Smart and Safe Birth Control Options

Find the Best Birth Control Method For You

By Denise Maher

 

Is your birth control planning up to date? A smart pregnancy prevention plan factors in your age, life stage, relationship status and personality—and evolves over time. As your body and life circumstances change, so may your birth control needs.

The most important thing to remember about birth control is to use it—and use it properly—every time you have sex. While even the most effective methods can fail, your chances of getting pregnant are much lower when you use birth control correctly every time you have sex. Almost 50 percent of all pregnancies in the U.S. are unintended. Unintended or closely spaced pregnancies are linked to negative health consequences for mother and child. Plus, research suggests that unintended pregnancy can negatively affect a woman’s physical, emotional and economic well‐being.

Many birth control methods do more for you than just prevent pregnancy. For instance, the Pill and other hormonal methods reduce the risk for developing certain cancers and improve menopausal and PMS symptoms such as heavy bleeding and mood swings.

Keep in mind that, with the exception of male condoms and female condoms, birth control will not protect you against sexually transmitted infections (STIs), like chlamydia, gonorrhea and HIV/AIDS.  Even condoms cannot protect against some STIs—for example, genital herpes can be shed from perineal skin that surrounds the genitals or anus and condoms don’t cover those areas.

This overview is intended to help you consider the various birth control methods on the market. Before you try a new method, be sure to understand how to use it properly, as well as what it does—and doesn’t—protect against. Discuss the risks, benefits, potential side effects and possible drug interactions with your doctor to ensure your birth control method is a good match for you.

 

Type
How It Works                   
Effectiveness                    
Recommended/
Not Recommended          
Abstinence/
Outercourse
Abstinence is refraining from any activity that could result in pregnancy.

Outercourse is sexual activity that doesn't involve vaginal intercourse or allow an egg to meet sperm
• Abstinence is 100% effective.

• Outercourse: Pregnancy is still possible if semen touches the vulva and gets into the vagina.
• Not recommended for people who find it difficult to abstain from intercourse

• Recommended for those who are very concerned about STIs since prophylactics may not prevent some STIs like genital herpes which can shed from perineal skin
Withdrawal
A man withdraws his penis from the vagina (or "pulls out") before ejaculation to stop sperm from entering.
• Only works if semen (including pre-ejaculate fluid or sperm remaining in the urethra from previous ejaculation) stays out of the vagina

• Typically, about 18% of couples who use withdrawal will get pregnant
• Not recommended as an effective form of birth control
Birth Control Implant
A small rod implanted in a woman's arm releases the hormone progestin, which suppresses ovulation and thickens cervical mucus to block sperm.
• 99% effective

• May not work as well for women who are overweight or obese.
• Highly recommended for teens by the American College of Obstetricians and Gynecologists, and for those who want an easily reversible method

• Not recommended for women who are concerned about privacy (implant is visible)
Birth Control Patch
A skin patch worn on stomach, arm or upper body for 3 weeks at a time. The patch releases progestin and estrogen to prevent ovulation and thickens cervical mucus to block sperm from reaching the egg
• Perfect use: 99% effective

• Typical use: 92% effective
• Recommended for women who are eligible for hormonal birth control but do not want to take a daily pill

• Not recommended for women with certain health conditions (such as hypercoagulability) or women over the age of 35 who smoke
Birth Control Pills/
Extended Use Pills/
Oral Contraception
A daily hormonal pill to prevent pregnancy. The pill contains progestin and sometimes estrogen to suppress ovulation and thicken cervical mucus to block sperm.
• Perfect use: 99% effective

• Typical use: 92% effective.
• Recommended for woman who want non-contraceptive benefits, like reduced bleeding and reduced pre-menopausal and menopausal symptoms

• Progestin-only pills are recommended for breastfeeding women

• Combination pills should not be taken by women over 35 who smoke or those with certain health conditions (such as hypercoagulability)
Birth Control Shot
A hormonal injection of progestin that prevents pregnancy by stopping eggs from leaving the uterus and by thickening the cervical mucus to block sperm. The shot is typically given in the upper arm and lasts for three months.
• Perfect use: 99% effective

• Typical use: 97% effective
• Recommended for women who don't want to take a daily pill

• Recommended for women who are breastfeeding or who aren't able to take estrogen

• Recommended for teens concerned with privacy (the shot leaves no physical evidence that a woman is using contraception)
Birth Control Sponge
The sponge covers the cervix so that sperm cannot reach any eggs in the uterus, and releases a spermicide to keep sperm from moving so they can't join the egg. 
• Considered moderately effective: About 90%

• This method may be combined with other methods to increase effectiveness
• Not recommended for women who have recently given birth

• Should not be used when a woman is experiencing menstrual bleeding or has symptoms of a urinary tract infection
Birth Control Ring/
Vaginal Ring
A small ring is inserted into the vagina once a month, releasing estrogen and progestin to suppress ovulation and thickening cervical mucus to block sperm.
• Perfect use: Fewer than 1 out of 100 women will get pregnant

• Typical use: 8 out of 100 women will get pregnant
• Not recommended for women who are breastfeeding or have certain health conditions (such as hypercoagulability)
Breastfeeding
Breastfeeding can prevent pregnancy when it is used exclusively to feed a newborn up until 6 months. During this time, a woman's hormones do not allow ovulation to occur.
• Perfect use: Fewer than 1 out of 100 women will become pregnant

• Typical use: About 2 out of 100 women will become pregnant
• Recommended for new moms who are able to breastfeed exclusively

• Some new moms who breastfeed but sometimes supplement with formula may have more risk of ovulating, providing for the opportunity to become pregnant.
Cervical Cap
A small, insert-able plastic cap is used with spermicide, and prevents pregnancy by blocking the cervix so sperm can't reach the egg.
• Considered moderately effective: About 90%

• More effective for women who have never been pregnant or given birth vaginally
• Recommended for women who can't or don't want to use hormonal contraception
Male Condom/Female Condom
The male condom is a thin cover that is worn on the penis during sex. The female condom is a lubricated plastic tube with a ring at each end to help it stay in place inside the vagina. Both block sperm from entering the vagina.
• The male condom is considered extremely effective with perfect use

• The female condom is considered to be less effective
• Recommended for both men and women as protection against sexually transmitted infections, but does not protect against all STIs such as genital herpes which can shed from perineal skin

• Condoms are available without a prescription
Intrauterine Device (IUD)
A small, plastic device containing copper is inserted into the uterus. Copper acts as a natural spermicide, disrupting the sperm's path to the egg.

Hormonal IUDs release the hormone progestin, which disrupts the sperm's path to the egg, helps to thicken cervical mucus, and may also prevent the egg from leaving the ovary.
• Perfect use: 99% effective

• Typical use: 99% effective
• Recommended for women who know they do not want to become pregnant for several years

• Although women who are at risk for frequent STIs (those with frequent new partners) may experience increased risk of pelvic inflammatory disease, the health risks of an unintended pregnancy are greater and IUDs may be an appropriate choice for teens
Fertility Awareness Methods (FAM)
Fertility awareness methods require charting or tracking cycles and avoiding unprotected sex during peak fertile times.
• Several different types of FAM exist; effectiveness varies between type

• When used to prevent pregnancy, FAM is less effective than many other methods
• Recommended for women who want to become pregnant in the near future  

• Not recommended for women with irregular menstrual cycles
Diaphragm
A diaphragm is a latex cup that is used with spermicide and is inserted into the vagina to block the sperm.
• Perfect use: 6 out of 100 women will become pregnant

• Typical use: 12 out of 100 women will become pregnant

• Can be made more effective by also using a condom or pulling out before ejaculation
• Recommended for women who can't or don't want to use hormones but may want children in the future

• Not recommended for women who are sensitive to silicone or spermicide and/or who get urinary tract infections frequently
If used within five days of unprotected sex, emergency contraceptive pills or the emergency insertion of a copper-T IUD can significantly reduce the risk of pregnancy by preventing fertilization.
• Copper-T IUD reduces the risk of pregnancy by 99%

• Emergency pills reduces the risk of pregnancy by about 75%
• Recommended for those who want to avoid pregnancy after unprotected sex or contraception failure

• Although women who are at risk for frequent STIs (those with frequent new partners) may experience increased risk of pelvic inflammatory disease with use of IUDs, the health risks of an unintended pregnancy are greater and IUDs may be an appropriate emergency contraception choice for teens
Surgery
A woman is made sterile surgically when the fallopian tubes are cut, tied or sealed by a medical professional to block eggs from reaching the uterus.

A man is made sterile surgically with a vasectomy, which involves closing or blocking the tubes in men that carry sperm.
• Surgical sterilization is nearly 100% effective for both men and women

• After a vasectomy, it takes about three months before sperm are completely cleared from a man's ejaculate
• Not recommended for people who may want to have biological children in the future - surgery is very difficult to reverse

• Vasectomy is recommended for men whose partner's health would be threatened by a pregnancy, or who want to spare their partner the risks and costs of female sterilization

 

 

Have a Backup Plan

Even the most effective birth control methods can fail. To make sure you are truly covered (and to enjoy peace of mind), consider using a backup birth control method in addition to your regular one. You can combine one or more methods, such as using condoms in conjunction with the Pill, to reduce the risk of unintended pregnancy. Make sure to read labels and instructions carefully, and be especially aware of any situation (like missing a Pill) that would require the use of a second birth control method. Not sure whether backup is necessary? Be safe and opt for the extra protection — and be sure to understand how long use of backup birth control is necessary (for example, one or two cycles).

 

Denise Maher is a health writer, reporter and editor who lives in Brooklyn, NY. She blogs at alternahealthgrrrl.com.


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