Which Method of Contraception Is Right For You?
There are tons of contraceptive options on the market right now, which is great because it gives more opportunity for a variety of people to engage in safe sexual activities, without the risk of getting pregnant. Having plenty of options allows for people to choose which form of contraception is the best fit for them based on their lifestyle, as well as the safety, effectiveness, and availability of the contraception method. Continue reading below as we discuss the differences between all the methods of contraception, to find which one best suits you.
Hormonal Methods:
Implants: Implants are small rods that are placed under the skin of the upper arm. They release progestin which stops the ovary from releasing the egg and thickens cervical mucus, making it difficult for sperm to enter the uterus. The current implants offered in the United States are Nexplanon® and Impanon®. They can be implanted underneath the skin for up to 3 years before needing to be replaced. Typical use failure rate: 0.1%
Injections: Progestin is injected into the arm or buttocks every 3 months. Depo-Provera® is the injection that is currently used in the US. This method of contraception can cause a temporary loss of bone density, especially in adolescents. It is recommended to eat a diet rich in calcium or vitamin D or to take supplements while taking this medication. Typical use failure rate: 4%
Combined Oral Contraceptives aka “The Pill”: COCs contain synthetic estrogen and progestin hormones, which function to inhibit ovulation. The pill is taken once a day, preferably at the same exact time each day. There are many different types of oral contraceptive pills available, so talking to your healthcare provider will ensure you are taking the correct one for your needs. Typical use failure rate (when used correctly): 7%
Progestin Only Pill aka “The Mini Pill”: The progestin only pill contains progestin, as opposed to the combine oral contraceptives which contain both estrogen and progestin. It is also taken once per day, at the same exact time. This may be an option for women who cannot take estrogen, such as if they are experiencing estrogen-dominance. Typical use failure rate (when used correctly): 7%
Patch: This is a thin, plastic patch that is placed onto the lower abdomen, buttocks, outer arm, or upper body that releases progestin and estrogen directly into the bloodstream. It is worn for 3 weeks, and on the 4th week you do not wear one so that you can enable menstruation. A new patch is placed 7 days after that. Ortho Evra® is currently the only patch in the US that is FDA approved. Typical use failure rate: 7%
Vaginal Ring: This is a thin, flexible ring about 2 inches in diameter. The ring is inserted into the vagina where it releases ethinyl estradiol and a progestin. It is kept in the vagina for 3 weeks, and on the 4th week it is removed to enable menstruation, similarly to the patch method. A new ring is inserted 7 days after that. The NuvaRing® is currently the only FDA approved vaginal ring in the US. Typical use failure rate: 7%
Intra-Uterine Methods:
Hormonal Intra-Uterine Device: A hormonal IUD releases a progestin hormone (Levonorgestrel) into the uterus, which causes thickening of cervical mucus, inhibits sperm from reaching the egg, thins the lining of the uterus, and may prevent the ovaries from releasing eggs. This type of IUD can stay in the uterus for 3-6 years, depending on the device, and can be taken out anytime before that as well. Typical use failure rate: 0.1-0.4%
Copper IUD: A copper IUD prevents sperm from reaching and fertilizing the egg, and may prevent the egg from attaching in the womb. A copper IUD can remain in the body for up to 10 years, and can also be removed at anytime. Currently, the only FDA approved copper IUD in the US is ParaGard®. Typical use failure rate: 0.8%
*For both types of IUDs, although uncommon, expulsion of the device from the uterus may occur, requiring the device to be reinserted. During any time, if pregnancy does occur, the physical presence of the device prevents the fertilized egg from implanting into the lining of the uterus, increasing the risk of an ectopic pregnancy.
Barrier Methods:
Male Condoms: Latex condoms are the most common type, placed over a man’s penis to prevent sperm from entering the woman’s vagina. Condoms should always be worn whenever having intercourse with any new partners because they are the only forms of contraception that also reduce the risk of spreading sexually transmitted infections (STIs). Condoms are worn only once and disposed of after use. Typical use failure rate: 13%
Female Condoms: These are thin, flexible plastic pouches that are inserted into the vagina up to 8 hours prior to having sex in order to prevent sperm from entering the uterus. Female condoms may also prevent the spread of STIs and should also be disposed of after one use. Typical use failure rate: 21%
Sponges: Contraceptive sponges are placed into the vagina before intercourse, similarly to female condoms. They contain spermicides which blocks sperm from entering the uterus and kills sperm cells. The sponge should be left inserted into the vagina at least 6 hours after intercourse and removed within 30 hours. The Today® Vaginal Contraceptive Sponge is the only FDA approved sponge in the US. Typical use failure rate: 14%
Diaphragm: The diaphragm is a shallow, flexible cup made of latex that is inserted into the vagina before intercourse, blocking sperm from entering the uterus. Spermicidal cream should be used with the diaphragm. The diaphragm should stay in place 6-8 hours after sexual intercourse to prevent pregnancy, but should be removed within 24 hours. Diaphragms can be used for 1-2 years before getting a replacement. Typical use failure rate: 17%
Fertility Awareness Method:
Fertility awareness methods are ways to track ovulation in order to prevent pregnancy by measuring your temperature, checking cervical mucus and/or tracking your menstrual cycles. This method requires the female to know when she is ovulating (aka the fertile window) and to avoid having sex during these days, or use an alternative contraceptive method like a condom. This method is considered all natural because it does not require any sort of implants, pill, or barrier. Effectiveness of this method varies due to the unpredictability of a woman’s cycle each month, varying from 76 to 88% effective. If you definitely do not want to conceive children in the near future, but want to use this method, it is important to talk to your physician so you can get the best education on how to make this method the most effective
Emergency Contraception
Emergency contraception is not a regular form of birth control. In the instance that contraception was not used or that it failed, and you fear the risk of getting pregnant, there are two options…
The copper IUD can be inserted into the uterus within 5 days of having unprotected sex and reduce the risk of becoming pregnant
Emergency Contraceptive Pills aka “Plan B”: These pills are located at drugstore pharmacies and can be taken up to 5 days after unprotected sex. However, the sooner the pill is taken, the better it will work.
Other forms of contraception are also available, these are some of the most common and reversible ones. If you are considering a permanent form of birth control, talk to your doctor about tubal ligation or a vasectomy. When considering birth control options, always take into account what is most compatible with your lifestyle and needs. And remember that abstinence and condoms are the only methods that prevent from sexually transmitted infections.
Check out the links below for resources and references I used for effectiveness data.
https://www.nichd.nih.gov/health/topics/contraception/conditioninfo/types
https://www.cdc.gov/reproductivehealth/contraception/index.htm