Women today have access to a wider variety of birth control than ever before, which can be overwhelming if you’re not sure where to begin when choosing one. Which method is the most successful? Which one is best for long-term family planning? Do they have any side effects, and if so, what are they?
Sometimes the best way to find an answer is to reframe the question. In this case, it may be helpful to ask which contraception is best for you. Your birth control should fit your current lifestyle, your future plans, and your personal values. Your health history will play an important role as well.
Memphis Obstetrics & Gynecological Association, P.C. is committed to providing women across the Mid-South with individualized care, expert information, and trusted resources. To help you determine the right birth control for you and your body, let’s take a look at the different types available.
Barrier methods prevent sperm from reaching an egg, and include both male and female condoms, diaphragms, contraceptive sponges, and cervical caps.
Male condoms tend to be the most effective barrier method for preventing pregnancy and sexually transmitted infections (STIs.) Spermicide is a chemical method that blocks sperm from entering the cervix and slows sperm’s ability to swim. It is inserted into the vagina before intercourse, and is available in cream, gel, foam, and suppository form. Spermicide is mandatory with diaphragms and cervical caps, and is often used in conjunction with condoms as well.
Short-acting hormonal methods
Combined hormonal contraceptives include oral contraceptives like the pill, the contraceptive patch (Ortho Evra), and the vaginal ring (NuvaRing.) These options contain synthetic estrogen and progestin that helps prevent pregnancy by inhibiting ovulation and thickening cervical mucus. There is also a progestin-only pill that is often referred to as the “mini pill.”
For maximum effectiveness, the pills should be taken at the same time every day. The patch sticks anywhere on the skin (except the breasts) and must be reapplied weekly, while the flexible NuvaRing is inserted into the vagina each month for three weeks at a time.
Long-acting reversible contraceptives
There are two types of intrauterine devices (or IUDs) in this category, hormonal and hormone-free. An IUD is inserted by a health care provider through the cervix into the uterus during an in-office procedure. No surgery is needed. The T-shaped device has a short string that hangs into the vagina that is used to remove it when the time comes.
Hormonal IUDs such as Mirena, Skyla, Liletta, and Kyleena release a progestin hormone called levonorgestrel into the uterus. This causes a thickening of the cervical mucus which inhibits sperm from reaching or fertilizing the egg. The devices may also prevent the ovaries from releasing eggs. These hormonal IUDs are FDA-approved for long-term use and will typically last for 3-5 years. They come with the added benefit of significantly lighter periods or sometimes no periods at all.
ParaGard is a hormone-free copper IUD that prevents sperm from reaching and fertilizing the egg. It will also prevent implantation of a fertilized egg, so it can be used for emergency contraception as well as birth control. In fact, it is considered to be the most effective emergency contraceptive if implanted within 120 hours of unprotected sex, with a 99.9% success rate. Although it can cause heavier periods with more cramping, many patients say this side effect declines over time. A ParaGard IUD can remain in the uterus for up to 10 years.
There is also a contraceptive implant available in the U.S. Nexplanon features a rod about the size of a matchstick that is placed under the skin of the upper arm. It works by releasing progestin to stop the ovaries from releasing eggs, and also thickens cervical mucus to make it more difficult for sperm to enter the uterus. Nexplanon lasts about 3 years. Some women may experience irregular menstrual bleeding with this method.
Depo-Provera is a shot of synthetic progestin that is injected directly into the arm or hip every three months. It stops the ovaries from releasing eggs, and also makes it harder for sperm to enter the uterus by thickening the cervical mucus. It’s important to maintain a schedule with this method, since getting the shot outside of an 11- to 13-week window will decrease its effectiveness.
For patients who are positive they do not want any more pregnancies, permanent contraception exists for both men and women. Men may choose a vasectomy, which involves a surgery that will cut and seal the tubes that carry sperm into the semen. Women may opt for tubal ligation surgery or the implantable Essure System. Both of these methods block the fallopian tubes and prevent sperm from reaching the egg.
Which birth control methods are the most effective?
Outside of permanent sterilization, the most reliable method of birth control is a long-acting reversible contraceptive like an IUD or implant. These are about 99% effective, with fewer than 1 in 100 women becoming pregnant while using them correctly. Although they are about as effective as a tubal ligation, these contraceptives are easier to place and simple to manage. Most women are also able to get pregnant soon after stopping them.
An injection like Depo-Provera is about 94% effective if taken within the 11-13 week window. Birth control pills and the contraceptive patch are around 91% effective with typical use, meaning you take the pills or change the patch on schedule. These options are a good example of why it’s important to consider your lifestyle when choosing the right birth control for you! Thankfully, almost every woman will be able to find a contraceptive method that works for her.
Why you should see a doctor before ordering birth control online
Your general health will always be a factor in your contraceptive choices. For example, obesity can lessen the effectiveness of certain birth control options. Some women aren’t able to use synthetic estrogens because they have a history of blood clots or breast cancer. It’s also riskier for women who smoke, are older than 35, or have high blood pressure to use methods like birth control pills or the patch.
Using birth control that’s not right for you and your body can put you at a higher risk for a stroke or cardiovascular event. That’s why it’s so important to work with your primary care provider or gynecologist to navigate your options! However, several websites and apps have popped up in the last few years that make it possible to procure a birth control prescription without visiting a doctor in person.
These prescriptions are written by a doctor after the woman answers questions about her health online or in a video. Birth control pills are available, as well as contraceptive patches and rings. Some are mailed directly to the woman’s home, while others send the prescription to a local pharmacy.
However, as we’ve discussed above, there are several factors involved in determining the right birth control for you. This includes everything from your medical and family history to your daily lifestyle. Like any other medication, birth control comes with potential risks and side effects. Speaking to your doctor before obtaining a birth control prescription is vital for your health and wellbeing!
Find the best birth control for your body with MOGA
Memphis Obstetrics & Gynecological Association, P.C. is the largest private women’s health practice in the Mid-South area, and has been providing superior service to our patients for over 30 years. With dozens of doctors and nurse practitioners available in Memphis, Germantown, Bartlett, and Southaven, we make it easy for you to get the personalized care you need, when you need it.
If you are looking for more information on birth control, let us help you find the perfect fit for you! You can make an appointment with us by calling our office or schedule one online through our website.