This article is written by Dr. Megan Wasson, gynecologist on Mayo Clinic’s Arizona campus.
There are many different options available to help prevent pregnancy. The most commonly known methods include condoms, birth control pills, and getting your tubes tied. However, several other choices are available. Each option has differences that can make it either the right or wrong choice for you.
In order to help decide what method is best for you, consider what your plans are for having children in the future, if you will remember to take a pill at the same time every day, or if you are ok with having a birth control device within your body. No decision is right or wrong. The best choice is the decision that is best for you.
Birth Control Pills
Birth control pills are not all the same. They come with different hormones (estrogen and progesterone or progesterone alone) and can affect your periods differently. Pills containing estrogen can increase your risk for blood clots in the legs and lungs and should not be used if you are more likely to develop these conditions.
Conventional birth control pills contain both estrogen and progesterone. The NuvaRing and OrthoEvra patch also contain these hormones and work similarly to conventional birth control pills. The advantage of the NuvaRing or OrthoEvra is that you don’t need to remember to take a pill every day. If you take birth control pills, the NuvaRing, or OrthoEvra in the conventional manner, you will have a period every month.
Alternatively, you can take birth control pills in a continuous manner. This means that you take a pill containing hormones every day. When using birth control pills continuously, you may not have any period, or may have if only four times a year.
An injection of progesterone (Depo-Provera) can also serve as an effective method of birth control. It lasts for 3 months. You need to visit a nurse every 3 months to continue receiving the injection. After stopping the Depo-Provera, it may take some time before your periods become normal and you are able to get pregnant.
Long-Acting Reversible Contraceptives
Long-acting reversible contraceptives (LARCs) provide you with effective birth control for several years. They are great options if you know you want to be pregnant eventually, but not anytime soon. LARCs don’t require you to take a pill every day and can easily be placed in your doctor’s office. When it is time for your LARC to be removed or you want to get pregnant, it can simply be removed in the office as well. You can get pregnant soon after removing your LARC.
Intrauterine devices (IUD) (Mirena, Skyla, Kyleena, Liletta, ParaGard) are “T” shaped and are inserted into the uterus. A pelvic exam is required for the placement of your IUD. The ParaGard is hormone free and effective for 10 years. The remaining IUDs have progesterone and are effective for 3-5 years. The progesterone can affect your period, often resulting in lighter and less painful bleeding.
A contraceptive implant (Nexplanon) can also be placed under the skin in your arm. This is effective for 3 years and does not require a pelvic exam. It contains progesterone and can cause your periods to become lighter.
Barrier Birth Control
Birth control that forms a barrier between the sperm and the uterus can also be used. These include male and female condoms and female diaphragms. These methods also help reduce the risk of getting a sexually transmitted infection. Barrier methods of birth control are less effective at preventing pregnancy than other methods and need to be used every time you have sex.
Natural Family Planning
Use of the rhythm method, checking your cervical mucus, and testing your temperature when your first wake up can be used to help predict when you ovulate. This is the time that you want to avoid unprotected sex if you don’t want to get pregnant. You can also use the withdrawal method, in which the man withdraws his penis from the vagina prior to ejaculation. Similar to barrier birth control, this method is not as effect as other methods of birth control.
When you know you don’t want the any possibility of pregnancy in the future, sterilization can be considered. For both women and men, a small surgery is required. For women, this can be performed by tubal ligation (tubes tied) or removal of the fallopian tubes (salpingectomy).
A device can also be placed through the uterus into the fallopian tubes causing the fallopian tubes to be blocked (Essure). This procedure does not require any abdominal incisions, but does require a test in radiology and alternative birth control for 3 months after the procedure.
For men, vasectomy is the only option for sterilization. During this procedure, the tubes that carry sperm into the semen are cut and sealed. A follow-up test is required after the procedure to make sure sperm are no longer in the semen.