When it comes to birth control, men and women have more options than ever before. But deciding which type is right for you can be a challenge.
“Decisions around birth control are largely based on personal preference,” says Melina Dendrinos, M.D., an obstetrician-gynecologist at Henry Ford Health. Some people want hormone-free options. Others only want to prevent pregnancy for a short time. Still others are more concerned about sexually transmitted infections (STIs) than pregnancy prevention.
Breaking Down the Methods of Birth Control
With the growing number of both hormone-free and hormone-based birth control options, you don’t have to avoid sex — or have a vasectomy or tubal ligation — to avoid pregnancy. In fact, with perfect use, many other options provide similar protection against pregnancy.
Here, Dr. Dendrinos highlights popular methods for preventing pregnancy:
Barrier methods
Barrier methods of birth control are true to their name — they literally put a barrier in place to keep the man’s sperm from reaching the woman’s egg. Diaphragms, cervical caps, contraceptive sponges and male and female condoms all fall under this category — and all are effective at preventing pregnancy. However, all of these methods demand advanced planning — for example, making sure you have the contraceptive device ready when you need it. Importantly, if you’re concerned about STIs, condoms are the only barrier method you should use.
Hormonal methods
Hormonal methods of birth control contain a small amount of man-made hormones that work to inhibit the body’s natural cycle to prevent pregnancy. They prevent eggs from being released from the ovaries, thicken cervical mucus to prevent sperm from entering the uterus, and/or thin the lining of the uterus to prevent implantation.
The options for hormonal birth control include pills, patches, rings, injections and implants. Certain intrauterine devices (IUDs) also rely on hormones for contraception. What you choose depends on factors ranging from whether you want to become pregnant in the near future (the pill may be best) to ease of use (an implant offers the longest protection with no daily duty on your part).
- The pill: Within the category of oral contraceptive pills, there are several choices. Most contain a combination of hormones estrogen and progesterone, and some contain only progesterone. The pill is effective but requires daily action on your part. (If you forget to take your pill, you’re going to need a back-up plan.)
- Patches and rings: You replace patches (worn on the belly, upper arm, buttocks or back) weekly. Vaginal rings can be left inside for weeks at a time (you take it out one week a month to menstruate).
- Injections: You’ll need to visit the clinic every three months to get a new injection, but if all goes according to plan, you won’t have a period at all between visits.
- Implants: The implant is a tiny rod that is inserted under the skin of your upper arm by a medical provider and releases the progesterone into your body. It lasts for three years. The downside is that it can cause irregular bleeding.
IUDs: According to the American College of Obstetricians and Gynecologists (ACOG), IUDs should be the first line of defense for women who are trying to avoid pregnancy. An IUD is a small, T-shaped device that is inserted into your uterus and blocks sperm from entering and fertilizing eggs. It needs to be inserted (and removed when the time comes) by a medical provider. They include both the copper PARAGARD®, which is hormone-free, along with hormone-based options, including Mirena®, Skyla®, Kyleena®, and others. Copper IUDs protect for 10 years while hormone-based options offer 3 to 5 years of protection.
Natural family planning: Natural family planning (sometimes called fertility awareness method) includes a mix of temperature taking, assessing cervical mucus and charting changes on a calendar to carefully track your menstrual cycles and times of ovulation, and then either abstaining from sex or using a barrier method during that time period. While it may be the least invasive option of the lot, it’s also the least effective and definitely takes a lot of planning ahead and attention.
Making It Work for You
The best contraception for you depends on your health, lifestyle needs, and reproductive forecast. “If you have high blood pressure, migraine headaches with aura or you are a breast cancer survivor, you may not be a candidate for estrogen-containing options,” says Dr. Dendrinos. If you’re planning to get pregnant in the not-so-distant future, you may want to avoid more long-term birth control such as injections, implants and IUDs. Talk to your doctor about pro’s and cons of the birth control methods you are considering.
No matter which option you choose, keep in mind you can change your mind. You can even avoid pregnancy if your chosen form of birth control fails. Emergency contraception methods, including Plan B One-Step®, Aftera, ella® and others can be used up to 72 hours after unprotected sex.
To discuss your birth control options with a Henry Ford primary care physician or gynecologist, visit henryford.com or call 1-800-HENRYFORD (436-7936) to find a provider or make an appointment today.
Dr. Melina Dendrinos is a board-certified OB/GYN seeing patients at Henry Ford West Bloomfield Hospital.
