Birth Control and Contraception Options

Types of Birth Control

Birth control is defined as any means, whether through a device, medication or procedure, that prevents pregnancy. This can be achieved in a variety of ways, including:

Barrier methods

This type of birth control includes condoms, diaphragms and other barriers that prevent sperm from reaching the egg. They need to be used every time you have sex to prevent pregnancy.

• Condoms: A thin covering of latex that is placed on the penis before sex and prevents semen from entering the vagina. Condoms are about 85 percent effective when used correctly and don’t tear or rip during intercourse. Condoms are also the best option for preventing the transmission of STIs.
• Diaphragm: This flexible rubber cup is inserted into the vagina and prevents sperm from entering the cervix.
• Sponge: The sponge is a small device that is placed in the vagina, covering the cervix and releasing spermicide. It contains enough spermicide to last 24 hours and shouldn’t be left in the vagina for longer than 30 hours. It is available over-the-counter at most drug stores. The sponge is most effective for women who haven’t given birth.
• Spermicides: These creams or foams are placed inside of the vagina to kill sperm and may also provide some level of protection against STIs. Used alone, spermicides are only about 70 percent effective at preventing pregnancy, but when used with a condom offers 94 percent effectiveness. Spermicides are available over-the-counter at most drug stores.

Hormonal birth control

Short-acting hormonal methods include oral contraceptives, vaginal rings, shots and patches, and need to be taken daily or every few months. Long-acting hormonal methods include removable devices such as intrauterine devices (IUDs) and implants. After your provide inserts an IUD or implant, it can last from three to 10 years, depending on the specific device.

• Oral contraceptives: Most birth control pills use the hormones estrogen and progestin to prevent ovulation (combination pill), while the mini-pill is progestin-only. Oral contraceptives must be taken daily to be effective. With perfect use, oral contraceptives are nearly 99 percent effective, but with typical use, they are about 93 percent effective. Oral contraceptive can have other benefits as well, including regulating the menstrual cycle and decreasing the amount and length of your period, preventing heavy menstrual bleeding, and preventing certain reproductive cancers. The can also be effective at controlling symptoms of conditions such as polycystic ovary syndrome (PCOS) and endometriosis.
• Birth control shot (Depo-Provera®): This method needs to be administered every three months to prevent pregnancy. While extremely effective, the overall rate of effectiveness is about 94 percent due to missed or delayed injections.
• Birth control patch: Worn on the skin, the patch releases hormone and estrogen into the bloodstream to prevent ovulation. It is meant to be worn for 21 days and removed for seven, then replaced with a new patch. The patch is most effective for women who weigh less than 198 pounds.
• Vaginal ring (NuvaRing®): This flexible ring is placed inside the vagina around the cervix and uses estrogen and progestin to prevent pregnancy. It is designed to be worn for 21 days, removed for seven days, and replaced with a new ring.
• Hormone implant (such as Nexplanon®): This device is implanted underneath the skin on a woman’s arm and releases hormones the prevent ovulation. The device lasts up to three years and is more than 99 percent effective at preventing pregnancy. The procedure to implant and remove is done in office using a local anesthetic.
• Intrauterine devices (hormonal): IUDs are more than 99 percent effective at preventing pregnancy. Hormonal IUDs use progestin to thicken the cervical mucus so that sperm can’t reach an egg. They need to be removed and replaced every three to seven years, depending on the specific IUD. Copper IUDs (Paragard) last for 10 years. The copper in the device prevents sperm from reaching the egg and makes the lining of the uterus less ideal for sperm.
• Emergency contraception. The morning after pill (Plan B) is available over the counter at most pharmacies as emergency contraception after having unprotected sex.

Implantable Devices

These longer-term birth control devices can last from 3 to 10 years, depending on the device. A healthcare provider is required to implant and remove the device.

• Hormone implant (such as Nexplanon®): This device is implanted underneath the skin on a woman’s arm and releases hormones the prevent ovulation. The device lasts up to three years and is more than 99 percent effective at preventing pregnancy. The procedure to implant and remove is done in office using a local anesthetic.
• Intrauterine devices (hormonal or copper): IUDs are more than 99 percent effective at preventing pregnancy. There are two main types of IUD: hormonal and copper. Hormonal IUDs use progestin to thicken the cervical mucus so that sperm can’t reach an egg. They need to be removed and replaced every three to seven years, depending on the specific IUD. Copper IUDs (Paragard) last for 10 years. The copper in the device prevents sperm from reaching the egg and makes the lining of the uterus less ideal for sperm.

Sterilization/Permanent birth control

This birth control method involves a medical procedure or surgery to permanently prevent pregnancy. Permanent birth control procedures are available for both women and men.

• Tubal ligation/occlusion: This sterilization procedure for women involves cutting or cauterizing the fallopian tubes to prevent an egg from being carried to the uterus. This is a surgical procedure that can be performed under general or spinal anesthesia. Tubal ligation is close to 100 percent effective and is considered permanent; surgery to reverse it can be attempted in certain cases but may not always be successful.
• Vasectomy: This male sterilization procedure cuts or clamps the vas deferens, the tube that carries sperm. Vasectomy is usually performed in an office or surgical setting under local anesthesia. It is close to 100 percent effective, but only after a healthcare provider confirms that the procedure was successful. Vasectomy is permanent birth control but can be reversed in certain cases.

Natural family planning/fertility awareness

This natural method of birth control relies on tracking your cycle and avoiding sex or using another birth control method on days when you are most fertile. This can be done tracking things such as basal body temperature and cervical mucus, as well as using at-home ovulation tests.

How to Choose a Birth Control Method

Your provider can help you evaluate the pros and cons of each method and determine which one is right for you. When considering methods of birth control, some of the questions to ask yourself include:

• Do I plan to have children someday and if so, how soon? If you plan to have children in the near future, shorter-term methods such as oral contraceptives or condoms may be more practical. If children are part of your long-term plans, reversible birth control such as an IUD can be considered as well. Permanent methods such as sterilization are a good option if you are done having children or don’t plan to have any.
• Do I need my birth control to protect me from STIs? Condoms are the only form of birth control that can protect against STIs as well as pregnancy.
• Do I have any health conditions that need to be considered? Some birth control methods may not be recommended if you have certain health conditions, such as history of blood clots, heart disease or certain cancers. You should discuss any health concerns with your provider before choosing a birth control method.
• How effective is the birth control? Many birth control methods are highly effective when used correctly and consistently. The more potential for user error in a contraceptive, the higher the risk of unintended pregnancy. For example, sterilization and IUDs have the highest effective rates, with a less than 1 percent chance of pregnancy. However, methods such as natural family planning and withdrawal (pulling out) have higher rates of error, and therefore have lower effectiveness overall.
• What are the potential side effects? Depending on the option you choose, there can be a variety of potential birth control side effects, including irregular bleeding or spotting, headaches, mood changes, weight gain or allergic reaction. You should discuss all side effects of any chosen birth control method with your provider to help determine if it’s the right choice for you.
• Is it convenient, affordable and easy to access? It’s important to choose a type of birth control that best suits your lifestyle. Things to consider include whether it is available over-the-counter or by prescription only, ease of use, and whether your chosen birth control is covered by insurance.