Thinking about going on birth control? When it comes to safe sex, there’s not a one-size-fits-all solution.
Forms of Birth Control:
Oral contraceptive pill (OCP, “the pill”): A pill you take every day. It contains hormones and comes in several different types: regular pills have progesterone and estrogen, low-dose pills have a smaller dose of estrogen, and the mini-pill has only progesterone and no estrogen. These can be dosed so you have a monthly period or taked continuously so you only have a period every 3 months. You must be able to remember to take a small pill every day. Failure rate with typical use is up to 9%.
The Patch: Brand name is Ortho-Evra. It is a skin colored patch a little less than 2 inches x 2 inches. It is placed on the skin and changed every week. It contains the hormones estrogen and progesterone. The estrogen that is absorbed through the skin is a higher dose than what is absorbed from the pill. It can sometimes cause skin irritation at the application site. It’s also not a great option for swimmers or very high level athletes as it may come off with a lot of exposure to water. Normal showering/bathing is fine. Failure rate is up to 9% with correct use.
Vaginal Ring: Brand name, Nuvaring. It is a thin flexible plastic ring about two inches around. It also contains estrogen and progesterone. You squeeze the sides together and insert it into the vagina, similar to putting in a tampon. Like a tampon, you shouldn’t feel it when it’s in the right spot. You can have sex with it in and your partner shouldn’t be able to feel it. The ring stays in for 3-4 weeks. Failure rate up to 9% with correct use.
Birth control shots: Depo Provera. These are hormone shots that you get every 3 months. They are progesterone only and don’t contain any estrogen. The shots have been associated with a very slight weight gain, and most women stop having their periods on them or have irregular spotting. Failure rate up to 6%
Intrauterine Device (IUD): These are small T-shaped devices that are inserted into the uterus by your doctor during an office appointment. They remain in your uterus for several years. There are currently two types of IUD:
1. Mirena IUD: This IUD contains the hormone progesterone. A small amount of the hormone is absorbed by the uterus making the lining very thin. Because of this thin lining, many women have very light to no periods. Spotting is common with this method. Very little hormone gets into the bloodstream so there aren’t many of the side effects associated with other hormonal birth control. The Mirena can stay in the uterus for 5 years. Failure rate 0.2% with normal use.
2. Paragard IUD: This IUD has no hormones; it is made of copper. It can make periods heavier and crampier but doesn’t usually cause spotting between periods. This type of IUD can be left in the uterus for up to 10 years. Failure rate 0.8% with normal use.
Birth control implant: Brand name is Nexplanon. This is a small rod about the size of a matchstick. Your doctor inserts it in your inner upper arm in the groove just below your biceps muscle. If you’re right handed it’s best to have it placed in your left arm and vice-versa. It contains the hormone progesterone and is slowly released into the bloodstream. It stays in your arm for 3 years and requires a doctor’s appointment to remove it. Spotting and irregular bleeding is very common with this method, but the failure rate is very low at 0.05%.
Condoms: Typically made of latex, but non-latex options available for people with latex allergies. Thin sheaths that cover the penis; they also protect from STDs. There are also female condoms available that go inside of the vagina. These can be trickier to use and have a higher failure rate. Male condom failure rate 18% and female condom failure rate 22%. Most of the failures are due to putting the condom on AFTER starting to have sex. Used properly the failure rate is much lower. The benefits of condoms is that they do not contain hormones, protect you from STDs, and don’t require a prescription. You can often get them for free at neighborhood clinics.
Diaphragm: A large rubber disc that is inserted into the vagina. You have to be fitted for a diaphragm by a gynecologist. It also requires the use of spermicide and must be left in the vagina for 6-8 hours after intercourse. Failure rate is 12% with normal use.
Sponge: This is a barrier method of a spermicide containing sponge that is placed within the vagina before having sex. The failure rate is anywhere from 12-24%
Rhythm method: This method means tracking your periods and having intercourse at times when you are not ovulating. Because ovulation can be affected by stress, weight gain, weight loss, etc it is a very ineffective method of birth control with a failure rate of 25-40% in teenagers.
Withdrawal: This is when the male partner “pulls out” before ejaculating. Because there are plenty of sperm in the drops of fluid at the tip of the penis prior to ejaculation, pregnancy can still happen. Failure rate 22-25%.
Emergency contraception: The “morning after pill,” brand name is Plan B. It is available over-the-counter at pharmacies. It is a pill that is taken when your normal birth control fails or you forgot to use it, if the condom breaks, he didn’t put one on, you forgot your birth control pill, etc. You can go to the PlanB website and use the store locator function to find a pharmacy that stocks it. It works the best if you take it as soon as possible but is still effective 3 days after unprotected intercourse. It will usually make your next period irregular. This is not to be used as regular birth control.
Abstinence: Remember, this is always an option. When you are abstaining from sex, however you define it, you still have to be careful about the transmission of bodily fluids like semen and vaginal fluid. You also have to be aware of any physical contact that could transmit a skin-based STI like herpes. If you have those bases covered, abstinence is the most effective way to prevent pregnancy and STIs.