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Choosing the Right Birth Control

What Should I Consider When Choosing a Birth Control Method?

Birth control, also known as contraception, can help prevent an unwanted pregnancy until you are ready to have a baby. Some forms of birth control also help protect you from a sexually transmitted disease (STD).

There are many different types of birth control and no single method is right for everyone. It’s important to consider the pros and cons of each type of birth control and select the one most suited to your needs and lifestyle. Think carefully about how easy it is to use and if you are comfortable using it. You will also want to consider if and when you are planning to have children.

Other important questions to consider when choosing a birth control method include:

  • Does it contain hormones?
  • Does it protect against sexually transmitted diseases (STDs)?
  • Does it require a visit to a doctor or a prescription from a doctor?
  • Does it require preparation right before sex?
  • Is it quickly reversible?
  • Is it easy to use and will I remember to take it?
  • Does it decrease monthly bleeding and cramping (females)?
  • Is it noticeable and do I want my partner to be aware that I am using it?
  • Is it safe?
  • Am I allergic to any of its components?
  • Does it have side effects and how long will they last?
  • Will it affect my sex drive/sensation during sex?
  • How effective is it?
  • How much does it cost?
  • Am I willing to pay a lot more now if the method lasts for a long time?
  • How often do I have to take it?
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Types

What Types of Birth Control Are Available?

Some methods of birth control work better than others. The following is a list of the various types of birth control available, sorted by how effective they are at preventing pregnancies.

Extremely Effective (99-100%)

  • abstinence: Abstinence is complete avoidance of sex.
  • intrauterine device (IUD): This is a small, T-shaped piece of plastic that is put inside a woman’s uterus by a doctor. There are two kinds. A copper IUD releases a small amount of copper to prevent sperm from fertilizing an egg. The complete mechanisms of action of hormonal IUDs are not completely understood. There are several different types available, all of which release small amounts of hormones into the uterine cavity. Some of the methods by which this inhibits conception include thickening of the cervical mucus to prevent sperm penetration, alteration of the uterine lining to make it inhospitable for a fertilized egg to implant, and also, in some cases, partially suppressing the release of eggs from the ovaries (ovulation).
  • implants: An implant is a soft plastic rod that is placed just under the skin of your arm by a doctor. The rod releases a synthetic progestin hormone over three years. Its primary mechanism of action is to prevent eggs from being released from the ovaries.
  • sterilization: This is a permanent method of birth control that involves cutting or blocking the tubes that carry sperm (in men) or the tubes that carry eggs to the uterus (in women).

Very Effective (>91%)

  • shot: This is an injection of a progestin hormone which is slowly absorbed by your body and prevents any eggs from leaving your ovaries. Each injection works for approximately 12 weeks, so it’s extremely important to receive subsequent injections on schedule if you wish to maintain contraception.
  • patch: This is asmall sticky patch worn on the skin that sends steady levels of hormones into your bloodstream.
  • vaginal ring: This is a soft, plastic ring that you put in your vagina, where it releases a steady dose of sex hormones.
  • birth control pills: This is a set of pills usually taken every single day at the same time, which contain hormones called estrogen and progesterone. The pill works by stopping the release of eggs from your ovaries.

Effective (>80%)

  • condoms: This is a thin, disposable wrap placed over the erect penis. If used correctly, sperm will be trapped inside the condom and will not be able to get inside the vagina
  • cervical barriers (diaphragm, cap, or shield): A cervical barrier is a small rubber cup that you fill with spermicidal jelly and place in your vagina, over the cervix, before sex. This prevents sperm from entering your uterus.

Moderately Effective (>70%)

  • spermicides: These are chemicals that come in the form of jellies, creams, or foams that kill sperm. They are usually used together with a cervical barrier, such as a diaphragm.
  • sponge: This is a small foam pad soaked in spermicide and placed in the vagina over the cervix.
  • fertility tracking: This method involves very carefully tracking changes in your body so you can know when you are most likely to be fertile and when you are not. You are not likely to get pregnant if you have sexual intercourse on the days you are not fertile.

Emergency Contraceptives

Emergency contraceptive pills are used to prevent pregnancy after you have already had unprotected sex (sex without using a birth control method). They are sometimes called the “morning after pill.” They may be used as a backup if your normal birth control method fails or you forget to take it.

Emergency contraceptives can prevent pregnancy for up to five days after sex. They will not work if you are already pregnant.

Ineffective Forms of Birth Control

These methods are not a reliable form of birth control:

  • douching
  • urinating after intercourse
  • feminine hygiene products
  • homemade condoms
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Pros and Cons

What Are the Pros and Cons of Each Type?

All methods of birth control, including the emergency contraceptive pill, have been carefully tested and are considered very safe. However, every method has its advantages and disadvantages.

Abstinence

Pros:

₋          There are no health risks.

₋          It’s completely free.

Cons:

₋          It requires self-control and offers no protection if you change your mind and decide to have sex. You should always have another birth control method nearby.

₋          You can still get STDs from oral sex or skin-to-skin contact, such as rubbing each other’s genitals.

Intrauterine device (IUD)

Pros:

₋          It lasts up to 12 years (copper IUD) or up to five years (hormonal IUD).

₋          You do not have to interrupt or stop sex to use it.

₋          It is completely undetectable during sex.

Cons:

₋          It does not protect against STDs.

₋          It requires insertion by a doctor.

₋          The cost up front is high ($500 or more).

₋          It may cause irregular bleeding or spotting.

₋          It is possible to get an infection when the IUD is inserted (this is rare).

Implants

Pros:

₋          It is effective for up to three years.

₋          It is convenient and private.

₋          The cost up front is high ($400 or more).

Cons:

₋          It must be inserted and removed by doctor who has had special training.

₋          There’s the possibility of infection at the site of insertion.

₋          It does not protect against STDs.

₋          Periods will change and bleeding may become irregular.

 

Sterilization

Pros:

₋          It’s permanent and is a good choice for men or women who do not want any more children.

₋          You do not have to interrupt or stop sex to use this method.

Cons:

₋          It does not protect against STDs.

₋          It requires surgical procedure by a doctor.

₋          The cost up front is high if you don’t have health insurance.

₋          It is irreversible, so you must be absolutely certain that you don’t want any more children before you decide to take this stop.

₋          It carries typical surgery risks.

Shot

Pros:

₋          You only have to get it four times a year (every 12 weeks).

₋          The effects wear off after the 12-week period.

₋          It reduces the risk of endometrial cancer.

₋          You do not have to interrupt or stop sex to use it.

₋          No one can tell that you are using it.

₋          After a few shots, many women will stop having periods altogether. This is safe.

Cons:

₋          It does not protect against STDs.

₋          It requires a doctor visit.

₋          It may cause irregular bleeding or spotting.

₋          It may decrease the strength of your bones since it lowers your body’s natural estrogen levels.

Patch

Pros:

₋          It’s easier to use than birth control pills and only needs to be changed once a week.

₋          You do not have to interrupt or stop sex to use it.

Cons:

₋          You need to remember to change it every week.

₋          It requires a prescription from a doctor.

₋          It does not protect against STDs.

₋          It may cause irregular bleeding or spotting.

₋          It should not be used if you have a blood clotting disorder.

Vaginal Ring

Pros:

₋          It may clear up acne.

₋          Periods may be more regular, lighter, and less painful.

₋          You do not have to interrupt or stop sex to use it.

₋          Reversible.

Cons:

₋          It does not protect against STDs.

₋          It requires a prescription from a doctor.

₋          It should not be used if you have a blood clotting disorder.

₋          You must insert and remove it every month.

Birth Control Pills

Pros:

₋          It’s a reversible form of contraception.

₋          They reduce menstrual cramps.

₋          They make periods regular and lighter.

₋          They reduce acne.

₋          They lower risk of ovarian and endometrial cancer and ovarian cysts.

₋          There are many different types available.

₋          It has a low monthly cost ($10-$50) and may be covered by your health insurance.

Cons:

₋          They do not protect against STDs.

₋          They may interfere with other medications you are taking.

₋          They can cause minor side effects and mood changes, but these should go away after the first few months.

₋          They should not be used by smokers above the age of 35 or by people who have blood clotting disorders.

₋          You MUST remember to take it every day at the same time.

₋          They require a prescription from a doctor.

Condoms

Pros:

₋          They can be purchased over the counter at a drugstore or grocery store without a prescription.

₋          They protects from STDs.

₋          They are inexpensive. You may be able to get them for free at a family planning clinic.

Cons:

₋          Some people are allergic to the latex or liquid used to package the condom.

₋          You have to interrupt sex to put the condom on.

₋          Some men or women do not like to wear them because it decreases or changes sensation during sex.

₋          Condoms are not effective it they break or rip during sex.

Cervical Barriers

Pros:

₋          They do not use hormones.

₋          They are reusable.

₋          They protect against certain STDs.

₋          A barrier can be inserted 24 hours before sex so you do not have to interrupt or stop sex to use it.

Cons:

₋          You need to plan ahead and insert the barrier properly up to 24 hours before sex.

₋          Barriers can dislodge during sex.

₋          They may cause vaginal discharge and odor.

₋          Some people are allergic to the material or the spermicide used with the barrier.

₋          They require fitting by a doctor and a prescription.

Spermicides

Pros:

₋          They can be used by women who smoke or breast-feed.

₋          They may provide lubrication during sex.

₋          They can be bought over-the-counter at a drugstore or grocery store without a prescription.

₋          They do not contain any hormones and will not change your periods.

Cons:

₋          They do not protect against STDs.

₋          They may cause allergic reactions in some people or irritation if used more than twice a day.

₋          You may have to interrupt sex to use a spermicide.

Sponge

Pros:

₋          It can be bought over the counter at a drugstore or grocery store without a prescription.

₋          It is easy to insert and can be used for a 24-hour period, during which you can have sex multiple times.

₋          No chemicals or hormones.

Cons:

₋          It does not protect against STDs.

₋          Some people are allergic to the spermicide in the sponge.

Fertility Tracking

Pros:

₋          There are no health risks.

₋          No hormones or chemicals will enter your body.

Cons:

₋          You will need to learn from a trained expert how to check and record your body signs for this method to work.

₋          It requires keeping a daily record (there are also electronic devices and mobile calendars or applications to help keep track of changes).

₋          It does not protect against STDs.

₋          This is only an option for women who have regular periods.

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Choosing a Method

How Do I Choose the Method That’s Right for Me?

Figuring out which method to use can be a bit overwhelming. A method that’s perfect for one woman may not be right for another.

Take a moment to consider all of the important questions and all of the available options. Then weigh the pros and cons of each option as it applies to your own lifestyle and future plans. You may even decide to use a combination of birth control methods for extra protection against pregnancy and STDs.

You can always talk to a doctor or to a clinic that specializes in family planning to help you choose a method that is right for you. The more you know, the more in control you can be of your sexual health as well as when you may want to have children.

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