When it comes to sex, there are quite a few decisions to be made: whom you have it with, when you want to have it and how frequently you want it to happen. And if all that wasn’t enough, now comes the doozy: choosing your birth control.
With so many confusing narratives surrounding birth control, many women turn to hearsay or random internet forums for information. Planned Parenthood provides a comprehensive list of options and information, though it can take a while to navigate.
Several companies are trying to simplify your decision process. Iodine created a webpage with survey information on how “worth it” each method was for users, and Bedsider.org provides user-friendly, in-depth info, complete with interactive graphics.
So if you're looking for the right birth control for you, don't worry — we got you! Read on for a quick and simple guide to the common birth-control methods that require a prescription, and be sure to check out the infographic below.
Are you worried about adding extra hormones to your body?
Most of the options that require a prescription contain hormones. Throwing extra hormones into your body can sound scary, especially considering that we often blame hormone fluctuations for occasional moodiness.
Most studies show that while complaints of physical symptoms like cramps and bloating are totally linked to our cycles, moods aren’t really. They found that moods were more strongly correlated with stress and physical health — meaning your ’tude may actually arise from the discomfort related to your period.
Only about 1 percent of women experience severe emotional symptoms, such as depression and irritability, before menstruation. Doctors call this premenstrual dysphoric disorder (PMDD). While hormone changes might play a role, studies show that women with PMDD have ordinary levels of estrogen and progesterone.
Estro-what and progester-who?
Estrogen and progesterone are two hormones produced naturally by your ovaries. They regulate your menstrual cycle and pregnancy. Hormonal birth control utilizes estrogen and progesterone hormones similar to the ones produced by your body.
Are you using birth control to stop your period and ease symptoms?
Then combined hormonal methods that contain both estrogen and progesterone might be right for you. Your body’s hormone levels naturally spike during ovulation, and combination methods get rid of that spike, according to Bedsider. That means your hormone levels stay consistent throughout the month. It also means that ovulation ceases, so you can use these methods to stop your period and vanquish awful cramps, migraines and bloating.
A few studies found that women with a BMI higher than 25 had an increased risk of accidental pregnancies compared to other women when on the combination pill, an oral ingestible taken daily, and the patch, which sticks to the skin and is swapped out once a month.
Not to worry: The ring — a small, flexible device that you place in your vagina once a month — works just fine for women who are overweight, as well as all progestin-only hormonal methods (we’ll get to those in the next section).
There are no estrogen-only birth-control methods because, when taken alone, estrogen can increase your risk of cancer of the endometrium, or your uterus lining, by making it too thick. Progestin helps to thin it out.
Do you smoke or have any chronic illnesses?
Hey, ladies, methods that contain both estrogen and progestin are risky if you have certain medical conditions. These conditions include high blood pressure, blood clots, stroke, heart disease and liver and breast cancers. If you smoke or need prolonged bed rest (and not the kind you get from binge-watching “Westworld”), also avoid combined methods. But that doesn’t mean you can’t use hormonal birth control: Progestin-only methods have your back.
Progestin stops ovulation in about 60 percent of women, so even though it’s not used to stop periods, it often makes them lighter. Unlike combined hormone methods, progestin methods do not impact your weight, and they don’t make headaches and migraines more common.
Progestin-based birth control can range in their methods. There’s the minipill, which is basically the same as the combination pill, only there’s no estrogen in it. Then you’ve got the shot, an injection of hormones you get every three months. There’s also the implant, a flexible rod about the size of a matchstick that a health care provider places in your arm, which can last up to four years. Then there’s the hormonal intrauterine device (IUD), a tiny, T-shape device that goes in your cervix, lasting anywhere from three to six years.
Each progestin method contains different amounts of hormones. However, the highest amount of progestin in any of these methods is still way lower than the natural spike of progesterone your body creates during your menstrual cycle, according to Bedsider. In other words, most women don’t need to worry about hormonal birth control dramatically changing their bodies or moods.
Are mood swings or depression a concern for you?
Despite all of the research cited above that debunks common lore about hormones and mood swings, some scientists are not convinced that hormones are harmless. A recent study found a striking correlation between use of hormonal birth control and the prescription of antidepressants — in some cases, a 60 percent increase in the latter when women were on the former.
So will hormonal birth control make you depressed? Meh. Many critics have called these findings into question. The number of women being prescribed antidepressants was small to begin with and increased only slightly if they were on hormonal birth control, from 1.7 to 2.2 out of 100.
Nevertheless, if you’re concerned, that’s totally your right, especially if you’re prone to mood swings or depression. But if you thought you were out of options, think again. For women who want long-term birth control without the hormones, there’s the ParaGaurd copper IUD.
Sperm hates copper, so it won’t get far enough to fertilize an egg. It’s actually extremely effective (better than 99 percent!) because there’s pretty much no chance you can mess it up. Once it’s in, you can forget about it. Fun fact: Copper IUDs are also the most effective method of morning-after emergency contraception if used within five days of unprotected sex.
Lastly, if you’re not about to commit to any of the above methods, you might want to look into cervical caps and diaphragms. They block the opening to your uterus and can be inserted hours ahead of time. Just know that they must be used with spermicide, which comes in the form of creams, film, foam, gels and suppositories and contains chemicals that keep sperm from moving.