Types of Birth Control

Woman at a doctor's appointment

OHIOHEALTH

KEY TAKEAWAYS:
• There are two main categories — hormonal and non-hormonal birth control. Hormonal methods include the pill, patch, ring, Depo-Provera shot, implant and hormonal IUD. Non-hormonal methods include the copper IUD and condoms.
• Hormonal birth control options use synthetic hormones like progestin and estrogen to prevent ovulation, block sperm or stop a fertilized egg from attaching in the uterus.
• Compare effectiveness before you choose. The implant is the most effective option, with a failure rate of just 0.05% to 0.1%. Most methods are 99% effective when perfectly used, while condoms carry a 13% to 28% failure rate.
• Match the method to your health history and routine. Daily pills, weekly patches, three-month shots, and multi-year implants each fit different lifestyles.
• Bring your questions to your provider to help find the right fit for you. Try to give a new birth control method about three months to settle before revisiting it with your care provider.

SUMMARY:
Choosing birth control gets a lot easier once you understand how each option works. In this guide, Allison Nostrant, DO, OB-GYN, breaks down the main types of birth control: hormonal methods and non-hormonal methods. Learn how each type works, their effectiveness and how often each should be used or replaced. The article covers birth control methods like the pill, patch, ring, shot, implant and hormonal IUD, plus non-hormonal choices like the copper IUD and condoms. Dr. Nostrant explains that that the best birth control is the one that fits your body, health history and life. It’s important to talk with your OB-GYN to make the best decision for you.

Choosing birth control can feel like a lot — there are pills, shots, patches, implants and devices, plus plenty of opinions floating around online. But you don’t have to sort it all out alone. Understanding the main birth control options can help make your next OB-GYN visit less stressful and more focused on asking the right questions.

Allison Nostrant, DO, an OB-GYN at OhioHealth, breaks down all the birth control types and how they work so you can go into your next appointment well-informed.

Hormonal birth control methods

Hormonal methods use hormones like synthetic progestin and estrogen to prevent pregnancy.

Depending on what type of hormonal birth control you’re using, the hormones will act to:

Prevent ovulation
Block sperm from entering the uterus
Or stop a fertilized egg from attaching itself to the uterus.

The birth control pill is the most well-known of the hormonal birth control options, but it’s not the only choice. There’s also a birth control patch, ring, implant, IUD (intrauterine device) and shot.

Hormonal methods can help with more than pregnancy prevention, too. Many people also use them to manage things like heavy menstrual bleeding, painful periods, endometriosis and premenstrual dysphoric disorder (PMDD), a condition that brings significant mood changes before or during a period.

Non-hormonal birth control and barrier methods

For those who prefer to skip hormones, the copper IUD is a leading choice. “The copper IUD mostly works through an inflammatory process that inhibits sperm from fertilizing an egg,” explains Dr. Nostrant.

Many people assume an IUD stops periods entirely, but that’s a misconception. “A lot of people think an IUD means they won’t have a period, but that’s only the case with the hormonal IUD, not the copper one,” says Dr. Nostrant.

Barrier methods, such as condoms, offer another hormone-free option and remain the only choice that also helps protect against sexually transmitted infections.

How to choose which method is right for you

When weighing your choices, Dr. Nostrant suggests thinking about your daily routine. “Are you comfortable taking a pill that you have to remember every single day? Are you the type of person who’s going to remember to do that?” says Dr. Nostrant.

Each type of birth control requires a different amount of attention.

Birth control pill: Taken daily.
Birth control patch: Change weekly.
Birth control ring: Must be removed or replaced every three to four weeks.
Depo-Provera shot: Administered every three months by a specialist.
IUD and Nexplanon implant: Lasts up to five years before needing replaced.

The IUD and implant require an in-office procedure to place them. When you get an IUD placed, a pelvic exam (similar to a pap smear) is required. The Nexplanon implant also requires an in-office procedure, but not a pelvic exam. These procedures are quick and can include pain management like ibuprofen or a local anesthetic.

When choosing birth control, many people also consider each type’s effectiveness. The implant is the most effective form of birth control with a remarkably low failure rate of only 0.05% to 0.1%. When used perfectly without missing a pill or application, most birth control methods are 99% effective against getting pregnant. In contrast, condoms have a failure rate of 13% to 28%.

As with any medication, side effects are possible with all types of birth control. The most common include irregular bleeding, headaches, sore breasts and nausea — especially when you first start. Hormonal birth control methods that contain estrogen are not for everyone, especially those with a history of blood clots. Some forms of birth control are also not recommended if you have a history of stroke or migraines with aura.

When deciding about birth control, make sure to talk to your OB-GYN about your medical history and what you are looking for in a birth control method.

Permanent and emergency contraception

If needed, emergency contraception, like Plan B, is available over the counter at most pharmacies. This can be helpful if you are concerned your birth control method failed. “This basically works to prevent you from ovulating so that you don’t end up having an unwanted pregnancy,” explains Dr. Nostrant.

For those who no longer want the opportunity to conceive, permanent options like getting your fallopian tubes removed exist.

Bringing your questions to your provider

Social media has made many people more informed, but it also spreads plenty of myths. Dr. Nostrant encourages patients to bring their questions and concerns to their OB-GYN. “Come in and ask, ‘I heard this, is it true? Is it actually something that can happen when I do this birth control?'” says Dr. Nostrant.

Just because one treatment didn’t work well for someone else doesn’t mean you’ll have the same experience. “Everybody is different,” says Dr. Nostrant. “So sometimes we don’t know how your body is going to react to something unless we try it. If it doesn’t work for you, we can always try something else.”

If your first choice does not feel right after using it for about three months, revisit the issue with your care provider. “There’s usually lots of other things in our toolbox we can try to see if that works for you,” says Dr. Nostrant.

Remember: the best birth control is the one that fits your body, your health history and your life.

Frequently asked questions

What are the different types of birth control?

There’s hormonal birth control options like the pill, patch, ring, IUD and shot. If you’re seeking non-hormonal birth control options, those include the copper IUD and barrier methods like condoms

How effective is birth control?

Effectiveness between each type varies. The shot and hormonal IUDs have failure rates below 1%. Condoms have a higher failure rate, but are also the only birth control method that protect against sexually transmitted infections.

What is emergency contraception?

Options like Plan B prevent ovulation and are effective if taken shortly after unprotected intercours

Can birth control affect fertility long-term?

Reversible methods, like hormonal birth control, copper IUD and barrier methods don’t affect long-term fertility. For those who no longer want the opportunity to conceive, permanent sterilization options, like getting your fallopian tubes removed, exist.