I remember as a young adult thinking that “the pill” was pretty much my only option when it comes to birth control. Obviously I knew about condoms and I had heard of the hormonal implant, but most people I knew were on the pill.
I’m happy to say I was very wrong. There are actually so many options out there! I think word has spread a little better in the last decade but I figured now’s my chance to put it all out there in one spot. If you’re wondering what options you have for preventing pregnancy, I now present to you: Birth Control 101.
Sterilization
If you’re going for permanent and highly effective, sterilization is the way to go. But let me emphasize again – permanent. This is something you wouldn’t want to do without a lot of thought, care, planning, and confidence that it’s the choice you want to make. When it’s over, you won’t be able to have children.
Vasectomy
The method of sterilization for males is called a vasectomy. This is done by removing a portion of each ductus deferens. Sperm is still produced, but it can’t come out anymore and instead is destroyed by phagocytosis. However, testosterone levels in the blood remain normal since no blood vessels are cut, so it should not have an effect on libido or sexual performance. A vasectomy can technically be reversed, but only 30-40% of reversals result in regaining fertility.
Tubal Ligation
This is commonly referred to as getting your tubes tied. There are a couple different methods for doing this: Placing a clamp on each tub, tying or cutting each tube, or cauterizing each tube. These procedures make it so eggs can’t pass through the tubes and neither can sperm.
Non-Incisional Sterilization
Unlike with tubal ligation, the woman does not need to go under general anesthesia for this process. This is done by inserting a coil through the vagina, into the uterus, and on into each uterine tube. Over the course of 3 months, the insert causes scar tissue to form in the tubes preventing eggs and sperm from passing through to each other.
As with any procedure, these do not come without risks and it is important to discuss those thoroughly with your doctor when making your decision.
Hormonal Contraceptives
I think the reason these are so popular is because they are highly effective at preventing pregnancy when used correctly. And they don’t take very much “work” on the part of the woman. Despite their long list of common side effects, this makes it worth their use to some.
Combined Pill
The combined pill contains both progestin and estrogens. Progestins thicken cervical mucus, blocking implantation, and estrogens inhibit ovulation by suppressing follicle stimulating hormone and luteinizing hormone. This pill is typically taken once a day for 3 weeks followed by one week of an inactive pill, allowing the woman to bleed. As discussed in the book, The Fifth Vital Sign by Lisa Hendrickson-Jack, this is not truly a period. It’s just a bleed, mostly for the sake of showing the woman she is not pregnant. An example of this type of pill is Yasmin.
Extended Cycle Pill
This is a combined pill that is taken every day for 12 weeks, followed by one week of inactive pills for the woman to have a bleed. Seasonale is an example of this type.
Minipill
The minipill contains progestin only and is taken every day of the month. This type does not prevent ovulation, but rather thickens the mucus to prevent fertilization and implantation. Micronar is an example of a progestin-only pill.
Skin Patch
The skin patch contains both estrogens and progestin and is placed on the upper arm, back, lower abdomen, or butt once a week for 3 weeks. No patch is used during the fourth week. Ortho Evra is a contraceptive skin patch.
Vaginal Ring
NuvaRing is an example of this type. It contains estrogens and progesterone and is inserted into the vagina by the woman herself. It can be left there for 3 weeks to prevent conception and then is removed on the 4th week to allow a bleed.
Emergency Contraception
You may have heard this referred to as “the morning after pill.” This is used as soon as possible after an unprotected sexual encounter. It induces the shedding of the uterine lining, which blocks implantation.
Implant
The implant is a small rod about the size of a match that is implanted by a health-care provider into the upper arm of the woman. It works by releasing progestins and can be kept in for up to 3 years.
Injections
Depo-provera is an example of a hormone injection, which is a shot of progestins given by a healthcare professional once every 3 months.
Intrauterine Devices (IUD)
An IUD is a small object made of plastic, copper, or stainless steel that is inserted into the uterus via the vagina by a healh-care provider. They can stay in for years and can be removed at any time. Aside from other risks or side effects of IUDs, some women find them uncomfortable or their body simply expels them involuntarily.
Hormonal IUD
The Mirena is one example of a hormonal IUD. These work by releasing a small amount of progestin into the uterus, thickening the mucus. They also prevent ovulation, thus preventing pregnancy.
Non-hormonal IUD
The copper IUD is a way of preventing pregnancy with an IUD that does not require the release of hormones. Instead, the copper wrapped around the IUD alters the sperm in a way that they cannot move properly and therefore cannot fertilize an egg. They can also cause localized inflammation, which may contribute to pregnancy prevention.
Spermicide
Spermicides come in the form of creams, jellies, foams, etc. and work by making the vagina and cervix unfavorable for sperm survival. They are to be placed in the vagina before sexual intercourse. They are more effective when combined with a barrier method, and many barrier methods rely on them for more complete pregnancy prevention.
Barrier Methods
Barrier methods are a physical barrier designed to block sperm and eggs from reaching each other. They do not rely on hormones. Another benefit is that some provide protection against sexually transmitted infections.
Male Condom
This is a latex covering placed over the penis which prevents sperm from getting into the vagina and cervix.
Vaginal Pouch/Female Condom
This is a thin plastic tube that is placed in the vagina. It works like a male condom physically blocking sperm from entering the uterus and also protecting from sexually transmitted infections.
Diaphragm
A diaphragm is a rubber dome shaped object that the woman can place over her cervix up to 6 hours before a sexual encounter. It works best when combined with a spermicide. The diaphragm blocks most of the sperm from entering the cervix and the spermicide gets the sperm that do pass through.
Cervical Cap
This is similar to a diaphragm, but it is smaller and more firm. It must be fitted by a health-care professional and also needs spermicide for most effective use.
Periodic Abstinence
These methods involve utilizing knowledge and information about how the female reproductive system works in order to time periods of abstinence in a way most likely to prevent pregnancy.
Rhythm Method
This is also often called the calendar method. This is when the couple abstains from vaginal sex on the days ovulation is most likely to occur – including the 3 days prior, the day of, and the 3 days after. This is one of the less effective abstinence methods since the exact date of ovulation varies from cycle to cycle. However, if you’re not too bent out of shape about the idea of getting pregnant, this could be for you.
Sympto-Thermal Method
This is a fertility awareness method that can be used to avoid pregnancy or achieve it, depending on your goals. This method involves tracking fertility symptoms such as basal body temperature and cervical mucus to determine which days you are fertile. If you are avoiding pregnancy, you should abstain from intercourse on those days. Alternatively, you could utilize another form of non-hormonal contraception on those fertile days.
As you can see, there are tons of options, and I am pretty sure I missed a couple in this list! For those interested in true health, it’s important to know all that is available. While using synthetic hormones is an effective way to prevent pregnancy, they can also wreak havoc on the health of the woman in many ways (see my book review of The Fifth Vital Sign). If you’re looking for permission to try something new, here it is. Go for it! Don’t be afraid to research all the options and find a method that works for you while maintaining your health.
Resources:
Introduction to the Human Body 10th edition | 9781118583180, 9781118884133 | VitalSource
Amazon.com : the fifth vital sign
(Not affiliate links)
