What type of birth control should I use?
There are several different methods of contraception and each method has its pros and cons. There is no “one size fits all” when it comes to pregnancy prevention. Determining the most appropriate form of birth control may require a detailed discussion in order to best meet your contraceptive needs.
What methods of pregnancy prevention are available?
Because there are so many options to consider when it comes to choosing a contraceptive, it may be helpful to first break up your options into categories of the following natural family planning / fertility awareness based methods.
Combined hormonal contraceptives
Combined hormonal contraceptives work by using a combination of an estrogen and a progestin to prevent ovulation (release of an egg). The combined hormonal contraceptive methods include the birth control pill (“the pill”) which is taken daily, a contraceptive patch (Xulane, Twirla) which is changed out weekly, and the contraceptive ring (Nuvaring) which is exchanged monthly. These methods are about 91% effective at preventing pregnancy.
“The Shot” (Depo Provera)
This method of birth control uses only one hormone, a progestin, to stop ovulation from happening which prevents release of an egg in order to protect against pregnancy. Progestin is very similar to the hormone progesterone that our bodies make naturally. The shot is given once every 3 months. This method of contraception is about 94% effective.
Barrier methods block sperm from reaching the egg. Some forms of barrier methods can reduce the risk of the spread of sexually transmitted infection. Condoms, spermicide, and “the sponge” are barrier methods that can be purchased at most pharmacies without a prescription. Two other barrier methods, the cervical cap and the diaphragm, are methods that are prescribed by a health care provider. Phexxi is an intravaginal gel available by prescription that works by lowering sperm mobility which reduces the chance the sperm will reach the egg. These methods are about 80% effective at preventing pregnancy.
Long acting reversible contraceptives (LARC)
LARC includes the intrauterine devices (IUDs) and the implant (Nexplanon) which goes in the upper arm. LARC methods are safe and highly effective in preventing pregnancy. They last for several years, and you can stop using them at any time if you choose. These methods of contraception are 99% effective.
There are 2 different types of IUDs. The copper IUD (Paragard) which is non-hormonal and the progestin-containing IUDs (Mirena, Liletta, Kyleena, Skyla). Progestin is very similar to the hormone progesterone that our bodies make naturally. The progestin in the IUDs helps to make for shorter, lighter periods, and some women with the progestin-containing IUDs enjoy the benefit of no periods at all.
The contraceptive implant (Nexplanon) uses a progestin to prevent pregnancy. It is a flexible, plastic rod about the size of a matchstick that is inserted just under the skin in the upper arm. Nexplanon is approved for use for up to 3 years.
Female sterilization or “getting your tubes tied” is a surgical procedure performed to prevent pregnancy. During the procedure the fallopian tubes are closed, cut or a portion removed in order to block the path that the egg and sperm travel so that the sperm cannot meet up with the egg to fertilize it. Female sterilization is 99% effective at preventing pregnancy and is considered permanent and not intended to be reversible. Male sterilization is accomplished through a procedure called a vasectomy. During this procedure the vas deferens tubes are tied, cut, clipped, or sealed to prevent the release of sperm into the semen. Male sterilization is 99% effective at preventing pregnancy and is considered permanent and not intended to be reversible.
Does birth control prevent sexually transmitted infections (STIs)?
Condoms are the only form of birth control that may help to reduce the risk of spread of sexually transmitted infections (STIs). There are two different types of condoms, the male condom which is placed on the penis and the female condom which is worn inside the vagina. DO NOT use a male and female condom together. Latex and polyurethane condoms provide the best available protection against STIs. Condoms should be used with a lubricant to prevent them from tearing or breaking and to reduce irritation. Use only water-based or condom-safe silicone lubricants with latex condoms. Throw condoms away after use.