Birth Control

Overview

Birth control is any method used to prevent pregnancy. Another word for birth control is contraception.

If you have sex without birth control, there is a chance that you could get pregnant. This is true even if you have not started having periods yet or you are getting close to menopause.

The only sure way to prevent pregnancy is to not have sex. But finding a good method of birth control that you are comfortable with can help you avoid an unplanned pregnancy.

Be sure to tell your doctor about any health problems you have or medicines you take. He or she can help you choose the birth control method that is right for you.

Types of Birth Control

There are many different kinds of birth control. Each has pros and cons. Learning about all the methods will help you find one that is right for you.

• Long-acting reversible contraception (LARC) is the most effective reversible method you can use to prevent pregnancy. If you decide you want to get pregnant, you can have them removed. LARCs are implants and intrauterine devices (IUDs). While they are being used, they usually prevent pregnancy for years.
  • Implants are placed under the skin of the arm. They release the hormone progestin and prevent pregnancy for up to 5 years.^{footnote 1}
    • Talk to your doctor about how long you can use an implant.
  • IUDs are placed in the uterus by a doctor. There are two main types of IUDs—the copper IUD and the hormonal IUD. The hormonal IUD releases progestin. IUDs prevent pregnancy for 3 to 12 years, depending on the type.^{footnote 2}
    • Talk to your doctor about how long you can use it.
• Hormonal methods are very good at preventing pregnancy. Combination birth control pills ("the pill"), skin patches, and vaginal rings release the hormones estrogen and progestin. Shots, mini-pills, hormonal IUDs, and implants release progestin only.
• Barrier methods generally do not prevent pregnancy as well as IUDs or hormonal methods do. Barrier methods include condoms, diaphragms, cervical caps, and sponges. You must use barrier methods every time you have sex.
• Natural family planning can work if you and your partner are careful and you have a regular ovulation cycle. You will need to keep records so you know when you are most likely to become pregnant (you are fertile). And during times you are fertile, you will need to not have sex or to use a barrier method. Natural family planning is also known as fertility awareness and the rhythm method.
• Permanent birth control (sterilization) gives you lasting protection against pregnancy. A man can have a vasectomy, or a woman can have her tubes tied (tubal ligation). But this is only a good choice if you are sure that you don't want any (or any more) children.
• Emergency contraception is a backup method to prevent pregnancy if you didn't use birth control or a condom breaks. The most effective emergency contraception is an IUD (inserted by a doctor). You can also get emergency contraceptive pills. You can get them with a prescription from your doctor or without a prescription at most drugstores.

Birth control following pregnancy

Talk to your doctor about the options for birth control after your delivery. They include implants and intrauterine devices (IUDs), hormonal methods, and barrier methods. Many types of birth control are safe to use if you're going to breastfeed. But some work better than others.

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Choosing a Birth Control Method

The best method of birth control is one that protects you every time you have sex. This usually depends on how well you use it. To find a method that will work best for you, think about:

• How well it works. Think about how important it is to you to avoid pregnancy. Then look at how well each method works. For example, if you plan to have a child soon anyway, you may not need a very reliable method. If you don't want children but feel it is wrong to end a pregnancy, choose a type of birth control that works very well.
• How much effort it takes. For example, birth control pills may not be a good choice if you often forget to take medicine. Or, if you are not sure you will stop and use a barrier method each time you have sex, pick another method.
• How much the method costs. For example, condoms are cheap or free in some clinics. Some insurance companies cover the cost of prescription birth control. But cost can sometimes be misleading. An IUD costs a lot up front. But it works for years, making it low-cost over time.
• Whether it protects you from infection. Latex condoms can help protect you from sexually transmitted infections (STIs), such as herpes or HIV/AIDS. But they are not the best way to prevent pregnancy. To avoid both STIs and pregnancy, use condoms along with another type of birth control.
• Whether you've had a problem with one kind of birth control. Finding the best method of birth control may involve trying something different. Also, you may need to change a method that once worked well for you.
• Whether you want children. If you are positive you don't want children, a lasting method of birth control might be best.
• Your health issues. Some birth control methods may not be safe for you, depending on your health issues. For example, women who smoke, are breastfeeding, or have had breast cancer may not be able to use certain methods.

Time and effort to use

Birth control must be used correctly in order to prevent pregnancy. When you decide which birth control method to use, be honest about how much effort you are willing to put into birth control. If you aren't comfortable with or might not consistently use a birth control method for any reason, that method isn't likely to be reliable for you in the long run.

Some birth control methods require more effort than others.

• Long-acting reversible contraception (LARC) (such as implants and IUDs) works to prevent pregnancy for 3 to 12 years.^{footnote 3} Talk to your doctor about how long you can use it. After it's in place, you don't need to do anything.
• Barrier methods (including the diaphragm; cervical cap; male condom; female condom; and spermicidal foam, sponge, gel, suppository, or film) can interrupt sex. And you have to use them every time you have sex.
• Combination pills are taken each day. Progestin-only pills must be taken at the same time each day. If you miss a pill, you'll need to use a backup birth control method.
• Patches are replaced 3 times each month.
• Vaginal rings are inserted into the vagina 1 time each month.
• Fertility awareness requires that a couple chart the time during a woman's menstrual cycle when she is most likely to become pregnant. The couple must avoid intercourse or use a barrier method during that time.
• Sterilization is a surgical procedure. It's done for men or women who decide that they don't want to have any (or more) children. It's intended to be permanent.

Health issues that might limit your choices

If you have health problems or other risk factors, some birth control methods may not be safe for you. To make sure a method is right for you, your doctor will need to know if you:

• Smoke. If you smoke more than 15 cigarettes a day and are 35 or older or have high blood pressure, a history of stroke, a history of blood clots, liver disease, or heart disease, you may not be able to use combined hormonal methods.
• Have any serious health problems, such as heart disease, high blood pressure, diabetes, or migraine headaches.
• Have had blood clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism), or have a close family member who had blood clots in the legs or lungs.
• Are pregnant.
• Have just delivered a baby. If you just had a baby, the estrogen-progestin methods of birth control aren't recommended in the first few weeks.
• Have breast cancer or a history of breast cancer.
• Have a sexually transmitted infection (STI).

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Emergency Contraception

Emergency contraception is a way to prevent pregnancy if:

• You had sex without using birth control. There is a chance that you could get pregnant even if you haven't started having periods yet or you are getting close to menopause.
• Your birth control method failed. Maybe you forgot to take your pill or get your shot. Or maybe the condom broke or came off, or your diaphragm slipped.
• You used a birth control method that isn't very reliable, or you didn't use it the right way.
• You were sexually assaulted. Even if you were using birth control, emergency contraception can help decrease your chance of getting pregnant.

Using emergency contraception right away can prevent an unwanted pregnancy. And it can keep you from worrying while you wait for your next period to start.

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How to Get Birth Control

• You can buy:
  • Condoms, sponges, and spermicides without a prescription in drugstores, online, and in many grocery stores.
  • Some forms of emergency contraception without a prescription at most drugstores.
• You need to see a doctor or visit a family planning clinic to:
  • Get a prescription for birth control pills and other methods that use hormones.
  • Have an implant or IUD inserted, including the type of IUD used for emergency contraception.
  • Get a hormone shot.
  • Get a prescription for a diaphragm or cervical cap.
  • Get a prescription for certain kinds of emergency contraception.

When to Call a Doctor

Call 911 or other emergency services if you have:

• Sudden, severe chest pain.
• Difficulty breathing.
• Sudden, severe headache.

Call your doctor now if you:

• Have severe pain in your belly.
• Have headaches that:
  • Happen more often.
  • Are getting worse.
  • Start with auras, such as seeing spots, wavy lines, or flashing lights. Your hands, arms, or face may tingle or feel numb.
• Have signs of a blood clot, such as:
  • Pain in your calf, back of the knee, thigh, or groin.
  • Redness and swelling in your leg or groin.
• Feel depressed.
• Have heavy or prolonged bleeding.
• Think you may be pregnant.
• Notice yellowing of your skin or eyes.

It's common to have mild headaches, mild nausea, mild breast tenderness, or irregular bleeding (spotting) when starting birth control. These mild symptoms should improve over time. If you have problems with a birth control method, talk with your doctor. They may recommend another birth control method or help you solve the problem you are having.