Finding The Right Alternatives To The Pill

Finding The Right Alternatives To The Pill

Following on from some drama surrounding the AstraZeneca vaccine, it came to light for many that the traditional pill also comes with a risk of blood clots. This may not be a deal-breaker for those who use the pill for one of many other health reasons they can help with (not sure what those are? Don’t worry, we’ve got you covered) but it can be for others. So, in this article, we’ll be talking about the many different options that are available to you.

Of course, we wouldn’t be doing our duty if we didn’t talk about the pros and cons of each of the alternatives to the pill. So, this isn’t just about telling you that you should definitely get one over any other. It’s all about finding out what works for you, your body and your mind. Sadly, many doctors approach birth control with the same, generic outlook. If it stops eggs from being fertilised, then they’re generally pretty happy with the outcome. Unfortunately, that outcome can include some detrimental side effects.

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The good news, however, is that there are many different options out there. While we’re not your doctor, and we don’t have access to your medical history, we can give generic advice with a bit more detail. After all, we’re not limited by office hours. There are 11 main methods of contraception, which are approved by the NHS, although all to differing degrees. One of these is the pill… but there are over 20 different brand-name combination and progesterone-only pills. That’s a lot of different types, with different side effects, and different benefits. So – instead – we’ll be focusing on alternatives to the pill, for now.

What Are Blood Clots?

A blood clot is a lump of blood cells that have come together to create a semisolid state. Similar in consistency to gel, the danger isn’t in the clot itself, but if the clot moves and blocks an important passage in the body. They may also build up over time, causing stress to the body and blocking passages. While clots are helpful in healing wounds – stopping you from bleeding consistently and preventing infection through open wounds – they can be dangerous if they cause a blockage.

Preventing blood flow stops oxygen from circulating around the body, which can lead to strokes (called Ischaemic strokes), pain and/or paralysis in part or all of the body. In the lungs, this is called a pulmonary embolism, while blood clots in one of the major veins are called Deep Vein Thrombosis (DVT). The most common area of the body for blood clots issues is in the legs.

Talk to your doctor about alternatives to the pill - The Live Life
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People with underlying medical illnesses that affect blood clot creation are often described as suffering from thrombophilia. An example of one of these is Factor V Leiden. Of course, if you have a condition similar to this, your doctor should already know that there is a higher risk of blood clotting issues, and should prescribe contraception accordingly.

One of the best ways to avoid blood clots is to stay active. You should also drink plenty of water to avoid dehydration. Those who smoke, those who have a high level of cholesterol or those who have a high body fat percentage are also more likely to suffer from strokes. Most importantly to this article, however, those who take a combined form of hormonal medication also have a higher risk of developing blood clots.

What You Should Do If You Suspect A Blood Clot

If you’re worried about blood clots in general, call your doctor and ask for a chat. This can be done over the phone or in person, if you prefer. For future reference, the general guidance from the NHS is to check for “throbbing or cramping pain, swelling, redness and warmth in a leg or arm”. Similarly, “sudden breathlessness, sharp chest pain (may be worse when you breathe in) and a cough or coughing up blood” may be a sign of a clot in the lungs. If you’re ever in doubt, call 111 and they will guide you through what to do next.

Why Should I Consider Alternatives To The Pill?

If you’re reading this, then the chances are that you’re already unhappy with the pill. Of course, for others, it may be that you know you can’t take the pill due to interactions with other medication or underlying medical differences. Either way, it’s important to work with what’s right for your body. Some of the most common reasons why people want to know more about alternatives to the pill include:

  • Spotting between periods (blood leaking when you’re not on your period)
  • Missed periods
  • Nausea
  • Migraines and headaches
  • Weight changes
  • Mood changes
  • Libido (sex drive) changes
  • Tenderness around the breasts
  • Changes in discharge
  • Changes in the eye (thickening of the cornea)
  • And, of course, increased risk of blood clots

And while many of these side effects can be altered with changes in the type of pill, some find that the majority of the types come with the same issues. Then, of course, there are the added risks for those with preexisting conditions. So, for those with untreated hypotension, a history of cancer in the family or those who smoke and are over 35, the side effects can be more severe and the risks increase in likelihood.

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Now, most doctors will take all of this into consideration. That being said, there are a number of reasons why these details can be missed. Sometimes, notes can go missing if you change practices, for example. So, if you still want to try the pill (or if you’re considering the injection, patch or hormonal coil – we’ll get into this later), then it’s worth just giving your doctor a gentle reminder of your medical history.

It’s Not All Risk And No Reward

Don’t forget, of course, that there are many wonderful benefits to taking the pill. For people with PCOS, endometriosis, POI and many more health concerns, taking the pill can be a lifesaver. Sadly, I can mean that quite literally. This article isn’t about choosing one over the other, and rather about finding what works for you. You know your own body best, and it is your right to choose the right medication for your needs.

Different types of pill - The Live Life
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Also, it’s worth noting for those who use no contraception at all that, typically, 85 in 100 people with a uterus will get pregnant within a year. So, there’s no denying that the pill can greatly help those families who aren’t looking to conceive, with the odds reducing to 8 in 100 on the combined or mini-pill. However, it might simply be that taking a daily pill can be a bit of a pain. Especially if, like me, you can be pretty forgetful at times. So, let’s get into some of those alternatives to the pill, shall we?

Alternatives To The Pill

Just a quick note before we get into these. If you’re thinking about using any other form of contraception other than condoms (including the pill), do be aware that none of these protects from STI’s. So, if you’re looking for long-term contraception and don’t want to use condoms, it’s worth taking the time to get yourself checked for STI’s. The NHS (god love ‘um) have a free STI checker that you can complete at home. Or, if you prefer to get yourself checked for the full range and/or are worried about accuracy, you can find your local clinic and be tested by a professional.

Alternatives to the Pill after AstraZeneca vaccine concerns - The Live Life
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Depending on your personal circumstances and medical history, your needs may be based on some of the simplest differences. For this reason, we’ll start with some of the most common non-hormonal alternatives to the pill. These may work better for those looking to step away from hormonal contraception.

Non-Hormonal Alternatives

The Copper Coil – The IUD

This is the most effective form of birth control without hormones, with less than 1 in 100 users getting pregnant in a year. It also has the added bonus of being used as a form of emergency contraception. If it’s placed within 5 days of having unprotected sex, it can lower your chance of getting pregnant by 99.9%. It works as soon as it’s placed (although it is unlikely you’ll want to fool around for the first few days, due to having period-like cramps), and lasts between 5 and 10 years, depending on the type. It can be placed at any time during your menstrual cycle.

Having an IUD/IUS contraception fitted - YouTube
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The IUD stands for intrauterine device, as it sits in the womb, above the cervix – so it’s doesn’t get in the way of anything. Thus, you can have sex and use tampons as normal. It’s also referred to as the copper coil, as it’s the copper that stops you getting pregnant. It does this by altering the cervical mucous, which stops sperm from reaching the egg and makes it more difficult for them to survive. If you’re over 40, it can be left until menopause or you no longer need contraception.

Benefits:

  • It’s extremely good at preventing pregnancies
  • It lasts for a long time
  • It doesn’t affect your hormones
  • No need to remember pills
  • It works immediately
  • Can be used as emergency contraception
  • It doesn’t interrupt sex

Potential Problems:

  • No protection from STI’s
  • It can be painful to insert/take out*
  • Periods may become heavier or more painful
  • It may become loose (1 in 20 women)
  • Very small risk of infection after being placed.

Further info can be found on the NHS website.

*Pro-tip: speak with your nurse and ask them to let you know when they’re about to remove the IUD. If you cough as they remove it, you’re less likely to feel anything.

Condoms

Ahhh condoms, these are likely the first contraceptive you will have heard about in school. They’re also the most readily available, as they need no prescription. You can get them for free in any GP, walk-in centre or even by post. Portable and the only form of contraception that protects from STI’s, they may not be everyone’s cup of tea, but they are made to suit everyone.

condoms alternatives to the pill
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If you’re looking to prevent pregnancy and STI’s, these are the only method that works. At least to a point, with 15 in 100 women becoming pregnant in a year when using condoms. If you already use another method, but want to have sex with someone who’s STI status is unknown, we wholeheartedly recommend using these anyway.

Diaphragm

Less common in the UK than in some other countries, the diaphragm is a barrier method of contraception. It comes as a shallow, domed cup that sits at the top of the cervix. This blocks sperm from entering the womb and finding some good-looking eggs to hang out with. It’s used with spermicide, which kills off sperm. You’ll also need to place it up to 3 hours before having sex. Using this, people typically become pregnant at a rate of 16 in 100, within a year.

Benefits:

  • Most women can use a diaphragm or cap
  • Can be put in up to 3 hours before sex
  • They offer some protection against STIs
  • Can have sex more than once with a diaphragm or cap in place (with extra spermicide)
  • Skin-skin contact

Potential Problems:

  • Diaphragms and caps are less effective than other methods
  • Technique needs a bit of practice
  • Need to be put in before intercourse
  • They need to be left in 6 hours after sex
  • The spermicide can be messy
  • Some spermicides can increase the risk of HIV transmission

Fertility Awareness Alternatives To The Pill

Fertility awareness is based upon knowing your menstrual cycle, so that you can avoid having sex during your ovulation phase. Roughly 25 in 100 people will become pregnant in a year using this method. It is generally recommended that those who want to use this method seek the advice of a fertility specialist first. When followed correctly, with professional guidance, the effectiveness rises to 99% – so you can see how much this can help.

fertility awareness family planning method alternative to the pill
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There’s a lot of admin that goes into this method, which usually falls upon the person with a uterus. Daily temperature checks, changes to cervical secretions and the length of the cycle should all be documented. These can change depending on stress, illness and so on, so this needs to be a continuous process. However, using some blank fertility charts can be a huge help, here.

Benefits:

  • Non-hormonal method
  • There are no side effects
  • The method involves learning how the body works
  • Skin to skin contact
  • Acceptable in most religions and cultures
  • Can be useful when trying to become pregnant

Potential Problems:

  • It can be tricky to learn, and takes a few months to monitor patterns
  • May have a higher risk of pregnancy
  • Daily monitoring is needed (temperature, thickness of fluid in the vagina)
  • Illness, stress or travel can make it hard to interpret records
  • Unprotected sex must be avoided on the most fertile days
  • No protection from sexually transmitted infections
  • To work best it should be taught by a qualified fertility awareness teacher

Withdrawal Alternatives to the Pill

Withdrawal is about withdrawing the penis before ejaculation. 27 in 100 people will become pregnant in a year using the withdrawal method. The NHS generally doesn’t recommend this, as sperm can live quite happily in pre-ejaculatory fluid (or pre-cum) and the chances are generally that, on average, 1 in 4 people will become pregnant using this method.

However, if you do wish to use this, it’s worth tying it in with the fertility awareness (also known as natural family planning) method. This way, you can feel a little more comfortable, knowing that the risk of pregnancy is significantly lower.

Benefits:

  • No need to see a doctor, nurse or healthcare professional
  • Free of charge
  • No hormones
  • Acceptable for those whose religion or culture forbids other methods

Potential Problems:

  • Requires extreme self-control and awareness
  • It’s not a very reliable way of preventing pregnancy
  • There can be small deposits of sperm before orgasm (ejaculation)
  • Some people find withdrawing unsatisfying for sexual pleasure
  • Difficult to do it every time

Hormonal Alternatives To The Pill

Implant

The implant is one of the most popular options, as it offers excellent protection. Less than 1 in 100 people who use this method will conceive, in a year. It’s a small plastic rod that goes in your upper arm which slowly releases progesterone. One of the biggest advantages is that it lasts up to three years and takes away the need to remember to take your daily pill. It works by preventing the release of an egg during menstruation. It also thickens the cervical mucous, making it more difficult for sperm to find an egg.

Discussing different types of contraception
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It’s a great alternative for those who don’t want to take a combination pill with oestrogen. However, it is worth trying out the progesterone-only pill first, for a few months. This will help you to understand and feel the differences, before tying yourself into a 3-year method. That being said, you can remove the implant again, at any time, if you aren’t happy. It can be fitted at any time during your cycle, but may take up to 7 days to work.

Benefits:

  • It’s extremely good at preventing pregnancy
  • Very convenient, and doesn’t interrupt sex
  • Periods can be lighter and less frequent
  • It helps to make periods less painful
  • It can help pre-menstrual symptoms (PMS)
  • Often suitable for people who can’t take oestrogen

Potential Problems:

  • A small injection of local anaesthetic is needed to put it in
  • Irregular bleeding can be a nuisance (for 1 in 5 people)
  • Some people get side effects like mood changes and changes in sex drive
  • No protection against STIs

IUS

Similar to the IUD in placement and type, the intrauterine system (IUS) is extremely effective. Less than 1 in 100 people will become pregnant in a year, using this. This one also comes with the benefits of using a progesterone-only pill or implant, as it only secretes progesterone. For those who have migraines but are looking for a long-term contraceptive, without taking the pill, this is likely to be one of the best options for you.

IUS or IUD
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Just like the IUS, it’s placed above the cervix, in the womb. Both of these come with the added benefit for older folks, in that it can be left in until menopause if you’re over 40. Again, it can be used as emergency contraception, too. Unlike the IUD, however, it may take up to 7 days to prevent pregnancies. It is advisable to use condoms for the first week after having this fitted.

Benefits:

  • Lasts up to 5 years
  • No need to remember pills or patches
  • It doesn’t interrupt sex
  • It’s extremely good at preventing pregnancy
  • Periods are usually lighter and less painful
  • It’s a low level of a very safe hormone
  • Often suitable for people who can’t take oestrogen
  • It’s usually quick and easy to take out
  • Can help with PMS

Potential Problems:

  • Having an IUS fitted can be painful
  • Some have irregular bleeding
  • The IUS can come out (1 in 20 users)
  • STI check needed before putting it in
  • No protection against STIs
  • Sometimes mood changes, skin problems or breast tenderness

The Injection

The contraceptive injection is a popular method that only uses progesterone. Do be aware that this is not one for those with a fear of needles, as you’ll need to get injected every 3 months. Occasionally, another brand type – called Noristerat – will be used, which needs to be injected every 8 weeks. This is a relatively new type, and isn’t available in all GP practices. As such, do ask which one you’ll be given if you’re planning to move, to ensure you can keep using the type that suits your needs.

Alternatives to the pill - injection - The Live Life
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It’s not affected by other medicines, and is ideal for those who can’t or don’t want to use oestrogen in their contraception. Depo-Provera (the most common type) and Noristerat can be injected into your bottom, or in the upper arm. The Sayana Press can be injected into your abdomen, and many people learn to complete this themselves, at home. Regardless of type, it can take up to 7 days to become effective.

Benefits:

  • It doesn’t interrupt sex
  • It helps to make periods lighter
  • May make periods less painful
  • Most users (7 in 10) have no periods
  • Often suitable for people who can’t take oestrogen
  • Extremely good at preventing pregnancy
  • It protects against cancer of the womb

Potential Problems:

  • It’s an injection, which some people hate
  • May cause irregular bleeding
  • Weight gain is fairly likely (3kg in 2 years)
  • Possible changes in mood and sex drive
  • Not suitable for someone who definitely wants a regular period
  • It can take several months to wear off
  • No protection against STIs

The Patch

For those who have no problem with using combinations, but don’t want to take a daily pill, the patch may be the right alternative to the pill for you. It comes under the brand name of Evra and will need to be replaced once a week. Working in a similar way to nicotine patches, the contraceptive patch is 99% effective against preventing pregnancy. This drops when used incorrectly, however, and the average in the UK is that 8 in 100 users will become pregnant in a year, using this method.

11 Things You Should Know About the Birth Control Patch | SELF
Image from Self

This option works by releasing hormones through the skin, and into the bloodstream. It also comes with the side effects that are more common in contraceptive choices that include oestrogen. So, you may feel more nauseous, have some slight spotting or tenderness in the breasts when you first start using these. They also come with a higher risk of blood clots than progesterone-only options. However, some users feel that there are major benefits to this option, such as being in control of their periods and feeling more energetic (due to less iron being lost through bleeding).

Benefits:

  • Easy to use
  • It doesn’t interrupt sex
  • The patch is good at preventing pregnancy
  • It helps make periods lighter and less painful
  • Periods are usually very regular
  • Easy to know and to control when a period will come
  • The patch can help with acne
  • Some users notice (and like) having bigger breasts
  • May protect against some types of womb and ovarian cancer, and pelvic inflammatory disease

Potential Problems

  • It can be hard to remember when to change
  • No protection against STIs
  • Only available in a light skin tone

The Vaginal Ring

Last but not least, is the vaginal ring. Coming under the brand name of NuvaRing in the UK, it’s a small, firm plastic ring that sits inside your vagina. Just like the patch, it releases oestrogen and progesterone into the bloodstream. When used correctly, it is 99% effective. But roughly 9 in 100 users will become pregnant in a year, when using this method. Each ring lasts up to 3 weeks and doesn’t need to put anywhere specific within the vagina.

Again, with this contraceptive, certain risks are higher due to the use of oestrogen – in particular, the risk of blood clots. Roughly 2 in 10,000 users may have a higher risk of developing a blood clot in the lungs or legs when using this method. You may also suffer from spotting, nausea and tender breasts for the first few weeks. Of course, just like any hormonal medication, it can also have benefits such as those we discuss in the introduction and within the other methods.

Benefits:

  • Doesn’t interrupt sex
  • The ring is good at preventing pregnancy
  • It helps to make periods lighter and less painful
  • Periods will usually be very regular
  • East to know and to control when a period will come
  • The ring can help with acne
  • Some users may develop bigger breasts
  • It protects against womb and ovarian cancer and pelvic inflammatory disease

Potential Problems:

  • Changes in mood or sex drive
  • Feeling more hungry
  • Need to change regularly

Final Thoughts On Alternatives To The Pill

No matter which contraception you use, be sure to take care of yourselves. That means that anyone with a uterus should regularly book a smear test to check for certain types of cancer, or pre-cancerous cells. Also, do be sure to keep in contact with your doctor, especially if there are any changes that are affecting your mental or physical wellbeing. Similarly, do check yourself for breast cancer regularly – this guide is extremely helpful in how to do that.

Wendy

Wendy

Editor-in-chief, lover of UX/UI and copywriter by trade. Wendy can usually be found ranting to herself over on Twitter, educating herself about health and wellness, parenting or gaming. Luckily, she doesn't do all of these things at the same time - though you'd be surprised how often they cross over.

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