Choosing the Right Birth Control for You

Updated April 2018
Being responsible for your sexual wellness goes a long way towards making sex enjoyable. Who wants to be taken out of the moment trying to remember if you’re ovulating or have to make a panicky, early morning trip to CVS for Plan B? Not us, and probably not you, but we know choosing the right birth control can be tricky.
Obviously, unwanted pregnancy isn’t the only thing birth control can guard against — condoms, for instance, also protect against STDs and STIs. As such, condoms are an absolute must for one-night stands, random hookups, and any non-exclusive relationship, regardless of what other birth control you may use.

Realistically, though, there comes a point in relationships — when you’ve established exclusivity and trust, and you and your partners both get clean bills of health — when the condom comes off. This is not the time to test the reliability of the pull-out method. There’s nothing like a missed period to bulldoze a blossoming romance, among other things.

Everyone’s needs, birth control-wise, are different: maybe you’re wary of hormones or have a medical condition that limits your options or would prefer not to be beholden to a daily “take your birth control” alarm. The internet can just add to your confusion, since research on the topic often results in a lot of contradictory, occasionally fearmongering, information. We highly recommend working with your doctor to identify the birth control that best meets your needs.

So you can have an informed discussion with your doctor, though, we’ve pulled together a list of the most popular birth control options below. We’ve divided the options into two categories: hormonal and non, since that can be a deciding factor for many women. Some disclaimers:

  1. Rather unfairly, nearly every option comes with side-effects. We’ve outlined some of the major ones here, but your doctor will best be able to determine how relevant these side-effects may be for you.
  2. As a general rule of thumb, it takes around 3 months for your body to adjust to new birth control, so unless you have a severe and dangerous reaction, any discomfort should be temporary. If you do have a severe or dangerous reaction, contact your doctor ASAP.
  3. We don’t discuss cost here, as that will depend on your insurance — but that’s another important factor to consider.

 

Hormonal Birth Control

Hormonal birth control uses estrogen and progestin to prevent pregnancy. Depending on your sensitivity, hormones may negatively affect your mood, but hormones can also clear up acne and make your periods significantly lighter — sometimes, they stop altogether.

Birth Control Pill:

The classic option, but maybe a little old-fashioned. The Pill is an approachable option, partly because it’s so culturally familiar. It’s 91% effective and doesn’t require any sort of procedure, like IUDs discussed below. But the Pill is also quite temperamental: you need to take it every day at the same time for it to work, which can be burdensome — even the most responsible women can slip up. The Pill isn’t a safe option for everyone, either, as its combination of hormones (estrogen and progestin) can be dangerous for smokers and those who suffer from migraines with aura (such as yours truly).

Birth Control Patch:

The Patch is pretty similar to the Pill: it too relies on a combination of estrogen and progestin and is 91% effective. Unlike the Pill, you don’t have to change the Patch every day. Rather, you switch out the Patch every three weeks. Personally, this seems more liable to cause slip ups — doing something every three weeks doesn’t feel as habit-building as a daily pill. Plus, that same combo of estrogen and progestin means the Patch also isn’t safe for everyone.

Birth Control Implant:

Also called Nexplanon, the birth control Implant is a matchstick-sized rod that’s inserted into your upper arm. No one can tell it’s there by sight, though we have a friend who enjoys wiggling it for laughs. Nexplanon is 99% effective, lasts for 4 years, and works by releasing progestin into your body. This is a great set-it-and-forget-it option for women who don’t want to take a daily pill or switch out a patch every three weeks. Because Nexplanon only uses progestin rather than estrogen and progestin like the Pill and Patch, it’s safer to use for those with health conditions, too. Typical side-effects include spotting for a few weeks after insertion.

Birth Control Shot:

The Depo-Provera shot is an injection of progestin every three months. It’s 94% reliable and, like the Implant, the lack of estrogen means it’s generally safe for more women. Still, it comes with needles, obviously, plus the hassle of regular doctor appointments. Also, the shot may delay your ability to get pregnant once you stop injections — up to 10 months, in fact, but the delay varies depending on the individual.

Hormonal IUDs:

Hormonal IUDs are tiny T-shaped devices that rest in your uterus, with a tiny string hanging down past your cervix. They require a short procedure to insert, and the procedure can be quite painful. The level of pain you experience during insertion depends on your body and sensitivity, with some people only experiencing minor cramping and other needing a day or two off work to recover. To make up for the pain, these IUDs are 99% effective, only use progestin, and last for several years, depending on the brand. Mirena lasts up to 6 years, Kyleena 5, Liletta 4, and Skyla 3. Your doctor will be able to help you choose between the brands, but all are effective set-it-and-forget-it options. Generally, your partner won’t be able to feel the string, but you may want to check for it every once in a while to ensure the IUD is still place. Very rarely, IUDs can sometimes move — or even perforate your uterus — so talk to your doctor about warning signs.

Non-hormonal Birth Control Options

Women may prefer non-hormonal birth control for a variety of reasons. Some people find hormones have too strong an effect on them, either physically or emotionally, while others avoid hormones for medical reasons. Unlike hormonal birth control, these options don’t make your periods lighter, though, so it’s up to you to determine which trade-offs you’re comfortable with.

Copper IUDs:

The copper IUD, or ParaGard, is very similar to hormonal IUDs, except it doesn’t include any progestin. Instead, ParaGards work by using copper to physically block sperm from reaching the egg. ParaGards are 99% effective and last for up to 10 years, promising a whole decade of stress-free fun. Unfortunately, copper IUDs may make your periods worse — heavier, crampier, longer — especially in the first three months. For women who’ve found hormonal options give them bad mood swings or put their health at risk or don’t work with their schedules, though, ParaGards can be a god-send. (And, full disclosure, it’s yours truly’s birth control of choice.)

Diaphragms:

Ah the diaphragm — probably your mom’s birth control of choice, though still worthy of consideration. These flexible little cups are made of silicone and work by covering your cervix. You’ll have to insert it before sex, which may be a mood-killer, though you have 2 hours after insertion to do the deed. For best results, you need to add spermicide to the cup, too, which can be messy and unpleasant. Diaphragms are also the least reliable birth control method on this list, with only 84% effectiveness — barely better than the pull-out method. Still, if you’re committed to finding an option that’s both non-hormonal and doesn’t require a potentially-painful procedure, the diaphragm is your best bet.

Ready to take charge of your sexual wellness? For additional information on your birth control options, we recommend reviewing the information available at Planned Parenthood.

Kat Crookshanks
Bob