Also known as contraception, birth control methods work in a number of different ways, and your provider can help you decide which one is right for you. It’s important to remember that there is no perfect method for everyone—that’s why there are so many options. Let’s explore several types.
Hormonal Birth Control
Birth Control Pills
What are birth control pills?
Birth control pills are a type of contraceptive taken by mouth to prevent pregnancy. There are two main kinds of birth control pills: combination birth control pills (or COCs) and progestin-only pills (or minipills).
Combination birth control pills contain both estrogen and progestin, whereas the minipill contains only progestin. Your health provider may recommend the minipill if you are avoiding estrogen for health or other reasons, such as having a history of high blood pressure or are breastfeeding.
How do birth control pills work?
Hormones in the pills work to prevent pregnancy by
- Stopping or reducing ovulation, which means there’s no egg for the sperm to fertilize
- Thickening cervical mucus (and making it stickier) to keep sperm from entering the uterus
- Thinning the uterine lining, so a fertilized egg is less likely to attach
When taken correctly and on time, the pill is a safe and highly effective method for preventing pregnancy. Like all birth control methods, there are pros and cons to each type of pill. There’s no “best” birth control pill; there are many options available, with varying levels and types of hormones.
Birth Control Patches
What are birth control patches?
Transdermal contraceptive patches, known as “birth control patches” or simply “the patch,” contain estrogen and progestin. Patches are placed on the skin to avoid becoming pregnant. Users change the patch once a week for three weeks. In the fourth week, users don’t wear a patch. That’s when you get your period.
How do birth control patches work?
The patch works by releasing hormones into your bloodstream that prevent your ovaries from releasing an egg. And these same hormones thicken your cervical mucus to keep sperm from reaching an egg.
One advantage of the patch is its convenience. The patch does not require daily attention, and it can be removed at any time. It is important to note, however, that the patch is less effective in obese women.
What are vaginal rings?
Commonly known as “the ring,” a birth control ring is a small plastic ring that you place inside your vagina for 21 days and remove for 7 days to allow for menstrual bleeding.
How do vaginal rings work?
To prevent pregnancy, the ring releases estrogen and progestin, which stop your ovaries from releasing an egg and thicken the fluid around the cervix to prevent sperm from getting to the egg. The hormones get absorbed into your body through your vaginal lining.
Similar to birth control patches, vaginal rings do not require daily care, and you can stop using the ring at any time if you want to resume fertility.
Long-Acting Reversible Contraception (LARCs)
If your life is crazy-busy or you’re not good at remembering to do something at the same time every day, like taking a vitamin or pill, long-acting reversible contraceptives, or LARCs, may be a great option for you. LARCs are easy to use, safe, long-lasting, and quickly reversible. And as an added bonus, some LARCs also help with menstrual bleeding, either making it lighter or disappear altogether. There are three types of LARCs currently on the market: implants, injections, and intrauterine devices (IUDs).
What are implants?
A birth control implant is a tiny rod inserted into your arm.
How do implants work?
The rod releases progestin, which stops the release of an egg from your ovary to prevent pregnancy. The rod also thickens your cervical mucus and changes the lining of your uterus.
Like IUDs, they do not require daily maintenance and can last up to 3 years.
Birth Control Shots
What are birth control shots?
The birth control shot is a hormonal contraceptive injection that releases progestin to prevent pregnancy. The shot can be given in your shoulder, abdomen, thigh or buttocks, depending on the formula.
How do birth control shots work?
The hormone progestin prevents ovulation (no release of the egg means no pregnancy). Progestin also makes the cervical mucus thicker, so sperm have a harder time entering the uterus to reach any eggs that may have been released. Progestin makes the uterine lining thinner to make it more difficult for the egg to attach to the wall of the uterus.
One injection can provide pregnancy protection lasting 30 days to 12 weeks. Shots are administered every 12–13 weeks (every 3 months or 4 times each year).
Intrauterine Devices (IUDs)
What are IUDs?
IUD stands for intrauterine device. Shaped like a “T,” an IUD is a small piece of flexible plastic placed inside the uterus to prevent pregnancy. There are two types of IUDs: hormonal IUDs, which slowly release progestin locally and can ease menstrual pain and heavy bleeding over time, and copper IUDs, which do not include hormones but can last up to 10 years.
How do IUDs work?
Both types of IUDs (hormonal and copper) make it difficult for sperm to reach an egg. IUDs are long-lasting and can work for 3-10 years, depending on the brand you choose.
IUDs typically require a consultation with your provider to explore whether an IUD is right for you and, if so, which makes the most sense, given your personal health history. If you decide to move forward with an IUD, a follow-up appointment may be required for insertion. The insertion process itself can feel comfortable, and you may have cramps and spotting afterward until your body gets used to the IUD. Typically, once an IUD is inserted, no maintenance is needed for the duration of its use.
What are barrier methods?
Barrier birth control methods are worn during sex to stop sperm from getting to the egg. They do not use hormones and do not affect your menstrual cycle. The barrier methods are most effective when used with a spermicide or sperm-killing substance. There are several types of barrier methods:
- A diaphragm is a shallow silicone cup inserted into the vagina that covers your cervix to prevent sperm from passing through.
- Similar to a diaphragm, a cervical cap is a small plastic dome that attaches to the cervix through suction and blocks sperm from entering the cervix.
- The contraceptive sponge is a thick, round device made of polyurethane foam that fits against your cervix.
- A female condom is a pouch that lines the vagina and is held in place with two rings.
- A male condom is a thin sheath worn over the penis during sex.
How do barrier methods work?
Barrier methods physically block or otherwise prevent sperm from reaching the egg for fertilization. Barrier methods work best when they are used properly every time you have sex.
Only condoms, which can be worn inside or outside the body, protect against sexually transmitted infections (STIs).
What is emergency contraception?
Emergency contraception (EC) reduces the chance of pregnancy after unprotected sex. When used within 5 days of unprotected sex, emergency contraception (EC) is effective. However, the sooner it is used, the better. Emergency contraception options include contraceptive pills (ECPs), commonly known as the morning-after-pill and copper-bearing IUDs.
How does emergency contraception work?
Emergency contraceptive pills prevent pregnancy by preventing ovulation (when your ovaries release an egg that can be fertilized by sperm). The copper-bearing IUD works by preventing sperm from reaching and fertilizing the egg.
Reach out to your provider as soon as possible if you need emergency contraception.
Permanent Birth Control Solutions
The methods described above are reversible or non-permanent types of contraception. Men and women have options when it comes to having permanent procedures to prevent pregnancy.
Female sterilization is a surgical procedure called tubal ligation or tubal removal (salpingectomy). During this minimally invasive surgery, the fallopian tubes are cut, tied, blocked, or removed to stop an egg from moving through the tubes to meet sperm. These procedures are generally performed under general anesthesia. Patients can typically return home several hours after the procedure.
Choosing a Birth Control Method
The important thing to know about contraception is that there’s no right way—only what’s right for you. Factors to consider when choosing a birth control method include
- type and frequency of side effects
- whether or not it protects against STIs