There are a lot of options when it comes to birth control. We get it; it can be a lot of work to figure out what works best for you. Your preferred option for birth control can be based on a variety of factors that impact your lifestyle (Do I want to think about it every day? Am I comfortable inserting something inside of my body? Am I allergic to latex? etc.). Please bear in mind that regardless of your gender, if you are sexually active, you should be thinking about what birth control option works well for both you and your partner(s). Also take note that although many contraceptive methods do a great job of preventing pregnancy, only condoms protect against STIs. Remember, your preferences may change over time and not everything may work for you/your body. As long as you are knowledgeable about your choices, you can always change your mind. That’s what options are for! For a quick overview, you can check out our summary cards at the bottom!
Let’s start with hormonal birth control options. What are they?
Today, there are numerous hormonal methods, including the Pill, Nexplanon, NuvaRing, the Patch (Ortho Evra), Depo-Provera, and intrauterine devices (IUDs). They work by preventing an egg from being released every month and thickening cervical mucus and thinning lining of uterus, thus inhibiting pregnancy by preventing sperm from entering your uterus. However, hormonal methods don’t protect against STIs. Also, if you’re taking progestin-only pills, it’s important to take the pill every day at the same time to maximize and ensure effectiveness!
Are there any non-hormonal methods of birth control?
If you like the benefits of the IUD, but are not comfortable with hormones, the non-hormonal (Copper) IUD might be the right option for you. The copper filament wrapped around the T prevents pregnancy by interfering with the sperm’s ability to reach the egg. Bear in mind, most people who use the Copper IUD tend to have heavier periods, especially for the first few months. You can also consider barrier methods a non-hormonal birth control alternative.
What are barrier methods?
“Barrier method” options include a cervical cap, diaphragm, sponge, and internal or external condom. Out of all the types of contraceptives, the external condom is the most commonly used, as it offers protection against both STIs and unwanted pregnancy. Internal condoms offer protection against STIs as well. For safety reasons, make sure you use a new condom each time you have sex — and be sure to check the expiration date!
“But condoms don’t feel as good.”
STIs don’t feel too great either. The greatest pleasure comes from peace of mind. If your partner is reluctant to use condoms, have a conversation, and be clear about your concerns. It’s your sex life, meaning you get to choose when, where, and how you want to have sex. If you are the partner that prefers not to wear condoms due to a feeling of decreased pleasure or comfort, consider trying out different kinds of condoms for fit and feel. Condoms come in a variety of sizes; if it feels too tight or loose, you might just need a different size! You can also add a drop of lube in the tip of the condom before rolling it on to increase sensation (but not oil-based lube, as it degrades latex). Last tip: practicing masturbation with a condom on can help you get used to the feeling!
What about sterilization?
Sterilization methods prevent pregnancy by blocking the reproductive function in men or women. They’re grouped into two categories: tubal ligation and vasectomy. Tubal ligation is a surgical procedure in which the fallopian tubes are clamped or severed, preventing eggs from reaching the uterus for implantation. A vasectomy consists of tying off and cutting the tubes that transport sperm. Both types are permanent and offer more than 99% protection against pregnancy (but none against STIs).
Is natural family planning a real thing?
Although not a pill or device, natural family planning is still a contraceptive method. Natural family planning is based on knowing the female partner’s menstrual cycle so couples can avoid having sex during times of fertility. There are different ways to determine one’s most fertile time, including the calendar, basal body temperature, and cervical mucus methods- keep in mind that higher protection rates occur when all three methods are used in combination. The effectiveness of this type of contraception varies because most people with a period don’t have a perfectly regular menstrual cycle. Natural family planning also does not protect against STIs (sensing a theme here?).
Does the pull out method actually work?
“Don’t worry; I’ll just pull out.” The withdrawal/pull out/coitus interruptus method is when a male partner withdraws their penis from the vagina prior to ejaculation. Fun fact: about 35 million couples around the world rely on the withdrawal method. Wow! So, is it effective? If always done correctly, of every 100 women whose partners use withdrawal, 4 will become pregnant each year. Conversely, if not always done correctly (we are human after all), of every 100 women whose partners use withdrawal, 27 will become pregnant each year. While a convenient option, the withdrawal method requires a lot of experience, self-control, and trust. The partner with a penis must really know their sexual cycle, and be able to exhibit maximized control. The withdrawal method is not recommended for individuals who experience premature ejaculation. It is also important to note that pregnancy can still occur if semen or pre-ejaculate/pre-cum is spilled on the vulva. The science on whether pre-cum can cause pregnancy is inconclusive, but studies suggest that it might, so it is at least worth acknowledging. Did we mention this method also doesn’t protect against STIs? (condoms for the win).
How does emergency contraception work?
Soooooo you’ve already had sex without birth control, or perhaps the condom broke. First of all, relax! Now is not the time to panic. If you are still within a 120 hour (5 day) window, you can take emergency contraception, colloquially known as the “morning-after pill,” to prevent pregnancy. Plan B is One-Step is the most well-known form of emergency contraception; you can get it at most drugstores or online. It is 95% effective within the first 24 hours, or about an 88% effective rate, on average, within 72 hours. Ella, also a pill, is 93-95% effective within 5 days. Ella requires a prescription from a doctor because it contains something called ulipristal acetate, which suppresses your body from producing progesterone, thereby delaying ovulation for up to 5 days (allowing sperm enough time to die before an egg is released). You can also get the copper (or non-hormonal) IUD inserted, which lowers your chances of getting pregnant by more than 99.9% if done within 5 days of unprotected sex. The copper IUD is the most effective form of emergency contraception, and can be left in for up to 12 years to help prevent future unwanted pregnancies. It is free under most insurance plans and Medicaid. Please read this Planned Parenthood article for more information on emergency contraception. If you have had unprotected sex, it is also wise to get tested for STIs, but not right away (different STIs can be detected in tests after different time periods after exposure to an infected partner). P.S. Emergency contraception is not the same thing as abortion, as it works before pregnancy begins. This is common misconception to be aware of.
What if I don’t want to use contraception?
Abstinence, the practice of voluntarily refraining from sexual activity, is the only way to enjoy 100% protection from both STIs and pregnancy. Abstinence, by the way, is a completely fair choice (whether you have been sexually active before or not)! Remember, there are other ways to enjoy physical pleasure, including masturbation (with or without a partner), kissing, massages, etc.! Never let anyone pressure you into something you don’t want to do.
Knowledge, confidence, and communication are the key ingredients to delicious, safe sex. If you’re going to engage in sexual activity, take control of your sexual health and future by using birth control to prevent unintended pregnancies and STIs. With the peace of mind, you will enjoy sex a whole lot more!
Finding the right birth control option for you can take time. What works for your friend might not work the same for you; that’s okay! Discuss your options with your doctor, and use these handy summary cards to help you think about what might work best for you. And don’t forget, condoms are the best (and only, besides abstinence) method to protect against STIs!