There are more choices for contraception now than ever before. And every option has different benefits, risks and levels of effectiveness. There are options for non-hormonal birth control, long-acting reversible birth control like IUDs and permanent birth control, too. Plus, plenty of birth control myths.
Hormonal birth control methods prevent pregnancy by releasing hormones into the body. Usually, hormonal birth control releases both estrogen and progestin, though some methods contain only one or the other.
These hormones thicken the mucus in the cervix, which then hinders sperm from reaching the egg. Hormones also thin the lining of the uterus, so fertilized eggs are less likely to attach to it. Hormonal methods work similarly, but today, they come in many different options. Many forms of hormonal contraception are also used to treat abnormal menstrual bleeding or even to stop periods from happening.
Is the birth control pill right for you?
The most common form of hormonal birth control is the pill, which you must take orally at the same time every day. Birth control pills are either combination pills, which contain estrogen and progestin, or progestin-only.
Birth control pills usually contain hormones for three weeks; during the fourth week, the period occurs. Placebo pills may be included in the pack to help maintain the habit of taking them.
“Continuous-dose” pills are another option for those with heavy or painful menstrual periods. These contain hormones throughout the month and reduce menstrual cycle frequency—or stop them completely.
- How effective is the birth control pill? With typical use, 8 in 100 people will become pregnant in their first year of taking the pill; if used perfectly (the pill is taken every day at the same time and never missed), 1 in 100 people will become pregnant in their first year.
- What are the benefits of birth control pills? Beyond preventing pregnancy, the pill may also be used to regulate the menstrual cycle, treat cramps and other causes of menstrual pain and sometimes control acne.
- What are the risks of taking birth control pills? The pill is generally safe, but it may increase the risk of deep vein thrombosis, heart attack and stroke—especially for older people, smokers and those already at risk for cardiovascular disease.
Is the birth control patch right for you?
A birth control patch releases hormones into the body through the skin. You must wear a new patch every week for three weeks. In the fourth week, no patch is worn, and menstrual bleeding occurs. Patches may be worn while bathing, exercising and swimming.
- How effective is the birth control patch? With typical use, 8 in 100 people on the patch will become pregnant.
- What are the benefits of the birth control patch? The patch may also improve acne, reduce menstrual migraines (if used continuously) and reduce unwanted excessive hair growth.
- What are the side effects of the birth control patch? Like the pill, the patch can increase the risk of heart problems for older people, smokers and those with risk factors for cardiovascular disease.
Is a vaginal ring right for you?
Vaginal rings, like NuvaRing, are inserted into the upper vagina and worn for three weeks. During the first week of each month, another birth control method (such as condoms) may be necessary, and during the fourth week the ring is removed, and menstrual bleeding occurs.
- How effective is NuvaRing? With typical use, 8 in 100 people wearing a vaginal ring will become pregnant.
- What are the benefits and risks of the NuvaRing? Vaginal rings share similar benefits and risks to those of the patch.
- Can my sexual partner feel the NuvaRing? If engaging in penetrative sex, your partner should not be able to feel the ring. If they can feel it during sex, the ring may need to be pushed up a little further.
Is the Depo-Provera birth control shot or birth control implant right for you?
Doctors may administer hormonal birth control injections, like Depo-Provera, which can prevent pregnancy for three months at a time.
For a longer-lasting option, the hormonal implant, like Nexplanon, is a single rod inserted under the skin. Implants can prevent pregnancy for up to three years at a time.
- How effective is the birth control shot? During a year of typical use, 3 in 100 people who receive injections will become pregnant.
- How effective is the birth control implant? During a year of typical use, less than 1 in 100 people who have an implant will become pregnant.
- What are the benefits of the birth control shot and the birth control implant? Both methods can be used by those who are breastfeeding, and the injection may decrease the risk of developing endometrial cancer.
- What are the side effects of the birth control injection? Injections pose the same heart risks to certain people as the patch and ring, and many have a decrease in bone density levels while receiving injections. These levels return to normal when injections cease.
- What are the side effects of implant birth control? The birth control implant isn’t known to have many side effects.
Is a hormonal IUD right for you?
An IUD (intrauterine device) is a long-lasting and highly effective method of birth control. The t-shaped device is inserted by a physician under the skin in the uterus. Once inserted, this long-acting method of birth control does not interfere with sex or other daily activities, though it serves as no protection against sexually transmitted diseases.
Although non-hormonal IUDs exist, a hormonal IUD continuously releases small amounts of progestin into the uterus, which prevents the fertilization of the egg. This hormonal method is effective for up to five years.
- How effective is the hormonal IUD? During the first year of use, less than 1 in 100 people using an IUD will become pregnant.
- What are the benefits of a hormonal IUD? An IUD can be inserted and removed by a trained healthcare provider and requires no action on the part of the user. Like other forms of hormonal birth control, it may decrease menstrual pain and heavy bleeding. Some people may stop having periods entirely after several years.
- What are the side effects of a hormonal IUD? Risks and side effects of hormonal IUDs are low, but some may experience headaches, nausea or breast tenderness, and others may develop ovarian cysts in their first months of using a hormonal IUD. Though becoming pregnant while using a hormonal IUD is rare, if it does occur, there is an increased risk of an ectopic pregnancy in which the fetus grows and develops outside of the uterus.
When choosing a birth control method, the one universal truth is that everyone is different! Feel free to talk to your friends about what works for them, but keep an open mind about the various methods and how they will work for you. Birth control is not one-size-fits-all, and there are many outdated myths about it.
Do you have questions about contraception? Make an appointment with one of our nurse practitioners, nurse midwives or physicians. Contact an office >
Sources: American Congress of Obstetricians and Gynecologists