Birth control is anything but one size fits all. “Every women is unique and her birth controls needs are different,” says OB/GYN Michael Krychman, M.D., executive director of the Southern California Sexual Health Center. “A woman’s health, relationship, lifestyle and how long she plans to use birth control can all affect what birth control method is ideal and which is less than.” After all, your weight, heart health and age can affect some methods’ effectiveness rates and even their possible side effects. Read on to learn about the most common birth control methods out there today, as well as their pros and cons and how to figure out which one is best for you.
1. Birth Control Pills
Birth control pills come in more varieties than you probably realize. Among your options are combination pills, progestin-only pills, and extended-cycle pills. Combination birth control pills like Ortho Tri-Cyclen Lo, Yasmin and Yaz prevent pregnancy through a daily dose of two hormones -- estrogen and progestin. While they offer 99-percent protection, making them the mainstay of birth control pills, smokers and women 35 or older are often advised against them since estrogen they can increase the risk of blood clots in those women. The progestin-only pill, often called the “mini pill,” protects against pregnancy through a daily dose of progestin (but not estrogen) thereby making it safe for women who are at risk of blood clots such as smokers, diabetics and heart-disease patients. However, they must be taken at the same time every day in order to effectively prevent pregnancy, says OB/GYN Michael Krychman, M.D. If you take a pill more than three hours later than you usually do, you'll need to use a backup method of birth control. Some women also experience spotting on the mini pill. On extended-use cycle pills, which allow women to have periods only every three months, breakthrough bleeding can also be common in the first few months of use. However, spotting generally resolves itself after the first few months, and then the only bleeding you have is during the one week every three months you take your placebo pills. While there’s no harm in not having a period every month, some women like getting a monthly assurance that they aren’t pregnant. Common extended-cycle pills include Seasonale and Seasonique. And on another, Lybrel, you only have your period once a year.
2. Intra-Uterine Devices
According to a 2015 study from the journal Contraception, more female family planning providers use IUDs compared to any other method of birth control. It’s easy to see why. “IUDs are a good choice for women who want to ‘set their birth control and forget it.’ To have protection for multiple years without having to do anything day in and day out,” says OB/GYN Michael Krychman, M.D. If a physician implants an IUD like Mirena and Skyla in your uterus, it works by stopping the sperm from reaching the egg while releasing hormones into the body. Some women stop having periods altogether on Mirena. Paraguard, on the other hand, is hormone-free and releases copper ions into the body to prevent pregnancy in addition to blocking conception. IUDs are 99 percent effective, with Mirena offering protection for five years, Skyla for three and ParaGard for 10. If and when you decide to have children, the devices can be removed by your doctor.
3. Fertility-Awareness Methods
Also called “natural family planning,” fertility-based awareness methods come down to tracking your menstrual cycle to figure out on what days you can get pregnant, explains OB/GYN Michael Krychman, M.D. Then, you avoid sex on those days. Fertility-tracking devises like Daysy, ONDO and Wink take women’s basal body temperatures first thing in the morning to give recommendations on when women are and aren’t fertile (temperatures rise about half a degree just after ovulation), while other women chart changes in their cervical mucus to determine their most-fertile days. Krychman notes that these methods typically come with a high failure rates and are also unattractive to many women because they limit the days you can have sex. However, for women who prefer not to use medications, hormones, condoms or other contraceptives due to health concerns or religious reasons, this is the method of choice.
Related: Quiz: Am I Pregnant?
The male, or traditional, condom is the most widely available, low-cost birth control option around. Plus, it's the only method on this list that can also prevent the transmission of sexually transmitted infections including HIV, so it can be important to use one even if you're using another birth control method. It can also act as a form of backup birth control should you miss taking a birth control pill. However, they are too often neglected in the heat of the moment, and if handled improperly, can tear or break, says OB/GYN Michael Krychman, M.D. According to the Centers for Disease Control and Prevention, they have a typical use failure rate of 18 percent. The female condom, though, can be inserted deep into the vagina hours before sex, so you can ensure a condom is used when the time comes. However, they provide less protection and have a higher failure rate than male condoms.
5. Hormonal Patches
The birth control patch, Ortho Evra, keeps you from having to think about birth control for one week at a time. You place a hormone-releasing patch, which looks somewhat like a nicotine patch, on your arm, butt or abdomen and replace it after a week for continued protection, explains Julie M. Levitt, M.D., a board-certified OB/GYN with the Women's Group of Northwestern in Chicago. Women who smoke or are 35 years or older, however, should not use the patch, as it contains about 60 percent more estrogen than combination birth control pills, according to Ortho Evra. Estrogen increases the risk of blood clots, especially in these women. Additionally, the patch may be less effective in women who weigh more than 198 pounds.
6. Hormone Shots
The birth control shot, called Depo-Provera, releases progestin into the body over the course of three months to prevent pregnancy. Since it contains only progestin and no estrogen, it’s an attractive option for women who are prone to blood clots and don’t want to have to take birth control every day, says OB/GYN Julie M. Levitt, M.D. However, like the progestin-only birth control pill, being regular with dosage is the key to effectiveness. It’s 99 percent effective at preventing pregnancy -- as long as you get your shot on time. If you miss a shot by more than a week or two, your doctor may require a pregnancy test before giving you the shot. Another possible drawback is weight gain. In a 2009 American Journal of Obstetrics and Gynecology study, women who got the Depo shot gained an average of 11 pounds over the course of three years, compared to an average of three to four pounds in women who used other birth control methods.
7. Implanted Devices
About the size of a matchstick, implants like Implanon and Norplant are inserted under the skin on your upper arm to prevent pregnancy for up to three years through a slow release of progestin (making this another safe option for women who cannot take estrogen). They are 99 percent effective, but may not work as well in women who are overweight. “Most women who have the implant experience irregular bleeding in the first few months of use,” says OB/GYN Julie M. Levitt, M.D. “It can be enough of an annoyance that it makes you want to have the implant removed, but after a year of use, most women have no more periods while using the implant.”
Related: Questions I Should Ask the Doctor
8. Vaginal Rings
The NuvaRing is made of flexible plastic that fits deep inside your vagina and, just like the combination birth control pill, delivers estrogen and progestin throughout your body to prevent pregnancy. However, instead of working for a day at a time, it works for three weeks. On the fourth week, you remove the ring and you have your period, says OB/GYN Julie M. Levitt, M.D. Potential side effects are similar to those of combination birth control pills, and women who are at risk of blood clots should not use the ring.
9. Emergency Contraception
It’s not meant to be your plan A for preventing pregnancy (although you can probably figure that out by the fact that it’s called Plan B), but emergency contraception can come in handy should your regular birth control method fail, says OB/GYN Julie M. Levitt, M.D. Plan B One-Step and Next Choice One Dose prevent pregnancy with a high dose of a form of progestin but are less effective in women who are overweight. Another newer option, ella, reduces your body’s levels of progesterone to delay ovulation and prevent pregnancy. Both are most effective when taken within 72 hours of sex but may work up to five days later. Plan B One-Step and Next Choice One Dose are available over-the-counter, but ella is only available with a prescription.
For women who do not wish to become pregnant in the future, several permanent birth control options exist. Tubal ligation -- commonly called “having your tubes tied” -- involves having the fallopian tubes clamped and blocked or severed and sealed, permanently preventing pregnancy. A less invasive option is Essure, a nonsurgical technique in which a small coil is inserted into each of the fallopian tubes using a scope, says OB/GYN Julie M. Levitt, M.D. Both of these female sterilization techniques are irreversible. If you are in a long-term monogamous relationship, a vasectomy, in which the tubes that carry a man’s sperm from his testicles are cut, can also permanently prevent pregnancy. The procedure is minimally invasive, and in some cases, it can be reversed.
What Do YOU Think?
Do you or have you ever used birth control? What forms of birth control have you used in the past? Are you interested in trying any new ones now? Tell us below in the comments -- and tell your doctor during your next visit!