Beyond “The Pill”

September 14, 2022

Beyond “The Pill”

By: Jacquetta Szathmari


Are you thinking about getting or changing your birth control? Do you need to take control of your reproductive health?

Girl, you have options!

When it comes to prescription contraceptives there is so much more than “The Pill”.

Your gynecologist is clearly your best source of information, but before your feet are up in the stirrups for that annual check-up, take some time to consider what is out there. Prepare for the conversation by asking yourself if you are in the market for something taken daily, monthly, quarterly or less than once a year. Consider the pros and cons of oral vs. internal contraception. Think about your lifestyle, sex life, current health, and health history, and be sure to make a list of questions for your doctor before you go.

Here is a quick rundown of highly effective (99%+) prescription contraceptives that are giving us the ability to plan and prevent parenthood.


A popular oral contraceptive, birth control pills have been regulating menstrual cycles and preventing unplanned pregnancies since the 1960s. The active ingredients are progestin and estrogen. Estrogen is a sex hormone that supports the reproductive system and its functions. Progestins are synthetic progesterone, which is a hormone naturally produced in the ovaries and the adrenal gland which prepares the uterus for impregnation. In birth control, both work to prevent ovulation. While some varieties contain both estrogens and progestins, and others only progestins, the outcomes are similar.

Birth control pills slow the development and movement of the egg and make the path to the egg less hospitable to sperm on the move by thickening the mucus in and around the cervix and lining the uterus. Sperm have a harder time swimming to the egg, and eggs that have been released during your cycle struggle to find a place to implant along the lining of the uterus, so they are unable to develop.

Unlike in the 60s, today’s birth control pills are not one size fits all. With your doctor you can choose between pills with one-month or three-month packs, having your period at the end of each cycle while taking a placebo. There are options for dosage, including low and ultra-low dose pills, pills that deliver the same daily hormone dosage, and pills that deliver hormones at different levels throughout the cycle.

In addition to preventing fertilization, birth control pills are used to alleviate pain and discomfort associated with menstruation and can lighten and shorten your period if you naturally have a heavy flow. They also keep your cycle regular. All you have to do is remember to take them every day—not such an easy feat for everyone. You can stop taking the pill whenever you are ready. Your cycle and fertility will revert to what they were before you started the medication.

Consider THE PATCH

Also called a transdermal contraceptive, the Patch is literally a sticker that you affix to your skin containing hormones that are absorbed into the bloodstream. Like the Pill, the patch also contains progestin and estrogen and prevents ovulation and sperm-to-egg movement with a steady dose of hormones. The active ingredients are released into your system for 3 weeks and if you desire to have a period simply remove it for one week. If not, you can continue with the next patch. You can decide to go off it at any time if your fertility goals change and your cycle will return to normal.


The vaginal ring is a small flexible ring, (it looks like a small plastic bracelet from the 80s), that contains the familiar hormonal combo of estrogen and progestin. It’s like a patch, but for your vagina—so wash those hands and open wide. Inserted into the vagina, the ring releases hormones at a constant rate while in place, thwarting ovulation and therefore fertilization. While you do need a prescription to get the ring, you can insert it yourself following both the manufacturers’ and your doctor’s guidance. It may seem daunting at first, but if you have used a tampon without an applicator, or a menstrual cup, you understand the basics of it. The ring resides in the upper region of the vagina and won’t go too far as it cannot pass through the cervix. It can be easily removed and re-inserted, which is handy because both the monthly and yearly options require periodic removal for health and safety.

Feel secure with THE INJECTION

Birth control injections deliver a shot of progestin that can prevent ovulation from one to three months, depending on the brand, but also prevent sperm from getting to an egg, in the event that one is released. In the United States only one brand of shot has been approved, Depo-Provera. It comes in two varieties and is estrogen-free. The shot, which must be administered by a medical professional, is very effective and it may take a while for fertility to return after using the shot- even once the effects have worn off- so plan accordingly. As with other methods, the shot may decrease the length and intensity of your flow, or even eliminate it altogether.


Implanted under the skin, contraceptive implants provide long-term birth control and can last up to 3 years. The active ingredient, progestin, is released at a constant rate into the blood and prevents ovulation and hinders the sperm from getting to the cervix. The effect of the implant on menstruation is variable, but it may reduce cramps and other discomfort associated with your period. The implant, which must be inserted and removed by a doctor, is about the size of a matchstick and after a few days becomes almost invisible. This is another more permanent option for those who are not able to use contraception containing estrogen.

Tried and True, THE IUD 

The Intrauterine Device (IUD), which resembles a tiny jackhammer, is available in hormonal and non-hormonal varieties. Both are implanted in the uterus by a doctor to prevent fertilization for years with the effects wearing off upon removal. The hormonal version of the IUD, (and there are many to choose from), releases progestin which disrupts ovulation and prevents sperm from meeting up with the egg, if an egg is released. Non-hormonal IUDs are made from copper, which naturally repels sperm. Both types of IUD are easily inserted and removed, do not interfere with normal activity, and are long lasting but not permanent.

Don’t wait! Talk to your GYN today and take charge of your reproductive health.





Jacquetta Szathmari, Dernier MileJacquetta Szathmari is a New York based writer and the founder of Dernier Mile, a boutique consultancy providing last minute and last mile solutions for your content-intensive, logistically complex, and totally unique creative projects.

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