remove it.
BREAK THE CYCLE
Jill Pearson, 34, of Little Silver, N.J., uses an extended regimen of oral contraceptives. Pearson said she likes the daily routine of taking a pill, but prefers to only get her period every three months.
“I sort of joke, I don’t know why anyone wouldn’t take it,” Pearson said. “I get my period so few times a year, and I get to decide when I have it. To me, it’s such a no-brainer.”
Pearson started on Seasonale, which is now available generically, and said it helped control migraines she got from hormonal fluctuations. A similar prescription called Seasonique can be an option for women who are juggling multiple responsibilities at home – perhaps acting as a single parent during deployment – and want one less thing to worry about, such as monthly periods.
HORMONE HOLIDAY
One concern for women who have taken birth control pills for more than a decade can be exposure to hormones. But those fears are unfounded, both doctors claim.
Thompson said there’s absolutely no evidence that long-term use of birth control can have adverse effects on your health. In fact, for healthy women – those who don’t smoke and who don’t have diabetes or hypertension – staying on the pill can lower their risk of ovarian and uterine cancer, she said.
“Risk does not accrue over time,” Thompson said, a medical truth backed up Cullins.
“For women who are using hormonal contraception, there is no need to have a hormone-free holiday,” Cullins said. “We used to think that after several years on the pill, it made medical sense to take a break for a couple months. That does not need to be done. The dosages of hormones in modern methods are very low.”
If women experience side effects, such as nausea or fatigue, they need to find a new pill formula or different method.
“All modern methods are very safe,” Cullins said. “You need to find a formulation you feel normal on, that fits neatly into your lifestyle.”
FERTILE GROUND
For women who want to start birth control for the first time before the homecoming, it’s best to start two to three months before they need to rely on it.
“You’re not always sure what your body will tolerate,” Thompson said. First-time users may have to try a couple brands before they become comfortable with a particular dosage.
In reality, she added, women who have used the pill successfully in the past can be protected within two weeks if they start taking their pill the first day of bleeding of any given cycle.
NOT SURE WHAT TO USE?
The American College of Obstetricians and Gynecologists posts in-depth descriptions of each form of birth control online. If you want to do some research before meeting with your doctor, click here. Here are some excerpts:
THE PILL
Most pills come in packs of 28, where one pill is taken at the same time every day. The pill is the most popular form of birth control, with brands offering different combinations of hormones to match with each woman’s body chemistry. Women on the pill typically get a regular period once a month.
THE EXTENDED REGIMEN
A variation on the classic birth control pill. Women on the extended regimen take “active” pills for three months, rather than three weeks, and only have four periods a year.
THE PATCH
The adhesive patch is worn on the skin on the buttocks, upper back or arm or abdomen, and estrogen and progestin are absorbed into the bloodstream. A patch is worn for a week at a time, three weeks in a row. During the fourth week, you don’t wear anything while you get your period. Then the cycle repeats.
THE RING
The ring is a flexible, plastic ring that a woman can insert herself. It releases both estrogen and progestin. The ring is worn for 21 days, removed for seven days when you’ll get your period, and then a new ring is inserted.
THE SHOT
Not for the needle-adverse. Depo Provera is a hormone injection that lasts for three months to prevent pregnancy and does not contain any estrogen. Many women stop getting their period and like it because they only have to think about birth control every three months – but a doctor’s visit is mandatory.
THE IUD
The IUD is a small, T-shaped, plastic device that is inserted by a doctor and left inside the uterus to prevent pregnancy. The hormonal IUD must be replaced every five years; the copper IUD lasts 10 years. Often recommended for women who already have children because insertion can be uncomfortable, but any woman in a monogamous relationship can request it. Fertility returns when the IUD is removed.
More questions? Visit the “My Method” online tool by clicking here. Women answer a series of questions and are provided with a recommendation for the type of birth control that might be most appropriate to their lifestyle.