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The Confusing World of Birth Control

March 30, 2018

You've got it together. You eat right. You exercise. But what about your birth control? There are as many contraceptive choices as there are yoga positions. And there's one that fits your lifestyle to a T.

Would you like a get-it-and-forget-it kind of birth control? Or would you rather monitor your monthly cycle? Or take a daily pill? What about sexually transmitted infections (STIs)? Some methods are better than others. And then there's the cost and, of course, the shared responsibility. That's right, your partner has a stake in this, too.

So it's time to take control of your birth control. The more you know about each method, the better choice you'll make.

Contraception 101: An Introduction to Birth Control

Simply speaking, birth control controls your chances of getting pregnant. Birth control methods are usually organized into three categories: long-acting contraception, hormonal methods and barrier methods.

Each method within each category has its level of effectiveness, its pros and cons, and its monetary effect on your Apple Pay account. It pays to spend some valuable me-time considering these factors when choosing your preferred method.

Another consideration is how effective your birth control method is at preventing STIs. Some are better at this than others. Discuss concerns and options with your partner and factor these into your decision.

Choosing your birth control method is all about recognizing what makes your lifestyle work and what method works with your style.
So finish your latte and start working on your new agenda: learning about each contraception method and what it means for you.




Long-Lasting Contraception

Implant - 99% effective

How It Works

A small rod that releases the hormone progestin is inserted under the skin of a woman's upper arm. This prevents ovulation and makes it more difficult for sperm to reach the egg if released.

Pros

  • Lasts for three years
  • Don't have to remember to take it
  • Can be removed any time with  no long-term effects on fertility

Cons

  • No protection against STIs
  • Must be inserted and removed by a doctor
  • Risk of pain or infection at implant site

Cost

  • With insurance, cost of one copay
  • Without insurance, up to $1,300 for implant and insertion, $100-300 for removal 

Intrauterine Device (IUD) - 99% effective

How It Works

The IUD is a small device inserted in the woman’s uterus. The copper (non- hormonal) device works by preventing fertilization and implantation. The one that contains progestin (hormonal) prevents fertilization and implantation, and also causes thickening cervical mucus to prevent sperm from entering the uterus. The progestin device can affect ovulation.


Pros

  • Lasts for 10 years (copper) or 3-5 years (progestin)
  • Don't have to remember to take it
  • Can be removed any time with no long-term effects on fertility
  • Progestin version can improve menses

Cons

  • No protection against STIs
  • Must be inserted and removed by a doctor
  • Risk of pain at time of insertion
  • Risk of moving out of place (rare)
  • Copper version can cause heavier menses

Cost

  • With insurance, cost of one copay
  • Without insurance, up to$1,300 for intrauterine device and insertion, $100-$200 for removal
Hormonal Methods

Birth Control Pills (The Pill) - 91%-99% effective


How They Work

This is a combination of estrogen-progestin or progestin that’s taken daily in pill form and prevents ovulation, making it more difficult for sperm to reach the egg.

Pros

  • Help with acne, heavy periods, irregular periods, menstrual cramps, PMS
  • Decreases ovarian cancer risk if taken longer than 10 years
  • Easy to take
  • No long-term effect on fertility

Cons

  • No protection against STIs
  • Must be taken at the same time every day
  • Not recommended for women who smoke and are over the age of 35
  • May increase risk of blood clots, high blood pressure and benign liver tumors 

Cost - $0-$75 a month


Patch - 91%-99% effective

How It Works

This is a small patch worn by the woman on the lower stomach, upper buttock or upper body. It is changed once per week for three weeks, then left off one week for menses to occur. Estrogen-progestin is released into the body to prevent ovulation.

Pros

  • Can help with acne, heavy periods, irregular periods, menstrual cramps, PMS
  • Decreases ovarian cancer risk if taken longer than 10 years
  • Easy to take
  • No long-term effect on fertility

Cons

  • No protection against STIs
  • Rare risk of falling off during the week
  • Not recommended for women who smoke and are over the age of 35
  • May increase risk of blood clots, high blood pressure and benign liver tumors

Cost - $0-$80/month


Ring - 91%-99% Effective

How It Works

This is a flexible ring containing estrogen-progestin that is placed in the vagina for three weeks, then taken out one week for menses to occur. Estrogen-progestin is released into the body to prevent ovulation.

Pros

  • Can help with acne, heavy periods, irregular periods, menstrual cramps, PMS
  • Decreases ovarian cancer risk if taken longer than 10 years
  • Easy to take
  • No long-term effect on fertility

Cons

  • No protection against STIs
  • Rare risk of falling out
  • Not recommended for women who smoke and are over the age of 35
  • May increase risk of blood clots, high blood pressure and benign liver tumors

Cost - $0-$80/month


Injection - 94%-99% effective

How It Works

An injection of progesterone is given to the woman once every 12 weeks to prevent ovulation.


Pros

  • Does not contain estrogen
  • Doctor's office helps you remember when you are due
  • May lighten or eliminate the menstrual period

Cons

  • No protection against STIs
  • Must be seen in the doctor's office for injection
  • May take up to 18 months after last injection for fertility to return
  • May result in temporary thinning of bones

Cost - $0-$100

Barrier Methods

Condom - 85%-98% Effective

How It Works

Man wears condom over the penis, which prevents sperm from entering the woman.


Pros

  • Helps protect against STIs (Latex and polyurethane)
  • Available over the counter
  • Non- hormonal

Cons

  • May not protect against STIs if using lambskin or if condom breaks
  • One-time use
  • Must plan ahead for intercourse to have available and can decrease sensitivity during sex

Cost

  • Free at family planning centers
  • $2 each over the counter

Female Condom - 70%-90% effective

How It Works

Woman inserts into the vagina prior to sex, prevents sperm from entering the woman.

Pros

  • Helps protect against STIs (Latex and polyurethane)
  • Available over the counter, non-hormonal

Cons

  • May not protect against STIs if slips out of place or if condom breaks
  • One-time use
  • Must plan ahead for intercourse and can decrease sensitivity during sex

Cost

  • Free at family planning centers
  • $2 each over the counter

Diaphragm or Cervical Cap - 71%-94% effective

How It Works

The woman inserts a soft silicone cap into the vagina prior to sex, which can be done several hours before intercourse. It prevents sperm from entering the uterus and is used with spermicide (decreases sperm motility) to increase effectiveness.


Pros

  • Non-hormonal
  • Can be reused

Cons

  • Does not protect against STIs
  • Needs to be fitted by a doctor
  • Can be difficult to insert properly
  • Can be difficult to obtain due to fewer companies manufacturing
  • Can be moved out of place during intercourse

Cost - $0-$90


Sponge - 76%-88% effective

How It Works

Woman inserts into the vagina prior to sex, which can be done several hours before intercourse. It prevents sperm from entering the cervix and is used with spermicide (decreases sperm motility) to increase effectiveness.


Pros

  • Non-hormonal
  • Over the counter
  • Can be worn several hours prior to and after intercourse
  • May have sex multiple times without reinserting

Cons

  • Does not protect against STIs
  • Difficult to find due to limited manufacturing
  • Can be difficult to insert and remove

Cost - $5


Permanent Methods

Rhythm Method - 76%-88% effective

How It Works

Woman tracks her temperature, cervical mucus and cycle days to minimize sexual activity during most fertile times of the month.


Pros

  • Non-hormonal
  • Free online tools available
  • Smartphone apps available for a small fee

Cons

  • Requires rigorous tracking and can be difficult to master
  • Less effective for those with irregular menstrual cycles

Cost - $0-low cost for online apps

For Those Who Have Had Enough: Permanent Methods

Sterilization - 99% effective

For those who are ABSOLUTELY sure they do not want any or additional children, sterilization may be the right choice. It should be considered a permanent procedure.

  • Tubal ligation: A procedure performed on a woman usually under anesthesia costing $0-$6,000
  • Vasectomy: A procedure performed on a man usually in the office costing $0-$1,000

In a Pinch: Emergency Contraception 

Morning-After Pill

This method is used to prevent pregnancy after unprotected sex or if another method failed. EC should NOT be used as a regular method of birth control. Pills that are taken up to five days after intercourse prevent ovulation. They are available over the counter for women ages 17 and up and available with a prescription for those under the age of 17.

The #1 Most Effective Birth Control

Drum roll please...

Abstinence - 100% effective

Abstinence (not having sex) is the ONLY method that is 100% effective at preventing pregnancy and preventing STIs. No sex - no pregnancy.

Let's Answer some Questions

Now's the Time

Now that you have your choices, it's time to take control of your birth control and choose what's right for you. It's always a good idea to discuss your options with your OBGYN. Don't have an OBGYN? We can help with that, too!


Visit OrlandoHealth.com/PrimaryCare or call 321.841.3724 to find an OBGYN near you.

Effectiveness of birth control methods is measured during "typical use", meaning how effective the method is during actual use, including inconsistencies and incorrect use.

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