Birth Control Overview

When there are so many birth control options, how do you know which one to choose? Birth control methods include various types of hormonal pills, condoms, IUDs, and more. Here's what to know when deciding which is right for you.

What Is Birth Control?

Birth control (contraception) is any device, medicine, or medical procedure used to prevent pregnancy. When it comes to birth control, most forms are for female contraception. Male birth control methods include condoms and vasectomy (surgery).

Female birth control use is fairly common in the United States. The CDC reports that more than 65% of women in the U.S. between the ages of 15 and 49 use some kind of contraception.

We've come a long way since the people of ancient Greece placed goat bladders in their vaginas to keep from getting pregnant. Whether you want a pill you take every day, a shot in your arm four times a year, or a device placed in your uterus (which could last more than a decade), you've got options.

Some forms of birth control, like condoms, you can buy off a store shelf. Others require a prescription or a visit with a healthcare provider.

Types of Birth Control

Your birth control choices include the ones below:

• Barrier methods (male and female condoms) keep sperm from reaching your uterus.
• IUDs (intrauterine devices) are small T-shaped devices. When one is placed inside your uterus, it stops sperm from fertilizing your egg.
• Hormonal methods (like the pill, implant, shot, ring, patch, and some IUDs) keep your ovaries from releasing an egg each month.
• Sterilization (tubal ligation for women or vasectomy for men) is a permanent surgical method to prevent pregnancy.
• Natural family planning relies on you figuring out the days you're most likely to get pregnant, then not having sex (or using a barrier method) on those days. You may also hear this called a fertility awareness-based method or a natural rhythm method. Products like fertility monitors can help track when you're most likely to conceive.
• Spermicide (in foam, suppositories, or film) blocks sperm from reaching your uterus.
• Emergency contraception (as a pill or IUD) is available if your current birth control fails. Birth control can fail if a condom breaks or you forget to take your pill. It can't reverse a pregnancy that's already started, but it does reduce the chances that sperm fertilizes an egg.

Birth Control Side Effects

As good as birth control is in preventing pregnancy, it can have its downside too. Side effects can range from mild to serious. Talk to your healthcare provider if you're concerned about possible side effects from your birth control. Here's a breakdown of the side effects by birth control type:

• Birth control pills can cause side effects like spotting, sore breasts, nausea, and headaches. Some types containing more than one hormone can also increase your risk of blood clots and high blood pressure. These conditions can lead to a stroke or heart attack.
• IUDs come in two forms: copper and hormonal. With the copper IUD, you may have painful periods and bleeding for the first few months. If you opt for a hormonal IUD, you may see spotting, more days of bleeding, and heavier bleeding at first. Other side effects include headaches, nausea, sore breasts, and mood changes.
  IUDs also increase the risk of ectopic pregnancies. An ectopic pregnancy is when the fertilized egg implants somewhere other than the uterus. It is a serious medical problem that requires immediate medical treatment.
• Vaginal rings may cause increased discharge, vaginal infection or other irritation, sore breasts, headache, vomiting, diarrhea, changes in sex drive, and weight changes. More serious but uncommon side effects include chest pain, shortness of breath, and depression. As a form of hormonal birth control, vaginal rings pose the same risks as the pill, namely an increased risk of blood clots and high blood pressure.
• Birth control shots can cause irregular bleeding. In the first year, you may also have longer periods of bleeding or spotting. Sometimes weight gain is reported as a side effect but is usually less than 5 pounds on average.
• Birth control patches can irritate your skin and cause breakthrough bleeding. They can also raise your risk of blood clots and stroke.
• Spermicides can irritate the vagina. Spermicides are recommended as contraception if you're in a monogamous relationship (you have sex with only one person) and that person is HIV-negative.

It's also worth noting that many of these side effects often go away on their own, and not everyone has side effects.

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Other Uses for Birth Control

Although the main point of using birth control is to keep people from getting pregnant, some types can help you out in other ways too. For instance, hormonal methods, like the pill, patch, shot, and some IUDs, can also help with the following conditions:

• Acne
• Heavy or irregular periods
• PMS (premenstrual syndrome)
• Breast or ovarian cysts
• Weak bones
• Anemia (low iron levels)
• Preventing endometrial or ovarian cancer

And don't write off "old-school" latex or plastic condoms—they're the only type of birth control that offers protection against sexually transmitted infections (STIs) like gonorrhea, chlamydia, and HIV. When used correctly, condoms can lower your risk of genital herpes, syphilis, HPV, and HPV-related diseases like cervical cancer.

Choosing a Birth Control Method

There's a lot to consider when figuring out which kind of birth control is best for you. You'll need to think about the following points (and discuss them with your healthcare provider):

• How soon you might want to start trying to have a baby
• What, if any, health issues you currently have
• How often you have sex
• How many sexual partners you have
• If you want your birth control to also protect against STIs and HIV
• How well you want your birth control to work
• Which side effects you're okay dealing with
• How well each method fits with your lifestyle

You'll also need to factor in your budget since, as of 2020, employers no longer have to cover birth control in health insurance plans. To give you an idea of costs, some types of vaginal rings can cost as much as $2,000 each year (if you pay out of pocket), and a patch can cost around $130 per week.

How To Use Birth Control

While you can buy a box of condoms or emergency contraception over the counter, most other birth control methods require planning.

• Birth control pill: Once you get a prescription, you'll take a pill every day, ideally at the same time, for 21 days. You'll get your period during the fourth week.
• Birth control shot: You'll need to take it every three months. While it's often given in a medical setting, sometimes you can bring the shot home and give it to yourself.
• Birth control patch: Available by prescription, the patch is placed on your upper body, lower abdomen, upper outer arm, or butt. You'll change it once a week for three weeks, take a week-long break, then apply a new patch.
• Vaginal ring: Once your doctor provides the ring, you'll put it into your vagina and leave it for three weeks. You'll take it out for seven days, then put in a new one.
• IUD: This tiny device is inserted by a healthcare provider during a quick office procedure. A copper IUD is effective immediately and will stay in place for up to 10 years. A hormonal IUD starts working in 7 days and will be effective for 3 to 7 years.

To note: The pill, patch, and vaginal ring give you the option of having a menstrual bleed. Usually, you would use the method for three weeks and have your period the fourth. But you can also use the contraceptives continuously, meaning you would skip week four—and skip your period. If you're considering using birth control to skip your period, it's best to run it by your healthcare provider first.

Pregnancy Prevention

Birth control isn't foolproof. For it to work as well as it's supposed to, you'll need to know how to use it correctly. Your healthcare provider will provide advice and guidance, but here's how to avoid some of the most common mistakes.

• Condoms: If you've had one sitting in your wallet or purse for more than a month, toss it. The warmth will damage it and make it less effective.
• Birth control pill: Know when you last had your period. If you start the pill within five days of your period starting, you'll have instant protection against pregnancy. If not, it will take a week to start working.
• IUD: Don't bathe, have sex, or wear tampons for 24 hours after it is inserted. At some point, you may feel a tiny, slippery string at the top of your vagina. Don't tug or pull it—this is how your doctor will remove your IUD when it's time.
• Vaginal ring: If you accidentally leave the ring in for more than four weeks, take it out immediately and use condoms for the next seven days. If you've had unprotected sex within the last five days, talk with a healthcare provider—you may want to use emergency contraception.
• Birth control patch: If your patch comes even partially loose, don't use tape or gauze to hold it in place. Replace it with a new one right away. If it's loose for more than 24 hours, you'll need to use a backup form of birth control for one week.

A Quick Review

With so many birth control options available, it's worth taking time to consider which type or types are best for your lifestyle, health needs, and personal preferences. You may also want to consider the side effects. Make sure you bring up any concerns with your healthcare provider.

While birth control is most commonly used to prevent pregnancy, it can be helpful for other medical conditions as well. Talk to a healthcare provider if you think birth control would be beneficial for your symptoms. And remember, birth control can help prevent pregnancy, but only condoms protect against STIs.