The ABCs of Birth Control: Everything You Need to Know

Birth control has been a hot topic in the U.S. for years. As often as new forms of birth control are invented and sent to market, new laws are created that attempt to make birth control less accessible. As the female body continues to be a political battleground, women need to be aware of the options that are available to them as well as how different forms of birth control can affect the emotional, mental, and physical health of your body.

Every woman has the right to comprehensive information about what she is putting into her body, as well as the ability to access birth control should she decide that she wants it. Read on to explore what birth control is, the different forms of birth control available in 2018, and the side effects and efficacy of each type.

How Does Birth Control Work?

Put simply, birth control works by either stopping ovulation or preventing the sperm from meeting the egg. Of course, each type of birth control works a bit differently, depending on the hormones (or lack thereof) involved. Let’s take a look at each type of birth control available to learn how they work.

Birth control isn’t just used for preventing pregnancy. In fact, the National Survey of Family Growth found that only 42 percent of women use the Pill for pregnancy prevention alone. Some women choose to take birth control to combat heavy or painful periods or to control endometriosis and acne.

What Types of Birth Control are Available in 2018?

There are several types of birth control methods, all with varying options: combination birth control, progestin-only birth control, permanent birth control, non-hormonal birth control methods, and barrier methods. Which you choose will depend on your goals.

What are my short-term birth control options?

Using short-term birth control requires you to play an active role in taking it, to ensure its efficacy. All of the options are only effective if you take them as scheduled. Here, we define short-term birth control as any method that lasts for up to five years.

Combination birth control methods

Combination birth control options, which contain estrogen and progesterone, are the most common type of birth control. These methods include the Pill, the Ring, and the Patch. If you start combination birth control within five days of the start of your period, you’ll be protected against pregnancy immediately. If you start it any other time, you won’t be protected against pregnancy until you’ve been using the birth control for seven days. It’s also important to note that you can get pregnant as soon as you stop taking combination birth control.

  • The Combination Pill: The Combination Pill is an oral contraceptive that is taken daily, ideally at the same time each day. This birth control prevents ovulation. A pack of pills contains three weeks of active pills and one week of placebo pills (which you take while on your period). Some women choose to skip the placebo pills to avoid having a period but this isn’t always the best idea.
  • The Ring: The Ring, also known as the NuvaRing, is a flexible, plastic ring that you insert into your vagina. It releases estrogen and progestin for three weeks and then remove it for one week to allow menstruation. This method also prevents pregnancy by stopping ovulation.
  • The Patch: Changed weekly, the Patch releases estrogen and progestin into the bloodstream to prevent ovulation.

These forms of birth control all work by releasing estrogen and progestin hormones to prevent ovulation. When ovulation doesn’t occur (or an egg is not released from your ovaries) there is nothing for sperm to fertilize, so you won’t get pregnant. All combination birth controls are 99.7–99.9 percent effective if taken perfectly. But, let’s be real, most women forget to take their birth control sometimes. Planned Parenthood points out that “real life” use—meaning you sometimes forget to take the Pill—makes this form of birth control 92 percent effective.

What are the benefits of taking the Combination Pill?

Birth control methods that contain estrogen and progesterone have ample benefits, including:

  • Less painful menstrual cramps
  • Lighter periods
  • Reduced risk of ectopic pregnancy
  • Reduced acne breakouts
  • Prevention of bone loss
  • Prevention of ovarian cysts
  • Lowered risk of endometrial and ovarian cancers
  • Prevent iron deficiency
  • Fewer PMS symptoms

What are the side effects of taking combination birth control?

All methods of birth control contain some amount of risk to your health. You and your doctor should have an honest conversation about the risks and side effects of taking any method of birth control you’re considering. Some of the common side effects of taking the Combination Pill include:

  • Breakthrough spotting or bleeding
  • Breast tenderness
  • Elevated blood pressure
  • Headaches
  • Nausea
  • Bloating
  • Weight gain (this is only true for the Shot — studies have shown that other combination hormonal birth controls do not cause weight gain.)

More serious side effects include:

  • Blood clots in the legs
  • Heart attack and stroke (especially if you smoke)
  • Liver disorders
  • Gallbladder disease
  • Abdominal pain
  • Chest pain
  • Depression
  • Severe mood swings
  • Eye problems
  • Fainting
  • Seizures

Though most of these serious side effects are rare, many women find that the added hormones from combination birth control can affect their mood and worsen depression and anxiety.

Progestin-only birth control methods

Just as with combination birth control, there are several birth control methods that only contain one hormone: progestin. The release of progestin into the body causes the cervical mucus to thicken, which prevents sperm from making its way to any eggs released by the ovaries and prevents ovulation.

Progestin-only birth control methods include:

  • The Progestin-only pill — Also known as the mini-pill, this form of birth control is also a once-daily contraceptive. It is 99.5% effective with perfect use and 90% effective with typical use.
  • The Depo Shot — This hormonal injection is given by your doctor or a nurse every 12 weeks. It contains progestin and stops your ovaries from releasing an egg. Its efficacy rate falls between 99.7% and 97%.
  • The implant — Known as Nexplanon, the birth control implant is a tiny rod that is inserted into your upper arm and prevents pregnancy for up to 4 years. Again, progesterone is released and both stops ovulation and thickens cervical mucus to prevent any sperm from reaching an egg if it were to be released. It is 99% effective at preventing pregnancy.

What are the benefits of taking Progestin-only birth control?

There are many benefits of using progestin-only birth controls like the mini-pill, the Depo shot, and the NuvaRing. These include:

  • Lighter periods
  • Does not increase risks of blood clots, stroke, or heart attack
  • Great for women who are breastfeeding
  • Does not reduce libido
  • Reduced risk of endometrial and ovarian cancer

What are the side effects of taking Progestin-only birth control?

Some of the common side effects of taking progestin-only birth control are:

  • Sore breasts
  • Irregular menstrual cycles
  • Spotting between periods
  • Headache
  • Nausea
  • Dizziness
  • Bloating or weight gain (especially with the Shot)
  • No menstrual period

Also, if you’re trying to become pregnant and stop taking progestin-only birth control, it can take between 12 weeks and 18 months, without underlying fertility concerns.

More serious (and rare) side effects include:

  • Leg pain
  • Swelling in your leg
  • Chest pain
  • Difficulty breathing
  • Unexplained fever or chills

What are my long-acting contraceptive options?

Short-term birth control methods like the Pill (either combined or progestin-only), the Ring, and the Patch require daily, weekly, or monthly use. The implant and Depo shot require active participation every few months. If you’re looking for a birth control method that lasts longer and requires less involvement from you, long-acting contraception can be the way to go. These methods include:

  • The hormonal IUD: There are a couple different IUDs available, all of which are highly effective at preventing pregnancy. The hormonal IUD releases levonorgestrel, a progestin hormone. It is inserted by a doctor into your uterus where it thins the uterine lining and thickens the cervical mucus. There are different brands of the hormonal IUD; some prevent pregnancy for up to three years, while others last for five years. The IUD is 99.8 percent effective.
  • The copper IUD: The copper IUD, called the Paragard IUD, is a non-hormonal birth control that is implanted into your uterus. The copper acts as a spermicide and helps prevent egg fertilization. With a 99 percent efficacy rate, it is one of the best birth control options available.

What are the benefits of IUDs?

Aside from being highly effective at preventing pregnancy, both forms of IUDs offer some great benefits:

  • Highly effective
  • The potential for lighter periods
  • The copper IUD can be used as a form of emergency contraception
  • No need to worry about taking a pill, putting on a patch, or inserting a ring

What are the disadvantages of IUDs?

Of course, no form of birth control is all positive. Some of the risks and side effects associated with IUDs are:

  • Mild to moderate pain when the IUD is inserted
  • Cramping or backaches for a few days after the IUD is put in
  • Spotting between periods
  • Irregular periods
  • Heavier periods and worse menstrual cramps (ParaGard)

According to Planned Parenthood, you shouldn’t get an IUD if you:

  • Have or might have an STD or other pelvic infection
  • Think you might be pregnant
  • Have cervical cancer that hasn’t been treated
  • Have cancer of the uterus
  • Have vaginal bleeding that’s not your period
  • Have had a pelvic infection after either childbirth or an abortion in the past 3 months

Which barrier methods of birth control can I use?

There are many reasons women choose not to take oral, injected, or inserted contraceptives. But if you’re trying to prevent pregnancy, it’s important that you use some kind of birth control. Barrier method birth control can be a great option and are also the only option for preventing the spread of STDs, something you want to be aware of if you’re having sex outside of a long-term, monogamous relationship.

Male and female condoms are ideal in these situations. They both work to prevent semen from entering the vagina. They’re also inexpensive, making them a convenient, easily accessible option. All condoms are about 98 percent effective when used correctly.

What are the permanent forms of birth control?

An increasing number of women are choosing not to have children. While this may still hold a social taboo, it’s important that women know which options are available to them if they know that they do not want to have children, for whatever reason.

Tubal ligation, or having your tubes “tied,” is a common form of permanent birth control that requires surgery. During the surgery, your fallopian tubes are permanently closed off from the rest of your reproductive system, so sperm can never meet an egg. It is highly effective with only a 0.5 percent failure rate. There are also two touted benefits that are very appealing to women who do not plan on ever having children: permanency and no effect whatsoever on your hormones.

However, as with any form of birth control, tubal ligation does have side effects and, although serious, are also very rare:

  • Rash
  • Swelling
  • Trouble breathing
  • Fever
  • Severe pain in your abdomen
  • Unusual vaginal odor or discharge
  • Infection at the incision site

Planned Parenthood points out that, “There’s a chance that your fallopian tubes can reconnect or become unblocked after sterilization, but this is really rare. If you get pregnant after sterilization, the pregnancy could develop in your fallopian tube—this is called ectopic pregnancy, and it’s very dangerous.”

Also, having your tubes tied does not protect against STDs so, while you may not be worried about pregnancy, it’s still a good idea to use barrier protection.

Which natural forms of birth control are effective at preventing pregnancy?

OK, so what about those of us who want to protect ourselves from unwanted pregnancy but don’t want to use birth control and don’t want to get our tubes tied? Are there options?

Yes, there are. And while we’re discussing these last, they certainly shouldn’t be considered as a last resort. All of the following methods are based on the idea of fertility awareness—where you come to understand your body’s natural rhythm and are able to monitor your fertility and use it to plan when to (and when not to) become pregnant.

Here’s an overview of the different types of natural family planning:

  • The Temperature Method: With the Temperature Method, you track changes in your body temperature throughout your menstrual cycle. This helps you predict when you’re ovulating, so you can avoid intercourse on those days.
  • The Cervical Mucus Method: Instead of tracking your temperature, this method of family planning requires that you track your cervical mucus to identify when you’re ovulating.
  • The Calendar Method: Over several months, you’ll track the length of your menstrual cycle and use that data to understand when you’re ovulating and should abstain from sex to avoid pregnancy.

All of these methods have an average effective rate of between 76–88 percent effective. They require absolute dedication and require you to abstain from sex on your fertile days. That being said, they have no negative side effects because you’re not putting any hormones into your body.

Birth control will likely always be a hot topic in the U.S. and around the world. There are endless options available and it’s your choice which is the best one for you. It’s wise to explore all of your birth control options and choose one, with your doctor, that is the best for your reproductive and overall health.

Featured image by Drew Dizzy Graham
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Author Bio A military veteran with over 7 years of experience, Christina is an Atlanta-based writer passionate about startups within the US healthcare system. She prides herself in working with companies that are taking innovation to the next level – specializing in content creation and strategy for companies addressing everything from consumer health information, population health management, and telemedicine to value-based care, and clinical workflows. She’s most passionate about women’s health rights and advocacy.

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