Birth Control

Help! I Don’t Want to Get Pregnant!

Which contraceptive should I choose?

There are lots of options for birth control, and it all boils down to what your situation is. If you want something to last for years that you won’t have to think about, an IUD or the Nexplanon (arm implant) might be a good choice. If you think you might want to come off of it soon, a pill or patch might work better for your needs. Talk to your doctor about your specific situation & interests, but here’s some additional reading!

Condoms:

The most common type of contraception, and the only type to protect against STD’s; it’s recommended to use condoms even if you rely upon another method, to protect against infections. Check the expiration date, don’t keep them in your car or wallet (overheating or compression can make small holes in them).

  • Pros: Simple & easy to use, cheap, one of the only ways to protect against STD’s, currently the only male-use contraceptive available.

  • Cons: Must plan ahead to bring and use every time for it to be effective. Considered by some to be “unsexy”, only 80% effective for pregnancy prevention

Oral Contraceptives:

Lots of different brands, doses, and types of hormones (whether combined estrogen & progesterone or simply progesterone on its own). All of them must be taken daily, at approximately the same time every day.

  • Pros: Cheap, easily available, simple, & with minimal side effects; won’t inhibit breastfeeding if started after milk is let down, ~90% effective

  • Cons: must be taken daily on a strict schedule, doesn’t protect against STD’s, can increase risk of clots, especially if used as a smoker or over 35 years old.

Hormonal Patch:

OrthoEvra is well known; Xulane is the generic equivalent. It deposits a combination estrogen & progesterone and is worn on the upper outer arm, buttocks, abdomen or thigh starting on the first day of your period. Every 4th week you don’t wear a patch and allow your period to come naturally.

  • Pros: Don’t need to worry about taking anything daily, easily reversible if you decide to stop contraception

  • Cons: can increase risk of clots (especially if used as a smoker or over 35 years old), skin irritation around patch, irregular bleeding between periods; can reduce breastfeeding success if used immediately after childbirth

Depo Shot:

A shot that injects three month’s worth of contraception within you. Must be given by a doctor.

  • Pros: Don’t need to worry about taking anything, lasts long periods, fertility returns in 3 months easily if you decide to stop contraception; approximately 94% effective

  • Cons: Associated with weight gain, can increase risk of clots (especially if used as a smoker or over 35 years old), can cause spotting for several months.

Nexplanon:

Progesterone implant, about the size of a matchstick.

  • Pros: unlikely to cause weight gain, lasts 3 years, easy insertion & removal (procedure takes less than 5 minutes); >99% effective

  • Cons: may cause headaches, may increase acne, may cause irregular periods within the first year, can increase risk of clots (especially if used as a smoker or over 35 years old), rare risk of migration, small scar from insertion point

IUD’s (Intra-Uterine Devices):

All share the same basic shape, with only slight differences

  • Paragard - thin filament of copper, last for up to 10 years

    • Pros: longest-lasting; >99% effective

    • Cons: may worsen periods & cramping

  • Mirena - Progesterone implant, lasts for up to 5 years

    • Pros: long-lasting, may reduce/eliminate periods; >99% effect

    • Cons: unpleasant placement for some

  • Skyla - Progesterone implant; same pros/cons as Mirena but for 3 years instead of 5

Permanent Contraception:

Not something that’s typically recommended unless you’re absolutely sure you never want to have any (more) children. 2-20% of men & women regret having permanent sterilization performed, with percentages highest in those under 30 years old.

  • Tubal Ligation (“Getting your tubes tied”): For the female partner. Can be a larger undertaking, consisting of either laparoscopy or open incision and clamping of the fallopian tubes which connect the ovaries to the uterus. Done in an operating room

    • Pros: Permanent, excellent efficiency, minimal scarring

    • Cons: Irreversible: It’s recommended to use condoms even if you rely upon another method, to protect against infections.Requires general anesthesia (which carries risk).

    • Side note: “reversing” this is typically not an option. Insurance doesn’t cover it, leading to a bill of approximately $20,000. Even then, chances of success are 33-50% at best - so be sure you want this before you get it!

  • Vasectomy: For the male partner.

    • Pros: Safer, easier, and cheaper for men to receive permanent sterilization than women. An in-office procedure that doesn’t require general anesthesia.

    • Cons: Irreversible