Which Birth Control is Best for Me?

Your health, lifestyle, and indi­vid­ual pref­er­ences can help you decide.

Con­tra­cep­tion, or birth con­trol, is used to pre­vent preg­nan­cy. Many fac­tors lead to start­ing birth con­trol. Whether it is to pre­vent preg­nan­cy tem­porar­i­ly, pre­vent preg­nan­cy per­ma­nent­ly, or to con­trol symp­toms relat­ed to peri­ods. Regard­less of the rea­son for start­ing birth con­trol, almost all patients use con­tra­cep­tion at some point and there are many options to choose from. 

This can make decid­ing between the many options for birth con­trol over­whelm­ing at first. The good news is, with so many options, there is bound to be one that is right for you! How well birth con­trol works (the effi­ca­cy) and how well it fits your lifestyle and over­all health are impor­tant fac­tors to consider. 

Here is what you need to know about some of the most com­mon­ly used methods: 

Note: Suc­cess rate with per­fect use” is the effec­tive­ness of the method if used cor­rect­ly, 100% of the time. Suc­cess rate with typ­i­cal use” reflects how the aver­age per­son actu­al­ly uses the method — which can be incor­rect or inconsistent. 

Male Con­doms

Male con­doms (exter­nal con­doms) are a type of bar­ri­er method, which is a type of birth con­trol that blocks sperm from reach­ing the egg. These con­doms go over the penis and col­lect sperm. Con­doms are the only type of birth con­trol that can pro­tect against sex­u­al­ly trans­mit­ted infec­tions (STIs).

Why You Might Like Male Condoms

Since con­doms can help pre­vent STIs, they are espe­cial­ly impor­tant to use if you or your part­ner are hav­ing sex with more than one per­son, or have had sex with some­one else in the past and have not been test­ed for STIs. If you are look­ing for a bar­ri­er method, male con­doms are usu­al­ly easy to obtain. You don’t need a pre­scrip­tion for them and they are wide­ly avail­able. While there are oth­er bar­ri­er meth­ods of birth con­trol, such as female con­doms, diaphragms, sponges, or sper­mi­cides, they are not as effec­tive or con­ve­nient. For exam­ple, a diaphragm needs to be fit­ted by a provider, while a sponge needs to be left in the vagi­na for at least 6 hours after hav­ing sex. 

Why You Might Not Like Male Condoms

Even though it’s usu­al­ly con­ve­nient to get con­doms, they aren’t always con­ve­nient to use. If you’re in the heat of the moment or for­got to restock, you might not have one avail­able when you need it. 

The major­i­ty of male con­doms on the mar­ket are made with latex, so they can be a bit tricky if you or your part­ner have a latex aller­gy. There are latex-free con­doms, but you have to be a lit­tle more care­ful about choos­ing which one to use. For instance, con­doms made of polyurethane (thin plas­tic) don’t fit as tight­ly, so you’re at a high­er risk of them slip­ping off. Con­doms made of lamb­skin are effec­tive for birth con­trol, but they aren’t as good at pre­vent­ing STIs. 

Oral Con­tra­cep­tives (“The Pill”) 

Birth con­trol pills con­tain hor­mones that pre­vent preg­nan­cy by pre­vent­ing ovu­la­tion which is the release of an egg from the ovary. The most com­mon form of birth con­trol pill is the com­bi­na­tion pill, which con­tains both estro­gen and prog­estin. Some oral con­tra­cep­tion pills con­tain only prog­estin. 

Why You Might Like the Pill 

Birth con­trol pills are among the most effec­tive forms of con­tra­cep­tion and they are gen­er­al­ly safe. In addi­tion to help­ing to pre­vent preg­nan­cy by con­trol­ling hor­mone lev­els, they may reduce oth­er symp­toms relat­ed to peri­ods:

  • Acne
  • Men­stru­al cramps 
  • Heavy bleed­ing
  • PMS or PMDD 
  • Men­stru­al migraines 
  • Ovar­i­an cysts 
  • Risk of uter­ine or ovar­i­an can­cer

Why the Pill Might Not Be Right For You 

For the pill to be effec­tive, it should be tak­en at the same time every day — which can be dif­fi­cult for patients with busy lifestyles. Addi­tion­al­ly, if you are a smok­er or are on cer­tain med­ica­tions, such as some med­ica­tions used to pre­vent seizures or treat HIV, you should avoid oral con­tra­cep­tives. Peo­ple who can’t take estro­gen, such as those who have breast can­cer, high blood pres­sure, a his­to­ry of blood clots, or who just deliv­ered a baby, shouldn’t take the com­bi­na­tion pill but may be able to take a pill con­tain­ing progesterone-only. 

Sched­ule an appoint­ment with a Duly Health and Care OBG­YN to learn about the best options for contraception. 

Nex­planon (Implant)

The Nex­planon is a small implant that goes under the skin of the arm. The implant is made of a flex­i­ble plas­tic and is rough­ly the size of a match­stick. The Nex­planon is the most effec­tive reversible form of con­tra­cep­tion.

Why You Might Like the Nexplanon 

The Nex­planon doesn’t require remem­ber­ing to do some­thing every day or even every week or month. It is effec­tive for up to three years of use. The Nex­planon also does not require a pelvic exam to insert.

Why the Nex­planon Might Not Be Right For You 

The Nex­planon is a safe form of birth con­trol for almost every­one. While it can help make peri­ods lighter, it may cause some irreg­u­lar bleeding. 

Intrauter­ine Device (IUD)

An IUD is a small T‑shaped device that goes into your uterus. Cop­per IUDs change how sperm cells move and stops them from get­ting to an egg. Hor­mon­al IUDs release a small dose of prog­estin into the uterus to thin the uter­ine lin­ing and increase cer­vi­cal mucous to pre­vent sperm from enter­ing the uterus. 

Why You Might Like an IUD

Once an IUD is placed in the cor­rect posi­tion in the uterus it is effec­tive for pre­vent­ing preg­nan­cy for any­where from 3 to 10 years depend­ing on the type. So, unless the IUD is removed or there is an uncom­mon issue, like the IUD shift­ing out of place, you don’t have to wor­ry about it again for a while. The hor­mon­al IUDs can light­en or even stop your peri­od alto­geth­er, they also tend to lessen cramp­ing with periods. 

Cop­per IUDs can be used as an emer­gency form of con­tra­cep­tion (sim­i­lar to a plan B pill) as long as they are placed with­in 72 hours of con­tra­cep­tion fail­ure or unpro­tect­ed intercourse. 

Why an IUD Might Not be Right For You 

The IUD inser­tion requires a pelvic exam and may not be the best option if you have nev­er had a pelvic exam or have dis­com­fort with exams. The inser­tion can be uncom­fort­able and may cause a short-term increase in bleed­ing or cramp­ing. How­ev­er, most patients do very well with the pro­ce­dure using only over-the-counter pain med­ica­tions. It also helps to have your doc­tor walk you through the pro­ce­dure so you know what to expect. 

Cop­per IUDs can cause cramp­ing or heav­ier periods. 

You should not get an IUD if you: 

  • Have a pelvic infection 
  • Have a struc­tur­al vari­a­tion that dis­torts your uterus (like a uter­ine septum) 
  • Are preg­nant
  • Are aller­gic to cop­per or have Wil­son dis­ease (for the cop­per IUD)

Also read: 7 Tips to Feel Less Awk­ward at an OBG­YN Appointment

Per­ma­nent Con­tra­cep­tion (Ster­il­iza­tion)

The female ster­il­iza­tion pro­ce­dure is tubal lig­a­tion, or get­ting your tubes tied.” This is when the fal­lop­i­an tubes (the tubes that car­ry eggs to the uterus) are closed, tied, or removed. Male ster­il­iza­tion is a vasec­to­my, which involves cut­ting and seal­ing the vas def­er­ens (tubes that car­ry sperm from the testes). Both pro­ce­dures stop eggs and sperm from meeting. 

Why You Might Like Per­ma­nent Contraception

If you know for a fact that you do not want to get preg­nant in the future, per­ma­nent con­tra­cep­tion means you nev­er have to wor­ry about it again. 

Both female and male ster­il­iza­tion can be per­formed as out­pa­tient pro­ce­dures, mean­ing you can go home the same day. Female ster­il­iza­tion requires gen­er­al anes­the­sia while male ster­il­iza­tion can be done under local anes­the­sia. Both pro­ce­dures have short recov­ery peri­ods and are gen­er­al­ly con­sid­ered safe procedures. 

Why Per­ma­nent Con­tra­cep­tion Might Not be Right For You

Both female and male ster­il­iza­tion should always be con­sid­ered per­ma­nent ster­il­iza­tion which means they should only be done if you are cer­tain you do not wish to become preg­nant in the future. In addi­tion, some patients have oth­er med­ical con­di­tions that increase the risks relat­ed to surgery. In these cas­es, oth­er forms of con­tra­cep­tion (such as the Nex­planon and IUDs dis­cussed ear­li­er) may be safer options and rec­om­mend­ed over per­ma­nent sterilization. 

Also read:Men­stru­al Cycle Track­ing 

Remem­ber that no method oth­er than absti­nence (not hav­ing sex) is 100% effec­tive at pro­tect­ing against preg­nan­cy. Some patients even decide to use more than one method for bet­ter pro­tec­tion. 

Choos­ing which type of con­tra­cep­tion to use can some­times be con­fus­ing, and the first one you try might not be the best one. If you can’t decide, reach out to your provider so they can help you choose the one that’s right for you. 

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  • I value the importance of practicing evidence based medicine and feel patients should be well informed of all treatment options before making shared decisions regarding their medical care. I believe communication and mutual understanding are critical in providing the best possible outcomes for my patients.