Birth Control

There are many different types of birth control you can use based on your needs and preferences. Talk to your partner(s) and your doctor to find out which might work best for you. Read all about the different methods people commonly use.

Diaphragm

A diaphragm is a shallow silicone dome that is inserted into the vagina and covers the cervix. It is used in combination with spermicide, which lowers the mobility of the sperm in addition to physically covering the cervix. This prevents the sperm from ever joining with the egg. Diaphragms are non-hormonal but do require an exam and a prescription.

Effectiveness: If used correctly, the diaphragm has a 94% effectiveness against pregnancy. Typical use has an 88% effectiveness.

Cost:

  • Examination: $0 to $200
  • Diaphragm: $0 to $75
  • Spermicide: $0 to $17 a kit

Lasts: Up to two years.

Pros:

  • Does not affect natural hormones
  • Can be inserted hours before sex
  • Cannot be felt by either partner in most cases
  • Effects are immediate and reversible

Cons:

  • Does not protect against sexually transmitted infections
  • Difficult for some people to insert
  • Spermicide may irritate some users
  • Cannot be used by people who recently had surgery on their cervix or an abortion after the first trimester
  • Must stay in for six hours after intercourse
  • Requires a prescription

External Condoms

External condoms, often referred to as “male condoms” or simply “condoms,” are a barrier form of birth control used by placing a sheet of latex or plastic over the penis before penetration. They are the most common type of birth control and come in a wide variety of sizes, textures, and colors. They can come lubricated, unlubricated, or with spermicide.

Effectiveness: If used correctly, the external condom has a 98% effectiveness against pregnancy. Typical use has an 82% effectiveness against pregnancy.

Cost:

  • Condoms: $0 to $2 each

Lasts: One use

Pros:

  • Protects against pregnancy and sexually transmitted infections
  • Does not affect natural hormones
  • Easily accessible
  • Effects are immediate and reversible
  • Certain textures can add to one or both partners’ pleasure

Cons:

  • Cost can add up
  • Some people believe condoms dull their sexual sensations
  • Some people have latex allergies or sensitivities which makes it difficult to find alternatives
  • Sizing issues are common

Implant

The birth control implant is a matchstick-sized plastic rod inserted into the arm that releases progestin hormones that keep eggs in the ovaries and makes the mucus in the cervix thicker, both of which prevent the sperm from meeting with the egg.

Effectiveness: The implant has a 99% effectiveness against pregnancy.

Cost:

  • Implant: $0 to $800
  • Removal: $0 to $300

Lasts: Up to three years

Pros:

  • Can be used by people who cannot take estrogen
  • No need to remember to do anything before sex
  • Does not affect sensations during sex
  • Effects are long-term and reversible
  • Some people may have lighter periods

Cons:

  • Does not protect against sexually transmitted infections
  • Must be inserted by a medical professional
  • Cannot be used by people with breast cancer
  • Some people may have heavier periods

Injection

The birth control injection is a shot into that arm that releases progestin hormones that keep eggs in the ovaries and makes the mucus in the cervix thicker, both of which prevent the sperm from meeting with the egg.

Effectiveness: The injection has a 99% effectiveness against pregnancy when used regularly. It has a 94% effectiveness rating against pregnancy if not used regularly.

Cost:

  • Exam: $0 to $250
  • Injection: $0 to $150

Lasts: 12 weeks

Pros:

  • Can be used by people who cannot take estrogen
  • No need to remember to do anything before sex
  • Does not affect sensations during sex
  • Effects are somewhat long-term
  • Some people may have lighter periods

Cons:

  • Does not protect against sexually transmitted infections
  • Must be injected by a medical professional
  • Cannot be used by people with breast cancer
  • Some people may have heavier periods
  • Not reversible until the shot wears off in 12 weeks
  • May change sex drive
  • May cause weight gain
  • May contribute to depression

Internal Condoms

An internal condom, or “female condom” (we would like to avoid gendering this method as not all users of it may identify as female) is a plastic pouch that has two rings on each side. One ring is squeezed and inserted into the vagina while the other remains on the outside of the vagina. Like an external condom, it collects sperm, which prevents it from meeting with the egg and causing pregnancy. It also protects against sexually transmitted infections.

Effectiveness: If used correctly, the internal condom has a 95% effectiveness against pregnancy. If used incorrectly, it has a 79% effectiveness against pregnancy.

Cost:

  • Condom: $0 to $4 each

Lasts: One use

Pros:

  • Protects against pregnancy and sexually transmitted infections
  • Does not affect with the body’s natural hormones
  • Can be used by people with latex allergies
  • Do not require a prescription

Cons:

  • May be difficult or uncomfortable for some people to insert
  • May slip into the vagina or anus
  • May dull sexual sensations

IUD

An IUD is an “intrauterine device”, a t-shaped medical device that is inserted into the uterus. An IUD can contain copper, such as the ParaGard, or it can be hormonal, such as Mirena or Skyla. All three are long-term forms of birth control but don’t protect against sexually transmitted infections. If you’re considering an IUD, check out my article on my IUD insertion.

Effectiveness: The IUD has a 99% effectiveness against pregnancy. It can also be inserted up to 120 hours (five days) after sex to prevent pregnancy as emergency contraception.

Cost:

  • Exam, IUD, and insertion: $0 to $1,000

Lasts:

  • ParaGard: 12 years
  • Miera: 5 years
  • Skyla: 3 years

Pros:

  • Very long term (3-12 years)
  • No need to remember to do anything before sex
  • Does not affect sensations during sex
  • Some people may have lighter periods
  • Reversible and the ability to become pregnant returns after removal

Cons:

  • Does not protect against sexually transmitted infections
  • Must be inserted by a medical professional
  • Some people may have heavier periods
  • Mild to moderate pain after insertion
  • Increased risk for ectopic pregnancy
  • Irregular bleeding or spotting
  • Can be expensive out of pocket

Oral Contraceptive

The birth control pill, or oral conceptive, releases estrogen and/or progestin hormones that keep eggs in the ovaries and makes the mucus in the cervix thicker, both of which prevent the sperm from meeting with the egg.

Effectiveness: The pill has a 99% effectiveness against pregnancy when used regularly. It has a 91% effectiveness rating against pregnancy if not used regularly.

Cost:

  • Exam: $0 to $250
  • Pills: $0 to $150/month

Lasts: Must be taken daily

Pros:

  • Progestin pills may be used by people who cannot take estrogen
  • Does not affect sensations during sex
  • Effects are somewhat long-term
  • Some people may have lighter periods
  • Some people may get their periods less often

Cons:

  • Does not protect against sexually transmitted infections
  • Requires a prescription
  • Cost can be high out of pocket
  • Requires the person to remember a daily pill
  • Some people may have heavier periods
  • May change sex drive
  • May cause weight gain
  • May contribute to depression
  • Certain factors such as age, smoking, weight, and blood pressure can also post additional risks to your health. Talk to a professional during your exam about these options

Patch

The birth control patch works by sticking to the skin and releasing estrogen and progestin which keep eggs in the ovaries and makes cervical mucus thicker, both of which prevent pregnancy.

Effectiveness: The patch has a 99% effectiveness against pregnancy when used regularly. It has a 91% effectiveness rating against pregnancy if not used regularly.

Cost:

  • Exam: $0 to $80/month

Lasts: Must be used daily

Pros:

  • Does not affect sensations during sex
  • No need to take action right before sex
  • Some people may have lighter periods
  • Some people may get their periods less often
  • Some people may have less acne

Cons:

  • Does not protect against sexually transmitted infections
  • Requires a prescription
  • Cost can be high out of pocket
  • Patch may fall off
  • Requires the person to remember a daily/weekly patch
  • Some people may have heavier periods
  • May change sex drive
  • May cause weight gain
  • May contribute to depression
  • Certain factors such as age, smoking, weight, and blood pressure can also post additional risks to your health. Talk to a professional during your exam about these options

Sponge

The birth control sponge is a foam sponge that contains spermicide and is inserted into the vagina and blocks the cervix and releases spermicide that lowers the mobility of sperm, making it harder to each the egg.

Effectiveness: 76-88% effective with people who always use it as directed (88% if not always used as directed) if the person has never given birth. 80% effective if always used as directed (76% effective when not always used as directed) if the person has given birth.

Cost:

  • $0 to $15 for pack of three

Lasts: One per use

Pros:

  • Does not affect natural hormones
  • Can be inserted hours before sex (do not leave in for more than 30 hours)
  • Cannot be felt by either partner in most cases
  • Effects are immediate and reversible
  • Can be used while breastfeeding
  • Does not require prescription

Cons:

  • Does not protect against sexually transmitted infections
  • Difficult for some people to insert
  • Spermicide may irritate some users
  • Cannot be used by people who recently had surgery on their cervix or an abortion after the first trimester
  • Cannot be used while menstruating

Sterilization

Sterilization prevents eggs from being released from the ovaries, which prevents pregnancy. This can be done by several methods, from cutting and tying the tubes, to removing a piece of them, to using a ring or clamp to block the eggs from being released. Talk to your doctor about which options work for you.

Effectiveness: Sterilization is meant to be a permanent form for birth control. Only 3-5 out of 1,000 people will get pregnant after sterilization.

Cost:

  • $0-$6,000

Lasts: Long-term/permanent

Pros:

  • Does not affect hormones
  • Does not affect sensations during sex
  • Effects are long-term
  • Very effective
  • No need to remember a daily pill, etc

Cons:

  • Does not protect against sexually transmitted infections
  • Serious medical procedure
  • Cost can be high out of pocket
  • Most people continue to have periods
  • Important life-long decision

Vasectomy

A vasectomy prevents sperm from being released during ejaculation, which prevents pregnancy. This can be done by sealing the vasa deferentia, the tubes that carry sperm from the testicles to make semen. Without sperm, ejaculate does not cause pregnancy.

Effectiveness: Sterilization is meant to be a permanent form for birth control. Only 1 out of 1,000 people will get pregnant after their partner has a vasectomy.

Cost:

  • $0-$1,000

Lasts: Long-term/permanent

Pros:

  • Does not affect hormones
  • Does not affect sensations during sex
  • Effects are long-term
  • Very effective
  • No need to remember a daily pill, etc

Cons:

  • Does not protect against sexually transmitted infections
  • Cost can be high out of pocket
  • Important life-long decision

Vaginal Ring

The vaginal ring is a flexible ring that is placed inside of the vagina for three weeks at a time, taken out for a week, and then replaced with a new ring. Like the birth control pill and patch, it releases estrogen and progestin, which are hormones that can prevent pregnancy.

Effectiveness: The vaginal ring has a 99% effectiveness against pregnancy when used regularly. It has a 91% effectiveness rating against pregnancy if not used regularly.

Cost:

  • Exam: $0 to $250
  • Ring: $0 to $80/month.

Lasts: One month

Pros:

  • Does not affect sensations during sex
  • Effects are somewhat long-term
  • Some people may have lighter periods
  • Can be used to eliminate the need for a period

Cons:

  • Does not protect against sexually transmitted infections
  • Requires a prescription
  • Cost can be high out of pocket
  • Spotting in between periods
  • Some people may have heavier periods
  • May change sex drive
  • May cause weight gain
  • May contribute to depression
  • Certain factors such as age, smoking, weight, and blood pressure can also post additional risks to your health. Talk to a professional during your exam about these options

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