Birth Control Basics - Know your options and make the best choice for you
Perhaps you're new to using birth control methods, or maybe you've tried a few and are looking for the right fit. Choosing the right birth control for you can feel daunting, and like there are too many options.
The truth of the matter is that there are tons of different birth control options available. Many are equally effective, but not all of them will be ideal for you.
Every person has a different body and different hormonal balance. What works for your best friend may be the worst form of birth control you've ever tried.
It may take some trial and error but always speak with a doctor before choosing any form of birth control (other than a condom.)
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Why do people take birth control?
The vast majority of birth control methods on the market are designed for women to take to prevent pregnancy.
They do NOT protect against any STI, STDs, or BBVs.
Certain types of birth control options can help you with acne. Others help you to control your period. Many allow you to skip your period entirely, and there are even hormone-less options available now!
Many forms of pregnancy prevention will have very high efficacy ratings, but those are based on ideal use. That means you follow the instructions to the T and never miss a single minute of usage. Of course, there are plenty of options where the possibility of human error is small.
How do I choose the right birth control?
You need to consider a few different factors before selecting the right birth control for you. Consider the following questions:
How effective do I want it to be?
The most effective forms of birth control are the ones that require the least amount of intervention from you. Again, the human error component is the reason most pregnancy prevention fails. The most effective methods are the longest acting. They often require a minor procedure such as the IUD or the implant.
If you're not having vaginal intercourse with a penis, then effectiveness may not be your main priority.
How easy do I want it to be?
Again the human error potential is critical.
Are you a forgetful person?
Or are you someone who sticks well to routines?
Some options like the pill you have to remember to take at the same time every day.
Others require weekly replacement, or even a replacement every 5+ years.
Consider who you are, your needs, and if you'll want to get pregnant sooner rather than later.
Do I want it to help with menstruation?
Many forms of contraception boast that they can help you skip, control, or avoid your periods altogether. It is perfectly healthy to skip or avoid your period. However, just because a type of birth control is well-known for it doesn't mean it'll work for you.
Many short-acting forms of birth control share similar hormone composition with the long term options. Ask your doctor if you can try out one form of short-acting (noncommittal) birth control first. That way you can see if your body works well with that particular hormonal blend.
Is it important for me to avoid a doctor or nurse?
Trying to avoid talking to your doctor by doing online research? You absolutely need to discuss with a doctor or nurse before trying a form of hormonal contraceptive. Some require a minor medical procedure. Most long-acting options require at least one doctor's visit for a minor procedure. Usually, these aren't a huge deal and are done in a regular doctor's office.
Am I sensitive to hormones?
Of course, different forms of birth control have different amounts of certain hormones that make them effective. Some people require a high dosage of hormones to get all of a pill's benefits. Others are more sensitive to those hormones and want to use as little or none if possible. Speak with your doctor or specialist about low or non-hormonal options to find out which is best for you.
The common side effects of birth control
Every medication comes with a long list of potential side effects.
Often the reward of the drug is worth the risk of the side effects.
Also, those side effects are often relatively rare, and odds are you won't have them.
Hormonal birth control options often have the most noticeable side effects, including:
Breakthrough bleeding, aka bleeding between menstrual cycles
Irregular periods
Lighter or skipped periods
Reduced cramping and discomfort during menstruation
Nausea
Headaches
Less acne
Mood changes
Weight gain
Sore breasts
Headaches
Of course, the side effects will vary from contraceptive type to type and from person to person.
Also, the side effects often lessen after you've used that form of pregnancy prevention for an extended time.
Common types of birth control for women
The statistics and facts stated here are taken from many sources at the time of publishing this article. You can find further information about birth control available in your area on your government website.
Low maintenance contraceptive options
These are ideal for people who may not have the best memory or are worried about the human failure rate.
These are considered "low maintenance" options because they're long-acting.
Some options are inserted by a doctor or nurse and can last more than a decade, and others work for a few months.
These are the "set-it-and-forget-it" types.
They're also great options if having children isn't something on your radar for several years.
These are all reversible options! If you decide you want kids sooner than you planned or if you don't like birth control you can easily have them reversed.
Always talk to your doctor and see which is the best option based on your lifestyle and needs.
The IUD
Copper Effectiveness: Over 99%
Hormonal effectiveness: Over 99%
Cost: $0-$1300 depending on country and insurance
Ease of use: Insert it once and have pregnancy prevention for 3-12 years
The IUD (Intrauterine Device) is a small device inserted into your uterus used to prevent pregnancy. It is a small "T" shaped pregnancy prevention option that needs to be inserted by a doctor or nurse.
There are both hormonal and non-hormonal options available. Their window of effectiveness is based on the hormone type and style of IUD.
The birth control implant
Effectiveness: ~99% if used correctly
Cost: $0-$1300 depending on country and insurance
Ease of use: Insert it once and have pregnancy prevention for up to 5 years
Often called "the chip," the birth control implant is a tiny, thin, plastic rod about the size of a match. Depending on the type, it can be implanted into your upper arm to prevent pregnancy for up to 5 years. It slowly releases hormones into your body to prevent pregnancy.
Most women will notice a change in menstruation patterns, and some will stop having their period altogether.
The contraception injection or the shot
Effectiveness: ~94% if used correctly
Cost: $0-$150 depending on country and insurance
Ease of use: Get 1 shot every 3 months
The contraceptive shot is an injection you get from a doctor or nurse every three months. It is a safe and relatively private form of contraception that is very effective when done on time. Some places let you take a supply of shots home to give them to yourself. Otherwise, make sure you book your appointments every 12-13 weeks.
Generally, most medical practitioners recommend you only use the injection for 2 years maximum.
After getting the shot, it can also take up to 10 months to get pregnant.
Schedule dependent contraceptive options
Schedule-dependent birth control options mean you have to actively remember to use the contraceptives.
Some are lower maintenance, only needing to be replaced once a month, and others you need to take daily.
Again, it all depends on what suits your lifestyle and hormonal sensitivities best.
The birth control vaginal ring
Effectiveness: ~91% if used correctly
Cost: $0-$200 depending on country and insurance
Ease of use: Put in and take out once per month
The ring is very effective if used correctly. You insert the small, flexible ring inside the vagina. It will slowly release hormones into your body over the month. While you may feel uncomfortable with the idea of you having to put it inside yourself, don't worry. If you can't feel it when you're walking around, you've done it correctly. If you can feel it, just push it in a little deeper. It can be left inside you during sex or any other type of physical activity.
You can also safely leave your ring in during your period and use period products such as tampons.
There is quite a bit to know about the vaginal ring, so make sure you ask your doctor any further questions.
The birth control patch
Effectiveness: ~91% if used correctly
Cost: $0-$150 depending on country and insurance
Ease of use: Replace weekly
If used correctly, the birth control patch is a very effective means of preventing pregnancy. You wear it on your skin, and it slowly releases hormones into your body to prevent pregnancy.
Where you can put it is based on the brand of birth control patch you use, but often it's the belly, butt cheek, or back. Pick a spot that isn't a high friction area (such as a waistband area) and where it can lie flat. Also, don't put it on the same spot every time.
You don't need to wear the patch while you're on your period. Otherwise, change it weekly!
The combined pill or "the pill"
Effectiveness: ~99% if used correctly
Cost: $0-$50 depending on country and insurance
Ease of use: take daily
The combined pill has two hormones that prevent the lease of an egg each month. While taking the combined hormonal pill, you'll likely get all of the positive side effects of birth control. Some of these are clearer skin and complete control over when you have (or if) your period.
While the classic pill comes with 21 days of active pills, they still have 7 days of placebo or inactive pills. Skip over the placebo pills and go straight to your next pack to prevent your period.
For the most effective use, set the alarm on your phone and take the pill at the same time every day.
Speak with your doctor about which type of pill is best for you. There is a massive range of options available - many with higher hormone doses.
The progesterone-only pill, "POP" or mini-pill
Effectiveness: ~99% if used correctly
Cost: $0-$50 depending on country and insurance
Ease of use: take daily
The mini-pill only has one hormone that works to prevent pregnancy. It's just as effective as the combined pill, and only it has fewer hormones. It is slightly different in that it doesn't prevent ovulation, but it does prevent the sperm from fertilizing the egg.
For the most effective use, set the alarm on your phone and take the pill at the same time every day.
Lifestyle pregnancy prevention options
Lifestyle-dependent contraception options are ideal for people in a long-term monogamous relationship.
They have been tested for STIs and BBV's. Ideally, they are paired with a barrier method such as a condom, but most people won't do that.
These often involve daily observations and keeping track of yourself. Therefore, their effectiveness will depend heavily on how reliable your cycle, partner, and awareness are.
Fertility awareness
Effectiveness: ~76-88% if used correctly
Cost: $0-$20 (apps, thermometer, etc.)
Ease of use: Tracking is done daily
Fertility awareness methods (aka FAMs or "the rhythm method") involve you tracking your ovulation cycle to prevent pregnancy. You track your menstrual cycle, so you know when an egg is released from your ovary or ovaries each month.
This method isn't very effective, has a high failure rate, and involves a high level of self-control and awareness.
Some people rely on taking their temperature each morning, as your temperature will rise during ovulation.
You have the option of checking the amount of mucous in and around your cervix daily.
Or just charting your menstruation and PMS symptoms on a calendar.
The pull out method
Effectiveness: ~78% if used correctly
Cost: $0
Ease of use: Use every time during sex
The withdrawal method or "pull out method" prevents pregnancy by keeping ejaculate away from the vagina. The penis owner is expected to withdraw from the vagina before ejaculation. Doing this greatly reduces the possibility of pregnancy.
Ejaculating away from the vulva or vagina can often prevent pregnancy. However, pre-ejaculate can still get a person pregnant.
If you use this method, pair it with another means of birth control such as the ring, condom, or pill.
Breastfeeding as birth control
Effectiveness: ~98% if done correctly
Cost: $0
Ease of use: Breastfeed every 4-5 hours
The breastfeeding method only works if a person has recently given birth. When you're nursing, you should be feeding the baby every 4-6 hours, which can prevent ovulation. Without ovulation, you also cannot get pregnant. But, it only works with perfect use and skin-to-skin nursing with the child. Pumping breast milk or using formula sometimes means that it will not be an effective way to prevent pregnancy.
Once your period returns, breastfeeding will no longer prevent pregnancy.
Abstinence or outercourse
Effectiveness: 100% if done correctly
Cost: $0
Ease of use: Depends on your self-control
I hesitate to even include this as an option as a sexologist, but you deserve to know your options. The only way to 100% prevent pregnancy is not to have penetrative sex. By not having sperm anywhere near a vagina, you will be able to avoid pregnancy 100% of the time.
Outercourse refers to the "everything but" definition. So you can engage in another type of sexual activity so long as the penis and vagina are not in direct contact.
Abstinence means different things to different people. For some people, it means avoiding ALL types of sexual activity. For others, it means avoiding only certain sexual acts.
Your definition is up to you.
Sexual use
Sexual use contraceptives mean that you use them only when you're about to have sex.
Many of these, such as condoms, are considered "barrier methods." Only condoms are shown to help prevent the spread of STIs or BBVs. If you're having "higher-risk sex" (i.e., with multiple partners, group sex, unprotected sex, etc.), always use a condom to protect yourself.
These tend to have a higher failure rate as they're not designed to impact your hormones. Instead, they're designed to only prevent the sperm from getting to the egg. Therefore, these are slightly higher-risk options if they're your only form of birth control.
External condom
Effectiveness: ~85% if used correctly
Cost: $0-$2
Ease of use: Use every time you have sex
They go by countless names, a jimmy, a rubber, a johnny, or just a condom. These are the types of condoms you roll onto a banana in health class. These are thin, stretchy pouches worn on a penis during sex.
Many men complain they're too small (get a different brand,) they're uncomfortable (get a different style), or they reduce sensation (get a thinner style.)
There are three main types of condoms: latex, plastic, and lambskin. Latex condoms or plastic condoms are the most effective. Whereas animal skin condoms don't prevent STDs, they only lessen the chance of pregnancy.
Internal condom
Effectiveness: ~79% if used correctly
Cost: $0-$3
Ease of use: Use every time you have sex
Also known as the "female" condom, these are worn inside a vagina as an alternative to external condoms. They provide a similar level of protection from STIs and pregnancy without the "discomfort" of external condoms.
These soft pouches cover the inside of your vagina, creating a barrier that prevents the sperm from reaching the egg. It also helps prevent sexually transmitted infections.
Spermicide
Effectiveness: ~72-86% if used correctly
Cost: $0-$270
Ease of use: Use every time you have sex
Spermicide is a gel you put deep inside your vagina before you have sex. It helps prevent pregnancy by blocking the entrance to the cervix. It also stops sperm from moving well enough to swim to the egg.
You don't need a prescription. You can buy it over the counter at most pharmacies and grocery stores in the condom aisle.
The significant factor is that spermicide is damaging to pH levels and lining of the vagina. It can make it more likely that you'll get a UTI or STI because of the damage done to the vaginal walls.
The sponge
Effectiveness: ~76-88% if used correctly
Cost: $0-$15
Ease of use: Use every time you have sex
Made famous by the sitcom Seinfeld, the sponge is a form of birth control. It is placed deep in the vagina before having sex. It contains spermicide and blocks sperm from getting to the cervix.
The sponge can be used by itself but is best used with a condom.
They're not a commonly used birth control technique. Most brands have been pulled from pharmacy shelves as they contain harmful spermicides.
Diaphragm
Effectiveness: ~71-88% if used correctly
Cost: $0-$75
Ease of use: Use every time you have sex
A diaphragm is a soft, bendable cup put inside the vagina before sex. Made of soft silicone, it is intended to work as a barrier preventing sperm from getting into the cervix. Pair your diaphragm with a spermicide for better protection.
Birth control & pregnancy prevention within relationships
Your uterus, your opinion. You are in control of if and when you'll have a family. Ensure that you're fully ready to have and raise a child. Prevent pregnancy by using a long-acting birth control method such as the pill or the IUD. Speak to your doctor first about what options are available to you based on your needs and lifestyle.
Remember that no two people are the same. What works for you won't work for your friend. Different bodies have different side effects. You may or may not find the right contraceptive on the first try.
Take your time and research before starting any pregnancy prevention option, so you know how to use it best.
“If men got pregnant, there would be safe, reliable methods of birth control. They’d be inexpensive, too.”
— Anna Quindlen
MEDICAL DISCLAIMER
Although I am a sexologist, I am not a medical professional. All content and information in this blog and on this website are for educational and informational purposes only. It does not constitute medical advice, nor does it establish a client-coach relationship. Although we strive to provide accurate and helpful information, the information here is not a substitute for any medical or medical professional advice. You should not rely solely on this information. Always consult with your doctor, GP, gynecologist, urologist, or other specialists before making any medical decision. If you need medical help or advice, please seek professional help from someone in a relevant field.
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