Nichole Mahnert, MD, an OBGYN with Banner – University Medicine Women’s Institute in Arizona, broke down the different forms of birth control and the risks and benefits of each.
What is birth control?
“Birth control is any method, medicine or device used to prevent a pregnancy when you don’t want to have a baby,” Dr. Mahnert said. “Each works a bit differently and some work better than others at preventing pregnancy.”
You can choose based on the following categories:
- Short-acting: pills, condoms, injection, etc.
- Long-acting: IUD (Intrauterine device) and implants.
- Permanent method: vasectomy and tubal ligation.
- Emergency contraception: Plan B.
Short-acting birth control
Short-acting methods refer to contraceptives that you need to remember to take or use regularly—daily, weekly or monthly. Although these methods are effective if used correctly, they are only as reliable as you are.
Short-acting birth control options fall into two general categories: barrier methods and hormonal methods.
Barrier methods are contraceptives that block the sperm from fertilizing an egg during sex (intercourse). Popular methods include:
- External condoms (worn on the penis).
- Internal condoms (placed inside the vagina).
- Diaphragms and cervical caps (placed inside the vagina).
- Sponges (placed inside the vagina).
- Spermicide (a gel that stops sperm from reaching the vagina).
“In addition to helping prevent pregnancy, external ‘male’ condoms and ‘female’ condoms are the only methods of birth control that offer reliable protection from HIV and sexually transmitted infections (STIs) when you use them correctly,” Dr. Mahnert said.
Barrier contraception methods don’t require a prescription and are available at many stores or online.
Short-term hormonal methods contain either estrogen and progestin or progestin-only (mini pill), and they work to prevent your ovaries from releasing an egg each month. The most popular methods include:
- Birth control pills, AKA “the pill” (taken every day).
- Vaginal ring, such as NuvaRing (put in the vagina and replaced once a month).
- Skin patch, such as Xulane (worn on the skin and replaced once a week with one week off every month).
- Contraceptive injection, such as Depo-Provera (given by a health care professional every three months).
“Some hormonal methods work better than others but using them along with barrier methods can make having sex a lot safer and are extremely effective at reducing the risk of getting pregnant,” Dr. Mahnert said. “Hormonal birth control can also decrease period pain, frequency and flow.”
If you’re experiencing negative side effects like weight gain, headaches or nausea that don’t go away after a few months, talk to your health care provider about switching birth control methods.
In addition, if you’re considering “the pill,” talk to your provider if you have a history of heart attacks, stroke or blood clots. Even though birth control pills are safe, they can slightly increase your risk of health problems.
All these short-term methods do require a prescription.
Long-acting birth control
Long-acting reversible contraception (LARC) options are a good choice if you want long-lasting birth control that doesn’t require you to remember to take a pill, change a patch or ring or get another injection. The most common forms include:
- Hormonal IUDs, such as Mirena and Skyla (placed in the uterus by a health care professional).
- Nonhormonal IUD ParaGard (placed in the uterus by a health care professional).
- Implants, such as Nexplanon (inserted in your arm).
IUDs most frequently use the hormone progestin to prevent pregnancy, but there is a brand of IUD called ParaGard that doesn’t use hormones. Instead, it uses copper, which is a natural spermicide. Implants use progestin just like a hormonal IUD.
“These devices are effective at preventing pregnancy for many years depending on the device or until you have them removed,” Dr. Mahnert said. “Only ParaGard can prevent pregnancy for 10 years.”
As with short-term hormonal methods, if you’re experiencing negative side effects, talk to your health care provider.
A permanent method of birth control is a great option to consider if you don’t want to have any children in the future or don’t want any more children.
With tubal ligation, the fallopian tubes are tied, cut or sealed to prevent eggs from reaching the uterus. With a salpingectomy, the fallopian tubes are removed. It is performed in an operating room and can be performed after a cesarean birth or in the hospital after a vaginal birth.
Vasectomy involves the clipping, cutting or sealing off of the vas deferens tube, which carries sperm to the outside of the penis. This procedure is performed in a clinic or medical office under local anesthesia.
“Recovery time is relatively quick, and your sexual function won’t be impacted,” Dr. Mahnert said. “Essentially it won’t change your day-to-day life, except your ability to get pregnant.”
Reversals are possible, but they don’t always work. Talk to your health care provider if you or your partner are considering a tubal ligation reversal or a vasectomy reversal.
Emergency contraception is medication you use if you have sex without using birth control or your birth control fails to prevent pregnancy. If you need emergency birth control, there are two types of pills available as well as a copper IUD.
“A copper IUD will need to be placed inside your uterus within five days of unprotected sex, and emergency contraception pills (ECPs) must be taken within five days of unprotected sex,” Dr. Mahnert said. “The sooner you take them, the more effective they are.”
You can purchase some ECPs at a pharmacy or drugstore without a prescription.
Taking ECPs won’t harm a pregnancy if you’re already pregnant and they won’t protect against STIs. If you use a condom and it breaks, get tested.
How do you pick the right birth control method?
The truth is that there is no such thing as one perfect birth control method for everyone. There are many factors at play, like ease of use, cost and effectiveness. Dr. Mahnert said the best birth control, however, is the one you’ll actually use.
“IUDs and implants are nice because you don’t have to remember to take anything,” she said. “The pill can help with acne, and the ring is great because it’s changed once a month.”
Here are some questions to ask yourself when it comes to choosing a birth control method:
- How well does the birth control work?
- Do you also need protection from HIV and other STIs?
- Will you be able to use it correctly every time?
- Are there any side effects?
- Do you have any health conditions?
Is birth control free or available at a low cost?
“Yes!” Dr. Mahnert said. “And some birth control pills are only $5 a month without insurance.”
Under the Affordable Care Act, most private insurance plans cover FDA-approved prescription birth control for all individuals at no additional cost.
According to the Department of Health and Human Services website, covered contraceptive methods prescribed by a health care provider include short-term methods like diaphragms and sponges; hormonal methods like birth control pills and vaginal rings; implanted devices like IUDs; emergency contraception like Plan B; permanent contraception; and patient education and counseling.
You can purchase short-term methods like condoms at your local drugstore or pharmacy or get them at family planning and STI clinics for free. If you have a FSA or HSA account with your health insurance plan, you can use these funds to purchase condoms and other family planning items.
There are many forms of birth control available today but finding one or a combination of contraceptives depends on which fits best with your current lifestyle.
Your health care provider is your best source to discuss all the benefits and risks based on multiple factors – not just those easily found online. Schedule an appointment so you can find the right birth control for you.
To find a Banner Health specialist near you, visit bannerhealth.com.