Welcome to the third installment in a new feature on Of Sex and Love: Science of Sex. In this feature, I plan to discuss the science of sexuality in an easy-to-digest format that’s accessible to the casual reader. I will also follow up with some extended reading material for people who want to know more about the subject of each post.
Barrier methods of birth control, including condoms, cervical caps, diaphragms and the sponge block sperm from moving through the cervix to the uterus, where it would otherwise fertilize an egg. If the barrier becomes compromised, say, by a pinhole or friction, it’s less effective.
Barrier methods are sometimes combined with spermicide in the form of nonoxynol-9. As I mentioned in my previous Science of Sex post on lube, nonoxynol-9 is detrimental to sperm, but it can also have a caustic effect on your sensitive vaginal tissues and can even make it more likely to contract an STI.
Hormonal birth control varies, however. The regular birth control pill, which contains a combination of both estrogen and progestin, a synthetic form of progesterone.
During a woman’s menstrual cycle, estrogen peaks, signaling for her pituitary gland to release other hormones (follicle stimulating hormone and luteinizing hormone, to be specific). This leads to the release of an adult egg, which can be fertilized if sperm makes its way to the egg.
When a woman is on combination birth control, the hormones create a balance and that estrogen spike is prevented from occurring, so no egg is released. Progestin also makes a woman’s uterine lining less ideal for hosting a fertilized egg. Other hormonal birth control methods, including the patch and NuvaRing, work in a similar way.
However, not every form of hormonal birth control contains a combination of hormones. The progestin-only pill (called a POP or mini-pill) lacks estrogen as the name suggests. These pills are less effective than combination birth control. Because they have no estrogen, these forms of birth control may allow more breakthrough bleeding than combination birth control.
Progestin-only birth control may be prescribed to women who are breastfeeding (breastfeeding naturally prevents ovulation, but the mini-pill in addition to breastfeeding is more effective than breastfeeding alone) as well as those who suffer from migraines. Combination pills were once believed to contribute to migraine headaches; however, more recent science suggests that this may not be the case and that combination BC may even help prevent migraines. Nevertheless, taking combination birth control if you already experience migraines with auras might contribute toward strokes.
The Mirena and Skyla IUDs (in the form of levonorgestrel), Implanon, and Depo-Provera are progestin-only BC methods.
Most birth control falls into the category of barrier or hormonal methods, but copper IUDs alone take a different route. Copper IUDs (Paragard in the US) are sometimes known as just a copper-T or coil and work by releasing small amounts of copper into your blood stream. Copper is an effective spermicide without the side effects of nonoxynol-9, damaging sperm so to prevent fertilization. Copper IUDs may also prevent ovulation.
- How Do Birth Control Pills Work?
- Effectiveness of COL-1492, a nonoxynol-9 vaginal gel, on HIV-1 transmission in female sex workers: a randomised controlled trial
- Hormonal Contraceptives and Migraine With Aura—Is There Still a Risk?
- Use of combined hormonal contraceptives among women with migraines and risk of ischemic stroke
- What is Skyla?
- Copper-T intrauterine device and levonorgestrel intrauterine system: biological bases of their mechanism of action
Did you enjoy the second installment of Science of Sex? Do you have further questions or suggestions for next month’s subject? Leave me a comment!