Wednesday, July 5, 2017

Choosing the birth control method that’s right for you

Factors to consider when weighing your options

by Anne Vaillant, CNM

A generation ago, birth control options were pretty limited: condoms, the pill, and the rhythm method (abstaining from sex when you are at your most fertile). Today, there are a wide variety of options, but it’s important to find the one that will work the best for you and your lifestyle.


Consider This

Effectiveness: When estimating the effectiveness of the various forms of birth control, it’s important to remember that they are calculated assuming you are using the method as instructed. For the pill, this means you must take it every day at about the same time to maximize its effectiveness. Start skipping days or taking it erratically, and its effectiveness decreases. Other options require diligence once a week or once a month. Some require regular trips to your health care provider. This requires a level of commitment.

On the other hand, options like a condom allow you to only think about birth control when you really need it—right before sex—but because condoms can tear or come off, you may be sacrificing effectiveness for convenience.

Price: Depending on your insurance, some birth control options are more affordable than others. Many options require prescriptions, while some are available over-the-counter.

Convenience: Some methods of birth control, like implants, are effective for up to three years, and even longer with IUDs. Once you have them, you don’t have think about birth control for significant periods of time. However, if you aren’t interested in a long-term option, you may be more willing to put up with the inconvenience of, for example, getting the shot every three months.

“Ick” Factor: Some women are more squeamish than others. If you will feel uncomfortable inserting something far up in your vagina, options like the ring may not be for you. Also, some require the addition of a spermicide before insertion, which some women find messy.

Allergies/Sensitivities: If you have any allergies or sensitivities, it’s important to know what each birth control option contains. Latex allergies may rule out some of the most common type of condoms (they are available in latex-free varieties). Some women have reactions to spermicide; others find the patch gives them a rash. If you are prone to urinary tract infections, the diaphragm may increase your risk for more.

Side Effects: Many forms of birth control (such as the pill, patch and ring) contain hormones—typically estrogen and progestin—that can result in a range of side effects, including some that are short-term and some that aren’t. Some women tolerate progesterone better than estrogen, so an option like the injection, which contains progestin only, may be a better choice.

Side effects aren’t all bad; certain forms of birth control, like the pill, can reduce the frequency, heaviness and cramps of your period.

At A Glance

The chart below provides a brief synopsis of the most common types of birth control, comparing them based on the factors described above.

MethodEffectivenessFrequencyPrescriptionDo-It-YourselfEstrogen
IUD/Hormonal99%+5-7 yearsYesNoYes
Implant99%+Every 3 yearsYesNoNo
Vasectomy99%+Once/ permanentSurgeryNoNo
IUD/Copper99%10-12 yearsYesNoNo
Shot94-98%QuarterlyYesNoNo
Pill92-99%DailyYesYesYes
Patch92%WeeklyYesYesYes
Ring92%MonthlyYesYesYes
Diaphragm (w/spermicide)88%Every time you have sex (within 6 hours)YesYesNo
Male Condom82%Every time you have sexNoYesNo
Cervical Cap (w/spermicide)80%Every time you have sex (within 48 hours)YesYesNo
Female Condom79%Every time you have sexNoYesNo
Sponge (w/spermicide)76-88%Every time you have sex (within 24 hours)NoYesNo
Rhythm Method (or withdrawal)76-78%Every time you have sexNoYesNo

Talk to Your Healthcare Provider

Your OB/GYN or certified nurse-midwife can help you choose the birth control method that’s right for you. Let them know what factors are most important to you, and be honest about any concerns you have.

For example, let your provider know if you want long-term or short-term—or even permanent—protection against pregnancy, as some options are easier to reverse than others. If you also want protection from STDs, condoms are the only option that offers this, but they can be used in conjunction with other birth control options to boost their effectiveness for pregnancy prevention.

Often, short-term side effects resolve in a few months, but if you are experiencing side effects that you find intolerable or concerning, talk to your health care provider about what you are experiencing and discuss other options.

If you need guidance about birth control, schedule an appointment online or call us: 413-562-8016 for our Westfield office or 413-736-9978 for our Springfield office. We’ll be happy to talk with you about your options and find birth control method that’s best for you.