One size does NOT fit all: features to consider when choosing your birth control

We are lucky to have so many birth control options available to us. Not all methods will be ideal for all couples, so how do you figure out how to pick a method? Here are some features to consider – but keep in mind that not all features will be important to you in your personal circumstances.

Effectiveness: How well will a particular approach work to prevent pregnancy?

There are some times in life where avoiding pregnancy is more important than other times, so most effective forms should be selected when it is critical to prevent pregnancy.

There are two scales of effectiveness, typical user effectiveness and perfect use rates. Some birth control depends a lot on user attention, such as oral contraceptives that require taking daily. Since there is room for error, the difference between typical user effectiveness and perfect use rates is more than with a method, such as IUD (intrauterine device), that does not need much attention.

Modern contraception is highly effective. Among American women at risk for unintended pregnancy, the 65% who use a contraceptive method consistently and correctly account for only 5% of unintended pregnancies. The 19% who use a method inconsistently account for 43%, and the 16% who do not use a method at all account for 52% (source).

Convenience: How easy is it to get and use this birth control?

As mentioned above, some methods need attention every day and other approaches need less attention. Some need to be used at the time of intercourse and you may object to having to interrupt sex to use birth control at the time.

A clinic visit is needed to obtain some methods and a trip to the drug store without a prescription is needed for others. Do you want permanent birth control or one that allows for pregnancy in the future? Is your birth control private or can others tell you are using it? A patch can be placed where it does not show except when unclothed. A birth control implant may be seen in the upper arm, especially in a slender woman. Some men may be able to feel the string of an IUD.

Expense: How much will it cost to use this birth control?

Expenses may depend on your health coverage and prescription benefit. For drug store methods such as spermicides and condoms, cost will depend on how often you have sex. There are some long acting reversible contraceptives (LARC for short) that may be expensive to start with but will be reasonably priced if used for the entire time they are effective. New birth control implants are effective for three years and IUDs are effective for five to ten years depending on type.

Health risks: Are there any health risks associated with using this birth control?

Your personal and family medical history should be reviewed carefully when picking a birth control method. Some personal habits, such as smoking, may make some methods more risky than others. This is a good reason to stop smoking!

Health benefits: Are there any health benefits to using this birth control?

Some hormonal methods make changes in menstrual patterns that may be helpful for women with heavy or painful periods. Use of oral contraceptives can help reduce the risk for uterine and ovarian cancer. Anemia and acne can be improved with some hormonal birth control.

Sexually transmitted disease: Do any methods help reduce the chance of getting STDs?

Latex and polyurethane male condoms and the female condom, when used correctly and consistently, may reduce the chance of getting sexual infections. The natural skin condoms do not work for STD risk reduction and the use of vaginal spermicides may increase the risk of getting HIV.

Partner involvement: How can my partner be involved in birth control?

Your partner may elect to have a vasectomy or use male condoms. In addition, he can help you remember to take your pill, change your patch or he can insert your vaginal birth control such as spermicide, diaphragm or ring. He can check IUD strings and help with non-intercourse sexual expression if you use natural family planning and avoid intercourse for some time in your cycle. Though less effective than other methods, he can use withdrawal.

Talk to your provider if you have questions about your birth control. If you would like to schedule a consultation to discuss birth control, you can call the Obstetrics and Gynecology department at Minor and James at 206-292-2200.