March 7, 2022
By Ella Ishaaya, Drexel University College of Medicine
Birth control is an important decision that is often accompanied by many questions. There are several options available, each with risks and benefits. Thus, it is important to know all information in order to choose which method is best for you.
The first class of birth control involves immediate use before and during sexual activity. They work by forming a “barrier” to prevent sperm from reaching the egg and options include condoms, diaphragms, spermicide and cervical caps. Condoms are the only form of birth control that offers some protection from sexually transmitted infections and are available over the counter; however, according to Healthline, they are 85-95% effective in preventing pregnancy and need to be used correctly.
The second class of birth control consists of short-acting hormonal contraception. They all work by altering estrogen and/or progestin levels to reduce likelihood of pregnancy. The pill (combined or progestin only) must be taken every day and is 91% effective with perfect use, according to Planned Parenthood. It can also help regulate periods and has been shown to reduce cramping and pain associated with menstruation. The patch (Xulane, Twirla) must be replaced weekly and is 91% effective with perfect use (Planned Parenthood). The vaginal ring (Nuvaring) must be replaced monthly and is 91% effective with perfect use (Planned Parenthood). Finally, the shot (Depo-provera), which contains only progesterone, requires a doctor’s appointment every three months and is 94% effective with perfect use (Planned Parenthood). Side effects may include headache, nausea, breast tenderness, mood changes, changes in libido, blood clots, spotting or changes in menstruation.
The third class of birth control is termed long-acting contraception (LARC). Unlike previously described methods, LARCs remain in place for years at a time, eliminating the need to remember to take a pill or schedule a monthly appointment for a shot. They are also 99% effective at preventing pregnancy (Planned Parenthood). The implant (Nexplanon) is a plastic rod that is inserted in the upper arm that releases progestin systemically. It lasts for three years but can be removed at any time; some potential side effects can include changes in menstrual patterns, weight gain, acne, breast tenderness, headaches and digestive problems. The hormonal intrauterine device (IUD; Skyla, Mirena, Kyleena) is placed in the uterus by a health care provider and releases the hormone progestin. It lasts for three to five years but can be removed at any time prior to that. Side effects could include spotting, headaches, breast tenderness, mood changes and nausea. The copper IUD (Paraguard) is also placed in the uterus by a health care provider but is a non-hormonal option. It works by releasing copper ions, which block fertilization and implantation of the egg. Since the copper IUD does not have hormones, you will continue to menstruate. Side effects may include heavier, painful periods. The copper IUD can stay in place for up to 10 years and can be removed at any time prior to that. All IUDs carry a very small risk for pelvic inflammatory disease and ectopic pregnancy.
Should you desire a permanent form of birth control, ask your doctor about tubal ligation or vasectomy. Tubal ligation involves cutting the fallopian tubes, permanently eliminating any chance of fertilization. Although very rare, there is risk for ectopic pregnancy. Vasectomy is a procedure that involves cutting or tying the vas deferens, which carries sperm from the testicles. Risks include minor bleeding and infection. These procedures are not meant to be reversible. Thus, serious thought about whether you want children in the future is required prior to consenting to the procedure.