How to Choose the Right Birth Control Method?

What’s the Right Birth Control For You?

There are a few questions you should ask yourself before choosing on a birth control method.  Things like—is there protection against STDs?  What is the convenience or cost?  While abstinence is the only 100% effective method—there are others that are nearly close in regards to effectiveness.  The following options will discuss birth control options.  It is best to review them and ask your doctor for advice on the right one for you.

Fertility Awareness

Also known as Natural Family Planning Fertility Awareness, this is when you avoid sex when you are the most fertile.  One way to do this is to watch for changes in the cervical mucus as well as your body temperature.  You may need to get help from a health care professional.  The pros to this method is there are no drugs, devices and it’s inexpensive.  The cons are it limits spontaneous sex.  25% of those who choose this method end up pregnant.

Spermicide

A spermicide contains a chemical that kills the sperm.  It comes in a foam, jelly, cream or film and is placed inside the vagina before sexual intercourse.  Some types are placed in the vagina 30 minutes before sexual intercourse.  If used frequently, it may cause tissue irritation and increased risk against infections or STDs.  Spermicides are mostly used with other birth control methods.  The pros to spermicide are it’s easy to use and cheap—about $1 per use.  The cons are an increase risk with STDs.  29% of users get pregnant with this method.

Male Condom

This is a latex condom is a classic barrier method.  It prevents the male sperm from entering the woman’s body which protects against pregnancy and most STDs.  Those who use this method, 15% get pregnant.  The pros to using a male condom are that they are widely available, protects against most STDs and cheap to use—about $1 each.  The cons—if used effectively every time, can protect against pregnancy and STDs.  This method can’t be reused.

Female Condom

This is a thin, plastic pouch that lines the vagina and is put inside up to 8 hours before sex.  People who use this can grasp the flexible, plastic ring at the closed end and guide it inside the vagina.  However, it is not as effective as a male condom.  The pros are is it is also widely available and gives some protection against STDs and conducts body heat better than the male condom.  The cons are that it can be a little noisy and 21% of users end up pregnant.  It is not reusable and should not be used in conjunction with the male condom to avoid breakage.

Diaphragm

This is a rubber dome that is placed over the cervix before having sex.  A spermicide is generally used with this method.  Effectiveness compares to the male condom in that 16% of those who use this get pregnant, even if it isn’t used correctly every time.  The pros are that it is inexpensive (about $15-$75 per device and lasts about 2 years).  The cons are that it must be fitted by your doctor and there is no STD protection.  Diapragms can’t be used during your menstrual cycle because of the risk of toxic shock syndrome.

Cervical Cap

This is similar to the diaphragm but smaller.  It fits in place over the cervix which blocks sperm from entering the uterus.  It is also used with a spermicide.  There is a 15% failure rate for women who have never had children and 30% for those who have.  The pros are that it stays inside for 48 hours, it is cheap to use.  The cons are that it too must be fitted by your doctor and also has not STD protection.  It too, can’t be used during your menstrual cycle.

Birth Control Sponge

This is a sponge that is made of foam and contains spermicide.  It is sold as the Today Sponge.  It is placed against the cervix up to 24 hours before you have sex.  It is just as effective as the cervical cap where the failure rate for women who haven’t had children is 16%; those who have—32%.  The pros to using the birth control sponge is you don’t need a prescription and is effective immediately.  The cons:  it is hard to insert correctly and has no STD protection.  It also can’t be used during your period.

Birth Control Pill

The most common form of birth control, the pill uses the hormones estrogen and progestin to prevent ovulation.  If taken on schedule, it is highly effective.  8% of users get pregnant, even if they miss a dose.  Like hormonal contraceptives, it requires a prescription.  The pros are more regular, lighter periods, or no periods, depending on the type of pill used, and there is usually less cramping.  The cons are the cost:  about $15-50 per month, and there is no STD protection.  The pill can cause side effects like breast tenderness, spotting, serious blood clots, elevated blood pressure.  Some women shouldn’t use birth control pills—it is best to check with your doctor first.

Birth Control Patch

This may be right for you if you have difficulty remembering to take the birth control pill.  Referred to as the Ortho Evra patch, it is worn on the skin and changed once a week for three weeks; the fourth week is patch-free.  It releases the same hormones as the birth control pill and can be just as effective.  The pros are it gives you more regular, lighter periods, have less cramping, and there is no daily pill to remember.  The cons are the cost at about $15-$50 per month, and may cause skin irritation or side effects that are similar to the birth control pill.  It also doesn’t protect against STDs.

Vaginal Ring

Sold as the NuvaRing, it is a soft, plastic ring that is worn inside the vagina.  It too, releases the same hormones as the pill and patch and is also just as effective.  But unlike the patch, it only needs replaced once a month.  The pros are lighter, more regular periods and is replace once a month.  The cons:  it costs $30-$50 per month and has the same side effects as the pill and patch.  It also doesn’t protect against STDs.

Birth Control Shot

Called Depo Provera, it is a hormonal injection that protects against pregnancy for three months.  A typical couple who uses it can be more effective than the pill with just 3% of users who get pregnant in a year.  The pros are it is injected 4 times a year and is highly effective.  The cons are the cost—about $240 per year and can cause spotting and other side effects.  It also doesn’t protect against STDs.

Birth Control Implant

Sold as Nexplanon, it is a matchstick-sized rod that is placed under the skin of the upper arm.  It too releases the same hormone in the birth control shot.  The implant protects against pregnancy for up to 3 years with a failure rate of less than 1%.  The pros are it lasts 3 years and is highly effective.  The cons are it is more expensive--$400-$800 for the exam, implant and insertion—and can cause side effects like irregular bleeding.  It doesn’t protect against STDs.

IUD

Referred to as an intrauterine device, it is a T-shaped piece of plastic that is inserted inside the uterus by a doctor.  The Copper IUD,or ParaGard, works for as long as 10 years.  Mirena, a hormonal IUD, is replaced every 5 years and can lighten periods and ease cramps.  Liletta/Skyla is also a hormonal IUD that prevents for up to 3 years.  Both types make it more difficult for sperm to fertilize the egg.  Fewer than 8 in 1000 women get pregnant with this method.  The pros are that it is long-lasting and low-maintenance.  The cons:  it may cause irregular, heavier periods with ParaGard, and is more expensive with upfront costs, and it can slip out as well as cause side effects.

Tubal Ligation

If you’re sure you’ve had all the children you want, this procedure is a more permanent method to birth control.  The traditional method was for a woman to have her tubes tied.  The surgeon closes off the fallopian tubes which prevent the eggs from completing their journey out of the ovaries—called the Banding method.  The pros are it is permanent and almost 100% effective.  The cons are it requires surgery and may or may not be reversible.  It too doesn’t protect against STDs.

Tubal Implants

A newer procedure it blocks the fallopian tubes without requiring surgery.  They are small implants of metal or silicone that are placed inside each tube.  Scar tissue will eventually grow around the implants and blocks the tubes.  Once an x-ray shows that the tubes are blocked, no birth control is needed.  The pros are it is permanent, but doesn’t require surgery and is also almost 100% effective.  The cons are it takes a few months to become effective and can raise the risk of pelvic infections.  It is irreversible and expensive.

Vasectomy

Along with condoms, this is the only birth control method available for men.  It surgically closes the vas deferens—the tubes that carry the sperm from the testes through the reproductive system.  It prevents the release of sperm, but doesn’t interfere with ejaculation.  The pros are that it is cheaper than a tubal ligation and is also almost 100% effective.  The cons are it does require surgery and is not effective immediately and may not be irreversible. 

Emergency Contraception

This works after you’ve had sex to avoid pregnancy.  It is usually used if no birth control was used or a woman suspects her usual method failed.  Plan B-Step 1 is a generic version that is called Next Choice and contains a high dose of the hormone in birth control pills.  It must be used within 72 hours of having sex.  Ella uses a non-hormonal drug and requires a doctor’s prescription.  It can be taken up to 5 days after having sex.

Options for Older Women

Age and lifestyle are important factors when it comes to choosing a birth control method.  If you’re over the age of 35, smoke, are obese—birth control pills, patch or ring may not be suitable for you.  You should consult with your doctor for safer alternatives.  If you’re heading into menopause, the birth control shot can give an added benefit and relieve the symptoms of periomenopause.

Withdrawal

6 to 10 women confirm that their partner uses this “pulling out” method—it is a centuries-old method that only requires the man to withdraw his penis from the vagina before he ejaculates.  Research reports that if done correctly every single time—4% of users get pregnant in a year.   If typically used, 18% get pregnant.  The pros are that it is free and you don’t need devices or hormones.  The cons are it can be hard to do correctly and there is no protection against STDs.

Least Effective Methods

If not using any form of birth control method, 85% of sexually active couples get pregnant in a year.  The least effective birth control methods reduce the number considerably.  Just how many get pregnant within a year are:  no birth control—85%; spermicide—29%; fertility awareness—25%; female condom—21%; withdrawal—18%.

More Effective Methods

Barrier methods like condoms and diaphragms are moderately more effective with typical patterns of use and the hormonal contraceptives are better to track for effectiveness.  There are several choices where couples like the lower odds of getting pregnant.  Two are reversible with IUDs and hormonal implants.  The only birth control method that is 100% effective is ABSTINENCE.  The following is a guide for effectiveness:  implant, IUD, vasectomy and tubal method—99%; birth control shot—97%; birth control pill/vaginal ring—92-95%; condom, diaphragm, cervical cap and sponge—84-89%.