As a sexually active woman, birth control is one of the most important decisions you’ll have to make. There are numerous types of birth control that have varying levels of effectiveness and so many different pros and cons for each. Using multiple types of birth control together, such as the pill and condoms, or condoms and the withdrawal method, or even the pill and a copper IUD can make these options even more effective, reducing your risk of pregnancy.

Only certain types of birth control are effective at preventing STDs, so it’s important to factor that into your choice. And if you decide on a form of birth control that doesn’t protect against STDs it’s important that you’re either using another method as well that does protect against them, or that you and your partner have both been tested and have come back with a clean bill of health! If you are having sex with multiple people it’s also important to get an STD test every 3 to 12 months depending on how sexually active you are. Even if you’re only having sex with one person, that doesn’t necessarily mean that they are doing the same. Always be aware for possible symptoms of STDs and continue to get checked at your annual gyno exam.

Big Mouth Season 2 Episode 5

The Planned Parenthood Show

I wasn’t entirely sure how I should order this list. By effectiveness? Difficulty level? Permanence? Ease of access? Cost? There are so many factors that go into picking your birth control, but I ultimately decided to list them in order of permanence, least permanent to most permanent. This way you know what kind of commitment you’re making.

None

First off, do you even want to use birth control? In my VERY important list of permanence, I wasn’t entirely sure where to place this option.On one hand, this choice is the least permanent because it involves nothing but your bodies and you can change your mind at literally any moment and use birth control. But, it could also be the most permanent choice since this is the most likely to result in a baby. And, contrary to popular belief, you aren’t just stuck with that kid for 18 years. Chances are you’ll love the shit out of that little thing and you’ll mother them for the rest of your life, whether they need you to or not. Obviously a large number of women in their childbearing years are looking to start their families and are actively trying to get pregnant. But, if you’re looking at types of birth control list, chances are you’re not exactly trying to have a baby right now. Of couples that use no form of birth control, 85% will become pregnant within the first year of trying.

Of course, this method does not protect against pregnancy or STDs. As we all can imagine, this method is probably the most fun. Worry free, protection free sex without having to think about anything other than just having fun with your partner! As we also all know, this isn’t an option for a majority of us. Luckily for us though, there are tons of birth control options to choose from. And hopefully one (or multiple) will be the perfect choice for you.

Abstinence

Abstinence is when you refrain from having sex, specifically vaginal sex. Outercourse is something that’s often associated with abstinence, which is when you participate in all other sexually activities besides vaginal sex. Abstinence won’t always mean the same thing to everyone you ask, it could be avoiding all sexually activity, only specific activities, or just avoiding vaginal sex. Abstinence works as birth control by not allowing semen near the vagina. Semen contains sperm cells and if those sperm cells can’t reach the egg, there’s no way to become pregnant. If you are completely abstinent then you will have a 0% chance of becoming pregnant.

If you would also like to prevent sexually transmitted infections then you will also have to refrain from oral and anal sex if you are solely using this method of birth control. As appealing as this pregnancy free, STD free choice may be, most of you are probably looking at this because you’re already having sex and abstinence is definitely not your first choice for protection.

Withdrawal

Withdrawal, also called the Pull Out Method, prevents pregnancy by having the man pull his penis out of the vagina before he ejaculates. A man should also make she he doesn’t ejaculate on or near his partners genitals because that could along some sperm cells to get inside the vagina. It is also possible for a mans precum to contain sperm cells If done correctly every single time (which is difficult, especially for men who are new to having sex or this method) 4 out of 100 women will become pregnant. Because this method is difficult to do correctly every time, about 1 in 5 women become pregnant when they are using withdrawal as their only form of birth control. It’s recommended to use a second form of birth control if this is the method you are using.

This method does not prevent STDs on its own. Precum can carry various types of STDs that can only be prevented by using abstinence or condoms. I know you all probably have that one friend, or older sister that “only uses the pull out method” and “has never gotten pregnant”. But this method should not be relied on. Just because you know someone that hasn’t had a scare does not mean that it’s 100% effective.

Condoms

Condoms are the only form of birth control, other than abstinence, that protect against both pregnancy and STDs. Condoms work to prevent pregnancy by using the barrier method. A latex pouch covers the penis during sex which prevents semen from entering the vagina. It prevents STDs the same way, by preventing contact between semen and vaginal fluids. If used correctly every time, condoms are 98% effective at preventing pregnancy. But, in real life everything can’t be perfect every time, so with regular use, condoms are about 85% effective. Condoms are also available in plastic and lambskin. But of the three types, lambskin is the only one that doesn’t protect against STDs.

Female Condoms

The female condom works very similarly to male condoms except they are internal and go inside the vagina. Although they’re called female condoms, they can also be used by any gender to protect against STDs during anal sex as well. Internal condoms are slightly less effective than the traditional condom at about 79% effectiveness with regular use.

Spermicide

Spermicide is a chemical that is put inside the vagina before sex. The chemical in spermicide kills sperm cells as they enter the vagina so they aren’t able to reach the egg. Spermicide also blocks the entrance to the cervix so if there are any sperm that weren’t killed by the chemicals, they aren’t able to enter the uterus. There are numerous types and brands of spermicide coming in many different forms. Each brand is different, so it may be useful to test a few different options to see which one works best for you. Using spermicide perfect is very difficult, so with regular use spermicide is about 72% effective.

Spermicide does not prevent against STDs. Spermicide is more effective when used with another form of birth control, such as condoms, which will also prevent STDs. Since this method isn’t completely reliable on it’s own, it’s important to use another method as well. The next three birth control methods, diaphragm, sponge and cervical cap, are all supposed to be used in addition to spermicide. So you should take a look at those if you think spermicide sounds like a good choice for you!

Diaphragm

A diaphragm is a small cup that is placed inside the vagina and covers the cervix. Diaphragms are designed to work with spermicide. Using the spermicide with the diaphragm helps to keep it in place, covering the cervix. The spermicide also kills most of the sperm and the ones that get by are blocked from entering the cervix by the diaphragm. With regular use, diaphragms are about 88% effective, that’s with the spermicide. Without the spermicide the effectiveness drops drastically.

Diaphragms do not protect against STDs. If used with a condom you can prevent STDs and increase the effectiveness of the diaphragm. Chances are that unless you’ve been having sex since before 2000 you’ve never used a diaphragm or know anyone else who has (except maybe your mom, that told you it’s a good option when she first gave you the sex talk). Although diaphragms are just as effective as condoms, their popularity has gone down drastically. Mostly due to the growing popularity of other birth control methods that are easier to use.

Sponge

The Birth Control Sponge, also known as the contraceptive sponge, is exactly what it sounds like. It’s a The Birth Control Sponge, also known as the contraceptive sponge, is exactly what it sounds like. It’s a sponge made from plastic that also contains spermicide. It’s small and round which makes it easy to insert into your vagina. The sponge works by blocking the cervix and by using spermicide.

The sponge works best for women who have never given birth, with about 91% effectiveness. If you have given birth the sponges effectiveness goes down to about 80%. Sponges do not protect against STDs. If used with a condom you can prevent STDs and increase the effectiveness of the Sponge. Since the sponge is one of the lesser used forms of birth control, there is only one brand for sale in the United States.

Cervical Cap

The cervical cap is similar to the diaphragm by covering the cervix. The cervical cap is smaller and shaped slightly different than a diaphragm and goes even further inside your vagina. The cervical cap is also used with spermicide. It can be left inside of the vagina for up to two days without issues. But, it is less effective than the diaphragm at 86% effectiveness for those who have never given birth. For those who have, the cervical cap is only 71% effective.

Cervical caps do not protect against STDs. If used with a condom you can prevent STDs and increase the effectiveness of the Cervical cap. Again, similar to the diaphragm, the popularity of the cervical cap has gone down over the past 20 years or so due to the growing popularity of other birth control methods that are easier to use.

Fertility Awareness (FAMs)

Fertility Awareness is often used by women who are trying to get pregnant so they are aware of when they are ovulating, but it can also be used to prevent pregnancy. For this method women avoid having sex or have sex with another form of birth control while they are ovulating. There are multiple ways to determine your fertility, cycle tracking, cervical mucus tracking, and body temperature tracking. If you are using all of these methods, that’s called the Standard Days Method. This method only works well if you are very diligent and understanding of your body and its changes. Fertility Awareness can be anywhere from 76-88% effective depending on how well you are tracking your cycle. Using period tracking apps can help with this method.

This method does not protect against STDs, so it’s important to be aware of your and your partner’s STD status and get regular checkups to keep that status up to date.

Birth Control Pills

The pill uses artificial hormones to prevent pregnancy. There are two different kinds of birth control pills, Combination Pills and Progestin-Only Pills, also known as Mini Pills. The Combination Pill contains both estrogen and progestin, which work together to prevent your body from ovulating and releasing an egg. They also cause the cervical mucus to thicken which makes it harder for the sperm to get into the uterus. This pill causes changes in the uterine lining making it a triple threat. If somehow the body is able to release an egg and a sperm cell managed to get through the thickened cervical mucus, the changes in the uterine lining make it so that the fertilized egg can’t implant itself into the uterine lining.

The Mini Pill works very similarly to the combination pill except that it doesn’t contain estrogen and it has a lower amount of progestin. The mini pill thickens the cervical mucus and thins the lining of the uterus the same way the combination pill does, except it doesn’t stop ovulation as well. It’s very important to take the mini pill at the same time every day in order to halt ovulation as well as possible. If taken perfectly, at the exact same time every single day, the pill is 99% effective. But, since none of use are perfect the pill is about 91% effective with regular use. Both of these pills can have other health benefits unrelated to preventing pregnancy which is a huge plus for some women. But, on the other side since the pill uses hormones, it can also have negative side effects that make this the wrong choice for some women. This method doesn’t protect against STDs so using condoms or another method is recommended for preventing STDs.

Vaginal Ring

The most popular vaginal ring in the U.S. is the NuvaRing. The NuvaRing works by placing a small, bendable ring inside of the vagina, up near the cervix and releases hormones similar to the pill. Just like the pill, the NuvaRing prevents ovulation, thickens cervical mucus and thins the lining of the uterus, working together to prevent pregnancy. You keep the ring in for 3 weeks at a time and then take it out for a week, which is when you’ll get your period. Then after the week of no ring, you put in a new one and do it all over again. Again, Like the pill, the ring is 99% effective with perfect use and 91% effective with regular use. And 0% effective at preventing STDs.

Patch

Since the patch is hormonal, it works the same way as the ring and the pill, except instead of ingesting the hormones or having them absorbed by your vaginal lining, they are absorbed through the skin where you place the patch. It can be placed on a few different parts of the body, stomach, upper arm, butt and back, whichever works best for you. You keep each patch on for a week at a time for three weeks in a row and then one week off (when you’ll get your period). With regular use the patch is about 91% effective at preventing pregnancy.

Like the other hormonal birth controls, the patch doesn’t protect against STDs. We all know that remembering to do something each week can be hard, so it’s important to be sure you’ll remember to change your patch on time for it to work correctly. There’s also a chance the patch could fall off and if you have it somewhere that you wouldn’t notice right away (like your back), then you’re putting yourself at risk. But luckily, if you aren’t great at remembering or don’t think you’d notice if your patch fell off, then there are other options!

Injection

The birth control shot is another form of hormonal birth control, but unlike the others we’ve looked at so far, you don’t use this one on your own. Every 3 months you’ll visit your gynecologist and they’ll give you your shot. It works the same way as the other hormonal birth control methods, by preventing ovulation and thickening cervical mucus. This method is really nice because you only have to worry about it every 3 months when you go to get the shot. You just have to make sure you make it to your appointment! As long as you get the shot exactly every 12 weeks, it is 99% effective. But, since we’re all busy, that might not always happen. So as long as you stay within the 3 month window, the shot is about 94% effective. Making it the most effective form of birth control we’ve looked at so far. If you haven’t noticed the trend yet, the less of a chance there is for human error, the more effective the hormones are at preventing pregnancy.

I know I don’t have to keep on saying it, but I do think it’s important, this method (and all hormonal only methods) does not prevent against STDs. If you’re using the shot please also use a condom if you need to protect yourself against STDs as well.

Implants

The birth control implant, also known as Nexplanon, is a little rod containing hormones, that’s placed under the skin in your arm. Your doctor implants this tiny rod and then it can protect you against pregnancy for up to 5 years! And of course if you want it removed before that you can. The implant uses progestin, which thickens the cervical mucus and prevents ovulation. Since you don’t have to remember to take a pill every day, or insert a ring or schedule an appointment to get your shot, this method of birth control is 99% effective. And, just to reiterate…the implant does not protect against STDs.

Emergency Contraception

The most common form of emergency contraception is Plan B, I’m sure most of you have heard of it before. It can also be called the morning after pill. This pill uses high does of hormones to prevent ovulation and to prevent a fertilized egg from attaching to the uterine lining. This is completely different than the abortion pill. The morning after pill will not end a pregnancy if you’re already pregnant. This method should only be used as a backup if your first method failed or you accidentally forgot to use birth control. It should NOT be used as your primary birth control. First of all, it’s way too expensive to have to use every time you’re going to have sex. Secondly, because of the higher doses of hormones, Plan B can cause your cycle to become temporarily irregular. As well as other negative side effects. You can get emergency contraception at most pharmacies as well as online providers, such as Amazon.

Plan B is about 89% effective at preventing pregnancy is you take it within 72 hours of unprotected sex. The sooner you take it, the better chance it has of working. If you take it within 24 hours, it’s effectiveness goes up to 95%. And again, this does not protect against STDs.

IUDs

There are two main types of IUDs on the market today; hormonal and copper. IUD is an abbreviation for Intrauterine Device, which is a small T shaped device that’s placed inside the uterus. Once the IUD is inserted there’s almost nothing else you need to do until you get it removed. Your doctor will check the strings on the IUD at your yearly exam, but other than that, you’re good to go for years.Except, you still can’t forget to protect yourself against STDs.

Hormonal IUD

There are 4 types of hormonal IUDs on the market in the US right now, Mirena, Kyleena, Liletta and Skyla. All 4 of these use progestin to stop sperm from reaching the egg and stop a fertilized egg from implanting in the uterus. Each of these are effective for a different number of years, anywhere from 3 to 7 years. But, they are all over 99% effective at preventing pregnancy.

Copper IUD

There’s only 1 copper IUD on the market in the U.S. right now, Paragard. The copper IUD works a little differently than the other 4 IUDs. This IUD doesn’t use hormones. Instead, it uses copper to demobilize sperm, which stops them from getting into the Fallopian Tubes and therefore stops then from getting to an egg. The copper IUD can also be used as a form of emergency contraceptive if it’s placed in the uterus within 5 days of having unprotected sex. This IUD is up to 99.9% effective at preventing pregnancy and lasts up to 12 years. This is a good choice for women who don’t want to use a hormonal birth control, but still want a long lasting effective birth control that they don’t have to worry about every time they have sex, like condoms and other barrier methods.

A copper IUD is actually what I use for birth control. After 8+ years of taking the pill, I wanted a change and started looking into Paragard. I had a difficult time finding out if my insurance covered this option and once I did, I found out that my doctor didn’t take that form of insurance. I was pretty bummed because I knew this would be the best option for me, but the Paragard costs upwards of $1,000 so that wasn’t really an option either. That’s when I came across this clinical trial for VeraCept. VeraCept is another copper IUD that’s currently being studied in the U.S. The clinical trial I’m in is a phase III trial that’s testing for side effects compared to Paragard. It’s slightly smaller than Paragard and contains less copper so it’s supposed to cause less side effects while remaining just as effective. I’ve been in the trial for about a year now and so far so good 🙂

Abortion

Abortion is obviously not to be used as a primary birth control method, but it is an important option for some women who become pregnant and know they can’t or shouldn’t have a baby right now. An abortion is the termination of a pregnancy, usually within the first 28 weeks of pregnancy. Abortions are relatively common and is the best option for some women for a wide range of reasons. There are two different kinds of abortion, a medication abortion and an in-clinic abortion. A medication abortion is also known as the abortion pill, which causes the body to have a miscarriage. An in-clinic abortion is when a doctor uses medical tools to remove the pregnancy from the uterus. Both of these procedures are very safe and effective.

Sterilization

Sterilization if a mostly permanent form of birth control. Both men and women can undergo sterilization surgery, a vasectomy for men or tubal Ligation for women. Neither of these surgeries protect against STDs and even though you will no longer be able to get pregnant, it’s still important to protect yourself against STDs and use condoms if necessary.

Vasectomy

A vasectomy is the male sterilization surgery. It’s a relatively simple procedure where a doctor will cut or block off the vas deferens (two tubes in the scrotum. Once these tubes are blocked the sperm won’t be able to leave. Because this is such a simple procedure, it’s relatively painless and most men are able to go home the same day. This surgery is almost 100% effective at preventing pregnancy. This method of birth control is meant to be permanent, so it’s unlikely you’d be able to get a vasectomy reversed. That’s why it’s important to be completely sure you don’t want to have children if you choose to have this procedure done. Some men are worried this will affect their ability to orgasm or the way their orgasm feels, but that’s not the case. Even though the sperm cells are no longer being ejaculated, all other fluids are still there. Your semen will look, feel and taste exactly the same as before your surgery. It just won’t contain sperm anymore.

Tubal Ligation

Tubal Ligation is the female sterilization surgery. It’s also known as “getting your tubes tied”. Like the vasectomy, this procedure cuts of blocks off the Fallopian Tubes so your body can’t release an egg. This surgery is a little more complicated than a vasectomy, but it is still a very safe procedure. This surgery is almost 100% effective at preventing pregnancy. This method of birth control is meant to be permanent, so it’s unlikely you’d be able to get a vasectomy reversed. That’s why it’s important to be completely sure you don’t want to have children if you choose to have this procedure done. Women can also have their uterus removed, called a hysterectomy, which would obviously prevent pregnancy. But, this is usually performed because of medical problems, not as a form of birth control.

Men

Some people think that birth control is mostly the job of the women in the relationship, but that’s not true at all. It takes two to tango and we’re all responsible for our own health. Men do have many less birth control options than women, but they do have options. Of the methods above men can be an advocate for their own health by using any of these methods:

– Condoms

– Female Condoms

– Spermicide

– Withdrawal

– Abstinence

– Vasectomy

Most types of birth control are covered by insurance, but sometimes there are still hoops that need to be jumped through and other obstacles that prevent you from being able to get the birth control you want or need. Talk with your doctor about your options and what you think might be right for you. And if you’re having trouble getting your insurance to cover you birth control method, talk to your doctor about that too! They’ll be able to give you advice on your best options. If your health insurance doesn’t cover your birth control, or you don’t have insurance, or you can’t use it for some reason, there are options for that too. There are a few companies that can send you birth control pills for as little as $15 per month without health insurance. A few of the most common companies that provide this service are NURX, Pill Club, Twentyeight and Simple Health. For women who don’t have a primary gynecologist or any other reproductive health resources, Planned Parenthood is an amazing place to go. You can get advice, yearly exams, birth control, PAP Smears, abortions, STD testing, breast cancer screenings and so much more.

To learn more about birth control methods I recommend going to Planned Parenthood. They have extensive information on each of these methods. They also have a quiz to help you decide which method is best for you!

Planned Parenthood Birth Control Quiz

If you’d like to know where I got my information from, or you’d just like to learn more about birth control, you can check out my resources below.

Resources:

https://clinicaltrials.gov/ct2/show/NCT03633799

https://clinicaltrials.gov/ct2/show/NCT03785366

https://gimletmedia.com/shows/science-vs/94hw6a

https://www.healthline.com/health/birth-control-cervical-cap

https://www.mayoclinic.org/tests-procedures/combination-birth-control-pills/about/pac-20385282

https://www.mayoclinic.org/tests-procedures/minipill/about/pac-20388306

https://www.medicalnewstoday.com/articles/295727.php

https://www.nurx.com/birthcontrol

https://www.paragard.com/

https://www.plannedparenthood.org/learn/birth-control

https://www.simplehealth.com/birth-control

https://thepillclub.com/

https://twentyeighthealth.com/

https://www.webmd.com/sex/birth-control/default.htm

https://www.womenshealth.gov/