A Comprehensive Guide to Different Types of ContraceptivesSexual Health
About 63% of reproductive-aged women in the United States are sexually active and are not seeking to become pregnant. Luckily, getting frisky doesn’t mean it has to be risky! Enter contraceptives, aka, the use of medicines, devices, or surgery to prevent pregnancy. If you’re someone who’s considering the adoption of, or a change in, birth control methods and is having trouble deciding which is best for you, continue reading for a comprehensive list of the types of contraceptives and how they compare.
Let’s start with the main character of contraception – condoms. When used correctly, male condoms (or external condoms) can be used as a barrier method to prevent unintended pregnancy by stopping sperm from meeting an egg, boasting a success rate of 98%. Not only that, but condoms (specifically the latex variety) exhibit the capacity to block out particles the size of STD pathogens, helping to protect against sexually transmitted diseases and infections (what could be sexier than protection against STDs?). Expert insight provided by our resident sexologist, Dr. Jess, detail how to effectively use male condoms:
Check the expiration date of the condom
Take your time to properly unwrap and roll the condom gently to the bottom of the shaft
Store your condoms in a cool, dry place
Use one condom at a time
Find the correct fit
A contraceptive method akin to male condoms is the female condom (or the internal condom), designed for insertion within the vaginal cavity to stop sperm from getting to the uterus. If used correctly, female condoms are effective 95% of the time and can protect against STIs and STDs. To properly use a female condom, compress together the sides of the internal ring at the sealed end of the condom and insert it into the vaginal canal. Pro Tip: try inserting an object of your choice as you hold the external ring in place on the outside to make insertion of the female condom easier.
Birth control pills are a type of widely used oral contraceptive that work to prevent pregnancy by helping keep sperm from joining the egg. The contraceptive pill can be made up of a combination of the hormones estrogen and progestin, or just progestin (aka the minipill). If used perfectly, meaning that you take the pill every single day, the pill is 99% effective. However, because effectiveness depends on consistent usage and no human error — the pill is really about 93% effective. Pros of taking hormonal birth control include convenience, regulation of menstrual cycles, reduced cramp severity, and management of acne. But yes, there’s always a “but”. Potential negative side effects of taking the pill include but are not limited to weight gain, breast tenderness, nausea, and mood changes. If you are someone who tends to be more forgetful, intrauterine devices (IUDs) may be the right choice for you. In the birth control realm, IUDs are small but mighty – these tiny T-shaped contraceptives are implanted into your uterus and tout a success rate of 99%. You may experience initial bleeding and/or cramps when the IUD is first inserted, but once placed, you can get rid of your daily pill-taking ritual and still have reliable protection long-term. The length in which an IUD is affective depends on the type of you get. Now, lets talk about your options:
Hormonal IUDs: These IUDs last for 3-8 years and work by releasing a type of hormone progestin that simultaneously thickens mucus and thins the lining of the uterus. Hormonal IUDs may help with cramping, heavy periods, and treating symptoms of health issues such as endometriosis or PCOS.
Copper IUDs: If hormonal contraception isn’t your cup of tea, the copper IUD may be a fit for you. It is non-hormonal, lasts up to 12 years, and works by creating an inflammatory reaction that keeps sperm from fertilizing an egg. Keep in mind you may initially experience heavier periods and cramping, although these symptoms usually go away with time.
In addition to the IUD, other hormonal birth control methods that don’t involve a pill routine include the contraceptive patch and the vaginal ring. The birth control patch delivers hormones through your skin, working its magic for an entire week – plus it is as convenient as slapping on a band-aid! You change the patch every 7 days for three weeks and then go the fourth week without the patch. On the other hand, the vaginal ring, which is a small, soft ring you insert inside your vagina, works by releasing the hormones estrogen and progestogen into your bloodstream and thickening cervical mucus. The standard way to use the ring is leaving it in for 21 days, then removing it and having a 7-day ring-free break. While both products are more than 99% effective when used correctly, it is important to note that using either product may cause side effects such as breakthrough bleeding and spotting, nausea, breast tenderness, and mood changes.
Long-Acting Reversible Contraceptives (LARCs)
If you are someone who wants more long-lasting contraception, while still being reversible, there are options that exist for you! First, meet the Depo-Provera (an injectable contraceptive). This contraceptive works by injecting the user with a shot containing progesterone that is inserted directly into your muscle once every three months. The birth control shot is 96% effective in preventing pregnancy. Potential side effects are similar to those of hormonal birth control pills (irregular menstrual periods, headaches, acne, changes in appetite), in addition to hair loss or excessive hair growth, and/or osteoporosis.
Another option is the contraceptive implant (Nexplanon) – a small, plastic rod that is placed under the skin in your upper arm by a doctor or nurse. The subdermal contraceptive implant is more than 99% effective, lasts for 3 years, and works by releasing the hormone progestogen into your bloodstream to prevent pregnancy. Side effects of the contraceptive implant may include initial bruising, swelling, or tenderness around the implant, in addition to irregular periods or no periods at all. These contraceptive methods are useful for women who can’t use birth control that contains estrogen or for women who find it difficult to take a pill every day. And the best part – they can both be quickly removed or stopped whenever you’re ready to say goodbye!
As you read this blog, the list of side effects that come with many of the contraceptive options may have caught your attention. If you’re weary of side effects, natural methods, or fertility awareness-based methods (FABMs) of contraception may be the holy grail you’re seeking. According to Medical News Today, natural birth control uses factors such as menstruation, cervical mucus, and basal temperature to predict ovulation. In order for natural methods to work successfully, you’ll need to become besties with your menstrual cycle. Now for a little “reproductive health 101”. A person’s best chance at baby-making begins 5 days before ovulation, which is the hormone-driven process in which the ovary releases the egg. If the egg is not fertilized, the person menstruates (aka you get your period). During the ovulation period, which is the fertile window, one can decide to abstain from sex or choose to use barrier methods such as condoms. While natural methods avoid the side effects of other birth control methods, they do come with a catch: effectiveness lies at 77%, a bit lower than alternative methods. This is because the success of this method lies solely in a person’s dedication and ability to accurately track their menstrual cycle, which can feel like detective work. Three fertility indicators to simultaneously measure to effectively monitor menstrual cycles include:
Menstrual Cycle Length: Using a calendar, measure your cycles over the course of 12 months to pinpoint when you’ll most likely be able to conceive. Period tracking apps, such as Flo, can help you with estimations. Keep in mind, it’s wise to leave a little wiggle room to allow for uncertainty on exact ovulation timing.
Daily Body Temperature Readings: Using either a digital monitor or a thermometer meant for family planning, capture your temperature every morning before you get out of bed. Look out for 3 days in a row when your temperature is higher compared to the previous 6 days – it’s likely that you’re no longer fertile at this time.
Cervical Mucus Shifts: Gently assess changes in the quantity or consistency of cervical mucus by employing your finger. Immediately before ovulation, you will find that mucus takes on a wetter, clearer, and stickier texture – an indication that you are at your most fertile. For a deeper dive into fertility, read our blog!
Another natural method that can be used is the withdrawal method, known to most as the “pullout method”. Pulling out is exactly as it sounds – withdrawing the penis from the vaginal territory before ejaculation to avoid pregnancy. Similar to fertility-based methods, the withdrawal method has no side effects. The downside is that timing is everything and when you’re in the moment it can be difficult to pull out on time. The withdrawal method works 78% of the time – meaning 1 in 5 individuals relying on this method will get pregnant. It is important to note that both natural methods mentioned work best when combined with another birth control method, such as a condom.
The morning-after pill, often dubbed “Plan B”, is used to prevent pregnancy after your initial strategy, or “Plan A”, malfunctions (maybe you had unprotected sexual intercourse, the condom broke, or you missed a pill). Operating as a safety net, the Plan B pill works by inhibiting or delaying ovulation and midcycle hormone changes. The closer you are to the “morning after”, the more effective the pill tends to be. However, you can take morning-after pills for up to 5 days after having unprotected sex. Since the pill is more effective when used pronto, it is a good idea to have it stashed in your medicine cabinet BEFORE you need it. If used effectively, Plan B reduces the risk of pregnancy by 75%. Side effects of Plan B may include a few irregular periods, headaches, nausea, dizziness, or tender breasts.
If you are giving the above birth control methods a serious side-eye, permanent contraception may be an ideal choice for you. This form of contraception is most often implemented by individuals or couples who are sure they are ready to put the baby-making chapter of their lives behind them. Both males and females can go through sterilization procedures to tie up loose ends, both being 99% effective in preventing pregnancy. Let’s break it down:
Tubal ligation (Female Sterilization): This surgical procedure, often known as “getting your tubes tied”, seals the deal by permanently closing, cutting, or removing sections of your fallopian tubes.
Vasectomy (Male Sterilization): According to our Sexual Health Advisor, Dr. Josh, this procedure cuts, ties, or sears shut the vas deferens, which is the tubular structure that allows for the transport of sperm from the testicle (where they are made) into the ejaculate fluid.
It is very important to note that these procedures often cannot be undone, and if undone, your fertility may not come back. If you’re absolutely, without a shadow of a doubt, certain that you do not want more children (or any children at all), the perks are that you will never have to worry about other birth control again. Say goodbye to trips to the pharmacy!
When it comes to birth control, men have historically had two main options – condoms or the definitive vasectomy. The challenge that comes with creating birth control for men is the high rate of sperm production (men produce 1,000 sperm per second). While hormonal and non-hormonal methods aimed at stopping sperm in their tracks are in development, the quest for an on-demand and reversible solution remains.
Choosing the Right Contraceptive Method
Choosing a contraception method involves considering a range of factors based on your individual needs including effectiveness, future plans, medical history, current medications, lifestyle, convenience, budget, and more. When in doubt, consult a healthcare professional for personalized advice, and remember, your personal reproductive management needs will change over time and therefore should be an ongoing and open conversation with your healthcare provider.
In this blog, we have discussed different birth control options, from barrier methods, hormonal methods, long-acting reversible contraceptives, natural methods, emergency contraceptives, and permanent contraception. How will you make informed and responsible contraceptive choices?