Which Birth Control Option Is Right for You?
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Which Birth Control Option Is Right for You?

From pills to patches, get the lowdown on your options for contraception.

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By Olivia DeLong

When it comes to birth control, there are more options than ever before. But with so many possibilities, it’s hard to know which route is right for you.

Some methods contain hormones that interfere with ovulation, or the release of the egg from the ovaries. Some disrupt the fertilization process—the meeting of the sperm and egg—or the implantation process, which is the attachment of an embryo (the dividing cells made from the egg and sperm) to the uterine wall. Other devices simply block the sperm from reaching the egg to begin with. And some do all of the above.

When you're choosing birth control, it’s important to remember that you’ll want to protect yourself from sexually transmitted infections, too, and not all methods do.

If you’re on the hunt for a contraceptive, the best thing to do is to talk to your OBGYN about the possibilities and pros and cons of each. But in the meantime, here’s a quick guide to help you keep all of your options straight.

Hormonal methods

2 / 8 Hormonal methods

Traditional hormonal birth control methods are popular and come in a variety of different forms, including pills, rings and patches.

These methods contain estrogen and progestin or progestin only, two hormones that can prevent ovulation, thicken the cervix—so it’s harder for sperm to find the uterus—and thin the lining of the uterus, which reduces the chance of implantation.

According to the American College of Obstetricians and Gynecologists (ACOG), with typical use (accounting for some missed pills and misuse), just 9 percent of women taking combined hormonal birth control will become pregnant during the first year. When used correctly 100 percent of the time, fewer than 1 out of every 100 women will become pregnant within a year of use. Progestin-only methods have similar success rates.

  • Pills: Some combination pills are taken for 21 days then stopped for 7 days or replaced with inactive or estrogen-only pills for 7 days. Other options are taken for 90 days, with inactive or estrogen-only pills being used the last 7 days. And some are taken consistently for 365 days to prevent or reduce bleeding altogether.
    Progestin-only pills (or “minipills) are taken continuously 28 days, without a hormone-free week.
  • Rings: Vaginal rings contain estrogen and progestin. They're inserted into the vagina, where they stay for 21 days, and are then removed for 7, at which time you’ll get your period. You'll likely need a new ring each month, though rings that can be reused for 13 cycles have recently been approved by the FDA.
  • Patches: Contraceptive skin patches with estrogen and progestin are placed on the buttocks, chest (anywhere except the breasts), upper back, arms or abdomen and changed out every week for three weeks. On the fourth week, the patch is removed and you get your period.
  • Implants: Inserted into the upper arm, this matchstick-size rod contains progestin, and lasts for up to four years.
  • Injections: Progestin-only shots are given every 13 weeks by an OBGYN, and the first one can be given any time during your cycle (as long as you’re not pregnant).

Some of these hormonal methods can be taken or used continually without skipping a week, so talk with your doctor about the best choice for you.

IUDs

3 / 8 IUDs

Many experts recommend intrauterine contraceptive device (IUDs), a form of long-acting reversible contraception (LARC). IUDs are small, T-shaped plastic pieces that are inserted into the uterus and left in for up to 3 to 10 years at a time, depending on the type.

Some hormonal IUDs release progestin, which helps to thicken cervical mucus, making it harder for the sperm to reach the egg in the fallopian tubes. Progestin also causes the lining of the uterus to thin, which makes it difficult for implantation to occur. Copper IUDs release copper, which restrict sperm’s mobility, and in turn, make it harder for sperm to reach the egg.

According to ACOG, IUDs have better prevention rates in the long run; they're 20 times more effective than hormonal methods like pills, patches or rings. IUDs may also lessen menstrual bleeding and cramping over time.

Barrier methods

4 / 8 Barrier methods

Barrier methods block sperm from getting to the egg. There are a variety of types; some can be purchased over the counter while others require a prescription. Women and men may opt for these contraceptives because they're hormone-free and easily accessible. About 18 to 28 women out of 100 will become pregnant when using these techniques for a year. Barrier methods include:

  • Diaphragms: Before sex, reusable cups made of rubber or silicone are placed deep into the vagina, with the rim behind the pubic bone. Diaphragms are used with a spermicide.
  • Cervical caps: Also used with a spermicide, these small plastic domes are placed over the cervix and must stay in for 6 hours after sex, but no longer than 48 hours total.
  • Condoms: Male condoms are made of rubber, plastic or animal casings, and placed over the penis and worn during sex. Female condoms are thin plastic pouches that slide inside the vagina and are held in place by rings at both ends. Condoms protect against sexually transmitted infections, too, although male condoms are slightly more effective than female condoms.
  • Spermicide: These lubricants, usually in the form of gels, foams, creams or suppositories contain a chemical called nonoxynol-9, which destroys sperm. Spermicides are inserted to the vagina, close to the cervix, and are effective up to an hour after application.
  • Sponges: Filled with spermicide, these round, disposable foam devices are inserted into the vagina to cover the cervix. Sponges should stay in place for 6 hours after sex, but not longer than 30.
Natural methods

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Natural birth control, or birth control methods that can usually be followed without a prescription or specific device, is another way couples choose to use protection.

The withdrawal method, or coitus interruptus, involves pulling the penis out of the vagina right before ejaculation, or the release of semen. It’s still possible for sperm to enter the vagina, though, if there is some pre-ejaculation fluid with sperm, or if the penis isn’t fully withdrawn before ejaculation begins. Up to 28 women out of 100 may get pregnant using the withdrawal method as birth control.

Lactation amenorrhea (LAM) is based on breastfeeding—for women who have recently given birth, nursing prevents ovulation, which makes it impossible to get pregnant. There are some guidelines, though: breastfeeding must be done every four hours or more during the day, and every six hours or more during the night. And, this method should only be used for up to six months after birth, or until a woman’s period returns. Although US research is sparse on the topic of LAM, Planned Parenthood reports that just 2 out of 100 women using LAM correctly would get pregnant in the six months post-birth.

And of course, completely abstaining from all sexual activities, including vaginal and anal sex, is considered to be 100 percent effective in preventing pregnancy. There is a chance that semen anywhere near the vagina—even during anal sex—can make its way into the vagina.

Fertility Awareness methods

6 / 8 Fertility Awareness methods

In a nutshell, fertility awareness means knowing when you’re the most fertile and using that to either boost or lower your chances of becoming pregnant. There are a variety of ways to do either, including the standard days method, basal body temperature (BBT) method and cervical mucous method.

The standard days method takes into account the length of your typical menstrual cycle as the basis for your most fertile days. Many women with a cycle lasting between 26 and 32 days are most fertile between days 8 and 19. For those who wish to prevent pregnancy, abstaining from sex (or using other forms of contraception) during that time is key.

Basal body temperature (BBT) methods involve taking your BBT at the same time every morning before you get up and move about. During ovulation (when you are the most fertile), your temperature usually rises 0.5 to 1 degree, and then stays higher through the end of your cycle. Women are most fertile the two to three days prior to the temperature increase. Nowadays, there are phone applications to help track your BBT, and inform you whether it’s “safe” to have sex.

The cervical mucous method involves observing the discharge that’s present in your underwear or on the tissue when you wipe. During your most fertile days, or the days around ovulation, you should notice thin, slippery mucous similar to the consistency of egg whites. To prevent pregnancy, avoid intercourse or use a barrier method whenever you have slippery mucous.

When used correctly 100 percent of the time to prevent pregnancy, 1 to 5 women out of 100 will get pregnant after using a fertility awareness method for a year. With typical use, 12 to 24 women out of 100 will become pregnant during the first year of use.

Sterilization

7 / 8 Sterilization

Sterilization procedures are for those who want permanent birth control, and there are options for both men and women.

For successful fertilization to occur, an egg released from your ovaries must travel through the fallopian tubes to find the sperm. A procedure called tubal occlusion or ligation—also known as having your tubes tied—closes off the fallopian tubes so this cannot happen.

Tubal occlusion can be done as an outpatient procedure anytime, or following a vaginal birth or C-section. The technique is very effective—fewer than 1 out of 100 women will get pregnant within a year.

Men can have vasectomies to lower the chances of a woman becoming pregnant. During this procedure, the vas deferens—which carries sperm from the testes—is cut, tied, clipped or sealed so the sperm cannot be released, and thus, cannot meet the egg. In terms of preventing fertilization, vasectomies are just as effective as tubal occlusions, if not more so.

In some cases, these procedures can be reversed, but it may be difficult to get pregnant afterwards.

Emergency contraception

8 / 8 Emergency contraception

It’s possible that some birth control methods will break, become dislodged or fail during intercourse. If this happens, you may want to consider emergency contraception options, which can lower the chances of pregnancy, after the fact.

Copper IUDs are the most effective for emergency contraception, as they make it difficult for the sperm to fertilize the egg. They must be inserted within 5 days after unprotected sex by an OBGYN, and after that, they can be used for long-term birth control for up to 10 years. When copper IUDs are inserted within 72 hours of unprotected sex, it’s predicted that they can prevent more than 95 percent of pregnancies.

Emergency contraception pills are another form of emergency contraception that should be used as soon as possible after sex. Otherwise known as the morning-after pill, there are three different types available in the US, all of which prevent or slow ovulation or lower the risk of fertilization.

  • One kind contains levonorgestrel, a type of the female hormone progestin, and can be purchased over the counter.
  • Another contains ulipristal acetate, a progesterone (or sex hormone) antagonist, and must be prescribed by your doctor.
  • The last kind, which isn’t quite as effective as progestin-only pills, is a combined form of emergency contraception containing estradiol (estrogen) and levonorgestrel. These combined methods may require a prescription and most of the time, two or more pills are needed, depending upon the type.

When used 72 hours after intercourse, ulipristal acetate pills prevent two-thirds of pregnancies, while levonorgestrel pills prevent about 50 percent of pregnancies.

When deciding on birth control, talk with your OBGYN or primary care physician. Together, you can decide the most effective option for you.

Birth Control

Birth Control

Do you want to prevent pregnancy? Do you want to prevent sexually transmitted diseases (STDs)? Those are the primary factors in deciding which type of birth control method you use. You have many options of birth control including ...

condoms, birth control pills, the patch, the vaginal ring, the IUD, hormone shots and implants, as well as sterilization. Make your decision based on factsincluding the failure rates for each type. And make sure you use the birth control method correctly each timeto avoid unplanned pregnancy.
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