Knowing Your Options
Birth control can be incredibly important for women’s health for many reasons – from balancing hormones and regulating cycles to family planning. In this day and age, options abound, but all of those options can make it difficult to determine what might be best for you individually. Read on for a run-down of birth control methods and their various benefits, as well as informative input from local women’s health experts on how to choose what’s right for you.
By Anna Hill
When it comes to forms of birth control, everyone’s needs are different. Perhaps you’re currently using the pill method, but your friend swears by her intrauterine device (IUD), and you keep seeing online ads for an arm implant. This variety can sometimes feel overwhelming, but it’s important to remember that each method comes with its own benefits and drawbacks, and that your doctor can help you decide what might be the best fit. In the meantime, we’ve broken down the options to help you get a lay of the land.
Oral contraceptives, commonly referred to as birth control pills or “the pill,” are one of the most common methods of birth control thanks to their accessibility and ease of use. Birth control pills are typically taken once a day at the same time every day and come in one of two forms. “There are combined oral contraceptives with estrogen and progestin in them, and progestin-only oral contraceptives,” explains Hannah White, a nurse practitioner with Associates in Women’s Health. “Progestin-only contraceptives are great to use during the postpartum period while breastfeeding because they don’t dry out the mother’s milk production as compared with the estrogen-containing birth control, which will.” On the other hand, the estrogen in combined oral contraceptives can often aid in regulating menstrual cycles, controlling acne, and shortening and lightening periods.
A less common version of the oral contraceptive pill is the emergency contraceptive pill, which can be up to 90% effective when taken within 72 hours of unprotected intercourse. “However, no pills will work if you have already ovulated,” emphasizes Dr. Shevonda Sherrow, an OB/GYN at Innovative Women’s Health Specialists. “This is why it’s important to take it as soon as possible after intercourse. It’s also important to know that Ella, a prescribed emergency contraceptive, is two times more effective than the over-the-counter pills.”
IUDs & Implants
IUDs and arm implants such as Nexplanon are increasing in popularity due to their effectiveness and significantly lower maintenance compared to some other methods. IUDs are available in copper form (Paragard) as well as several varieties of hormonal IUD, and once in place can prevent pregnancy 99% effectively anywhere from three years to a decade, depending on the type. Nexplanon, the implant, is typically placed in the upper arm just beneath the skin and releases progestin to prevent pregnancy. Also 99% effective, the arm implant can last for up to five years.
IUDs are a great option for a number of reasons, primarily due to their high effectiveness and low maintenance; in fact, they’re often utilized in underserved communities because of this. However, there are some important things to know before making it your contraceptive of choice: There might be some irregular bleeding and spotting within the first few months, and insertion might cause discomfort for some women. “There is some pain with insertion, and I usually tell patients to take an ibuprofen while in the waiting area so that it is on board before the procedure,” says Dr. Angela McDowell, an OB/GYN on the medical staff at Hamilton Medical Center. “I tell patients who have had a child that it feels like a contraction when it is inserted, but insertion is less than 30 seconds, and the pain usually doesn’t last much beyond two minutes after the insertion.”
Shots, Patches, & Vaginal Rings
While shots, rings, and patches might be less common forms of birth control, they’re all still over 90% effective when deployed correctly. Depo-Provera, usually known as the depo shot, is an injection containing progestin that’s administered every three months; however, it must be administered on time and on schedule for it to be most effective.
Birth control patches, such as the Xulane or the Twirla patch, release estrogen and progestin through the skin and are typically worn on the stomach, back, buttocks, or upper arm. Patches must be changed once a week to remain effective.
A vaginal birth control ring, not to be confused with an IUD, is a small, flexible, hormonal ring that you insert on your own and change or replace regularly. The NuvaRing is inserted and then replaced every five weeks, whereas the Annovera ring is good for one year and is inserted for three weeks, removed and stored for seven days, then inserted again for three weeks, and so on. For those looking for something more convenient than oral contraceptives but less long-term than an IUD, rings can be a great option. “The NuvaRing is 91% effective, and Annovera is 97% effective,” says White.
Once a woman has determined that she is finished with childbearing, permanent sterilization is an option to consider. “Known as a tubal ligation, the fallopian tubes are either clipped or a portion of the tube is removed so that there is no way for the sperm and the egg to meet,” says Dr. McDowell. “This is 99% effective at preventing pregnancy.” However, patients are usually encouraged to consider that the procedure is truly a permanent one and not meant to be reversed. This form of sterilization might also be used if a woman has a condition that poses a serious danger to her health. It’s also important for couples to consider that male vasectomy is the safest, most inexpensive, and effective form of sterilization.
How To Know What’s Best for You
Though the above methods of birth control are among the most popular, there are even more that aren’t covered here, such as female condoms, birth control sponges, spermicide gels, and fertility awareness methods. To decide which option is best for you, Dr. Sherrow points to the FEES acronym:
When would you like to start a family? If you’re unsure for now, methods that can be easily discontinued, such as birth control pills, rings, shots, or patches, might be best for you. If you have no plans to start a family anytime soon, something more long-term like an IUD might be best.
It’s important to seek out methods that are highly effective when used correctly in order to maintain your peace of mind. IUDs and the arm implant are both almost completely effective.
How reliable are you when it comes to your daily routines? If taking medication at the exact same time every day doesn’t fit easily into your schedule, you may want to consider bypassing pills and going for a more “set it and forget it” option such as
an IUD, implant, or ring.
What is your current health status? Do you need
combined contraceptive pills to help control something else, like painful period cramps or acne? Or are you at an elevated risk for blood clots, which can also affect which method is safest for you?
It’s important to have a conversation with your doctor about your individual needs, preferences, and medical history before deciding on your method of birth control. An appointment with your primary care provider or OB/GYN will allow them to prescribe you an option that’s best for you.