9 Birth Control Options: Advantages, Disadvantages & Side Effects

November 2021

There are several birth control methods that help to prevent pregnancy, such as the birth control pill or the implant in the arm. The only method that can prevent pregnancy and additionally protect against a sexually transmitted infection at the same time is the condom, and therefore it should be used when having sex, especially when you don't know your partner's sexual history.

Before choosing a contraceptive method, it is important to consult your gynecologist to decide which option is best for you. Factors your gynecologist will take into consideration include your gender, age, cigarette use, health history, and allergies.

Learn more about the several birth control options available:

1. Birth control pill

The oral contraceptive pill, also known as the pill, is the method most commonly used by women to prevent pregnancy. It has hormones that are similar to those produced by the ovaries, and works by preventing ovulation from occurring (which means there is no egg available to be fertilized).

The types of birth control pills that exist are the combination pill, which contains estrogen and progestin, and the minipill, which only has progestin. The minipill is most commonly prescribed to women who are breastfeeding, women who smoke or women over the age of 35.

You can get a prescription from a doctor or nurse practitioner and obtain the pills at your local pharmacy. Common brands of birth control pills include Alesse, Yasmin, Cerazette, Desogen, Aranelle, Aviane, and Lessina,

●    Advantages: in addition to helping to prevent pregnancy, the pill can also be used for treating many symptoms like decreasing menstrual blood flow, helping with period pain, regulating the menstrual cycle, improving acne, reducing excess hair growth, and helping with PMS symptoms. Oral birth control pills can also play a role preventing pelvic inflammatory disease, cysts, and ovarian cancer

●    Disadvantages: although it is a very effective and safe method, it will only work to prevent pregnancy if taken every day at the same time, without interruption

●    Possible side effects: the most common ones include nausea, breast pain, occasional spotting, decreased blood flow, and symptoms of depression.

How to take the birth control pill correctly

In a 21-pill pack, you have to take 1 pill a day (at the same time of the day) for 21 days until the end of the pack and when you finish, take a 7-day break with no pills, which is when your period comes. On the 8th day, start a new pack.

2. Contraceptive implant

The contraceptive implant, such as Implanon or Nexplanon, is a birth control method that helps prevent pregnancy through the insertion of a small plastic rod into the inner part of the arm, under the skin, by the gynecologist. The implant releases hormones into the blood slowly, preventing ovulation and making it difficult for sperm to enter the woman's uterus.

This implant can remain in the woman's arm for up to 3 years, but it can only be inserted and removed by the gynecologist. Fertility can be regained within one month of removal.

●    Advantages: in addition to preventing pregnancy, it can be used to reduce period-related abdominal pain. The implant does not interfere with intercourse or breastfeeding. It is an excellent option for women who often forget to take the pill, have mental health conditions, or have gastrointestinal problems.

●    Disadvantages: it is a more expensive method and requires a health professional for placement.

●    Possible side effects: it may cause irregular spotting, blotchy skin, nausea, headaches, and mood swings.

When and how to place the implant

The implant needs to be placed in a clinical setting by the gynecologist within the first 7 days of the menstrual cycle (or at any time during the cycle if it is certain that the woman is not pregnant). A minor procedure is required to place and remove the implant, and local anesthesia is applied to numb the area where it will be inserted or removed. It's normal to experience mild pain or bruising within 3 days of the intervention.

3. Intrauterine Device (IUD)

The intrauterine device, known as an IUD, is a T-shaped plastic contraceptive method that is inserted into the uterus by the gynecologist. It can remain in the uterus and be effective for up to 5 years.

This contraceptive technique is very effective and does not cause discomfort. It can prevent pregnancy and fertilization in 2 ways: by slowly releasing hormones (in the case of a hormonal IUD) or through the action of copper within the uterus (in the case of a copper IUD).

●    Advantages: this does not interfere with intercourse and is a good option for women who forget to take the pill every day at the same time. It can remain in the uterus for several years.

●    Disadvantages: it needs to be inserted by a health professional and in some cases, it can lead to anemia.

●    Possible side effects: may cause pain for a few days after being inserted, cause light bleeding in the following months and may increase the risk of vaginal infections.

4. Male and female condoms

Condoms are an excellent contraceptive method to prevent pregnancy. They are the only method that additionally protects against the spread of sexually transmitted infections, such as AIDS or syphilis.

To prevent pregnancy, the condom must be placed correctly before intercourse, and must intercept direct contact between the penis and vagina to stop sperm from reaching the uterus.

●    Advantages: they are generally inexpensive, easy to put on, and do not cause any changes to the body. They additionally protect against sexually transmitted infections.

●    Disadvantages: Some people may be allergic to the condom material, which is usually latex. Also, condoms can cause discomfort for some couples and can tear during intercourse, increasing the chances of getting pregnant.

●    Possible side effects: Other than the risk for allergy to the type of material in the condom, there are no major side effects associated with condom use.

5. Vaginal diaphragm

The diaphragm is a ring-shaped rubber contraceptive method that prevents sperm from entering the uterus, which prevents fertilization of the egg. The diaphragm can be re-used for up 2 years, as long as it is properly washed with each use and stored in a clean place.

●    Advantages: it does not interfere with sex and can be inserted up to 24 hours before intercourse. Furthermore, it reduces the risk of pelvic inflammatory disease.

●    Disadvantages: it needs to be placed at the most 30 minutes before intercourse and removed at the most 12 hours after intercourse. It must be reinserted every time there is intimate contact, otherwise it will not effective.

●    Possible side effects: There are no side effects associated with using a vaginal diaphragm.

6. Vaginal ring

The ring is a rubber device that is inserted into the vagina, with its placement very similar to inserting a tampon. The ring is kept in place for 21 days, and then removed for 7 days (in time for a period to come and go). After menstruation, a new ring is reinserted.

●    Advantages: it is easy to use and does not interfere with intercourse. It is easily reversible and easy to regain fertility, and additionally does not alter the vaginal flora.

●    Disadvantages: it does not protect against STDs, it can lead to weight gain and it cannot be used in many cases, such as liver problems or high blood pressure.

●    Possible side effects: some women experience abdominal pain, nausea, decreased libido, painful periods, and an increased risk for vaginal infections.

7. Contraceptive injection

The contraceptive injection, such as the Depo-Provera shot, is typically injected into an arm muscle or leg muscle once a month or every 3 months by a health care professional.

The injection solution slowly releases hormones that prevent ovulation, but its prolonged use can delay fertility and increase appetite (which can lead to weight gain). Other associated symptoms may include headaches, acne, and hair loss. It is a great method for women with health conditions for which birth control pills are contraindicated (e.g. mental health conditions, tuberculosis, or epilepsy). This is also a good option for women who experience frequent vaginal infections and cannot use a ring or IUD.

8. Female sterilization or Vasectomy

Surgery is a permanent contraceptive method that prevents women or men from having children for the rest of their lives. In most cases, this method is only recommended once the decision to not have any more children has been made, which is more common in men and women over the age of 40. 

For women, female sterilization is performed under general anesthesia, where a cut or ligation is done to the fallopian tubes. This closes off the fallopian tubes, preventing the sperm from meeting the egg. This surgery requires hospitalization for about 2 days and recovery usually takes about 2 weeks.

A vasectomy is a male contraceptive surgery performed that is done underlocal anesthesia. The procedure takes about 20 minutes. With a vasectomy, a cut is made in the duct where the sperm travels from the testicles to the seminal vesicles. Although you are no longer considered fertile after this procedure, ejaculation remains the same and erections are not affected.

9. Natural methods

There are other methods that can also help prevent pregnancy, but they should not be used as the sole method because they are not 100% effective. Some of these methods include:

●    Calendar method: this method requires avoiding sex during a woman's fertile window. This can be determined by subtracting 11 days from the longest cycle and 18 days from the shortest cycle to obtain an average period of days where fertility is at its highest

●    Temperature method: body temperature is higher following ovulation. To know the time of the month when a woman is most fertile, she must read her temperature daily, making sure to obtain readings the same way every day

●    Mucus method: during her most fertile period, a woman has thicker mucus, similar to egg white, which can indicate that the probability of getting pregnant is greater.

●    Withdrawal method: This method involves removing the penis from the vagina right before ejaculation. This method is not always effective nor recommended.

All of these methods require abstaining from sex during the woman's the fertile window, which is when the woman is more likely to become pregnant. In order to gain a good understanding of your fertile window, you should track 3 to 6 cycles.

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Edited by Tua Saude editing team in November 2021. Medical review completed by Dr. Sheila Sedicias - Gynecologist in September 2021.
Medical review:
Dr. Sheila Sedicias
Gynecologist
Physician graduated in Mastology and Gynecology by UFPE in 2008 and member no. 17459 of CRM-PE, Brazil.