Know your birth control options to help you decide which is best for you

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Contraception continues to make headlines, such as the recent news in France that from next year contraception will be free for all women aged 25 and under. However, the various forms of birth control remain a confusing topic for many women.

Contraception is still widely used in the United States, with 64.9% of 72.2 million women ages 15 to 49 using some form of birth control, according to the CDC. It is easy to confuse with the many birth control options and which are the best, but it is important that everyone understands the different common types and determines which is better for each person.

Spirals

Intrauterine devices (IUDs) are currently the longest lasting reversible form of contraception. An IUD is a small “T” -shaped device that a doctor inserts into the uterus to prevent pregnancy. They can be fed with or without hormones.

For example, the two main types of IUDs are the copper IUD (without hormones) and the levonorgestrel IUD, which releases a small amount of a hormone called progestin each day to help prevent pregnancy. These devices can offer years of protection; the copper IUD could last up to 10 years and the levonorgestrel IUD could last up to 3-6 years.

According to the CDC, IUDs have some of the lowest pregnancy failure rates compared to other forms of reversible contraceptives and are removed by a provider when no longer desired or when it is to be replaced. Contrary to a TikTok trend of women removing their own IUDs, I don’t recommend removing an IUD without a healthcare doctor.

Birth control pills

Birth control pills are an easy form of birth control, but your medical history should be considered. Oral contraceptives or birth control pills are prescribed by a provider and must be taken daily to be fully effective. The type of pill that is best to use depends on a person’s medical history.

For example, the estrogen-progestin pill may not be recommended for someone who has smoked in the past, has blood clots, or has breast cancer. However, the progestin-only pill can be a good option for women who cannot take estrogen. Overall, it is necessary to discuss with a provider which form of the pill suits you better.

Hormonal contraceptives

Hormonal contraceptives can take many forms, including implants, injections, and patches. These contraceptives are given either with the hormone progestin or a combination of progestin and estrogen, either as an injection, as a patch on the skin, as a ring in the vagina or as an implant in the arm.

The implant is a very small flexible plastic rod that is placed under the skin of the upper arm by a doctor and can last for about three years, during which the doctor can remove or replace at the patient’s request. The injections, like the Depo-Provera syringe, are given every three months. The patch and ring are used for three weeks and removed on the fourth week to allow menstruation, similar to the pill.

Of these hormonal options, implants in the arm have the lowest failure rate, according to the CDC, but all are effective in reducing the chances of pregnancy.

Barrier methods

Some barrier methods provide protection that can help reduce your risk of sexually transmitted infections (STIs). Methods like male and female condoms are the only contraceptives that can help prevent STIs.

STIs like chlamydia and gonorrhea have hit all-time highs for the sixth year in a row, making these barrier methods invaluable when combined with other contraceptives. It is important that a diaphragm or cervical cap, both types of barrier methods, do not prevent STIs.

As we know, barrier methods are not foolproof and still carry the risk of developing an STI or becoming pregnant. However, it is recommended that condoms be used in addition to other forms of birth control to effectively protect against STIs.

“Tubular bandages” and vasectomy

“Tubular bandages” and vasectomy are the permanent forms of contraception. The most common method of contraception used by women in the US was female sterilization or “tube bandaging” at nearly 19%. This procedure is performed by a doctor in a hospital or outpatient surgery center. The method works immediately and women can usually resume normal activities within a few days.

The same goes for a vasectomy in men. After the operation, the man see a doctor to test his sperm count and make sure it has dropped to zero, which can take a few months. Both are safe, routine procedures with very high success rates in contraception.

Weighing the options

With a wide variety of birth control options, the key is to discuss the ideal options with a provider to determine which is the most convenient and safest for you. Taking into account medical history and preferences are important factors in deciding which option is best for you.

Alexis E. Carrington MD will be a resident dermatology in the Department of Dermatology at George Washington University. She completed her tentative year of internal medicine at the Mount Sinai Icahn School of Medicine Elmhurst Hospital Program in New York City as the COVID-19 pandemic set in. She is interested in ethnic and medical dermatology, underserved and global health dermatology, and dermatological surgery.



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