The best birth control depends on several factors, including how effective it is, possible side effects, and your lifestyle. Health concerns, such as acne, polycystic ovary syndrome (PCOS), and weight loss, are also important to consider. There are hormonal, barrier, and fertility awareness-based methods. Other options include intrauterine devices (IUDs), emergency contraception, and sterilization.
The only birth control that's 100% effective is abstinence, but other types are highly effective if you are sexually active. Some types, namely condoms, can also prevent sexually transmitted infections (STIs). Read on to learn what types of birth control are available and what the best option for you is.
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Going Off Birth Control: What You Need To Know
There are a lot of things to take into consideration when you're shopping around for the best birth control method for you. Some things to consider include:
- How long it will prevent you from getting pregnant
- How well it prevents pregnancy
- How your method of choice affects your menstrual cycle
- What side effects it might cause
It's a good idea to use effectiveness rates as a guide for what birth control to go with. Experts use data based on "typical use," or how real people use each method, to measure effectiveness. The effectiveness rate is calculated by counting the number of people out of 100 who have an unintended pregnancy during the first year of typical use.
Types
Birth control includes intrauterine devices (IUDs), hormonal methods, barrier methods, fertility awareness-based methods, and sterilization to prevent pregnancy. You can also use emergency contraction right away after unprotected sex. A healthcare provider can help determine what options best align with your preferences.
Intrauterine Devices (IUDs)
An IUD is a tiny, T-shaped device that's placed in the uterus by a healthcare provider during a quick office procedure. This type of birth control can potentially last for several years. There's little for you to do to make sure it's working once you have an IUD. There's a slight possibility that an IUD may dislodge.
Talk with an OB-GYN about when, if ever, you plan on getting pregnant to get a sense of if an IUD is right for you. Describe your periods each month and ask about the potential side effects, such as cramping and spotting.
There are two types of IUDs: copper and hormonal IUDs. The copper device doesn't contain any hormones and can be left alone for up to 8 years. It's the metal itself that prevents pregnancy by making the uterus inhospitable to sperm. The copper IUD has a typical use failure rate of 0.8%.
The copper IUD, like all IUDs, is a good option for people who know they don't want to be pregnant in the next decade, whether they've already had a baby or not. Some people prefer the copper IUD because it's totally hormone-free. People with heavy or painful periods may want to avoid the copper IUD since it can make these period side effects worse.
Four types of hormonal IUDs have been approved by the Food and Drug Administration (FDA). Each works by releasing progestin. This hormone thickens cervical mucus, making it harder for sperm to reach an egg. Progestin may also stop ovulation, so no egg is released. Hormonal IUD works for up to eight years and has a typical use failure rate of 0.1% to 0.4 %.
Hormonal Methods
Hormonal methods use hormones, typically estrogen, progestin, or both, to prevent pregnancy. These birth control options stop ovulation and thicken cervical mucus, which makes it difficult for sperm to fertilize an egg.
Hormonal methods include:
- Implant: This progestin-releasing implant is placed by a healthcare provider under the skin high up on your inner arm. The implant's effects are systemic, meaning the hormones travel through your whole body. Like an IUD, the implant is something you don't have to think about and does not require ongoing maintenance. This option has a typical use failure rate of 0.1%.
- Injection: This method relies on the hormone progestin. The shot is administered by a healthcare provider every three months. Injections may be more likely to result in weight gain than other hormonal methods, but they might be a good option if you have trouble remembering to use other methods regularly. This option has a typical use failure rate of 4%.
- Patch: The patch contains estrogen and progestin. You just stick on a new patch once a week, take it out the week of your period, and you're covered. The patch emits hormones that are absorbed through your skin on the belly, upper arm, back, or butt. The patch has to be well-applied to make sure you're getting the right amount of hormones. This option has a typical use failure rate of 7%.
- Pill: There are several types of birth control pills: combination pills that contain estrogen and progestin, progestin-only pills, and extended-cycle pills that reduce the frequency of your period. Side effects range from spotting and lighter periods to skin changes. You might want to enlist the aid of a daily reminder on your phone or try an app to keep you on schedule, like Bedsider or myPill. This option has a typical use failure rate of 7%.
- Ring: You wear a vaginal ring inside the vagina for three weeks and take it out for one week to have your period. The ring releases estrogen and progestin, which are absorbed through the vaginal lining. You'll need to keep track of when it's time to put in a new ring and how long you've gone without it. The ring can stay in during sex or a pap smear, but you can take it out for up to three hours. This option has a typical use failure rate of 7%.
Barrier Methods
Barrier methods prevent pregnancy by blocking sperm from fertilizing an egg. You can purchase some of these over the counter, while others are available by prescription.
Barrier methods include:
- Diaphragm: This rubbery barrier fits inside the vagina to keep sperm out of the uterus. Diaphragms come in different sizes, so you'll need to be fitted for one by a healthcare provider. You'll need to use it with spermicide, which immobilizes or kills sperm. A diaphragm emits no hormones, and you only use it when you're ready to have sex. It has to stay in for at least six hours. This option has a typical use failure rate of 17%.
- Female condom: This option is inserted into the vagina up to eight hours before sex and covers the cervix to prevent sperm from entering. It's not as effective as a male condom. A lot of that is because it's complicated to insert and position correctly. The female condom doesn't have anything to fit tightly over, and it can shift around and feel uncomfortable. This option has a typical use failure rate of 21%.
- Male condom: These latex or polyurethane sleeves prevent sperm from coming anywhere near an egg. Worn properly, condoms also protect against STIs. Make sure the condom is unrolled all the way down the shaft of the penis with a little room at the top. Wait until the penis is erect to do so. This option has a typical use failure rate of 13%.
- Phexxi: This non-hormonal prescription vaginal gel is effective when used immediately up to one hour before each act of vaginal sex. Phexxi is made up of lactic acid, citric acid, and potassium bitartrate, which lower the pH in the vaginaand immobilize sperm. This option has a typical use failure rate of 14%.
- Spermicide: You can find spermicide in creams, gels, films, foams, or suppositories. No matter what form you go with, you'll need to insert the spermicide right before having sex. Always use spermicide with a diaphragm. It can also increase the effectiveness of condoms, which is why many condoms are coated with spermicide already. You can use it on its own to slow sperm and block the cervix. This option has a typical use failure rate of 21%.
- Sponge: The sponge, made of squishy plastic, covers the cervix and blocks sperm. It contains spermicide to immobilize or zap sperm if they happen to get close. The sponge has to stay in place for at least six hours after having sex to be effective. You must place the sponge correctly for it to work. It might not fit perfectly if you've given birth in the past. This option has a typical use failure rate of 27% in people who have given birth and 14% in those who haven't.
Fertility Awareness-Based Methods
You might consider a fertility awareness-based method, also sometimes called natural family planning or the rhythm method. This option has a typical use failure rate of 2% to 23%.
These methods involve closely tracking your period and ovulation to know when you're most fertile. You won't have sex (or use another birth control method) on those days. Opting for a fertility awareness-based method also means taking your temperature every morning, checking cervical mucus every day, or charting cycles to determine when you're near ovulation.
Fertility awareness-based methods work best when your cycle is pretty predictable, so you can track these changes and follow the patterns. Keep in mind that the withdrawal method, or when the penis is withdrawn from the vagina right before ejaculation, is not very effective.
The withdrawal method has a typical use failure rate of 22%. Pregnancy is possible if just a little bit of semen gets in or near the vagina during the withdrawal process. There isn't a lot of research on the topic, but some evidence suggests that sperm might be in pre-ejaculate fluid.
Emergency Contraception
Emergency contraception prevents pregnancy after unprotected sex. These options can prevent ovulation or stop sperm from reaching an egg. There are two types of emergency contraception: pills containing progestin and the copper IUD.
Emergency contraceptive pills are available over the counter or by prescription. Options include Plan B One-Step, Next Choice, and Ella. These pills are most effective if you take them within five days of unprotected sex. The copper IUD also can be inserted in the first five days after unprotected sex. A healthcare provider can remove it after your next period.
Sterilization
Sterilization includes permanent methods of birth control. Male sterilization (vasectomy) involves cutting or blocking the vas deferens, or the tubes sperm travel through from the testicles. This option has a typical use failure rate of 0.15%.
A vasectomy can be reversed in many cases, but the procedure is meant to be permanent. It's also less invasive than female sterilization, which involves abdominal surgery and has a greater potential for complications. Vasectomy is much less risky because it's done in a healthcare provider's office with local anesthesia.
Female sterilization (tubal ligation) means removing, blocking, or cutting the fallopian tubes. This prevents an egg from traveling to the uterus and being fertilized by sperm. Female sterilization has a typical use failure rate of 0.5%.
Tubal ligation is a somewhat more complicated surgery than a vasectomy. There's nothing you need to do to make sure this method is effective, but all surgical procedures come with risks. Sterilization won't affect your periods, unlike hormonal methods.
STIs are infections caused by bacteria, viruses, and parasites that spread through sexual contact. Correctly using latex condoms significantly decreases the risk of contracting and transmitting STIs. The best way to prevent pregnancy and protect against STIs is to use condoms and another form of birth control, such as a pill, ring, patch, or injection.
What Are the Options for Male Birth Control?
A Quick Review
The best birth control depends on how effective it is, possible side effects, and your lifestyle. Several types of birth control methods exist. Hormonal methods include an implant, injection, and the birth control pill. Barrier methods include a diaphragm, condoms, and spermicides. Fertility awareness-based methods revolve around tracking your period and ovulation windows.
Talk to a healthcare provider if you are considering birth control. They can help you determine what method best aligns with your health and preferences.
