Birth Control — Which is Your Best Option?



Choosing the right birth control option

 

If you have ever considered a method of birth control, you know there are a lot of options ranging from the economical withdrawal or fertility awareness methods, to the more expensive intrauterine devices.  Each method is unique, and not every method is going to work well for every person.  I am here to simplify the contraception search for you.

There are sixteen unique contraceptive methods listed below.  

How do you know which one to pick?  Let’s consider your family planning.  

A common method of contraception is the combined hormonal pill for females.  This pill works by tricking your body into thinking it is pregnant, and therefore preventing the release of an egg from the ovaries.  If you are able to remember to take the pill every day, this option may be right for you. You can choose between regimens that will have you with a monthly period, a period every three months, or sometimes even delay your period indefinitely.  Contraception pills are a very popular method of birth control and are covered by most prescription insurance plans.  

If you are certain you do not want to get pregnant in the next few years, and you do not want to take a daily pill, options include an intrauterine device (IUD) or the progestin-only implantable rod.  IUDs are inserted by a healthcare professional through the cervix, into the uterus.  Both the copper and hormonal IUDs prevent sperm from meeting with a female egg.  The IUD can last for up to 5 years and remains in place until you are ready to have it removed.  The progestin IUD contains hormones that may trick your body into thinking it’s pregnant, which also prevents the release of an egg from your ovaries.  The implantable rod is also inserted by a healthcare professional and remains in your upper arm up to 3 years; it can be removed earlier if you want to get pregnant.

Birth Control Choices

Birth Control Choices


Another contraceptive option is the progestin injection.  

This hormonal shot is administered by a healthcare professional every 12 weeks.  When selecting this option, be sure that you do not want to get pregnant in the near future; it may take up to a year after stopping the shot to become pregnant.

Self-administered non-pill options include a vaginal ring and a topical patch.  A new ring is inserted vaginally each month.  It remains in place for three weeks, and is then removed for the fourth week and you will have a period.  The topical patch must be changed every week for three weeks, and the fourth week of each cycle is patch-free (when you get your period).

If you participate in high-risk relationships where you are worried about contracting a sexually transmitted infection (STI), remember that most methods of birth control will NOT protect you; consider using a barrier form of birth control such as the male or female condom.

If you have had sexual intercourse, and either forgot to use contraception, or you think the contraception may have failed (i.e. the condom broke), you may wish to use the emergency contraception pill as soon as possible within 72 hours after intercourse.  The emergency contraception pill is available over the counter at a pharmacy, regardless of your age.

If you prefer to avoid any type of hormonal contraception, the copper IUD and the male condom have the highest rates of efficacy.  Spermicide alone and fertility awareness have the lowest efficacy rates.

If you need quick access to contraception, and you are unable to neither visit a healthcare provider nor obtain a prescription, the best options for you are the male or female condoms, the sponge, or the emergency contraception pill.

The chart below summarizes the available methods of birth control.

You can ask your prescriber about contraception, or your community pharmacist is always available to answer questions on contraception or other medications.  

 

Method of birth controlTypical effectiveness(2)Perfect effectiveness(2)Protection from STIs(1)Requires health care provider visit(1)Quickly reversible(1)
Hormonal methods
Combined hormonal daily pill92%99.7%NoYesYes
Emergency contraception pill75-89%NoNoYes
Injection97%99.7%NoYesNo
Progestin- intrauterine device (IUD)99.8%99.8%NoYesYes, but must be removed by a healthcare professional
Patch92%99.7%NoYesYes
Progestin-only implant99.05%99.05%NoYesYes, but must be removed by a healthcare professional
Vaginal ring92%99.7%NoYesYes
Non-hormonal methods
Cervical cap84%91%NoYesYes
Copper intrauterine device (IUD)99.2%99.4%NoYesYes
Diaphragm with spermicide88%94%NoYesYes
Female condom79%95%YesNoYes
Fertility awareness75%NoNoYes
Male condom85%98%YesNoYes
Pull-out method82%NoNoYes
Spermicide alone72%82%NoNoYes
Sponge88%91%NoNoYes

 

References:

  1. Method Match. Association of Reproductive Health Professionals. www.arhp.org/methodmatch
  2. Shrader SP, Ragucci KR. Chapter 62. Contraception. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey L. eds. Pharmacotherapy: A Pathophysiologic Approach, 9e. New York, NY: McGraw-Hill; 2014. http://0-accesspharmacy.mhmedical.com.crusher.neomed.edu/content.aspx?bookid=689&Sect ionid=45310515. Accessed July 22, 2015.
  3. Birth Control. Planned Parenthood. www.plannedparenthood.org/learn/birth-control

Dual Authorship:

Dr. Peter J. Rice (see below)

Beth Carter, PharmD:

Beth is a graduate of the Northeast Ohio Medical University College of Pharmacy and a community pharmacy resident at University of Colorado and King Soopers Pharmacies.

Birth Control -- Which is Your Best Option? 2

 

About Dr. Peter J. Rice

Dr. Peter J. Rice is a professor of Pharmacology emeritus at the East Tennessee State University Quillen College of Medicine and Professor of Clinical Pharmacy at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences. --------------------------------------------------------------------------He received his BS in pharmacy from Northeastern University, PhD in pharmacology from the Ohio State University and PharmD from the University of Kentucky. He is a Board Certified Pharmacotherapy Specialist and practices in the ambulatory care and community pharmacy settings. Professor Rice is the author of Understanding Drug Action: An introduction to pharmacology (APhA, 2014) and is a fellow of the American Pharmacists Association. --------------------------He welcomes interesting medication questions and suggestions for future columns.

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