With so many safe and effective methods of birth control available, choosing the right one can be daunting.
“There’s no best or worst method — it depends on preference, age, lifestyle and existing medical conditions. These things need to be discussed between the patient and her health care provider,” said Guita Tabassi, DO, WHASN, chairwoman of the OB/GYN department at Southern Hills Hospital and Medical Center.
While finding birth control to suit your individual needs should be decided upon with your doctor, knowing your options can be instrumental to your health.
Permanent methods
“These methods are irreversible and reserved for women who have completed their family and/or are no longer interested in conceiving,” Tabassi said.
Surgical tubal litigation
Having your “tubes tied” is an outpatient procedure, performed under general anesthesia, in which the fallopian tubes are sealed shut.
Essure
This is a nonsurgical procedure in which a coil-like device is implanted into each fallopian tube. The coil then becomes imbedded in the fallopian tube, causing scarring that blocks the passageway.
Both methods are over 99 percent percent effective.
Nonpermanent, hormonal methods
“All hormonal methods work by preventing ovulation, thickening the cervical mucus to make sperm penetration difficult, and thinning the endometrial lining to make it more difficult for a fertilized egg to attach,” Tabassi said.
There are two types of hormones used: progestin, a synthetic version of progesterone, or a combination progestin and estrogen.
Common side effects of hormonal birth control include headache, nausea, breast tenderness, breakthrough bleeding, weight gain, mood changes and decreased libido. Side effects typically improve after three months of use and vary between women depending on the method type, hormone and dosage. Many women need to try a variety of methods before finding the right one for them.
The pill
- Availability: RX only
- Hormone: Both progestin-only and progestin/estrogen combination
- Frequency: Daily
- Efficacy: 99 percent when used perfectly; forgetting/missing pills and some medications can lower its efficacy—about 9 in 100 women get pregnant while on the pill
Plastic IUD
T-shaped device inserted into the uterus
- Availability: RX only; must be inserted by a doctor
- Hormone: Progestin
- Frequency: Needs to be replaced every 3-5 years (depending on the brand)
- Efficacy: 99 percent
Shot
- Availability: RX only; must be injected by a doctor
- Hormone: Progestin
- Frequency: Administered every three months
- Efficacy: 99 percent when used perfectly; waiting too long between shots can lower its efficacy — about 6 in 100 women will get pregnant while on the shot
Implant
Thin rod implanted under the skin of the bicep
- Availability: RX only; must be implanted by doctor
- Hormone: Progestin
- Frequency: Replaced every 3-4 years
- Efficacy: 99 percent
Patch
- Availability: RX only
- Hormone: Both progestin-only and progestin/estrogen combos
- Frequency: Replaced every three weeks (with one week off during menstruation)
- Efficacy: 99 percent when used perfectly; forgetting to replace the patch on time/the patch falling off can lower its efficacy — about 9 in 100 women will get pregnant on the patch
Vaginal ring
Flexible ring you insert into your vagina
- Availability: RX only
- Hormone: Progestin/estrogen combo
- Frequency: Replaced every 3 weeks (with one week off during menstruation)
- Efficacy: 99 percent when used perfectly; forgetting to replace the ring and certain medications can lower its efficacy — about 9 in 100 women will get pregnant on the ring
Can anyone use hormonal birth control safely?
Generally, yes. However, some women with pre-existing health conditions aren’t considered good candidates.
Nonpermanent, nonhormonal methods
These methods protect against pregnancy and do not interfere with the body’s natural hormones and rhythm. While they are less likely to cause side effects, some are possible.
Copper IUD
Copper device inserted into the uterus
- Availability: RX only; must be inserted by a doctor
- Frequency: Can be used for up to 10 years
- Efficacy: 99 percent
- Side effects: Because it’s nonhormonal, there are fewer common side effects. However, “menstrual pain and bleeding may increase and bleeding between periods may occur. These effects are common in the first few months of use, and usually decrease within one year,” Tabassi said.
Barrier methods
Male/female condoms, diaphragm, cervical cap, sponge
- Availability: Mostly over the counter; diaphragms and cervical caps require a prescription
- Frequency: Use during sexual activity
- Efficacy: Varies depending on the method and how well it’s used; in general they are 70-90 percent effective
Note: While barrier methods tend to be convenient, easily purchased and some can protect against STDs, they’re generally less reliable than hormonal methods. Tabassi notes that the only nonhormonal contraception that is as effective as hormonal methods is the copper IUD.