Most Common Types of Birth Control
Our office is here to help each individual patient find the contraceptive methods that are optimal for you during the different periods of your life, as no one method is universally suitable for all women. Today, there are many options as it relates to birth control. Many women are misinformed about the risks of birth control and are not aware of the many other benefits that contraceptives can provide. We are well versed in the pros and cons of each method and would be happy to go over them with you at your visit.
We have briefly reviewed the most commonly used forms below. For more information, download the CDC’s brochure on the “Effectiveness of Family Planning Methods.”
Birth Control Pills
Birth control pills are the most commonly used reversible method of contraception in the United States. They are a form of oral contraception (OCs) that generally contains two hormones, estrogen and progestin and taken daily to prevent a woman’s ovaries from releasing eggs. If you are good at taking pills and consistent, OCs are effective and safe, and they produce a low incidence of side effects. They are simple to use, and easy to start and stop; fertility usually returns immediately upon discontinuation. They can be used up through menopause if you don’t smoke to help regulate cycles. Some women are sensitive to estrogen’s effects and there are progestin-only pills (the mini pill) available that are often a suitable alternative with side effects of some irregular bleeding.
Intrauterine Device (IUD)
Worldwide, IUDs are the most popular reversible contraceptives due to their efficacy, convenience, and safety. An IUD is a small plastic T-shaped device inserted into the uterus designed to prevent pregnancy for 3 to 10 years depending on the type of IUD. IUDs may be inserted at any time in the menstrual cycle (although expulsion incidence is higher if inserted during menses) and may be used in young nulliparous women. Women can expect prompt return of fertility following removal of the implant or IUD. They do not prevent sexually transmitted infections.
Paragard is the only copper IUD, and it can prevent pregnancy for up to 10 years. It works by interfering with sperm movement, egg fertilization, and may prevent implantation. Paragard is hormone free and can be used whether or not you have had a child.
A hormonal IUD prevents fertilization by making the mucus in the cervix thick and sticky so sperm can’t get through to the uterus, as well as keeping the lining of the uterus too thin for a fertilized egg to implant. The 52-mg levonorgestrel IUD also is approved for the management of heavy menstrual bleeding and endometrial protection during menopausal estrogen therapy.
- Mirena is a hormonal IUD that prevents pregnancy for up to 5 years and can also treat heavy periods. It inhibits sperm from reaching and fertilizing an egg, thins the uterine lining, and thickens cervical mucus to prevent sperm from entering the uterus. Mirena is recommended for women who have had at least 1 child. Learn more about Mirena
- Skyla is a hormonal IUD made by the same company as Mirena, but this IUD is smaller. It may be less likely to be expelled in women who have never had a baby because of its smaller size. Skyla can be used for up to 3 years to prevent pregnancy. Learn more about Skyla
- Kyleena™ is a hormonal IUD that can prevent pregnancy for up to 5 years. Kyleena releases the lowest dose of hormones for the longest amount of time, compared to other IUDs. It can be used by women whether they have given birth or not. Learn more about Kyleena
Insertion and Removal of an IUD
An IUD is inserted by your doctor in the office and will only take a few minutes. During the procedure, you may experience side effects like discomfort, cramping, or dizziness. We recommend an over-the-counter painkiller before the procedure and/or may use a local anesthetic during the procedure to ease pain. The T-shaped IUD is left in the uterus, leaving 2 small strings outside the cervix for later removal. Your partner should not be able to feel the strings during intimate activity.
A follow up appointment may be scheduled after the procedure to be sure the IUD is still in place. Your IUD will be removed when your IUD has reached its expiration date, if you have a medical problem, or if you plan to become pregnant. It can be removed during a short procedure in the office with minimal discomfort.
Birth Control Patch
Used correctly, the patch works similarly and is as effective as birth control pills in preventing pregnancy. It is a form of birth control that a patient wears on the skin and looks like a small bandaid. The hormones it contains (estrogen and progestin) are similar to those used in birth control pills but are absorbed transdermally through the skin; and are used on a 28 day cycle but may be used continuously. Since the patch contains a dosage which is 60% higher than that delivered by the pills, there is the risk of side effects such as blood clots and it is important to not be used by smokers.
A vaginal ring is a form of contraception that is a soft and flexible ring that is worn in the vagina. The key benefit of the ring is that a patient does not need to take it daily to get a complete monthly protection. In a given 1-month period, the ring must be inserted into the vagina, removed after 3 weeks, and a new ring inserted no more than 7 days later. While the hormones it contains (estrogen and progestin) are similar to those used in birth control pills, unlike birth control pills, they are absorbed directly into the blood stream through the vaginal wall, delivering a consistent level of medication improving effectiveness and limiting side effects. Oral contraceptives on the other hand, differ in that they take time to be absorbed into the blood stream causing peaks and valleys in the hormone blood levels.
Another long-acting method of contraception is the depot medroxyprogesterone acetate (DMPA) injection (Depo Provera). Depot injections are given every 3 months with a 2-week grace period. Once depot injections are discontinued, the return to regular menses may be delayed by 18 months due to DMPA’s long duration of action. Thus, an alternative method may be more appropriate for women wishing to conceive within the year.
A diaphragm is a thin rubber dome shaped device with a springy and flexible rim. Inserted into the vagina by the patient, it fits over the cervix and is held in place by muscles in the vagina. The diaphragm is designed to hold a spermacide in place over the cervix to kill sperm. To maximize the effectiveness of the diaphragm it should be left in place for up to 6 to 8 hours after intercourse. The effectiveness for birth control ranges from between 86-94%. If one chooses to use a diaphragm it must be fitted in the clinic.
Tubal Ligation is a procedure that seals off a woman’s fallopian tubes that carry an egg from the ovaries to the uterus. By blocking these tubes, where fertilization usually occurs, sperm are unable to reach the egg to fertilize it. The procedure seals the fallopian tubes with thread, bands, clips, an electric current, or small implants. Patients near Fort Worth should be aware that the procedure provides permanent birth control and generally is NOT reversible.
Condoms are a barrier form of birth control that physically blocks the sperm from entering the vagina. They are the only form of protection that can help to stop the transmission of sexually transmitted diseases (STDs) like HIV and prevent pregnancy. Condoms should always be used to reduce the risk of STDs in conjunction with other methods of birth control. A condom is a latex or polyurethane sheath that is closed at one end and fits over a man’s penis. Condoms are also available for females. These have a flexible ring at either end. One end is closed and inserted into the vagina and the other end is open with the ring remaining outside the vagina. Condoms without spermicide have a high failure rate due to the risk of getting a hole in the end or it accidentally coming off. Even with spermicides, the failure rate is higher than other methods.