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Whether single, married or dating, birth control is a choice for all reproductive-aged women. The conversation around the female body and reproduction is highly sensitive, yet has been one of the most debated topics in recent years. As states continue to argue abortion rights, contraceptives have come under scrutiny. As women search for contraceptive options that best fit their lives, questions about the overall effects on reproductive health come to the surface. For Black women, already genetically predisposed to certain medical conditions, concerns about the benefits and risks of contraceptives are climbing.
Pills, patches, implants and IUDs are all methods used by women to protect against pregnancy. More than pregnancy prevention, birth control is a multi-purpose substance. It can help to ease menstrual pains as well as treat and prevent certain medical conditions.
“We use birth control to prevent ovarian cancer, we use it to treat and also prevent uterine cancer. We use it for women who have conditions like PCOS, which stands for polycystic ovary syndrome. We also use it for women who are having extremely painful periods. It’s not just about fertility. It also helps to treat different conditions that women might experience that could be debilitating for them,” said Dr. Monique Swain, program director for the Obstetrics and Gynecology Residency Program at Henry Ford Hospital.
More likely to develop uterine fibroids than any other demographic, African Americans are diagnosed three times as frequently as white women, Black women over 35 have an increased chance of developing fibroids. By the age of 50, more than 80 percent of African American women will have developed a uterine fibroid.
“The main issue related to fertility due to fibroids is the location of the fibroids. As you know, after the fertilization of the egg the embryo will be implanted in the lining of the uterus, the lining of the womb. If there are any fibroids that are disturbing or disrupting the lining, any fibroid that’s growing into the uterine cavity or if there are any endometrial polyps that’re growing from the lining, these types can impact the implantation of the embryo which results in either failure to achieve pregnancy or early loss of the pregnancy,” said Dr. Omar Zwain, a minimally invasive gynecologic surgeon with Ascension Providence Hospital.
Aside from fibroids, PCOS is another medical diagnosis that can cause issues in reproduction. Black women are also at a higher risk of developing the syndrome and thus have a harder time conceiving.
“Having other medical gynecological problems can lead to infertility and the high prevalence of infertility in African American women,” said Dr. Zwain.
Black historical traumas have created mistrust in the medical community. Misconceptions about birth control and fertility plague all women, however, Black women have long been the subjects of medical racism. Putting a strain on the doctor-patient relationship, medical mistrust by African American women makes it more difficult to navigate conversations around reproductive health.
“There’s a lot of women prior to the 80’s, in the 70’s and 60’s and before them, that had their fertility taken away from them without their knowledge. So, there’s this distrust that birth control in itself is going to take away their fertility and that’s just not true,” said Dr. Swain.
Although contraceptives themselves have been medically proven to not affect fertility, some women find it difficult to conceive after extended use. The return of a natural hormonal menstrual cycle is key in becoming pregnant. Oral contraceptives may filter out of the system quicker than the birth control shot. Commonly referred as the depo shot, it can take 12 to 18 months for regulation and conception.
“Basically, the main reason is when will her cycles resume and to be more specific, when the ovulation takes place again. In general, women may resume menstrual cycles and ovulation within two to three cycles after stopping the birth control,” said Dr. Zwain. “However, we have certain methods that may take longer.”
Though women are the vessel, doctors remind trying couples that it is not always the woman who presents barriers in conception. While infertility is stereotypically placed on women, men can also suffer from issues that can prevent pregnancy.
“One of the unfortunate situations, most of the time if the couple is suffering from infertility they think that the chances of the woman having infertility is more than the man, but that’s not the case” said Dr. Zwain. “That could be due to either of the partners. That’s why we start with evaluation of the male partner.”
Overall contraceptives have been proven safe and effective when used properly and will not affect fertility in women. To find out more or to find the best contraceptive method for you, contact your gynecologist.