Birth Control and Beyond... Teaching girls about different uses for hormone birth control.

I was sixteen the first time my mother mentioned menstruation to me. She was concerned because she had assumed I hadn’t had a period yet. My first period came just shy of my thirteenth birthday and I had taken money from the household change jar to buy supplies at the local 7-Eleven. She was sad that I hadn’t come to her, but I wasn’t capable of starting that conversation as a twelve-year-old.

Two Girls Swinging over a Lake

Needless to say, if my mother waited until sixteen to even say the word menstruation, the word “sex” was entirely taboo. Even when I announced to both my parents, brazenly, that I believed in abortion, they remained silent on the methods to avoid the surgical intervention of gestation. My parents were not alone. Many of my friends were woefully lacking in information about sex and birth control and it was up to the school system to make up for our ignorance.  

But things have changed, right?

Sexual education has not changed as dramatically as I’d wish in the resulting 20+ years. While birth control is now covered in most schools, the use of birth control for non-sexual medication is still not addressed well in sexual education classes. This is dangerous because it paints a medicine as a non-necessity rather than a reasonable solution to common hormone based medical problems - childbirth included. It’s safe to say that focusing solely on sex gives certain legislative bodies reason to pull or alter programs that teach about the benefits of birth control in any form. Understanding and teaching non-sexual benefits of birth control as well as contraception may keep the medication relevant for the abstinence only crowd. 

To be honest, while I certainly rectified my parents’ mistake of silence and introduced the basics of human reproduction incrementally throughout my children’s lives, I didn’t think of birth control as a medical necessity until my oldest daughter developed a tumor in the pituitary region of her brain at the age of 13. We had a choice: operate at great risk, leave it alone and hope it didn’t cause her to go blind, or take a low dose of estrogen in the form of birth control and let the tumor shrink on its own. You can imagine how thankful we were for that medication! Secretly, I was relieved that the option of birth control had been decided for her. The tumor dissolved as did the risk of future teenage pregnancy.

Years later, we again turned to birth control as medication. It was discovered that my eleven-year-old had a form of hemophilia that caused menorrhagia. It was then that I learned that many teens and women suffer needlessly through dangerously heavy periods, or menorrhagia. My daughter was hospitalized and given two blood transfusions. While rarely severe enough for a blood transfusion, menorrhagia is fairly common. According to the Center of Disease Control and Prevention, about one in five women suffer with some kind of menorrhagia. We ultimately opted to use an IUD (intra-uterine device) due to the discovery of this genetic blood disorder, but many cases of menorrhagia can be controlled through any form of low estrogen birth control.

Packet of Birth Control Pills

According to Planned Parenthood, menorrhagia is not the only condition that a combination hormone birth control will treat. It also treats:

• acne
• bone thinning
• cysts in your breasts and ovaries
• endometrial and ovarian cancers
• serious infections in your ovaries, fallopian tubes, and uterus
• iron deficiency (anemia)
• PMS (premenstrual syndrome)

The question remains, how do we introduce the concepts of birth control as health care to our children?

I believe the best method is to begin very early. Here are a few tips:

•         Use medically appropriate names for body parts. Identify the penis and vulva at the beginning of self-inspection. About age 2.
•         Look at a picture book and ensure your child can identify the body parts of the opposite sex. This will not rob them of innocence, but simply give them a vocabulary to use as needed.
•         Talk about reproduction in age appropriate ways throughout their childhood.   A five-year-old can understand that babies start as eggs in their mother and are fertilized by their father.
•         Use obvious genetics to give them the ability to apply the information in a practical way. “You have dad’s brown eyes and mom’s curly hair.”  
•         By age ten they should understand the mechanics of reproduction. How is a baby made?
•         At age nine or ten is a great time to start talking about birth control and what it can do. Go beyond sex. Make sure they know about medical uses beyond avoiding conception.
•         At the event of a first period, it’s time to begin offering birth control. Don’t wait. Twelve and thirteen-year-old girls can get pregnant and sometimes do and the first year is the often the most painful and erratic of a girl’s life. A child who is struggling with heavy periods may not know what is normal or that there is a solution.
•         Offer again, at least once a year, until your “child” is well into their 20s. Keep the line of conversation open and non-judgmental.

Looking at hormonal birth control beyond reproduction serves your child in two different ways. First, this can be one of the first opportunities for your child to manage their own healthcare – a skill that many adults struggle with. Second, when they are ready for sex, they may already have protected themselves from unwanted pregnancy through managing other medical issues. 

Freely discussing birth control as medication in your communities is also important. Investigate your children’s sexual education curriculum and share these concerns with other parents. Ask other parents in playgroups if they’ve begun to discuss reproduction. It takes open dialog to change preconceived bias toward reproductive health and while you may be capable of modernizing the concept of reproductive health in your family, there are many parents without the knowledge base to do the same. Positing hormonal birth control as the medication it is places it in the hands of girls who need it most-those least likely to have access to it any other way.