If Swallowing Isn't Your Thing, Try Chewing

Birth control pills remain one of the most popular forms of contraception, with up to 12.6 percent of women in the United States using the pill to prevent unwanted pregnancies and to control symptoms associated with the menstrual cycle.

However, the oral contraceptive pill isn't a suitable option for everyone. Thankfully, there is an alternative that can provide the same benefits with added convenience.

What is chewable birth control?

The clue is in the name. Chewable birth control is simply a contraceptive pill that can be taken without water and chewed, rather than swallowed.

Despite many people being unaware of this form of birth control, it isn't new. In fact, the first chewable birth control pill, Femcon Fe, was approved by the U.S. Food and Drug Administration in 2003.

"Chewable birth control pills are just as effective as the standard brands of pills," explained Kate White, M.D., MPH, an associate professor of obstetrics and gynecology at the Boston University School of Medicine and author of "Your Guide to Miscarriage and Pregnancy Loss." "They all contain a combination of two hormones, estradiol and a progestin, that work together to stop your ovaries from releasing an egg (ovulation) and make it more difficult that sperm could reach an egg if there was one (by thickening your cervical mucus and changing the motion of your fallopian tubes)."

Just like most conventional birth control pills, the chewable pill follows a 28-day regimen. You will take one pill every day, preferably at about the same time, for four consecutive weeks. On day 29, you will begin the new pack. The final seven pills will typically be placebos, meaning they do not contain any hormones; they are simply there to remind you to keep taking the pill daily.

Unlike the progestin-only pill, you do not have to take it at the same time every day. In the event you forget to take a pill, you can simply take it whenever you remember to.

The benefits of a chewable pill

"The benefits of chewable birth control pills are around the convenience of using them. Since you don't need a glass of water, you can take your pill any time," White said. "If you carry them in your bag, and you forget to take your pill at your usual time, you can take it while you're sitting in traffic, in line at the grocery store, sitting in class or even at work."

Los Angeles-based Sarah Yamaguchi, M.D., board certified in Obstetrics and Gynecology, said chewable birth control pills are beneficial for people who cannot swallow pills. It's believed between 10 and 40 percent of the adult population has difficulty swallowing pills, so chewable birth control pills may help many women who have dysphagia, or difficulty swallowing.

What options are there?

Femcon Fe is now discontinued, but fortunately, there are a few other chewable birth control brands available. These include Generess FE, Layolis FE, Minastrin 24 FE, Wymzya FE and Zenchent FE. When deciding what the right option is for you, speak to your doctor about your expectations and what you need from birth control.

"Doctors should be talking to patients about all the factors that are important to them about their birth control method," White said. "If a patient is interested in pills, the doctor will talk about what their plan is to take a pill every day. If it comes up during counseling that a patient doesn't like to swallow pills, or thinks they may want to take their pills on the go, hopefully their doctor will suggest chewable pills as a good alternative."

Side effects to keep in mind

Chewable birth control pills have the same side effects as most conventional birth control, the most common of which are nausea, breast tenderness, bloating, spotting and loss of libido.

However, it's not uncommon to experience moderate to severe side effects that can interfere with your daily activities. If this happens, it indicates this form of birth control isn't working for your body. You can discuss any unpleasant side effects with your doctor or nurse, who will help you find a better alternative.

Who shouldn't use chewable birth control?

Chewable birth control pills are suitable for anyone who can take conventional birth control pills, since the only difference is they are chewed and not swallowed. However, it often comes down to personal preference.

"Most of my patients do not like the aftertaste of the chewable pills, especially the generic ones," Yamaguchi said."The common birth control pill is very small and easy to swallow, so most of my patients prefer that one."

According to Yamaguchi, most of the options available contain estrogen and progestin, which means it's not suitable for women who have the following:

• Blood clots or a history of clots
• A history of heart attacks or an ongoing heart condition
• High blood pressure
• Unexplained vaginal bleeding
• Uncontrolled diabetes

If you have any of the above conditions or any concerns about your health, speak to your doctor for advice about what to do next. They may recommend the progestin-only pill or a non-hormonal alternative.