Birth control options: Things to consider

November, 15th, 2023

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If you’re considering using birth control (contraception), you have a variety of options. To help pick the right method of birth control for you and your partner, consider the following questions.

What birth control options are available?

Your birth control options include:

• Barrier methods. Examples include male and female condoms, as well as the diaphragm, cervical cap and contraceptive sponge.
• Short-acting hormonal methods. Examples include birth control pills, as well as the vaginal ring (NuvaRing), skin patch (Xulane) and contraceptive injection (Depo-Provera). These are considered short-acting methods because you have to remember to use them on a daily, weekly or monthly basis.
• Long-acting hormonal methods. Examples include the copper IUD (ParaGard), the hormonal IUD (Mirena, Skyla, Kyleena, others) and the contraceptive implant (Nexplanon). These are considered long-acting methods because they last for three to 10 years after insertion — depending on the device — or until you decide to have the device removed.
• Sterilization. This is a permanent method of birth control. Examples include tubal ligation for women and vasectomy for men.
• Spermicide or vaginal gel. These are nonhormonal options for birth control. Spermicide is a type of contraceptive that kills sperm or stops it from moving. Vaginal pH regulator gel (Phexxi) stops sperm from moving, so they can’t get to an egg to fertilize it. You put these products in the vagina right before sex.
• Fertility awareness methods. These methods focus on knowing which days of the month you are able to get pregnant (fertile), often based on basal body temperature and cervical mucus. To avoid getting pregnant, you do not have sex on or around the days you are fertile, or you use a barrier method of birth control.

It’s also important to be aware of emergency contraception — such as the morning-after pill (Plan B One-Step, Aftera, ella, others) — which can be used to prevent pregnancy after unprotected sex.

How do the different birth control options work?

Various types of birth control work in different ways. Birth control methods may:

• Prevent sperm from reaching the egg
• Inactivate or damage sperm
• Prevent an egg from being released each month
• Alter the lining of the uterus so that a fertilized egg doesn’t attach to it
• Thicken cervical mucus so that sperm can’t easily pass through it

What is the method’s effectiveness?

To be effective, any method of contraception must be used consistently and correctly. Contraceptives that require little effort on your part, such as IUDs, contraceptive implants and sterilization, are associated with lower pregnancy rates. In contrast, methods that require monitoring fertility or periodic abstinence are associated with higher pregnancy rates.

Is it reversible?

The method of contraception you choose depends on your reproductive goals. If you’re planning pregnancy in the near future, you may want a method that’s easily stopped or quickly reversible, such as a short-acting hormonal method or a barrier method. If you want to prevent pregnancy for a longer amount of time, you may consider a long-acting method, such as an IUD. If you’re certain that you don’t want to get pregnant at any time in the future, you may prefer a permanent method, such as sterilization. You may find that different contraceptive options work for you at different stages of your life.

Is it compatible with your religious beliefs or cultural practices?

Some forms of birth control are considered a violation of certain religious laws or cultural traditions. Weigh the risks and benefits of a birth control method against your personal convictions.

Is it convenient and affordable?

It’s important to choose a type of birth control that suits your lifestyle. For some people, the most convenient form of birth control may be one that is easy to use, has no bothersome side effects or does not disrupt the sexual experience. For others, convenience means no prescription is required. When choosing a method of birth control, consider how willing you are to plan ahead or follow a rigid medication schedule.

Some methods of contraception are inexpensive, while others are more costly. Ask your insurance provider about your coverage, and then consider the expense as you make a decision.

What are the side effects?

Consider your tolerance for the possible side effects associated with a particular birth control method. Some methods pose more side effects — some potentially serious — than others. Talk to your doctor about your medical history and how it might affect your choice of birth control.

Does it protect against sexually transmitted infections?

Male and female condoms are the only methods of birth control that offer reliable protection from sexually transmitted infections. Unless you are in a mutually monogamous relationship and have been tested for sexually transmitted infections, use a new condom every time you have sex in addition to any other method of birth control you use.

Does it offer other benefits?

In addition to preventing pregnancy, some contraceptives provide benefits such as more predictable, lighter menstrual cycles, a decreased risk of sexually transmitted infections or a reduction in the risk of some cancers. If these benefits are important to you, they may influence your choice of birth control option.

Is it acceptable to your sexual partner?

Your partner may have birth control preferences that are similar to or different from your own. Discuss birth control options with your partner to help determine which method is acceptable to both of you.

How do I choose?

The best method of birth control for you is one that is safe, that you are comfortable using, and that you are able to use consistently and correctly. Your preferred method of birth control may change over your lifetime and is influenced by many different factors, including:

• Your age and health history
• Your reproductive goals, such as the number of children you want and how soon you want to get pregnant
• Relationship factors, including marital status, number of sexual partners, how often you have sex and partner preferences
• Religious beliefs
• Differences between birth control methods, including how effective they are at preventing pregnancy, side effects, cost and whether they prevent sexually transmitted infections

Knowing your options is definitely part of the decision process — but an honest assessment of yourself and your relationships is just as important when deciding which type of birth control is right for you.