What Women Should Know When Choosing a Birth Control Option

There is a wide variety of birth control options available to women today.

With so many choices, deciding which one to use can be overwhelming and confusing.

To make the selection process easier, here is an overview of the basics of different birth control options.

Birth control can be divided into five categories:

• Combination estrogen-progesterone methods – Birth control pills (OCPs), Nuvaring, and the Patch.
  
  
• Progesterone-only methods – Nexplanon, Depo-Provera, progesterone pills and intrauterine devices (IUDs).
  
  
• No hormones – Copper IUD.
  
  
• Barrier methods – Condoms (both male and female), cervical caps and diaphragms, and sponges with spermicide.
  
  
• Surgical options – Vasectomy and tubal ligation.
  
  

Birth control also can be divided into the following:

• Non-procedures – OCPs, Nuvaring, Depo-Provera and barrier methods.
  
  
• Procedures – Nexplanon, IUDs and permanent surgical sterilization.
  
  

OCPs are the most common method in the United States and Europe. They are taken every day and, in addition to birth control, have benefits that include regular periods, lighter and shorter periods, decreased premenstrual symptoms, improved acne, and decreased risk of ovarian and endometrial cancer.

Procedural methods, such as IUDs and Nexplanon, are the most effective reversible forms of contraception, with failure rates of less than 1% per year. Both are simple in-office procedures that typically take 10-15 minutes.

Once inserted, these methods don’t require the woman do anything more. There are five IUD brands on the market – four contain progesterone only, and the fifth has copper, which is toxic to sperm.

The most well-known IUD is Mirena and is good for five years.

The other progesterone-only IUDs are good for three years.

The copper IUD lasts for 10 years.

Another procedural method, Nexplanon, is a progesterone-only thin plastic rod that is inserted in a simple office procedure and provides continuous birth control for three years. It is one of the most effective birth control methods other than abstinence.

For women who don’t like the thought of something inserted into their bodies – be it a device or hormones – there are several fertility awareness methods where a woman tracks various physical changes during her monthly cycle. Intercourse is avoided around the most likely time of ovulation.

Regular menstrual cycles make it much easier for this method to be effective.

The advantages are no pills, devices or added hormones.

These same methods are used to facilitate pregnancy in couples having difficulties conceiving.

Birth control methods that are designed for use at or near the time of sex (e.g., the condom, diaphragm) are generally less effective than other birth control methods (e.g., IUD, birth control pill); however, only condoms or abstinence protect against STDs.

There are times when specific birth control options are not appropriate, especially if a woman has a health condition that may be aggravated by the hormones in the birth control.

Estrogen-containing methods can increase the risk of deep vein thrombosis (DVT) or “blood clots” in women who:

• Are smokers older than the age of 35.
  
  
• Have a prior history of DVTs, a known condition causing a hypercoagulable state (breast cancer, other cancers within six months, certain clotting disorders).
  
  
• Have multiple risk factors for cardiovascular disease.
  
  
• Have a history of stroke, heart attack or migraine headaches with aura.
  
  
• Are in the first 3-6 weeks post-partum.
  
  

When it comes down to choosing the “right” birth control option, it’s really about what is going to work best for you.

Birth control pills are the easiest, but some women have problems remembering to take a pill every day.

Some women would like an easily reversible method, while other women would like the most effective method.

Talk with your doctor, talk with your friends on what they like and what has worked for them, and talk with your partner.

Most importantly, do your research.   

Keep in mind that with any method, you have to allow several months for your body to adjust.

If you have any questions or concerns, you can always talk to your primary care physician (PCP) to discuss the method that is the best choice for you.

Published on: April 10, 2019