As a woman, there’s good news and there’s not-so-good news when it comes to choosing the right birth control method.
The good news: You have lots of options. Choice is good.
The not-so-good news: You have lots of options. Choice can be overwhelming.
As Ann L. Honebrink, MD, Medical Director of Penn Health for Women at Radnor, will tell you, every kind of birth control comes with its own list of pros and cons.
So, how can you find the best birth control for your lifestyle? Here’s a look at the pros and cons of a couple of main types of contraception.
Barrier methods include:
- Female condoms
- Male condoms
- Cervical caps with spermicide
- Diaphragms with spermicide
Like their name implies, barrier methods prevent pregnancy by physically blocking the egg and sperm from meeting.
When used correctly and consistently, the Association of Reproductive Health Professionals (ARHP) says that barrier methods are effective:
Vaginal spermicide that is labeled as okay to use with condoms can increase their effectiveness, Dr. Honebrink adds. Some male condoms have spermicide on them already.
Pros Of Barrier Methods
There aren’t many side effects, and many of the barrier methods can also protect against sexually transmitted infections (STIs).
“In people under the age of 25 or 26, there’s a much higher chance of gonorrhea or chlamydia,” says Dr. Honebrink. “Anyone under that age who is not in a long-term mutually monogamous relationship—and even if they are—should be thinking about using something like a condom in addition to whatever else they’re using.”
While having multiple partners can increase the risk of a young person contracting an STI, biology also plays a role. Young women’s bodies are simply more prone to sexually transmitted infection, according to the Centers for Disease Control and Prevention.
But young people aren’t the only ones at risk of getting an STI. “It’s not like you can stop worrying about that once you get to be over the age of 25 or so,” she explains. “I try to get everybody to think about that with any new partner.”
Cons Of Barrier Methods
The drawback with barrier methods is simple: “You have to use them at the time you have sex in order for them to work,” explains Dr. Honebrink. “They can also be incorrectly used, which will make them not work as well.”
For instance, cervical caps and diaphragms must be used in conjunction with spermicides that are designed to work with these particular methods.
“The most common reason that barrier methods don’t work is that they don’t get used,” she adds. Some people forget. Others skip using them consistently. Then, there are people who are allergic to spermicide and latex.
Hormonal contraceptives include:
- Birth control pills
- Contraceptive patches
- Vaginal rings (like NuvaRing)
- Birth control injections (like Depo-Provera)
Hormone-based contraceptives release hormones—like estrogen and progesterone—into a woman’s body. “This affects ovulation,” says Dr. Honebrink. “But it also affects the mucus in the cervix and the lining of the uterus, and the way the sperm would move in the fallopian tube.” Together, these factors can prevent pregnancy.
When used correctly, the ARHP says that the main types of hormonal contraceptives—birth control pills, contraceptive patches, vaginal rings, and birth control injections—are effective 99% of the time.
Pros Of Hormonal Contraceptives
One group who might want to consider hormonal birth control is women who are about to enter menopause.
“We see a lot of women in their forties and early fifties in our practice, and once or twice a year there’s someone who comes in pregnant,” Dr. Honebrink says.
“The likelihood of getting pregnant at 48 or 49 is way lower than in your 20s or 30s, but it doesn’t go away until you’ve had that full six months to a year without your period,” she explains.
Still, some low-dose hormonal methods can help with perimenopausal symptoms like hot flashes, in addition to preventing pregnancy.
“In women without these symptoms—because blood clot and hypertension risk increases with age, and these are risks for oral contraceptives—another method of birth control might a better choice,” Dr. Honebrink adds.
Cons Of Hormonal Contraceptives
As with barrier methods, the biggest challenge is remembering. “You have to take the pill every day or change the ring every month,” explains Dr. Honebrink. “You have to put the patch on once a week. Or you have to show up for a shot every three months.”
So, if you think you might struggle to stay on top of your birth control—or if your day-to-day life is not so routine-friendly—perhaps consider a different method to prevent pregnancy.
There is also a risk of blood clots. “If somebody has ever had blood clot problems or has been told that they’re at risk for blood clots, they’re probably not a good candidate,” she says. This includes postpartum women, who often have a higher risk of blood clots.
Birth control pills are also generally not recommended for women with other medical issues besides blood clot risk—like high blood pressure, liver disease, and migraine headaches, Dr. Honebrink adds.
Hormones can also interfere with milk supply for postpartum women who are breastfeeding.
Coming up in part two: Dr. Honebrink discusses two more types of birth control that women may want to consider.