Does a "Superior" Birth Control Exist?
A guide to choosing which birth control is right for YOU
If you're one of nearly two-thirds of womxn according to the Center for Disease Control, then you are currently using a contraceptive method. If you are one of the 99% of womxn who are sexually active, then you have used a contraceptive method in your life time. Many womxn who enter the doctor's office to inquire further about birth control don't get all of the information (mainly side effects) that they need in order to make an informed decision. According to a study conducted by Dr. Ed, an online medical service, only about half of womxn are satisfied with their birth control choice, with none answering 100% satisfied.
Many factors are necessary to think about when choosing the birth control that is right for you. How safe, effective and accessible are contributing factors in choosing the best contraceptive method. Although it has been said on every birth control method, one must be prepared to also make an informed decision to protect themselves from STI exposure as well.
So, if you're considering switching methods or want to take a closer look on contraception in general, this guide may help you. NOTE: This guide is not intended to replace medical advice, consult with your healthcare provider before definitively choosing a birth control method. All facts below have been sourced by the Planned Parenthood website.
Long-term birth control methods - can last up to 12 years
IUD: The longest-term method of birth control is the IUD. The term "IUD" actually does stand for something. The acronym means Intrauterine Device - essentially meaning that the device is inserted in your uterus to prevent pregnancy. There are copper and hormonal types of IUDs. They both prevent the sperm from reaching the egg. Sperm actually does not like copper, so it will avoid the area all together. The hormonal IUD conducts their "sperm evading" a little bit differently. The hormones actually prevent you from releasing an egg and to add an extra layer of protection, they thicken the mucus of the cervix so sperm cannot penetrate.
IUD's are 99% effective, and you are protected from 3 to 12 years depending on which IUD you get. There are other several benefits aside from their percentage of effectiveness. They are placed inside your uterus and last for years so you can forget about it and still be protected against pregnancy. And, if you don't want added hormones in your body, the copper IUD is an option. It is also important to know the risks associated with an IUD. The IUD has several side-effects listed: pain and cramping after insertion, irregular periods, and menstrual cramps. Though uncommon, serious side effects include: ectopic pregnancy (when a pregnancy grows outside of your uterus) due to the IUD moving, infection, and risk of the IUD pushing through the uterine wall. Be on the lookout for signs including: feeling the plastic of the IUD, bad pains in your lower abdomen, pain during sex, fever, chills, and different vaginal discharge.
IUD's can cost between $0 and $1300, depending on insurance. Because of the Affordable Care Act, most health insurance companies do cover the IUD. However, if you do not have health insurance you still may be eligible through your state's Medicaid program. Planned Parenthood will work with you to provide the services you need, regardless of health insurance or legal status.
Birth Control Implant: Known as the brand name Nexplanon, the implant is a thin rod that is inserted in your arm. The implant works by releasing hormones that prevent pregnancy, similar to the IUD. Progestin thickens the mucus on your cervix and prevents you from ovulating. It can last up to 5 years. You can remove the implant at any time, but it does require an in-office procedure in a doctor's office. The implant is over 99% effective, largely due to the implant being implanted in the arm. The implant becomes effective immediately if you are in the first 5 days of your period. At any other time, the implant becomes effective after a week so additional birth control methods must be used.
The advantages of the implant include: it's effectiveness, privacy due to the location, it can make your periods less intense or stop them all-together, and it only has one hormone (many birth control methods have two). The disadvantages include: irregular bleeding during the first 6 months, headaches, breast pain, nausea, acne and weight gain. DON'T get the implant if you have ever had breast cancer. It is possible for an infection to occur at the implant site, so be sure to call your doctor if you have bleeding or pus surrounding, yellowing of eyes or skin, heavy vaginal bleeding or if the implant moved.
The implant can cost between $0 to $1300 and removal can cost between $0 to $300. Implants are free with most health insurance plans, and are cost effective since they last for 5 years. As stated previously, Planned Parenthood can help go over and mitigate costs regardless of insurance.
Shorter-term birth control methods - must be used on a schedule
Birth Control Shot: The "depo" shot is an injection a healthcare provider provides every three months. The shot contains Progestin (stated above) to prevent the sperm and egg from meeting. The shot's effectiveness is dependent on the timing of each one. You should get a new injection every 12-13 weeks. That's every 3 months or 4 times a year. What happens if you're late? Be sure to use alternative contraception if you can anticipate it. The healthcare provider may ask for a pregnancy test and offer emergency contraception if you've had vaginal sex in the past 5 days.
Advantages from the shot include: it (can) be convenient, it is private, less periods, can help prevent uterine cancer and ectopic pregnancy, and it's temporary. Disadvantages include: the timing of the injections, irregular bleeding, nasuea, and weight gain. The shot should not be used if you've had breast cancer. You also may experience temporary bone thinning, but it goes away after you stop using it. It can also cause severe depression and headaches with bright, flashing lights.
Usually an exam is required before a healthcare provider can administrate the shot. That may cost between $0 and $250. After that, the shot itself can cost $0 or $150, each time.
Vaginal Ring: Also know as the NuvaRing, this birth control is a small ring shape that is inserted in the vagina. The ring includes two types of hormones - estrogen and progestin. The hormones are essentially absorbed through the vaginal lining to prevent ovulation. Depending on the schedule, the ring needs to be removed and re-inserted every 3 to 6 weeks. What's nice about the ring is that you can decide whether or not you want to get a period. Planned Parenthood has a great resource to find a ring schedule that fits your life best. You can find it here: https://www.plannedparenthood.org/learn/birth-control/birth-control-vaginal-ring-nuvaring/how-do-i-use-nuvaring . If used perfectly, the ring is 99% effective. That seems to be most people's downfall, however. In reality, the ring is about 91% effective. Note that there are certain medications that may interact with the effectiveness of the ring: Rifampin, Griseofulvin, certain HIV medications, anti-seizure medications and St. John's wort.
The advantages of the ring include: convenience (for those who don't want an every-day method), less or no periods and health benefits (acne, cysts, bone thinning, infections in ovaries, Fallopian tubes and uterus and PMS.) The disadvantages of the ring include: timing the effectiveness of it, decrease in sexual libido, spotting, sore breasts, nausea and headaches. If you are over 35 and a smoker, it is not suggested to use the ring. It is also best to avoid using the ring if you've ever had a history of blood clots, breast cancer, heart problems, migraines, uncontrolled high blood pressure and serious diabetes.
The ring itself can cost between $0 to $200 and a doctor's visit to get the prescription can cost $35 to 250. Read on previous methods about the use of health insurance and Planned Parenthood.
Birth Control Patch: This birth control is a patch that you wear on your skin - either on your butt, upper arm, belly or back. The patch contains the two hormones - estrogen and progestin to prevent pregnancy from occurring. The hormones are absorbed through the body from where you placed the patch. If used perfectly the patch is about 99% effective. In reality, it is about 90% effective. The patch and the ring have the same medications that will decrease its effectiveness (listed above).
Advantages of the patch include convenience (for scheduled use birth controls) and health benefits which include protection from pelvic inflammatory disease, acne, bone thinning, cysts, etc. The disadvantages of the patch include changing the patch on time every time, bleeding between periods, tender breasts, nausea and headaches. If you are over 35 and a smoker, it is not suggested to use the ring. It is also best to avoid using the ring if you've ever had a history of blood clots, breast cancer, heart problems, migraines, uncontrolled high blood pressure and serious diabetes.
The patch requires a prescription from a doctor or NP. 3 birth control patches (for 3 weeks of protection and one week for a period) cost around $0 - $150, depending on insurance.
Birth Control Pills: Birth Control pills are what folks most commonly think of as "birth control." It is a hormonal pill taken daily to prevent pregnancy from occurring, but it also has a surprising amount of health benefits. If used perfectly, the pill is around 99% effective. Most folks do not use it perfectly, so the effectiveness of the pill for the average person is 91%. The same medications that makes the ring and the patch ineffective also makes the pill less effective (see above).
There are two different types of pills. The first type is a "combination pill." These pills include the two main hormones used for birth control - estrogen and progestin. You DO NOT have to take the combo pill at the same time for it to have the same effectiveness, just every day. The second type is the "mini pill." These are progestin ONLY pills. These pills must be taken within the same three hours every day. If you start the combo pill within 5 days of your period, you'll be protected immediately. Otherwise, wait one week while using another type of method. The mini pill becomes protected anytime after 48 hours.
The pill has many health benefits including: reduction of menstrual cramps, lighter periods, lower risk of an ectopic pregnancy, acne, cysts in breasts and ovaries, bone thinning, endometrial and ovarian cancers, anemia, PMS, and more. You can also use the pill to skip your periods safely. Disadvantages of the pill include: taking it every day (and within 3 hours if you are taking the mini-pill), change in libido, heavier periods, sore breasts, and headaches. These side effects usually dissipate after 3 months but talk to a doctor if side effects persist. Though rare, there are serious side effects. For the combo pill, do not smoke. However, smokers can use the mini-pill. Avoid combo pills if you've ever experienced: blood clots, breast cancer, stroke, heart attack, migranes, high blood pressure and abnormal diabetes. Usually, the mini pill does not risk these side effects. See a doctor right away if you have trouble breathing, sudden back pain, chest and stomach pains, sudden headaches or yellowing of skin.
Pill prices vary depending on insurance, but a month pack can cost $0 to $50. In a few states, you can get birth control pills online.
Every time uses
Condom: Ah, the condom. Condoms are thin, pouch like contraceptives that penis-owners put on to protect against HIV, STI's and pregnancy. Condoms can be made out of latex, plastic or lambskin. NOTE: lambskin condoms do not protect against STI's or HIV. Condoms collect sperm in it's pouch which limits sperm from entering inside to meet the egg. Using condoms orally, anally or vaginally is the best way to prevent against STI's. Using condoms every time correctly is 98% effectively in preventing pregnancy. Realistically, it is 85% effective. Condoms should not be used with internal condoms. Learn how to put a condom on here: https://www.plannedparenthood.org/learn/birth-control/condom/how-to-put-a-condom-on
Advantages of condoms are: they are not just for birth control - they are the most effective tool in preventing the spread of HIV and STI's. Condoms also do not cost a lot of money. In many heath centers, they are free of charge. Condoms (different styles, flavors, and feelings) can also spice up your sex life. Most folks do not have side effects when wearing a condom, unless they are allergic to latex. Disadvantages of condoms include: using protection every time you engage in oral, vagina or anal sex. Condoms - at first - can reduce sensation, however there are many ways to make condoms sexy (as listed above)!.
Condoms are virtually at every drug store, gas station, or convenience store. Condoms usually cost a dollar per condom, especially in a pack. Anyone can buy condoms as well - you do not need to be a certain age. Condom size is important, because a wrong sized condom can lose effectiveness. The best advice is to try on different ones before you have sexual intercourse!
Internal condoms: Otherwise known as "female" condoms, internal condoms go inside the vagina which creates a barrier between the sperm and egg. It is similar to the condom! Internal condoms can also go inside the anus for protection against HIV and STIs there. If used perfectly every time, they are 95% effective. Realistically, they are about 79% effective. Here is a guide on how to use an internal condom correctly: https://www.plannedparenthood.org/learn/birth-control/internal-condom/how-do-i-use-an-internal-condom . As stated before, do not combine using a condom with an internal condom. Doubling up will cause friction for either condom to break, which breaks the barrier created.
Advantages of internal condoms include: helping protect against STIs, they are comfortable and latex free, and they can actually make sex - sexier! Disadvantages include: using them every time you have sexual intercourse and they can be uncomfortable AT FIRST. Internal condoms can be trickier to find. You can find them in health centers, the female condom website, and by prescription in a drug store. They cost about $2 to $3 dollars each.
Diaphragm: This birth control is a cup that you insert inside your vagina that covers your cervix to prevent sperm from reaching an egg. A diaphragm works best with spermicide (a gel that kills sperm). Using perfectly, it is 94% effective. Realistically, it is about 88% effective. Here is a guide on how to insert it correctly: https://www.plannedparenthood.org/learn/birth-control/diaphragm/how-do-i-use-a-diaphragm . Using a diaphragm with another birth control method (condom) will increase its effectiveness. They DO NOT protect against HIV or STIs.
Advantages include: They don't have to interrupt sex as they can be placed up to two hours before, they don't have hormones, and they can last up to two years. Disadvantages include: using every time you have vaginal sex, they can be difficult to use, and UTIs can occur if you're sensitive to the material. Spermicide can also irritate the vagina if used too often. They also need to be a correct size. Do not use a diaphragm if you're allergic to silicone or spermicide, you gave birth in the last 6 weeks, you or your partner have HIV, and if you have had a second or third trimester abortion with 6 weeks.
Diaphragms need to be fit for your body, so they will need to be fitted and prescribed by a doctor. They can cost $0 to $150 and spermicide to use in conjunction can cost $5 to $15 a pack. Planned Parenthood can help you navigate if you do not have health insurance.
Birth Control Sponge: The sponge is made of plastic and is inserted in your vagina before sex to protect the cervix and prevent sperm from meeting with an egg. The sponge contains spermicide to help even further slow down the sperm. If used perfectly the sponge is 91% effective. Realistically, it is about 80% effective. Here is a guide on how to use the sponge effectively: https://www.plannedparenthood.org/learn/birth-control/birth-control-sponge/how-do-i-use-sponge
The advantages of the sponge include: the sponge can stay in for up to 24 hours, they don't interrupt sex, and they're hormone free. Disadvantages include: the sponge DOES NOT protect against HIV and STIs, it has to be used every time, and if kept in too long can cause toxic shock syndrome. Don't use the sponge if you have had an abortion, miscarriage or birth recently, you have an infection around your vagina or if you have a history of toxic shock syndrome.
You can by the brand the Today Sponge over the counter at pharmacies, drugstores and some supermarkets and at health clinics. Packs of 3 cost around $15.
Cervical Cap: Cervical caps are cups that look like sailor's hats and are inserted in the vagina to cover the cervix. It is most effectively used with spermicide. Cervical caps are smaller than diaphragms and can be keep inside your vagina for up to two days. Cervical caps are actually significantly more effective if you have never given birth. For that, they are about 86% effective. For those who have given birth it is 71% effective. Cervical caps are most effective when used every time perfectly. They need to be left in at least 6 hours after completion for more effectiveness. They do NOT protect against HIV or STIs.
Advantages of cervical caps include: they don't interrupt sex, they don't have hormones, and they are reusable. Disadvantages include: having to use it every time, they are difficult to use correctly, and the sizing of the cup can change depending on life events. You need to get fitted for a cap, so it does require a doctor's visit and prescription. You must also buy spermicide for the cap to work. They can cost between $0 and $260 dollars, depending on insurance.
Pull-out method: The pull out method involves pulling the penis out of the vagina before ejaculation. However, there are complications and controversy with this method. First, you must ALWAYS pull out before any sort of ejaculation occurs. However, sometimes a penis owner may not notice due to pre-cum (it actually prepares the body as a lubricant for sex). It is best to rely on this method only with another form of birth control, such as a condom. If used perfectly, 4 in 100 will get pregnant. Realistically, relying on this will cause 1 in 5 to get pregnant. Withdrawal also takes a LOT of self-control. Masturbating can help you understand your body the best way.
Advantages are: it's free and always available, it technically causes no side effects, and it can make other birth control methods more effective. Disadvantages are: difficulty in "pulling out" on time well before ejaculation and you need to trust that your partner will do it effectively and has self-control.
Bottom-line: There are many different birth control methods and it is likely that there is one for you and one you will enjoy! I hope you learned something about birth control and will be able to make a better informed decision with your doctor about which birth control is best for you!