"It's just not something we should stop," says Meyer, a 33-year-old graduate student at Wayne State University. She's using a traditional pill because she says it's convenient, inexpensive and feels like the more natural choice. But she has also thought about whether an intrauterine device, or IUD, might be worth trying.
Companies marketing prescription birth control methods like Seasonique, the multi-month pill; Mirena, an IUD, and others spent $188 million on advertising in 2008, according to a report from the New York-based Nielsen Co., which does market research. That's an increase of about $40 million over spending in 2007. In these ads, drug companies offer "birth control plus" - better skin, fewer cramps, a period-free vacation or a reduction of premenstrual syndrome symptoms, the personality and physical changes that may occur in some women just before their period begins, says Andrea Tone, a professor of the social history of medicine at McGill University in Montreal.
"It's pregnancy prevention and a whole new way of life," says Tone. Dr. Brent Davidson, chief of women's health services at Henry Ford West Bloomfield Hospital, says he routinely fields questions from women trying to wade through the choices to pick the best option. He weighs a woman's health history - some estrogen-like pills can exacerbate chronic illnesses like high blood pressure - her insurance coverage and family planning goals when making a recommendation. "The key is we have choice - many more than our parents' generation - and safe choices," says Davidson, who also is the Michigan Department of Community Health medical director for contraception.
Most forms of birth control are effective if used exactly as directed. Davidson says the fail rate is 1 percent to 2 percent, but most methods do not prevent transmission of HIV, the herpes virus or the cervical cancer-causing human papilloma virus. The chart, right, outlines many of the birth control measures women can consider:
Pills offer varying concentrations of estrogen-like and progesterone-like compounds. The most common are taken on a 28-day cycle, with three weeks of hormones and one week of placebo, during which a period happens.
The pill needs to be taken at the same time every day for maximum effectiveness.
Hormones in the pill signal the body to reduce levels of natural estrogen and progesterone, which are responsible for ovulation. Hormonal control is also linked to reduced acne, a selling point for pharmaceutical companies.
Examples include brands such as Yaz and Mircette, Ortho tri-cyclen and Ortho Novum. Cost: Up to $24 for a one-month prescription.
Side effects, says Davidson, include risk of heart attack, stroke, blood clots, nausea and high blood pressure. Some users also report tender breasts, spotting between periods and mood changes. Few long-term health problems are associated with the pill, but some estrogen pills can exacerbate chronic conditions such as diabetes and high blood pressure.
Seasonique is similar to monthly birth control pills in that users take one pill a day, but instead of the placebo pills once a month, there is a single week of low-dose hormone during the 12th week, so users have only four periods a year. Another long-term pill is Lybrel, which users take every day to suppress ovulation, and have no periods at all. Both cost $170 for a three-month supply.
NuvaRing is a flexible plastic ring that is vaginally inserted once a month. It releases a low dose of hormones directly into the reproductive tract, rather than through the bloodstream, like pills. Users take the ring out after three weeks to induce a period.
It's a popular choice among women who have nausea problems with pills, says Davidson. Cost: Up to $50.
The side effects are similar to the pill, but also include the possibility of vaginal infections and increased secretions.