Contraception, also known as birth control or contraception, refers to methods or techniques used to prevent pregnancy. It allows individuals or couples to make informed choices regarding their reproductive health and family planning. Contraceptive methods work by either preventing sperm from reaching the egg or inhibiting the release of eggs from the ovaries.
There is a wide range of contraceptive options available today, offering choices that cater to different preferences, lifestyles, and health considerations. Let’s explore some of the most common methods:
“The Pill”
The phrase “the pill” usually refers to hormonal birth control, which often comes in the form of a daily pill you swallow, but there are other ways to get the same drug. You can use options such as
- Daily pills (you swallow)
- Vaginal ring
- Patch
- Injections
There are two types of birth control pills: the combined oral contraceptive pill, which contains estradiol and progestin and the progestin-only pill. Most birth control pills contain both hormones.
Progestin-only pills may be safer for women who are at risk of cardiovascular disease or who have a history of blood clots. They may cause unpredictable breakthrough bleeding.
Currently, all birth control pills require a prescription, but one brand of progestin-only pill, the Opill, which has been used for 50 years, may become available over the counter in the second half of 2023.
The combination of estrogen and progestin prevents you from ovulating or releasing an egg. Both the combination and progestin alone thicken your cervical mucus and thin the lining of your uterine wall, which work to reduce the likelihood that a sperm will enter the cervix and implant on the cervical wall.
For some women, birth control pills they may be used to treat symptoms such as acne, irregular bleeding or painful periods. For those with conditions like polycystic ovary syndrome (PCOS), they can help regulate bleeding and reduce your risk of endometrial cancer.
If used perfectly, the pill is thought to be about 99% effective. However, based on real life usage (some people may miss taking a pill, for example or not take them at the exact same time every day) nine out of every 100 women who use either progestin-only pills or those with both estrogen or progestin get pregnant each year.
Progestin is also available as a shot you get every three months, called Depo-provera. Out of 100 women who use this shot each year, six get pregnant.
Read more about the side effects of birth control pills.
Is Weight Gain a Side Effect of Birth Control Pills?
Cells in many parts of your body—even your skin—respond to the hormones that birth control medications contain, so there can be a wide range of different side effects.
The injection, often called the Depo shot, has been shown to make about 25% of women who take it gain weight, but large studies haven’t found consistent evidence that most other forms of hormonal birth control lead to users putting on pounds. Still, birth control affects everyone differently and many women who use contraceptives do report gaining weight.
Some Birth Control Stops Periods
Some brands of birth control will allow you to skip your period for up to a year at a time, though you may experience occasional spotting or unpredictable breakthrough bleeding.
If you take daily pills, most packs come with three weeks’ worth of pills that contain hormones and one week of placebo pills. During the placebo week, you’ll get your period. Some women choose to skip this week to prevent their periods.
Read more about hormonal birth control pills.
Long-Acting Hormonal Birth Control
Rather than take a pill every day, some women opt for long acting hormonal birth control methods, which include small devices implanted in the uterus or under the skin of the arm. These devices release the hormone progestin (which is similar to progesterone, a hormone you make naturally). Like birth control pills, they prevent pregnancy by blocking the release of eggs from your ovaries and by thickening the mucus in your cervix, making it difficult for sperm to implant.
Fewer than 1% of women using long-acting hormonal birth control get pregnant, but if you do, you need to see your doctor right away. You have a heightened risk of experiencing an ectopic pregnancy. Other side effects include breakthrough bleeding, headaches, acne, and more. Many women report cramping and abdominal pain during insertion and removal, both of which must be done by a doctor in an office setting.
Read more about long-acting reversible contraceptives.
Non-Hormonal Birth Control
For women who don’t want to take hormones or who have experienced side effects when doing so, there are several non-hormonal options. Bear in mind, however, that these also can come with side effects.
Phexxi Gel
Phexxi is a gel that you apply using a tampon-like applicator up to an hour before sex. The gel lowers the pH of your vagina, making it difficult for sperm to thrive. On its own, the gel is 86% to 93% effective, but it can also be used with other birth control methods like condoms and oral contraceptives.
Spermicide
Spermicide is a gel similar to Phexxi that you apply to your vagina using your finger or an applicator before sex. The gel prevents sperm from finding and fertilizing an egg. Out of every 100 women who use spermicide without barrier methods, 28 get pregnant each year. Using spermicide alongside a diaphragm or condom reduces that number to 12-23 women.
Copper IUDs
Copper IUDs are a type of long-acting reversible birth control. A healthcare provider will insert it into your uterus, where it stops sperm from being able to swim to an egg. Side effects include heavy and painful periods, though they typically become less problematic after three to six months. When you no longer want to use the IUD, you’ll need your healthcare provider to remove it. Less than 1% of women who use copper IUDs get pregnant each year.
Condoms and Other Barrier Methods
Condoms, diaphragms, and birth control sponges create physical barriers that prevent sperm from coming in contact with an egg. According to the American College of Obstetricians and Gynecologists (ACOG), barrier methods of birth control are not quite as effective as other strategies. Out of every 100 women who use barrier methods regularly, 18 to 28 will become pregnant each year.
Read more about non-hormonal birth control methods.
Cycle Tracking
You can also use cycle-tracking apps to predict the days on which you’re most and least likely to conceive and plan accordingly. There are other methods of tracking your cycle as well, including tracking the consistency of your cervical mucus each day or by taking your temperature each day. Twenty-four out of every 100 women who use these methods to prevent pregnancy get pregnant each year. Two out of three couples who use them in hopes of getting pregnant (without fertility problems) are able to conceive, according to the American Academy of Family Physicians.
Surgery
Of course, for those who know they never want kids, or have finished having them, there are surgical options. Men can get vasectomies (more than 99% effective), and women can get tubal ligations (2.64% of women still got pregnant within a year of the procedure). Women will still menstruate and men will still ejaculate after these procedures but no eggs or sperm will be released.
Emergency Contraception or Plan B
Emergency contraception is a pill you can take after having unprotected sex or if you suspect your usual contraption may not have worked (for example if your condom broke). There are two types: levonorgestrel, approved by the FDA in 1999, sold under a variety of brand names including Plan B One-Step, which can be taken immediately after intercourse and up to 72 hours after; and ella (ulipristal acetate), which requires a prescription because its manufacturer didn’t apply for over-the-counter (OTC) status. It can be taken up to five days after unprotected sex. They both work by preventing ovulation or preventing sperm from fertilizing an egg. As of February 2023, Plan B is available in all 50 states.
Side effects of emergency contraception include nausea, cramps, and irregular bleeding.
Read more about the morning after pill.
How Effective Plan B Is
If you use emergency contraceptives within five days of having had intercourse, they can prevent up to 95% of pregnancies, according to the World Health Organization.
