Whether you have decided that you are done having children all together, or you are just looking for information on how to prevent future pregnancies for a while, choosing the best birth control can be confusing and difficult. There are many things one has to consider when choosing a birth control method, from potential side effects to exactly what problem you need your birth control to solve.
There are generally five main birth control methods, each with its own considerations. In addition, it is also important to consider what your final goal is and whether you have a backup plan.
What Questions Do You Need to Consider?
Before you begin your quest for the perfect birth control method, I urge you to ask yourself the following questions and talk them over with your doctor.
- Are you willing to accept if your birth control fails?
- Do you want your birth control to help prevent sexually transmitted infections, as well as pregnancy?
- What is your budget?
- Do you want to have children in the future?
- Are you looking for a solution to other symptoms?
- Can you be counted on to take medication on a set schedule?
- How do you feel about getting a pelvic exam?
- Are you aware of the potential side effects of the different birth control methods?
- Are you using more than one birth control method for extra protection?
What If You Don’t Have Insurance?
As with most medications, birth control can be expensive depending on what you opt for, and some insurances will not cover it. If yours doesn’t, or if you do not have insurance to begin with, you do still have hope. Many family planning clinics and local health centers have cost-effective programs that can help subsidize your options.
What Types of Birth Control Are There?
Generally speaking, there are five main categories of birth control. These include:
Barrier Methods, which are used during sex to physically prevent sperm from reaching an egg. Examples include condoms, diaphragm, cervical cap and a contraceptive sponge.
Short-Acting Hormonal Methods, which work by adjusting your body’s natural estrogen and progestin levels to make pregnancy highly unlikely. They rely on you to remember to take your medication regularly for them to work.
Long-Acting Hormonal Methods, which work in much the same way as the short-acting methods, but they require an implanted device that remains in the body and makes it so that the user does not have to remember to take any medication.
Fertility Awareness Methods, which focus on understanding the body and knowing the exact days and times you are fertile so that you can avoid intercourse and pregnancy. This method can be tricky, but many women swear by it.
Sterilization, which is a permanent method of birth control, usually requiring surgery to remove the ability for a man or woman to create a baby.
As an addition, there is also the sixth birth control type, which is Emergency Contraception, which can prevent pregnancy after unprotected sex, though it is not helpful in preventing STIs.
Barrier contraception can only be used when you are having sex, and it must be used correctly to be most effective. The average of all barrier methods in preventing pregnancy is between 71% and 88%, which is definitely not foolproof. Combining methods is generally your best bet if you want to stick to barrier contraception.
For instance, using spermicide with a diaphragm or cervical cap is much more useful than either one alone. And using another form of short- or long-term hormonal birth control along with a barrier is even better.
Speak to your doctor to understand the pros and cons of each.
What is it? These are latex-free, hormone-free pouches worn inside of the vagina that work much the same as male condoms by catching ejaculate before it can reach an egg. They decrease the risk of pregnancy and STI transmission.
How effective is it? Between 79% and 95%
Pros: These can be inserted up to eight hours before intercourse, making them much less intrusive than regular condoms. They are also guaranteed protection just in case you find yourself with a partner who refuses to wear a condom.
Cons: These are pricey. They range from $2-$4 each, and they can be difficult to use correctly, meaning you might end up wasting some cash as you learn. They are also not a snug fit around the penis, which could be a pro or a con depending on user preference.
What is it? These are rubber sheathes that encase a penis during sex, and they are designed specifically to catch and contain any fluid that may flow from the penis.
How effective is it? Between 86% and 97%
Pros: Condoms help prevent pregnancy and STIs, making them a great method for those who want ease of use and full protections. They are also inexpensive and often free. They come in latex-free versions, as well, so allergy exposure is low. With many varieties, brands have created a plethora of textures meant to enhance the act of intercourse for both parties involved. Finally, cleanup is very simple.
Cons: They do still fail, and they can expire. Make sure you check the package before use for best results.
What is it? This is a squishy plastic disk completely covered in spermicide. Placed deep inside the vagina, it covers the cervix and blocks sperm from entering the uterus, killing any that may cross over.
How effective is it? Between 80% – 91%
Pros: This can be placed up to 24 hours ahead of time, and it can be left there over many rounds of intercourse (within that 24 hour window).
Cons: After sex, you have to leave the sponge inside for six hours. This doesn’t always feel the cleanest, and it increases the risk of toxic shock syndrome. They can also be difficult to place, especially if you have trouble with tampons. Plus, they are expensive.
What is it? Very similar to the sponge, the diaphragm is a prescription only, reusable option in the form of a soft, silicone disk. To use, simply saturate it with spermicide and insert it into the vagina to keep sperm out.
How effective is it? Between 88% and 96%
Pros: It is nonhormonal and non-latex, which is nice. Like the sponge, it can be left in for 24 hours, though you must add spermicide every six hours. Cost can be free – $80 depending on your insurance, but it is reusable, so the cost breakdown is favorable.
Cons: This is not a great option for anyone prone to Urinary Tract Infections. It is also not a ton of fun having to reapply spermicide every six hours. The biggest con is that these are easily knocked out of place, so if you’re a fan of energetic sex, you will have to tone it down or go with another option.
What is it? Like its name implies, this prescription silicone covering looks exactly like a little hat! It’s up to you to fill it with spermicide and place it over your cervix to prevent sperm from entering your uterus.
How effective is it? If you have never given birth, it is around 86% effective. If you have already had kids, it’s around 71%
Pros: Unlike the diaphragm, you do not need to reapply spermicide, and this guy can be left in for up to 48 hours over many rounds of intercourse. Price depends on insurance, but it ranges from free to $90 and only needs to be replaced once per year.
Cons: It must be left in place for four hours after sex, which is annoying. They need to be replaced every 12 months.
What is it? Like its name implies, spermicide kills sperm. It can be used with any of the mentioned barriers, but it’s also good to go all one its own. Just squirt or insert it into the vagina prior to intercourse and it’ll do its best to kill any sperm it finds.
How effective is it? On its own, it is around 72% effective
Pros: No prescription needed, and no hormones. Easy to find anywhere and lots of brands to choose from.
Cons: Spermicide is time sensitive, needing around 15 minutes to dissolve before sex. You will need to reapply every hour for it to remain effective.
Short-Acting Hormonal Methods
Short term hormonal birth control will always require a prescription. It involves adjusting the body’s natural estrogen and/or progestin levels to ensure pregnancy is unlikely to occur. The most common methods include daily pills, weekly patches, monthly vaginal rings or quarterly shots. These methods are between 91% and 95% effective. These types of birth control can be great for those who have trouble with their menstrual cycles, including pain, frequency and flow.
What is it? The shot is an injection of the hormone progestin which needs to be administered every three months in a doctor’s office. It prevents pregnancy by stopping ovulation from taking place. As a result, it may lessen or stop menstruation.
How effective is it? Between 94% and 99%
Pros: This is one of the most effective methods of hormonal birth control when used perfectly. This requires ensuring that you receive the shot every 12 to 13 weeks without fail. Many women love that it stops them from having a period all together, and others report far less period flow and pain.
Cons: Side effects include nausea, headaches, weight gain, depression, dizziness and more. Some women will end up with a period that does not stop, but this is rare. Also, if you end up deciding you do want to try for a baby, the shot’s effects can last up to a year after your last dose.
What is it? This is a small plastic ring containing estrogen and progesterone. You insert it yourself, leaving it for three weeks before removing it for a week to allow a period. Then you swap it out for a new one. Like the shot, it stops ovulation, which makes pregnancy highly unlikely.
How effective is it? Between 91% and 99%
Pros: It can help regulate periods, make acne better and reduce menstruation flow. It doesn’t take a ton of upkeep since you only need to remember it once a month.
Cons: The most common side effects are headaches and breast tenderness. There is also the possibility of human error, which means it is not quite as effective as other methods.
What is it? If you’ve ever seen a nicotine patch, you’ll understand how this works. It’s like a big sticker you place on your upper arm, back or butt for three weeks, removing it for a week so you can have your period. Like the shot and the ring, it works by releasing estrogen and progestin into the body, helping to reduce the likelihood of pregnancy by preventing ovulation.
How effective is it? Between 91% and 99%
Pros: Place it and then forget it for a week – couldn’t be easier! There are very rarely any side effects. Also, it’s more cost effective than the shot or the ring.
Cons: High degree of human error since it does require weekly upkeep. Rare side effects may include headache, nausea, breast tenderness and irritation of the skin around the patch.
What is it? A small pill that must be taken every day at the same time. It combines estrogen and progestin to prevent ovulation and thus pregnancy.
How effective is it? Between 91% and 99%
Pros: No messy insertion or implantation. It can help reduce the severity of your period pain and other symptoms.
Cons: Human error makes this option worrying. The pill must be taken every single day at the exact same time to be effective. Miss a single dose and the effectiveness wanes considerably.
What is it? The mini pill is a progestin-only pill, no estrogen allowed. It works by suppressing ovulation and reducing the likelihood of pregnancy.
How effective is it? Between 93% and 99%
Pros: The mini pill has many positives and is useful for a variety of folks, including women who are breastfeeding, over 25, less than a month postpartum or who have had bad reactions to the combination pill. It has been known to help the severity of menstrual symptoms.
Cons: Like the combination pill, human error is high since it needs to be taken every day at the same time. Side effects can include breast tenderness and acne.
Long term contraception may be right for you if you want the benefit of lasting birth control without a lot of maintenance. Options may include implants inserted into your arm or your uterus, and they are 99% effective at preventing pregnancy. They work for 3-10 years depending on what option you choose, and there are both hormonal and non-hormonal options to choose from. The benefits include low maintenance and long term control. The downsides can include pain or discomfort on insertion and ongoing side effects such as weight gain, headaches and period issues. Your doctor can fill you in on the specifics of each option.
What is it? This is a small plastic rod that is the size and shape of a matchstick. It is implanted under the skin, usually in your arm, where it releases progestin that blocks ovulation, preventing pregnancy.
How effective is it? More than 99%
Pros: This is one of the most effective birth control options available. It does not require a pelvic exam, so it’s great for younger folk. It does not contain estrogen, which is helpful for those who need or wish to avoid it. And it can last up to three years, though it is removable at any time.
Cons: Implantation will require a local anesthetic and a large needle, so it can be scary for those who are squeamish about such things. It also may make you sore for a few days. Cost can be a factor here as having it implanted can be as much as $800 with removal around $300. Side effects may include acne, weight gain, breast tenderness and disrupted periods.
What is it? A non-hormonal option is the Copper IUD (intrauterine device), a small T-shaped device that is placed in your uterus by a doctor. It works by using copper to deter sperm. For some reason, sperm hate copper, so when they come upon it, they run away. The Copper IUD prevent sperm from reaching an egg, therefore making pregnancy highly unlikely.
How effective is it? Over 99.9%
Pros: Set it and forget it. This one can last up to twelve years, so it’s perfect for long-term birth control. It can be taken out at any time if you decide you want to get pregnant, and you can start trying immediately.
Cons: Cost is high, though when you think about how long it lasts, it’s not so bad. But initial outlay can be as high as $1300. Side effects include random spotting, more cramps and heavier periods.
What is it? Another IUD, this one works by releasing small amounts of progestin, blocking ovulation and making pregnancy unlikely. It can last from 3 – 7 years.
How effective is it? 99%
Pros: It is long-lasting, from 3-7 years. It has a much lower amount of progestin than birth control pills, and it only circulates in the genital region.
Cons: Cost can be as much as $1300 depending on your insurance coverage. Some may stop having periods all together, which may be a pro or a con depending on your perspective.
Permanent sterilization is a big decision and should only be considered by those who are certain they are done having children, are certified child-free, or have a medical reason to do so. The processes for men and women are very similar, each entailing a surgical intervention. They’re almost 100% effective at preventing pregnancy. Tubal ligation (for women) or vasectomy (for men) are relatively simple procedures with minimal recovery. They are both possibly reversible, but there is no guarantee that fertility will return, so this is an option best considered very carefully.
What is it? This is an outpatient surgery performed on those with testicles, and it involves blocking or cutting the tubes that carry sperm to the penis. It makes it so that sperm is not added to any ejaculate, which means pregnancy is impossible.
How effective is it? More than 99%
Pros: This is a permanent birth control solution for those who wish to receive it. While it is reversible, it is generally a dependable means of permanent sterilization for those with the sex organs it applies to.
Cons: While it is a fairly simple procedure, it does require local anesthetic. It is not immediately fool-proof, and most times you will have to wait a few months before full sterilization is achieved. A doctor will be able to verify that your ejaculate is free from semen.
What is it? This is a procedure that involves blocking or cutting the fallopian tubes, which are the means of transport of an egg from the ovaries to the uterus. Without passage, pregnancy cannot be achieved.
How effective is it? More than 99%
Pros: Like a vasectomy, it is a permanent form of birth control that will ensure you can not get pregnant. Reversal is possible, but pregnancy after ligation is difficult, and there are no guarantees it will work.
Cons: This is a surgery, and sometimes it can be an invasive one. While it generally can be done on an outpatient basis, there are methods that require incision and hospital stays. Also, while some believe this process eliminates periods, it absolutely does not.
Fertility Awareness Methods
Being aware of your own fertility means you can track the specific times of the month when you are capable of becoming pregnant. Making lifestyle choices that preclude pregnancy as an option – such as abstinence, outercourse and fertility tracking – can be helpful in ensuring you don’t find yourself in an unwelcome pregnancy situation.
What is it? Abstinence basically boils down to choosing not to engage in vaginal sexual intercourse. If there is no sexual interaction, pregnancy is impossible.
How effective is it? 100% if both parties are committed
Pros: It is the easiest method of all, requiring no special equipment or extra alarms. It is fool-proof.
Cons: It can be mentally, emotionally and even physically painful to abstain from sex if you are someone who would otherwise enjoy it.
What is it? Outercourse means different things to different people. For some is means no sexual interaction under the clothes. For others, it can mean no vaginal penetration of any kind, including with fingers, toys, mouth or anything else. Where pregnancy is concerned, outercourse means absolutely no penis in vagina sex.
How effective is it? 99%
Pros: There is still a lot of fun to be had without P in V sex. Depending on your own set of rules, you can absolutely have a totally fulfilling sex life with nothing but outercourse on the menu.
Cons: Can be sexually frustrating. Is not fool-proof. While it is extremely rare to get pregnant during anal, oral or finger sex, it is not impossible, as pregnancy can occur any time sperm gets near a vagina.
What is it? This involves tracking your menstrual cycle and symptoms and avoiding intercourse on your most fertile days. This can be done by using a calendar, monitoring your body temperature and paying attention to your cervical mucus.
How effective is it? 76% to 88%
Pros: Low risk, no cost and puts you in tune with your own body like never before.
Cons: High failure rate. This method is ultimately a better option for those who want to become pregnant than for those looking to avoid it.
What About Birth Control for Trans Males?
Birth control for trans males can be tricky, but it is very important to get correct. There is a false belief that people assigned female at birth who are taking testosterone can’t get pregnant. However, this is not always the case. Unless you have taken steps to become sterile or know yourself to be unable to become pregnant, there is always a risk.
Looking beyond the anatomy of your partner and the type of sex you are having is very important, and choosing a birth control method that allows you the freedom to live your life is a conversation you need to be having with your doctor. Any of the mentioned birth control methods are available, and hormonal birth control is able to be used alongside hormone replacement therapy.
What If I Just Want Birth Control to Manage Symptoms?
Birth control can be great for managing a whole host of symptoms. It definitely isn’t only for preventing pregnancy. If you are looking for particular symptom management, the chart below may help.
|Symptom||Best Birth Control Options|
|Cramps||Ring, Patch or Combination Pill|
|Polycystic Ovary Syndrome (PCOS)||Combination Birth Control Pill|
|Heavy Periods||Hormonal IUD|
|Hormonal Acne||Combination Birth Control Pill|
Finding the right birth control is highly personal, and a variety of considerations must be weighed before choosing. Even with research, not every birth control is going to work out. Work with your doctor to find the best option for your situation, but understand that you may need to switch at some point if the side effects are too much to handle.
Also remember that your body is your own. Do not let anyone tell you what to do with it. Advocate for yourself and make sure that you are comfortable with anything you are doing to or putting into your body.