Whether or not you’re ready to get pregnant is an intensely personal decision, with numerous important implications and consequences. So many things matter when it comes to having a baby, and contraception is of the utmost importance for most women. But, with so many options available, how do you choose?
Dr. Marsha Bornt and the staff at Apple Hill Gynecology understand why birth control is such a critical topic, and we know how difficult the decision about what method you choose can be. Your medical history, personal circumstances, goals, and many other factors come into play.
In this post we take a look at the four main types of birth control. We encourage you to discuss all your questions about contraception with Dr. Bornt because you are a unique individual and the best answers address your specific needs.
1. Intrauterine devices
IUDs come in two forms: levonorgestrel intrauterine system and copper T intrauterine device. Each type of IUD is placed in your uterus and is designed for long-term birth control. Sometimes IUDs are referred to as LARCs—long-acting reversible contraceptives.
The levonorgestrel IUD releases a small amount of progestin each day and works for three to six years. The copper T IUD is a non-hormonal device and works for up to 10 years. Both have a failure rate of less than 1%. Either can be removed if you decide you want to get pregnant.
2. Hormonal methods
Hormonal contraceptives use either estrogen, progestin, or both to prevent pregnancy. According to the CDC, hormonal methods of birth control have a failure rate of around 7%. There are numerous types of hormonal contraceptives, including:
You can take a combined pill, which includes both estrogen and progestin. This type of contraceptive is available with a doctor’s prescription. There are some women who shouldn’t take it, such as those over the age of 35 who smoke.
Progestin-only pills, which are sometimes called the mini-pill, are also available with a prescription and may be a good option if you can’t take the combined pill.
A small patch that releases hormones through your skin can be worn on your lower abdomen, buttock, or upper body. You replace the patch once a week for three weeks, then skip the fourth week.
You place a ring that releases hormones inside your vagina for three weeks, remove it during the fourth week, then put in a new ring.
3. Barrier methods
Like hormonal methods, there are several options for contraceptives that work by creating a barrier between sperm and egg, including:
Diaphragm or cervical cap
Both of these devices cover your cervix and block sperm. They are shaped slightly differently, but work similarly. You place the device in your vagina, usually in combination with spermicide, to prevent sperm from reaching your egg.
Dr. Bornt will need to properly fit you for a diaphragm or cervical cap to make sure you’re using the right size. The failure rate for these devices is around 17%.
A contraceptive sponge is placed inside the vagina and works for about 24 hours and must remain in place for at least six hours following intercourse. Once you remove it, throw it away.
A sponge contains spermicide, and the failure rate depends on whether you’ve had a baby before. For women who have not, it’s around 14%, and for women who have had a baby, it’s about 27%.
A condom worn by a man prevents sperm from entering the woman. In addition to functioning as birth control, male condoms made of latex can also prevent spreading many sexually transmitted diseases. Failure rate is around 13% when used properly.
Condoms used by women may help prevent STDs as well as pregnancy. They can be inserted up to eight hours prior to intercourse and have a failure rate of around 21%.
Available as creams, foams, gels, tablets, films, or a suppository, a spermicide is placed in the vagina. Spermicides can be used in combination with a male condom, diaphragm, or cervical cap. Used alone, spermicides have a failure rate of about 21%.
4. Fertility awareness methods
By understanding when your egg is most likely to be fertilized, you may be able to avoid pregnancy. You need to track your menstrual cycle and avoid sex on the days you’re fertile. Most women have at least nine fertile days per month. Depending on how you track and how closely you adhere to the method, the failure rate could be anywhere between 2-23%.
If you have questions about which method is right for you, please schedule an appointment to talk to Dr. Bornt. You may be surprised by the number of available options!