By Jackie Goodwin
Starting or switching birth control is a big decision, and most of us don’t know the delicate intricacies of our female body as teenagers and young adults. If you’re thinking about trying birth control for the first time or switching to a new form of birth control, it’s important to equip yourself with tools to make informed decisions that advocate for your own health. As much as it can be a challenge, deciding which birth control method works for you is a valuable exercise in getting to know your own body and protecting yourself.
Why do you need birth control?
There are a few reasons for going on birth control, the first being protection against unwanted pregnancy. In this instance, you have an array of options to choose from. If you have multiple partners, you should have protection from sexually transmitted diseases, which are preventable by using an internal or external condom, or condoms worn on a penis/toy, or worn inside a vagina. For painful periods or the desire to reduce period frequency, talk to your healthcare provider about hormonal options to prevent pregnancy while managing menstrual cycle symptoms.
The most effective form of birth control is the one you’ll stick to. The pill is an easy choice for many, but if remembering to take it every day isn’t your style, it’s less likely to prevent pregnancy. Maybe you travel a lot and can’t head to the pharmacy every month, or switch time zones frequently. In that case, a long-term method like an implant or Intrauterine device might be best. If you’re not a fan of synthetic hormones, there are non hormonal options too.
Choosing Your Method
Daily Use: The Pill
Hormonal birth control pills use synthetic forms of the hormones estrogen and progesterone to prevent fertilization, suppress ovulation, and thicken cervical mucus. The pill is a great option if you have painful periods that aren’t due to underlying medical conditions and if taken perfectly, it’s 99% effective against pregnancy. You can use an alarm or app on your phone to remind you when it’s time to take the pill. There are tons of versions of the pill and every woman is different, so it can take some time to find the right fit. There can be negative side effects, including changes in mood and in rare cases, serious problems like blood clots. Talk with your doctor about your medical history and they’ll be able to help you find a hormonal balance that feels right.
Every Time: Condoms
Internal and external condoms are the only form of birth control that protects against sexually transmitted diseases and they should always be used with new partners. Condoms are pretty effective at preventing pregnancy when used perfectly, but nothing is perfect, so it’s a good idea to pair condoms with another form of birth control to be safe.
Weekly and Monthly: Patches and Rings
The birth control patch works similarly to the pill, but transmits hormones through your skin. A new patch is put on each week and is pretty effective with perfect use. To work properly, the patch has to be completely stuck on your skin and should not be reapplied. The patch is designed to stay put while exercising, swimming, and showering, but you’ll want to check it everyday and avoid high-friction on it. Check out the Xulane website for more information on best practices.
For something on a monthly basis, check out the NuvaRing or Annovera. NuvaRing is a small ring that contains hormones and is inserted by you for three weeks at a time. Once your cycle is over, a new ring is put in. Annovera is a relatively new option and one ring can be reused for an entire year of cycles. These are just as effective as other forms of hormonal birth control, without the need to remember something each day.
Every Three Months: The Depo-Provera Shot
For a fairly noninvasive option, Depo-Provera is a progestin shot that you get every three months. There is evidence of complications with bone health and calcium deficiencies when on the shot, so that’s something to consider before trying it out. The hardest part about the shot is being on a rigid schedule with making appointments and keeping them to ensure you’re protected from pregnancy.
Five Years: The Implant
Nexplanon is a small rod that’s inserted by a medical professional into the arm. It contains progestin to prevent pregnancy and can last up to five years. For some people, the idea of having something foreign just beneath the skin is a little freaky, but it’s a great option for those not interested in an IUD who want a long-term solution.
Three to Twelve Years: The Intrauterine Device
IUDs are by far the most effective and low maintenance birth control option on the market. These are small devices that are inserted into the uterus by a medical professional and remain for 3-12 years, depending on the brand you opt for. Once inserted, IUDs are 99% effective since there isn’t room for human error. There are two types of IUDs: the hormonal IUD (Mirena, Skyla, Kyleena, Liletta) and the copper IUD (Paragard). Hormonal IUDs release levonorgestrel, a synthetic form of progesterone, directly into the uterus on a daily basis. Because of its placement, a very low amount of the hormone enters the bloodstream and the side effects can vary. Hormonal IUDs can be used to treat heavy and painful periods and it is possible to stop having a period altogether after a few months.
The copper IUD is a piece of plastic wrapped with copper, which redirects sperm as they enter the uterus, making it impossible for them to reach an egg. The copper IUD can be used for 12 years, which makes it the longest-lasting option. Unlike hormonal birth control, you may experience heavier bleeding and discomfort during your period, but you won’t have any of the risks associated with synthetic hormones. There are some risks of expulsion of an IUD and insertion can be very painful, but if you’re looking for long-term, no fuss birth control, the IUD is your best bet.
Make the Choice
For more assistance in making your choice, check out this Planned Parenthood resource on more options for birth control, including the sponge, spermicide, and sterilization. To be extra safe, all of these options can be used in tandem with a condom, which is the only way to prevent STDs. It might take a few changes to find your correct method and it’s ok that what works for you now might not work in one, two, or ten years.
When you start or switch methods, try to track any changes you notice in your body so you can share with your doctor if you’re having more mood swings, changes in your period, or other issues. It’s good to note which days you’re bleeding and if it’s longer or shorter than normal. Hormones have the ability to change our bodies in unexpected ways and it’s helpful to know your baseline so you can advocate for change when you feel you need it.
Want to hear a firsthand experience?
Read Maddy's experience with the shot, the implant and the IUD
Jackie Goodwin is a freelance writer who works with Public Goods, a company that sells eco-friendly household essentials such as toothpaste, deodorant and toilet paper. Check out their blog for a wide range of topics: everything from essential oils and hygiene habits to recycling and making the most of your products.