As we mentioned before, preventing unplanned pregnancy isn’t the only focus of Sexual Health Month anymore, but it’s still an important one! If you have a vagina, are sexually active with a partner with a penis, and don’t want a baby, birth control should definitely be on your mind. While it’s slightly troublesome that it’s almost always the responsibility of the female to choose their BC method and use it properly (and deal with the full weight of the consequences if something goes wrong), thankfully, we have options.
Merriam-Webster’s dictionary defines prophylactic (adj.) as “guarding from or preventing infection or disease; tending to prevent or ward off”. As a noun, “something prophylactic, especially : a device and especially a condom for preventing venereal infection or conception”. We’re focusing on the latter part of that one – methods and means to prevent pregnancy, more commonly referred to as birth control. There are as many forms of birth control as there are different reasons to use birth control, and hopefully everyone who needs a method can find one that fits their needs and lifestyle perfectly. The Cleveland Clinic offers a great page detailing the many possible varieties and forms of birth control. We’ll go over the basics of some of the most common and popular choices here!
Condoms
Condoms are one of the easiest to use, least expensive, most temporary prophylactics. They have the bonus feature of preventing the spread of Sexually Transmitted Infections, too. Even if pregnancy isn’t a concern, you might use them for safer sex, especially with a new partner. Male condoms (or external condoms) must be put on and worn correctly on the penis as soon as genital contact begins to be fully effective. If you missed that lesson in health class, you can watch this simple video from WebMD on correct condom use.
It’s important to use a condom that fits properly – Dr. T does a great job showing you how to measure in her video. Be aware of any latex allergies and choose a material that is safe for both parties. Water- or silicone-based lubes are safe with condoms. Apply lube to the outside of a condom only, or it could slip off during sex. Never use massage oil or an oil-based lube, as they will destroy the condom, rendering it ineffective. Leave a little space at the tip for ejaculate, and take it off carefully and once you are away from the vagina and throw it in the trash. You must wear a fresh condom every single time you have P-in-V sex. Never reuse them (even if you didn’t fully ejaculate), and throw it away and try again with a new one if it ever tears or breaks while putting it on.
According to Planned Parenthood, external condoms are 87% effective at preventing pregnancy, so many condom users may desire to use a pill or another backup method of birth control just in case. Female or “internal” condoms are also a thing, but they are trickier to use, often described as uncomfortable or bulky during sex, and are only 79% effective. They’re better than nothing if you don’t have another option, but are usually not ideal as your sole prophylactic. Coincidentally, condoms are the only birth control option that also protects against most STIs.
The Pill
Birth control pills are a simple and relatively safe option for preventing pregnancy. Most birth control pills introduce some combination of hormones – usually a combination of estrogen and progestin – which interfere with your ovary’s ability to release an egg during your normal ovulation cycle. The hormones in the pill also change the conditions in your uterus and cervix, making an egg harder to fertilize if one should be released. They typically make your cervical mucus thicker & stickier, giving the sperm a harder time getting through. The pill hormones also change the composition of the uterine lining so a fertilized egg would have a hard time attaching to the wall of the uterus. The pill often provides the bonus of more controlled, more predictable periods with less cramping and fewer PMS symptoms. Some women take birth control pills just to control their cycles, and it is perfectly safe to take them for as long as you need to.
Birth control pills are 93% effective with perfect use, which means taking your pill consistently, every day, and at roughly the same time each day. Some antibiotics and other medications may interfere with hormonal birth control pills, so always check when you get a new prescription, and use a backup method like a condom for as long as you need to. If you and your partner choose that you’d like to start trying to conceive, it may be possible to get pregnant almost immediately after stopping the pill.
IUD
IUD stands for intrauterine device. It is a tiny T-shaped plastic device which is inserted inside your uterus by a doctor. IUDs use either hormones or copper to interfere with how sperm can travel once inside your uterus, so they can’t fertilize an egg. Most IUDs remain in place and effective for 3-8 years, depending on the brand, and a copper IUD can last up to 12 years. They are a good choice for women who want long-lasting birth control with minimal hormones and minimal maintenance. There is a small chance of certain side effects or complications from an IUD but they are rare, making them a go-to “set it an forget it” form of birth control.
If at any point you choose you want to try and become pregnant, IUDs can be removed by a doctor and their effects immediately go away. At 99% effective and with very minimal upkeep, an IUD is one of the most effective forms of birth control out there.
Birth Control Implant
The implant (most common US brand name: Nexplanon) is a small, thin rod – about the size of a matchstick – that gradually releases hormones to prevent pregnancy. A doctor or nurse gives you a numbing shot, then places the implant in your upper arm with a quick needle jab. The injection site might hurt a little for a day or two, but once it heals, no one but you will even know it’s there. After that, it continues to work at preventing pregnancy for 5 years. Side effects are typically minimal, are similar to those of the pill (spotting/irregular bleeding, breast pain or tenderness, etc.), and usually subside after the first few weeks. Many women do not get their periods at all while they have the implant, which may be considered a nice little bonus by many. At 99% effective and with no upkeep to worry about for five years, it’s a great choice for long-term, low maintenance pregnancy prevention. And if you choose you’d prefer to remove it earlier than the five year mark, you can do so with no problem, and you will be able to try and get pregnant right away.
Lifestyle Methods
Some women who choose to prevent pregnancy without hormones, chemicals, per-use prophylactic devices, or medical procedures may follow a certain lifestyle method of pregnancy prevention, such as:
- Fertility Awareness Method aka the calendar method, which requires you learning the ins and outs of your cycle and not having sex (or strictly using condoms) around the time when you are ovulating and at your most fertile.
- Withdrawal, aka the Pullout method or coitus interruptus. The man pulls out of the vagina before he ejaculates. It’s only 78% effective and is hard to perform faithfully, because the penis needs to be far from the vagina before any semen comes out – even precum contains some sperm, so this one is risky.
- Breastfeeding as birth control. Nursing an infant on a certain schedule prevents you from ovulating. This method is about as effective as the pill when done correctly, but it takes a lot of commitment and consistency to maintain breastfeeding on that strict a schedule.
Sterilization
Last but definitely not least – it’s the most effective and in fact, it’s (surprisingly) the most commonly used form of birth control in the US – is female sterilization, AKA “having your tubes tied”. I say this statistic is surprising, because it’s historically difficult for women – especially younger women – to get a doctor to perform this procedure, because “WhAt iF yOu cHanGe YoUr MinD?!?!” I’m guessing this is because the ages in this study go up to 49 – it’s much more common with older women; younger women still mostly rely on the pill for birth control. Cost may be a prohibitive factor here, too. A tubal ligation procedure isn’t cheap, and may or may not be covered by insurance.
Female sterilization is done through a procedure called tubal ligation, described in much better detail here by the Mayo Clinic. In the simplest terms, it is a surgical procedure which somehow cuts off your fallopian tubes from your uterus, so eggs released from your ovaries can never get through to where they could be fertilized by sperm. Sterilization is permanent, so it’s not a good fit if you may ever want to become pregnant in the future, if you’re being pressured by anyone, or if you’re trying to use it to solve a temporary problem. At over 99% effective at preventing pregnancy, it may be a good fit if you are confident you never want to have a child or have a medical condition that would make becoming pregnant unsafe, and you want a permanent & effective solution with very few long-term side effects.
This is one form of BC where males can get involved, too. Male sterilization, also known as a vasectomy, is also upwards of 99% effective. It’s a fairly simple outpatient surgical procedure which cuts off the supply of sperm to the semen. After a few days of taking it easy while it heals, you can both go on to all the amazing sex you want with no risk of pregnancy.
