Birth Control: Which Option is Right for You?
Updated: Nov 17
We are fortunate today to have a plethora of options when it comes to birth control and family planning. Birth control can be an effective way to prevent pregnancy, but it is also used to treat other medical conditions. With so many options on the market, it can feel overwhelming to determine which method is the best choice for you. Let’s explore some of the options available from most effective to least effective methods and learn about factors to consider such as ease and frequency of use, hormonal changes and lifestyle fit.
Common Birth Control Options
Tubal Ligation: Permanent birth control solutions such as tubal ligation or bilateral salpingectomy are available options. With these options the fallopian tubes are either cut or removed and the egg can no longer travel to the uterus, ultimately preventing insemination. This surgical procedure can be completed using laparoscopy – a minimally invasive surgical technique where one or two small incisions are made in the abdomen. Tubal ligation is highly effective in preventing pregnancy, with only 1 in 100 women experiencing pregnancy following the procedure. As a permanent procedure, attempted reversals are not recommended as they may not be effective.
Intrauterine Device (IUD): IUDs are small T-shaped devices inserted inside the uterus to prevent insemination and pregnancy. There are two versions – copper and silicone – and while both are long term birth control options, they work in different ways. The copper IUD, ParaGard®, prevents conception by creating a toxic environment for sperm with the copper wrapped device. It has no hormones and lasts up to 10 years. Silicone IUDs, such as Mirena®, Kyleena® and Skyla, have low doses of a hormone called progestin. This helps to prevent pregnancy by thinning the uterine lining to inhibit sperm travel and partially suppressing ovulation through thickening cervical mucus. These IUDs last between three and five years.
Implantable Rod: A long-acting reversible contraception, the implantable rod is the size of a small matchstick inserted into your arm. It releases the hormone progestin which works to either thicken cervical mucus or thin the uterine lining. This birth control solution lasts up to five years. The rod needs to be removed by making a small incision in the arm in a provider’s office.
Hormone Injection: Administered every three months, the injection releases a dose of the progestin hormone. It works on the cervical mucus or uterine lining in the same way as the implantable rod or silicone IUD. However, the injection has a higher pregnancy rate at 6 out of 100 women.
Oral Contraceptives: Oral contraceptives come in two forms: “The Pill” or the “Mini Pill.” Both options must be taken daily, although the Mini Pill must be taken at the same time every day. The Pill is comprised of estrogen and progestin, while the Mini Pill has progestin only. Both forms have the same pregnancy prevention effectiveness rate of 9 out of 100 women becoming pregnant.
Vaginal Contraceptive Ring: A flexible plastic ring inserted into the vagina releases a combination of hormones to prevent pregnancy. Typically, the vaginal ring is inserted and left in for three weeks, then taken out for one week during menstruation. Prevention of pregnancy with this method is comparable to that of oral contraceptives.
Male or Female Condoms: Condoms are the only birth control method used to prevent pregnancy and sexually transmitted diseases or infections. Male and female condoms have been designed and should be used each time you have sex. Of the previous methods, this method is the least effective at preventing pregnancy with 18-21 pregnancies out of every 100 women.
Check out this comparison chart from beyondthepill.ucsf.edu
Non hormonal options or Fertility awareness methods: Fertility awareness is knowing and recognizing when the fertile time (when a woman can get pregnant) occurs during the menstrual cycle. If you are practicing fertility awareness as a birth control method to prevent pregnancy, you need to avoid having sexual intercourse during fertile time or use a barrier method of birth control.
Menstrual cycle tracking: This method requires you to be familiar with the timing of your cycle and works best if your cycle is regular and consistent every 26-32 days. Simply avoid intercourse or use barrier method contraception during the days you are fertile.
Cervical mucous: This method may take some practice to distinguish the qualities of the cervical mucus and how it changes over the month and during ovulation. During ovulation, cervical mucus will appear clear, stretchy and slippery - think raw egg white. You will also notice it is a little more abundant. If desiring fertility this is the time to have unprotected intercourse, and if not – well, this is the time to abstain or use barrier method.
Body Basal Temperature: This is your temperature during complete rest. There are several thermometers on the market and apps to go along with this. This will help you understand when you are ovulating, as there will be a slight rise in temperature.
Symptothermo Method (STM): This method uses a combination of basal body temperature and other signs and symptoms of ovulation.
Fertility tracking app: This is a convenient and easy way to track ovulation, menstrual cycles and help predict the best time to have intercourse or not to have intercourse. However, there are a few things to consider when using technology: accuracy with determining cycles and data privacy concerns.
If you decide using combined oral contraceptives is the right option for you, you may want to consider adding a nutritional supplement or replenishing these 6 nutrients that get depleted with long term use.
Folic acid – take the methylated version of folic acid
The right birth control option depends on individual needs, preferences, and lifestyle. For some, remembering to take a pill everyday may prove challenging and a long-term method that can be reversed at any time such as an IUD, might be a more desirable option. Regardless of the method you choose, it is important to talk with your health care provider about your options including risks, benefits, effectiveness, and lifestyle fit.
At The Chronic Pelvic Pain Center of Northern Virginia, Dr. Melissa Delgado is an SRC-accredited Surgeon of Excellence in Minimally Invasive Gynecology with Reston Hospital Center, recognized for adherence to meticulous standards in patient safety and care. Dr. Delgado specializes in women’s health care, including gynecologic care, pain management and surgical procedures. Learn more about what an SRC accreditation means for your care here.
Call The Chronic Pelvic Pain Center of Northern Virginia today at 517-261-6260 to discuss the best birth control option for you!