Choosing the right birth control for your life and body isn’t always easy. There is a lot that nobody tells you about birth control, including possible negative impacts on your mood, weight and libido from the pill, for example, or vaginal irritation from vaginal rings.
Many people don’t even know exactly how we get pregnant.
Types of birth control and contraception
Birth control comes in four main forms: physical barrier methods, hormonal methods, IUDs and natural birth control.
Condoms stop sexually transmitted infections as well as pregnancy, but hormonal and IUD methods only protect you from pregnancy.
Natural birth control methods use the menstrual cycle and other clues to avoid sex during fertile windows to avoid pregnancy. These do not protect you from STIs.
The only permanent form of birth control is sterilisation (tubal ligation), also known as ‘having your tubes tied’, or a man can have a vasectomy.
Physical barrier birth control – condoms, dental dams
As the name suggests, a physical barrier creates a blockade between a fertile egg and the live sperm, during sexual intercourse.
Condoms also stop most penis or semen-borne bacteria, viruses, fungi and parasites from entering your vagina (or entering the penis, from your vagina). Diaphragms and sponges do not offer this protection.
Hormonal birth control options
There are an abundance of hormone-based pills, patches, rings, and implants available from your doctor via prescription, which prevent ovulation. No egg available means pregnancy is not possible.
What’s the difference between different brands?
Each type of hormonal birth control has a unique formulation of hormones, since a pharmaceutical company cannot patent regular versions of hormones – only slightly molecularly different versions of hormones.
This is why some hormonal contraceptives will suit you better than others. You can try different hormonal birth control types and see what works for you. Some will feel better than others.
Types of hormonal birth control
- The pill (oral contraceptive pill)
- The mini-pill
- Nuvaring
- Patches
- Implants
- Hormonal IUD (Mirena, Skyla, Kyleena, Liletta)
Natural birth control techniques
The two main methods here are cycle charting and the pull-out or withdrawal method.
How to decide which birth control is right for you
First you need to figure out whether you need to be protected from bacteria, viruses, fungi and parasites, or just pregnancy. You can use more than one method of birth control, like be on the pill while also using condoms, or charting your cycles and using a condom during fertile times.
If no babies is the only goal, then you have all the options. If you need to be protected from infections, you need to get good at using condoms.
Emergency contraceptives: The Morning After Pill, Plan B, the regular pill (higher dose)
There are options for stopping the process of pregnancy before it can progress, with emergency contraception available in many countries from pharmacies and supermarkets.
If you can’t get hold of emergency contraceptive pills, you can use regular ‘the pill’ pills – read the chart to figure out how many pills of the brand you have to take.
Copper and Hormonal Intrauterine Devices (IUDs)
There are two types of IUD – hormonal and non-hormonal (also known as the copper IUD). The hormonal IUD releases hormones into the uterus, which causes a reduction in period blood volume so implantation can’t occur, thickens cervical mucous so sperm can’t get through, and often, suppresses ovulation.
You may not get any periods. The hormonal IUD is also smaller than the copper IUD, so can be better tolerated for many women. Both have their pros and cons, but which choice is best for you will depend on your body.
The copper IUD is a non-hormonal option, slightly larger than the hormonal IUDs, but you get a natural menstrual cycle with ovulation. This is one of the perks of the copper IUD; sex during ovulation is fun!
Both forms of IUD are extremely painful to have inserted and removed unless under anaesthetic, can be expensive, and may come with a ‘settling in’ period of heavier, more painful periods, and vaginal microbiome disturbances.
Natural birth control options
The withdrawal method (also known as the pull-out method or coitus interruptus)
The withdrawal method is where the man pulls his penis out of the vagina before he ejaculates, and the semen goes somewhere else. This means the sperm doesn’t have a chance to make its way to the egg, and no pregnancy can occur.
This method of birth control has been in use since time began, and has been extremely controversial for one very good reason: it sometimes works and sometimes definitely does not work.
But how do you know if withdrawal will work for you or not?
Well, that’s not super easy to answer because it turns out that every individual man is either able to successfully pull out, or he is not.1 Now, we don’t mean he is unable to pull his penis out before he ejaculates – let’s assume he’s got that covered – but it means the pre-ejaculate fluid (precum) of each man is either fertile or it is not.
While you are having sex, some pre-ejaculate fluid escapes the man’s penis and enters the vagina. This is normal. Each man is either fertile in this stage, or he is infertile in this stage, and this remains constant throughout his life.
This status has as much to do with his plumbing as anything else, and there is nothing you can do to change his status as either a pre-ejaculate-fertile man or a pre-ejaculate-infertile man. That is, successfully avoiding pregnancy using the pull-out method.
The only way to figure out a man’s status as a potentially successful puller-outer is to either undergo testing (which is likely to cost a lot as part of fertility testing) or to take your chances.
Many couples can successfully go through their whole relationship without getting pregnant using this method alone. The pre-ejaculate fertility is often the reason why.
Menstrual Cycle Charting
Charting your cycles is a valid method of birth control, so long as you know exactly what you’re doing!
Usually, the minute you learn when you ovulate – and the associated fun bits that go with it – you want to experience that all the time while also enjoying sex without contraception when it’s safe to do so.
To keep your natural cycle and have sex during ovulation, your only options are a copper IUD, barrier methods, or natural birth control.
Termination of pregnancy
If you do get pregnant, you may be able to get an abortion, but how easy, safe, and cheap this is will depend very heavily on where you live.
Women on Waves provides online medical consultations and mail abortion drugs to people who can’t get an abortion in their own country or area. Contact them for confidential help.
References
- 1.Killick SR, Leary C, Trussell J, Guthrie KA. Sperm content of pre-ejaculatory fluid. Human Fertility. Published online December 15, 2010:48-52. doi:10.3109/14647273.2010.520798
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