Among the majority of U.S. women who are at risk of unwanted pregnancy, almost 68% use contraceptives correctly and regularly. Out of these many numbers of women, only 5% account for unintended pregnancies. On the other hand, 18% of women who use birth control methods inconsistently are responsible for 41% of unwanted pregnancy.
These stats confirm the importance and effectiveness of contraceptives when used regularly and adequately. There are different birth control types available for both males and females. While some are permanent, others are considered reversible. There is a method for every kind of lifestyle and every individual.
So, what does birth control mean? It means contraception and preventing pregnancy. Birth control has been around for a very long time now, and it is widely used for family planning. It is effective for warding off unplanned pregnancies and planning the family size.
The most common types of birth control are sterilization, implants, intrauterine devices, and hormone pills, etc. Some other but less effective methods are diaphragms, condoms, and withdrawals. Birth control may include any medicine, device, or method to prevent pregnancy. Women can choose from a wide range of contraceptives depending on their current health, the need to prevent STD, and the desire to have children in the future.
Birth control can prevent pregnancy in various ways, depending on the method a woman chooses. The sterilization method prevents sperm from getting to the egg or ovum by damaging or cutting the tube that carries the egg for women or sperm for men.
In a LARC (long-acting reversible contraceptive) method like an IUD or implantation device, the ovaries stop releasing eggs and sperms are prevented from getting to the egg, making implantation unlikely.
Short-acting hormonal methods also stop fertilization, and they include pills, vaginal rings, shots, etc. Barrier methods act as a barrier preventing sperm from meeting the egg as a condom does.
Effectiveness Of Birth Control
Birth control methods vary in terms of their effectiveness. Contraceptives can fail in their job if they are not used properly. For example, if you miss taking pills regularly, then there is a chance of conception.
Certain birth control methods like IUDs and implants have the lowest risk of failure because there is an ease of use. Once inserted, they continue to do their work without requiring the woman to do much. These are the methods that women can consider for the lowest risk of pregnancy.
Methods of contraception that is used closer to the time of sexual intercourse like condoms, pills, or diaphragms are less effective than other methods like IUDs. In case you forget to take the contraceptives on time, then there are emergency contraceptives like the morning after pill that can reduce the risk of getting pregnant.
Birth Control Methods
Methods of birth control are varied and can be divided into Intrauterine contraceptives, hormonal methods, barrier methods, fertility awareness methods, permanent and emergency methods. Read on to learn about the different types of birth control in detail.
– Hormonal Methods
Hormonal methods use hormones to prevent the fertilization or meeting of egg and sperm. They can vary from medical procedures to getting injections or hormone-induced pills. Some of the hormonal birth control methods are explained below:
The implant is a thin rod inserted in the upper arm, under the woman’s skin. This device has Progestin which is released into the body over a period of three years, in small doses. The failure rate is very low at 0.01%.
The implants can be used by breastfeeding women, those who forget taking daily pills or those who have a medical condition that prevents other contraceptives. However, it is not suggested for women who smoke, have a history of diabetes, ectopic pregnancy, cholesterol, heart disease, depression, migraine, and acne.
Effectiveness: Implants can be as effective as surgical sterilization which is pretty high. The pregnancy rates in the first year are 0.2%, and in the third year, it is 0.5%.
Pros: Women regain fertility after the implants are removed from the body, which means the woman can have children when she is ready. Implants are quite durable.
Cons: Women need to undergo a minor surgical procedure to insert this. There can be menstrual irregularities along with side-effects such as headaches, weight gain, mood swings, acne, and facial hair.
2. Birth Control Shot/Injection:
Women can take hormone shots every three months in the buttocks or arms. The failure rate for this is 4%. The depo medroxyprogesterone acetate hormone (DMPA) stops ovulation and is active within 24 hours of taking the shot. One can get these injections at the doctor anytime.
Effectiveness: DMPA is a good and effective contraceptive. Other medications or eight of the patient does not reduce the efficacy. In the first year, the failure rate is only0.3%.
Pros: This method does not have adverse effects that are often observed with Estrogen, like an increase in blood clot formation. The risk of certain types of endometrial cancers and irregular periods is reduced with usage.
Cons: In the first year of use, some women may not bleed. Any irregular bleeding can be managed by taking the next dose earlier or by taking a low-dose estrogen. The DMPA lasts in the body for several months after stopping the injections and hence the return to fertility may take some time. Weight gain, period irregularities, and depression are among the known side effects, even after the last injection.
3. Oral Contraceptives:
Also known as the “pill” this is a mix of Progestin and Estrogen. Usually prescribed by a doctor, it needs to be taken at the same time each day. The failure rate is 7%. It is prescribed for women who are younger than 35 years, do not smoke, and do not have a history of breast cancer or blood clots.
Effectiveness: The pregnancy rates with the use of a pill can range from 0.1% of proper use to 5%with typical use.
Pros: These pills can treat irregular menstruation, and the cycle can be manipulated to prevent bleeding during specific events like vacations. These pills can prevent conditions like pelvic inflammatory disease, breast disease, and cysts. There can be the prevention of ectopic pregnancies, and the pills can prevent endometrial and ovarian cancers as well.
Cons: Side effects include nausea, weight gain, absent periods, depression, anxiety, headaches, breast tenderness, and breakthrough bleeding. The woman needs to be regular in taking the pills and cannot miss it any day. Also, it may take months before the menstrual cycles become regular, and she can become pregnant once she stops the pills.
4. Progestin-only Pill:
This pill has only one hormone and can be prescribed by a doctor only. It needs to be taken daily at the same time. It has a failure rate of 7%. The pill is best for breastfeeding women and those who cannot take Estrogen.
Effectiveness: Similar to the combination pill, these pills are highly effective if taken every day.
Pros: The Progestin-only pill help in clear acne in many women. Besides these, they are also useful for treating irregular menstrual cycles. The pills can also prevent ovarian cysts and cancer.
Cons: The most side effects of using this pill includes nausea, weight gain, anxiety, breakthrough bleeding.
5. Birth Control Patch
Women wear skin patches on buttocks, lower abdomen, and the upper body, except the breasts. The skin patch releases hormones, Estrogen, and Progestin into the bloodstream and should be prescribed by a doctor. With the failure rate of 7%, one patch is used for three weeks.
Effectiveness: The FDA has listed the failure rate at 1% per year. This may not be as effective for women who weigh more than198 pounds.
Pros: This is a convenient method, and users do not need to remember to take it like taking pills. A new patch is applied every three weeks, but in the 4th week, it is not used when periods are expected.
Cons: The side effects are similar to oral contraceptives. The patch can cause skin irritation and may come off in the shower.
6. Hormonal Vaginal Contraceptive Ring:
The Vaginal Ring ring releases Estrogen and Progestin and has a failure rate of 7%. The hormones are released slowly and absorbed by the vaginal walls. The doctor places the ring inside the vagina, and it stays there for three weeks. Whenever the periods are due, the ring is removed and replaced by a new ring afterward.
Effectiveness: They work like birth control pills but with fewer side effects.
Pros: These rings are easy to use and do not have to be managed daily.
Cons: If the ring is expelled and has been out for more than 3 hours, then there is a chance of pregnancy. This ring is available only through prescription.
Barriers prevent the sperm from getting to the egg. It includes the cervical cap, diaphragm, and condom.
1. Diaphragm or Cervical cap:
This placed inside the vagina, covering the cervix to block sperm. The cervical cap is a thimble-shaped cup and diaphragm is like a shallow cup that has spermicide and then inserted inside the vagina before sexual intercourse. They come in different sizes and have a failure rate of 17%.
Effectiveness: In perfect use of a cervical cap, a woman who has not gone through childbirth has a theoretical failure rate of 9% in comparison to a rate of 20% for women who have gone through childbirth. For diaphragms, the failure rate in the first year of use is 20%.
Pros: The diaphragm and cervical cap does not use any hormones and can be used right before the sex. The cervical cap provides continuous protection as long as it is placed correctly during intercourse. Repeat applications of spermicide are not required in a cervical cap during repeated intercourse.
Cons: Prolonged use of a diaphragm increases the risk of urinary tract infection. It cannot be used for more than 24 hours as it may lead to vaginal erosion or toxic shock syndrome. It requires professional fitting and must be cleaned regularly. In a cervical cap, cervical erosion may cause spotting. Both methods have a high failure rate.
These come in the form of gels, foams, creams, or tablets and kill the sperm. They need to be placed in the vagina an hour before sexual intercourse. They can be used for 6-8 hours after intercourse. This is a great reversible method because when a woman stops the usage, fertility can be resumed.
Effectiveness: Spermicides are not as effective when used alone and as such need to be used with other contraceptives like condoms. Failure rates can range from 20% to 50%.
Pros: They do not usually affect other physical systems.
Cons: Some spermicides need a long waiting period before use, which makes it a little inconvenient. It must be reapplied before every intercourse. It may irritate the penis or vagina and cause allergic reactions and UTIs.
3. Male Condom
Condoms that are made of latex are the most commonly used contraceptive methods. They help in preventing HIV, STDs, and pregnancy. Lambskin or natural condoms do not protect against STDs or HIV. Condoms can be easily found in drug stores.
Effectiveness: The failure rate with correct use is 3% but can go up to 14% with incorrect use.
Pros: Relatively cheap and readily available. No prescription is required, and they can protect against HIV.
Cons: It may not be as enjoyable as going bare. There is a risk of the condom breaking or falling off. Some may have an allergic reaction to latex, and oil-based lubricants can damage condoms.
4. Female Condom
A female condom is worn by the woman to prevent sperm from getting inside her. The man and woman should not wear condoms at the same time; otherwise, they can stick to each other and dislodge.
Effectiveness: With the usage in the first six months, the pregnancy rate is 15%. The FDA listed a failure rate of 21% in 2002.
Pros: The female condom protects the labia and the base of the penis during sex. It can be inserted for 8 hours before sex.
Cons: The lubricant in the condom does not have spermicide, and it is difficult to place in the vagina. Prolonged use can lead to UTI, and the inner ring can also cause some discomfort.
5. Birth Control Sponge
The Sponge contains spermicide and is placed over the cervix. It can work for 24 hours and must be left for 6 hours after intercourse.
Effectiveness: Like other birth control methods, birth control sponge is very effective when used correctly before the sex. It is also very effective for women who have never given birth. The failure rate as per FDA is 14% to 28%.
Pros: The sponge is readily available and is appealing to those who want to avoid hormonal contraceptives. It is easy to use and remove and does not interrupt during sexual intercourse.
Cons: Users may experience an allergic reaction or irritation along with difficulty in removal. Toxic shock syndrome is a possibility if its left inside longer than is prescribed.
Reversible Methods of Birth Control
Reversible methods mean those contraceptives which can be removed, and then the women can have children. These are usually long-term contraceptive devices that are inserted into the woman’s body. The IUD, as well as the implant, are among the most effective Reversible birth control.
- Intrauterine device (IUD): IUDs are small T-shaped devices that are placed inside the uterus where it can stay up anywhere between 3 to 5 years depending on the type of brand. The hormonal IUD has Progestin hormone that is released into the uterus. The failure rate is very low at 0.8%. FDA has approved the use of four hormonal IUDs in America named Mirena, Liletta, Skyla, and Kyleena. Besides these four hormonal IUDs, there is one copper IUD named Paragard, which does not use hormones. Instead, the Copper wire around the IUD produces a strong toxic reaction for eggs and sperm, preventing pregnancy. Paragard is approved by the FDA to be used for ten years.
- Levonorgestrel intrauterine system (LNG IUD): LNG is a small plastic IUD that looks like a Copper T. It is placed in the uterus ad releases small doses of Progestin. It can stay inside up to for five years, and the failure rate is 0.1 to 0.4%.
Fertility Awareness-Based Methods
The Fertility awareness-based Method entails understanding the monthly fertility pattern based on the menstrual cycle. It involves understanding the days where the woman is most fertile and the days when she is not fertile. Normal menstruating women have nine or more fertile days in a month. Sex on fertile days is not a good idea. Failure rate scan rage from 2% to 23%.
Lactational Amenorrhea Method
The LAM or Lactational Amenorrhea Method is suitable for breastfeeding women. This birth control method is effective when the woman is not having her periods after delivery, is breastfeeding, and less than six months have passed after childbirth. It is a temporary birth control method and has pretty strict conditional requirements.
Emergency Contraception is not a regular birth control method but must be strictly used as a last option after unprotected sex. Copper IUDs can be inserted within five days after unprotected sex. It is advised to take emergency contraceptive pills within 72 hours of unprotected sex.
Choosing a Birth Control Method
There are various factors responsible for making an individual select a suitable birth control method. Depending on the ease of use, future planning, affordability, and fewer side effects, one can choose the birth control. Factors to consider are:
- The effectiveness and convenience
- The number of uses (daily use or one time)
- The reversibility and possibility of having children in a short time.
- Bleeding patterns, complications, and side effects.
- Affordability and prevention against STDs.
Frequently Asked Questions
Which types of birth control can I get without a prescription?
Ans: You can get following contraceptives without a prescription:
- Female and male condoms
- Emergency contraceptive pills
Which types of birth control help prevent sexually transmitted infections (STIs)?
Ans: Female and male condoms can best prevent STIs.
How can I get free or low-cost birth control?
Ans: Affordable Health Care Act has insurance plans that cover prescription birth control approved by the FDA. Female sterilization, pills, and IUDs, along with birth control counseling is also covered. One can check with the insurance provider or check with Family Planning clinics for low cost or free birth control. Medicaid holders do have birth control covered.
What is the best method of birth control?
Ans: Birth control can work differently for each woman, and there is no one “best method.” One can decide on the best option by talking to a nurse or doctor about:
- The time when a woman wants to get pregnant.
- How each method can prevent pregnancy.
- Side effects.
- The frequency of intercourse.
- The number of sexual partners.
- Overall health and comfort.
Birth control is a stress-free way of enjoying life with your partner without worrying about unplanned pregnancies. It gives freedom and power to women and couples to plan children when they are ready. Until then, they can select the most effective birth control methods as per their convenience to prevent any unscheduled emergency of getting pregnant.
When you hear from your doctor about the effectiveness of certain birth control methods, there are different ways it is considered “ideally.” That means using it exactly how it was made versus how an average person actually uses it. Learn about each birth control method and their effectiveness, pros, and cons to select the one that suits you the most.