About 45 percent of pregnancies in the U.S. are unintended, with the highest rates among 18-24-year-old women, according to a 2016 article published in the New England Journal of Medicine. Given this alarming statistic among college-aged women, conversations about contraception must start earlier. Contraception can be a stressful and confusing topic, but it doesn’t have to be. Here are some points to consider while selecting a contraceptive product.

Contraceptives exist in many forms. Despite popular thought, contraceptives do not increase your risk of infertility or miscarriage. They mimic natural hormones that regulate menstruation and prevent pregnancy. They can also cause side effects that may include nausea, increased blood pressure, spotting, and weight gain, among others. Best practice recommends sharing non-resolving side effects after three months of use with your health-care provider (HCP). These methods of contraception are all different, so it’s important to consider the pros and cons of each to select the right choice for you.

Pills (91-99 percent effective)

Pros: Treats acne, migraines, excessive hair, and painful/heavy or prolonged menstruation

Cons: Must remember to take every day

Patch & Vaginal Ring (91-99 percent effective)

Pros: Removable at any time and return to fertility is quick

Cons: Keep in place; change weekly/monthly; comes in less variety of dosage that can limit use for additional benefits (e.g. acne)

Injectable (94-99 percent effective)

Pros: Administered every 3 months, less scheduling required

Cons: Menstrual irregularities; weight gain; use longer than 2 years not recommended due to a decrease in bone mineral density—requires adequate intake of calcium, vitamin D and regular exercise

Intrauterine devices (Over 99 percent effective)

Pros: Provide long-term contraception up to 10 years; return to fertility state is within 30 days of removal; menstruation may stop after 1 year of use

Cons: Abnormal bleeding initially

Implant (Over 99 percent effective)

Pros: Provides 3 years of contraception; return to fertile state is within 30 days of removal. Implants cause fewer side effects, such as headaches, weight gain, acne, and breast and abdominal pain

Cons: High chance of irregular menstruation; risk for temporary pain, bruising, or infection

There may be certain conditions that may be harmful when using a particular method of contraception (for example, smoking can increase your risk of clotting with pills). Be sure to disclose these habits and any chronic illnesses you may have with your HCP so they can help select a safe method of contraception for you.

Having conversations about contraception can be difficult because it’s not necessarily something people talk about in everyday conversation. Luckily, there are resources available on campus that can help. If you have any questions about where to begin, Student Health and Wellness provides a variety of services related to sexual health for registered UI students including prescription/non-prescription contraception, annual exams for women, and more. You can find more information about cost/availability on their website or call them at (319) 335-8394. Either way, no matter who it is with (student health, partner, HCP), start the conversation about contraception sooner, rather than later.

— Guadalupe Chavez, PharmD Candidate, Class of 2021