Choosing the right method of birth control is a complex process. You have a lot of options, so here's a basic explanation of the more commonly used ones, and what you'll need to consider with each.
This is an enormous topic. Consider this a very basic primer on where to start your search — but be sure to do some extra research (using the links provided in this piece) and talk to your doctor before you decide on one method.
What To Consider Before You Search
We spoke to Dr Dan Weiswasser, a primary care physician who has been in outpatient practice for the last nine years, to find out what you'll want to consider before you head in for that appointment. "I would say that the primary considerations would be convenience, reliability, cost, flexibility (i.e. how easy it is to turn "off" and "on"), associated risks & benefits, and effectiveness in protecting against STDs," he says.
Another factor you may think about is effectiveness over time — the more you use one form of birth control, the higher the risk is that you'll use it incorrectly and it may fail.
Birth control isn't just for contraception, either. If you're a woman, here are a few other medical reasons you may talk to your doctor about using birth control:
- Regulation of your period
- Treatment of irregular, heavy or painful periods
- Treatment of endometriosis (when the uterine lining grows outside the uterus)
- Treatment of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD)
- Treatment of acne, hirsutism or alopecia
- Treatment of anemia
With that said, here are your main options.
Generally, you'll experience fewer side effects with non-hormonal methods of birth control. Most non-hormonal options are "barrier methods" that prevent the sperm from coming into contact with ova.
Condoms are one of the easiest options for both men and women. If you're worried about STIs and are sexually active, condoms are your main protection option. Male condoms are easier to find, but you can also find female condoms for sale. You should be careful of any allergic reaction you or your partners may have to latex condoms (and if you do, polyurethane or polyisoprene condoms are a good alternative). You need to use a condom every time you have sex for full protection, and you should never use a condom more than once.
If you're a woman, you can also use a diaphragm, sponge or cervical cap to protect yourself against pregnancy. Each of these methods are often used with spermicide for more protection. It's possible to use spermicide on its own, but that's considered one of the least effective forms of birth control — it's definitely recommended you use it with condoms. Like condoms, you must use each of these methods every time you have sex.
Non-hormonal IUD — aka a copper IUD — is considered highly effective (less than 1 in 100 women who use it get pregnant). This method relies on copper's toxicity to sperm and eggs. You must get it inserted by your healthcare provider, but the procedure can be worth it as the IUD can last up to 10 years. It carries the risk of cramps, bleeding, pelvic inflammatory disease, infertility, and potential damage to your uterus, however. Talk to your doctor for more information.
When you use a hormonal method of birth control, you have two main options. A combined method uses both estrogen and progestin which mainly suppresses ovulation and thickens the cervical mucus some. The progestogen-only methods rely more on thickening of the cervical mucus to prevent pregnancy. There are several side effects associated with hormonal methods of birth control, but they don't affect most people. Work with your doctor to find the right method for you.
You've undoubtedly heard of birth control pills as a contraceptive option. It requires swallowing a pill daily. You may consider the pill because it is extremely easy to start and stop, in case you want to go off birth control. You also don't have to worry about allergies or carrying it around with you for immediate use as you do with condoms. You'll still have a period once a month, though you may be able to have it once every three months by skipping the placebo pills (again, talk to your doctor). As with almost all types of birth control, especially hormonal methods, you can react differently than others, but possible side effects include nausea, vomiting, and bleeding between periods.
The vaginal contraceptive ring — commonly referred to as "the ring" or by a popular brand name, NuvaRing — — is another hormonal method. You insert the ring yourself and keep it in place for 3 weeks. Then you remove it for a week, and start again with a new dose.
Other options include the patch, which you apply every week and carries a similar level of effectiveness as the pill or ring. The Birth Control Implant, also known as Implanon or Nexplanon, is an implantable rod you get inserted in your upper arm just under the skin. You have to visit your doctor to have it implanted, but it lasts up to 3 years. Consider that this option does carry the potential side effect of weight gain and breast and abdominal pain.
If you're ok with needles, you may also consider the birth control shot, which consists of a shot of progestin from a healthcare professional. It will last for around 3 months.
For a shorter term IUD option (compared to the copper IUD mentioned above), consider the hormonal IUD. It is effective for 3-5 years depending on the type you get. Like the copper IUD, you must have a healthcare provider insert it, and the effectiveness is similar. However, this version of an IUD does carry the potential risks of ovarian cysts, irregular bleeding, and abdominal or pelvic pain, so check with your doctor to see which IUD would be ideal for you.
Whether you're a man or woman, surgical options are considered some of the most effective forms of birth control. You should take time to weigh your other options though, because having surgery is much harder — or impossible — to reverse once you go through with it.
If you're a man, one option is getting a Vasectomy — tying or esaling your vasa deferentia to prevent sperm from being ejaculated. You go through the procedure once, but there is a short waiting period of about a week before the effects take place. You may experience some pain, bleeding, or infection if you have a vasectomy since it is a type of surgery.
For women, Tubal ligation — often referred to as "getting your tubes tied" — is also a one-time procedure. Your fallopian tubes will be clamped or tied to prevent the egg from reaching your uterus. However, this carries some small risk as well, of an ectopic (tubal) pregnancy.
The above are all preventative measures, but if your birth control fails — or worse, if you didn't use any to begin with — there are emergency options available as well. These should not be your main method of birth control, but they can be useful as a back-up. There are two main ways they work: preventing an egg from being released or preventing a fertilised egg from attaching to the uterine wall.
Plan B or Next Choice are the most common options for emergency contraception. You need to take the pills within 3 days of when you had unprotected sex. You may experience side effects like nausea, vomiting, abdominal pain, fatigue, and headaches. You might also choose Ella, which is less effective than your other emergency options, but can be taken within 5 days of having unprotected sex.
If none of the above methods appeal to you, we'd be remiss not to include abstinence. Not having sex is, by far, the most effective birth control, as it eliminates your risk of pregnancy and STIs. But, if you think abstinence is unrealistic, make sure you use another form of birth control to stay protected.
If you're a visual person, the US FDA has a detailed chart you can check out for more information. This chart reviews most of these methods, the risks, how often you must use them, and their effectiveness. You can also talk to your partner about splitting the associated costs. Whatever you choose, stay safe and healthy.