One of the most significant and impactful decisions a person can make in their lifetime is to become a parent. Providing women and men with healthy and safe alternatives to support making this monumental choice is the mark of a humane society and one that respects the sanctity of life.
With that in mind, let’s talk about birth control, defined as any method of preventing pregnancy. There are many methods of birth control and it can be confusing to figure out which method is right for you.
5 Questions to Ask Before Choosing a Birth Control Method
Is STI-prevention important to me?
A topic that's closely related to birth control is the prevention of sexually transmitted infections (STIs). They're often thought about in the same way, probably because condoms are the first line of defense for both. But of course one is about preventing unwanted pregnancy and the other is preventing the spread of infection. You can easily choose a birth control method other than condoms and simply add condoms when engaging in intercourse. Whereas, if you have been tested for STIs and are in a committed or long-term relationship, you may not be concerned about preventing STI transmission. In that case, using any number of hormonal options, such as an IUD, or a non-hormonal method like fertility awareness or withdrawal may be good options for you.
How reliable am I at taking medication every day?
If you’re the type of person who already takes supplements or medication daily, then the pill might fit perfectly into your routine. But if you’re worried about forgetting to take a pill, you might consider the patch, ring, or implant which are a “set it and forget it'” type of solution.
Is budget a consideration?
The U.S. Affordable Care Act has ruled that women’s birth control methods are fully covered by health insurance; but, in some cases a doctor’s prescription is needed or else you will need to pay out of pocket. Additionally, condoms and vasectomies (male sterilization) are not typically covered by health insurance. If budget is a concern, we recommend visiting your local Planned Parenthood or other local public health facility to discuss --
Would I be okay not getting my period anymore?
Some hormonal birth control can lighten or eliminate your period altogether (amenorrhea). For example, about half of women with a hormonal IUD have no periods after six months, and an additional quarter of women have lighter periods. On the other hand, the copper IUD – a non-hormonal method – is known to cause heavier periods.
Do I want children someday? If not, would I be open to a permanent or long-term solution?
For those who have thought about these important questions and have decided they aren’t interested in having children, sterilization may be a topic to discuss with their healthcare provider.
Now that you’ve weighed the relevant factors, let’s break down the different types of birth control, their effectiveness, and how to choose which method may be right for you. If you are interested in birth control, make sure you talk to your health care provider so they can help you distinguish which methods are best suited for you.
Birth control methods can be broken down into two umbrella categories: hormonal birth control and non-hormonal birth control. Let’s break down the different methods in these categories.
Hormonal Birth Control 101
Hormonal birth control methods are used to change the body’s chemistry through releasing hormones that prevent pregnancy, such as preventing the ovaries from releasing eggs or thickening cervical mucus to prevent sperm from reaching an egg. These methods of birth control usually involve the release of one or both of two hormones: estrogen and progestin. Most hormonal birth control methods will contain estrogen or a mix of estrogen and progestin.
Because hormonal contraceptives affect your body on a systemic level, side effects are not uncommon and can vary widely depending on how your body reacts with each method. Here are some of the most common side effects:
- Headache and migraine
- Breast tenderness
- Nausea
- Vaginal dryness
- Weight gain
- Acne
- Mood changes
- Decreased libido
- Missed periods or spotting between periods
It’s important to remember that trying out hormonal birth control can involve trial and error, as some methods work better for some than others. For example, you may begin with the pill and have moderate to severe side effects, but have almost no side effects with the ring. If you experience side effects that are intolerable to you or that last more than three months, talk to your doctor about switching to another method.
Here’s a breakdown of the main methods of hormonal birth control:
Pill
The birth control pill is one of the first developed and most popular methods of birth control. They typically come in a one-month pack and one pill is taken per day. The pill is known to be safe, effective, and affordable, which is why it is such a popular option. There are two types of birth control pills: combination pills (combined oral contraceptives and/or COCs) and progestin-only pills (POPs or mini pills). The combination pills include both estrogen and progestin hormones, while the progestin only pills contain only progestin.
- How does it work? The birth control pill prevents pregnancy by preventing sperm from joining with an egg, as well as safely stopping ovulation through the release of hormones. The hormones in the pill also thicken cervical mucus, which serves as a blocker for sperm so that it cannot fertilize an egg.
- How effective is it? The birth control pill is 91% effective when used correctly. To use the pill correctly, you must take it daily. The most common reason that the pill may not work is because people often forget to take their daily pill. Setting a reminder on your phone or keeping your pills next to something you use every day can help you remember to take it every day.
- Does this method prevent STIs? No
Patch
The birth control patch is a hormonal method of birth control that you wear on certain parts of the body. The patch releases hormones through your skin and body that prevent pregnancy. There are two brands of birth control patches in the United States: the Xulane and the Twirla patch.
- How does it work? The birth control patch prevents pregnancy in stopping sperm from fertilizing an egg by releasing estrogen and progestin hormones into the body. Through the release of these hormones, the patch stops ovulation, which means there is no release of an egg for the sperm to fertilize. This method also thickens the cervical mucus, which blocks sperm from swimming to an egg. The patch can be worn on four parts of the body: the belly, buttocks, back, or upper arm.
- How effective is it? When used correctly, the birth control patch is 91% effective at preventing pregnancy. To use the patch correctly, the prescription must be refilled on time and a new patch must replace the old one at the correct time. Noting your patch changes on a calendar you check often, setting reminders on your phone, and continuously checking your patch to ensure it is sticking correctly are ways that you can ensure it remains an effective method of birth control.
- Does this method prevent STIs? No
Vaginal Ring
The ring is a birth control method that is used by wearing a small and flexible ring inside the vagina. This method of birth control is effective 24/7 during use through releasing hormones into the body. NuvaRing and ANNOVERA are the two types of vaginal rings.
- How does it work? The ring works similarly to the other hormonal methods of birth control. During use, the ring releases estrogen and progestin hormones that prevent egg fertilization and ovulation. These hormones are absorbed through the vaginal lining. The two types of vaginal rings work differently. The NuvaRing lasts up to 5 weeks. After the 5 weeks is up, you take the old ring out of the vagina and put in a new one. The ANNOVERA ring lasts for 1 year. The ring is taken out of the vagina for 7 days after 21 days of use. After the 7 ring-free days are up, the ANNOVERA ring is put back into the vagina. This ring is not compatible with vaginal products that contain oil or silicone. Water based lubes are ok to use with the ANNOVERA ring.
- How effective is it? The ring is 91% effective when used correctly. Refilling the ring prescription and putting the ring in on time is essential for effective use. Putting your refill dates and insert dates on your calendar can help you remember to use your ring on time.
- Does this method prevent STIs? No
Shot
The birth control shot, also called the depo shot (Depo-Provera) is an injection that is given every three months to prevent pregnancy.
- How does it work? The shot contains the hormone progestin, which prevents pregnancy by stopping ovulation and thickening cervical mucus. A doctor or nurse administers the shot, so you must make an appointment every 12 to 13 weeks to receive another dose of the depo shot.
- How effective is it? The shot is 94% effective at preventing pregnancy if the shot is injected on time. Keeping your refill dates on your calendar, setting alerts on your phone, or having a partner remind you is a great way to stay on track.
- Does this method prevent STIs? No
Implant
The birth control implant, or Nexplanon, is a small and thin rod about the size of a matchstick that is implanted into the arm. Once a nurse or doctor implants the rod into your arm, it continuously releases hormones into the body that prevent pregnancy. The implant prevents pregnancy for up to 5 years.
- How does it work? Once the implant is implanted into the arm, it releases the hormone progestin into the body. This hormone thickens the cervical mucus and prevents ovulation, which prevents sperm from fertilizing an egg. The implant can last for up to 5 years, but if you decide you wish to get pregnant before that, it can just be taken out of the arm.
- How effective is it? This method of birth control has a very high effectiveness rate at 99%. It does not need upkeep or refills like other methods of birth control.
- Does this method prevent STIs? No
Hormonal IUD
A hormonal IUD is a device that is placed into the uterus to prevent pregnancy. The IUD is a small flexible device that is shaped like a T. There are four brands of hormonal IUDs and each has different time frames of effectiveness: Mirena (7 years), Kyleena (5 years), Liletta (7 years), and Skyla (3 years).
- How does it work? Hormonal IUDs release progestin, a hormone which thickens the cervical mucus and prevents ovulation. Cervical mucus thickens to prevent sperm from swimming to eggs. The prevention of ovulation makes it so that eggs are not released to be fertilized.
- How effective is it? The hormonal IUD is 99% effective at preventing pregnancy. Once the IUD is inserted, it remains effective until it's time frame expires and it needs to be taken out.
- Does this method prevent STIs? No
Your Options for Non-Hormonal Birth Control (Or Low-Hormone)
There are multiple more methods of birth control that are non-hormonal or include very few hormones. These include popular “barrier methods” like the condom which control prevent pregnancy by blocking sperm. People who wish to stay away from hormonal birth control or find they have side effects with hormonal birth control, and/or who also want to prevent the transmission of STIs, may prefer the methods listed below.
Condoms
Condoms are thin and stretchy pouches that are put onto the penis before and during sex that collect semen. Condoms are the #1 most commonly used method of birth control, so they are easy to find and buy at a low cost.
Did You Know There Are Different Types of Condoms?
There are three types of materials that are used to make condoms: latex, plastic, and animal skin.
Latex condoms are made from rubber and are the most common type of condom. These condoms prevent pregnancy and the spread of STIs. Be careful to only use water-based or silicone lube with latex condoms. Using oil-based lube with latex condoms can damage them during use.
Plastic condoms are made from materials like polyurethane, nitrile, or polyisoprene, which are types of plastic. These condoms are often used by people who have latex allergies. Plastic condoms can effectively be used to prevent pregnancy and the spread of STIs. Any type of lube is generally safe to use with plastic condoms unless the package directs otherwise.
Animal skin condoms, also called lambskin condoms, are made from the lining of animal intestines. These types of condoms are generally used by people who have latex allergies. Lambskin condoms prevent pregnancy but do not prevent the spread of STIs. Any type of lube can be used with lambskin condoms.
There are also internal condoms, often called “female condoms”. Internal condoms are similar to conventional condoms, but they are put inside of the vagina rather than on the penis during sex. They cover the inside of the vagina to catch sperm and prevent the sperm from reaching an egg. They reduce pregnancy and the risk of STIs.
- How do they work? Condoms collect semen and therefore prevent sperm from getting into the vagina.
- How effective are they? If used correctly, condoms are 85% effective at preventing pregnancy and internal condoms are 79% effective.
- Does this method prevent STIs? Some condoms prevent the spread of STIs and some do not. Latex, plastic, and internal condoms prevent the spread of STIs. Animal skin condoms do not.
Copper IUD
The copper IUD, also known as Paragard, is a small T-shaped device wrapped in a small amount of copper. It is effective at preventing pregnancy for 12 years.
- How does it work? The Paraguard IUD prevents pregnancy through its use of copper. Sperm is not compatible with copper, so the presence of the material in the uterus makes it almost impossible for sperm to get to the egg.
- How effective is it? The copper IUD is 99% effective at preventing pregnancy.
- Does this method prevent STIs? No
Diaphragm
A diaphragm is a shallow and bendable cup that is inserted into the vagina. The cup covers your cervix during sex in order to prevent pregnancy. You insert a diaphragm into the vagina by bending it in half.
- How does it work? The diaphragm works as a barrier to your cervix during sex, which prevents sperm from joining and fertilizing an egg. To maintain effectiveness, it is recommended that spermicide is used with a diaphragm.
- How effective is it? If used correctly, diaphragms are 88% effective at preventing pregnancy.
- Does this method prevent STIs? No
Birth Control Sponge
The birth control sponge (also called contraceptive sponge) is a small and round sponge made from plastic. The sponge is inserted deep in the vagina before sex, which covers the cervix and prevents pregnancy.
- How does it work? The sponge prevents pregnancy in two ways during use: it contains spermicide and covers the cervix which prevents sperm from getting to an egg. The sponge can be used alone or with condoms, which provides extra protection against pregnancy or STIs.
- How effective is it? The sponge is 76%-88% effective, depending on correct use and the addition of condoms.
- Does this method prevent STIs? No
Spermicide or Contraceptive Gel
Spermicide is a birth control that contains chemicals that stop sperm from reaching and fertilizing an egg. Spermicide is put inside the vagina before sex to prevent pregnancy. Spermicide can be bought over the counter at most drugstores and there is a contraceptive gel called Phexxi that can be prescribed.
- How does it work? Spermicide is a chemical that is inserted deep inside the vagina right before sex. It blocks the entrance to the cervix and prevents sperm from moving well enough to swim to an egg. This method can be used by itself or combined with other birth control methods, such as a diaphragm, cervical caps, or condom. Using spermicide with these methods can improve their effectiveness.
- How effective is it? This method is 72%-86% effective at preventing pregnancy.
- Does this method prevent STIs? No
Cervical Cap
A cervical cap is a cup made of silicone that is inserted deep inside the vagina to cover the cervix.
- How does it work? A cervical cap covers the cervix, which stops sperm from joining and fertilizing an egg. It is recommended to use spermicide with a cervical cap to maintain effectiveness.
- How effective is it? Depending on whether spermicide is used with a cervical cap, the effectiveness ranges from 71% to 86%.
- Does this method prevent STIs? No
Fertility Awareness
Fertility awareness is a method of birth control in which one tracks their ovulation in order to prevent pregnancy. This method is also referred to as “natural family planning” and “the rhythm method”.
- How does it work? Tracking ovulation cycles can help prevent pregnancy as the days near ovulation are your most fertile days. Someone using the fertility awareness method would avoid sex or use another birth control method in the days near ovulation. The three most popular methods of fertility awareness are the temperate method, the cervical mucus method, and the calendar method. It is recommended to combine all three of these methods for maximum effectiveness. This method requires discipline and awareness, so it can be more daunting to take this method on. To read more in depth about the fertility awareness method, check out Planned Parenthood's fact sheet.
- How effective is it? If done correctly and carefully, this method is between 76%-88% effective at preventing pregnancy.
- Does this method prevent STIs? No, not unless other methods like condoms are used.
Breastfeeding As Birth Control
Breastfeeding can be used as a form of birth control because when you are engaging in breastfeeding, your body naturally stops ovulating. No ovulation means you cannot get pregnant and you also can't have your period.
- How does it work? This method is effective when you are exclusively breastfeeding (EBF), which means you are nursing at least every four hours during the day and every six hours at night. This method is only effective if you are actually nursing your baby, and not if you are using a breast pump. This method can be used for up to six months after the baby is born.
- How effective is it? If done correctly, this method is 98% effective at preventing pregnancy.
- Does this method prevent STIs? No
Withdrawal Method
The withdrawal or pull-out method is a way to prevent pregnancy by keeping semen away from the vagina, often during ejaculation.
- How does it work? The pull out or withdrawal method is when the penis is pulled out of the vagina before ejaculation. In order for this method to be effective, you have to pull out before any semen comes out of the penis every time you have vaginal sex. This method is not the most effective, so it's recommended to combine it with the use of condoms or spermicide.
- How effective is it? If done correctly, this method is 78% effective at preventing pregnancy.
- Does this method prevent STIs? No
Female Sterilization
Female sterilization is a permanent surgical method of birth control in which the fallopian tubes are closed, cut, removed, or blocked.
- How does it work? Pregnancy occurs through the fertilization of an egg during ovulation. The egg moves through the fallopian tubes waiting for sperm to fertilize it. Once the fallopian tubes are blocked or removed after sterilization, pregnancy becomes impossible. Sterilization is only for those who know they will never want to get pregnant in the future.
- How effective is it? This method is 99% effective.
- Does this method prevent STIs? No
Male Sterilization (Vasectomy)
A vasectomy is a surgical procedure that blocks or cuts the vas deferens tubes in the penis.
- How does it work? The vasectomy procedure involves cutting or blocking the vas deferens tube in the penis, which is a tube that carries sperm during ejaculation. This procedure stops sperm from leaving the body, which prevents the possibility of getting someone pregnant. There are two types of vasectomies: the incision method and the no-cut method. This procedure is often permanent.
- How effective is it? The procedure is 99% effective at preventing pregnancy.
- Does this method prevent STIs? No
If you are interested in one of these birth control methods and want to know if it is right for you, be sure to consult with your doctor to get more information and make the best decision for you.
