A Beginner's Guide to Birth Control

Just like the name says, condoms and other birth control methods in this category work by putting a barrier between sperm and egg.

This concept has been around for centuries. Back in ancient Rome, people used animal bladders to protect against sexually transmitted infections (STIs). Today’s barrier birth control methods are usually made of latex or rubber.

Male condom

These latex or synthetic sheaths slip over the penis to stop sperm. They’re one of the most accessible birth control methods. You can buy them at your local drugstore without a prescription, and they cost as little as $0.50 each.

In case you’re into variety, condoms come in many textures (ribbed for her pleasure!) and flavors.

With perfect use, condoms are 98% effective. But the potential for breakage and other mishaps makes them only about 87% effective for preventing pregnancy with typical use. In other words, each year, about 18 of every 100 users who can get pregnant will if condoms are their only birth control method. Condoms can also irritate sensitive skin.

Female condom

The female condom goes inside your vagina to prevent sperm from getting in. At 95% effectiveness with perfect use, it’s slightly less effective than its male counterpart at preventing pregnancy. But it’s also good protection against STIs.

Diaphragm or cervical cap

You can place one of these little latex or silicone cups inside your vagina and over your cervix before you have sex. This blocks sperm from getting into your uterus.

Diaphragms and cervical caps aren’t one-size-fits-all. Your doctor will need to fit you for one, and it may cost a couple hundred dollars. The upside is that you can keep using your diaphragm or cervical cap for up to 2 years.

A diaphragm is about 88% effective for preventing pregnancy, while a cervical cap is about 77% effective. For max sperm-blocking potential, you can use either one with a spermicide cream or jelly.

Irritation, UTIs, and other infections can be an issue with anything you stick “up there.” Very rarely, if left in for longer than the recommended 24 hours, a diaphragm or cervical cap can increase the risk of a serious complication called toxic shock syndrome.

Sponge

Like a diaphragm, a sponge fits over your cervix and blocks sperm from getting in. It also needs to be used in combination with spermicide for the best protection, and its effectiveness hinges on whether you’ve given birth before.

While the sponge prevents pregnancy about 88% of the time if you’ve never had a baby, its effectiveness drops to 76% once you’ve given birth.

When the first hormonal method came along in 1960, it revolutionized birth control. For one thing, it gave women more power over their reproductive destiny. Plus, couples no longer had to scramble every time mid-sex to find and unwrap a condom.

The basic premise of hormonal birth control hasn’t changed. These methods prevent pregnancy by stopping your ovary from releasing an egg (ovulating) and by making your cervix an unfriendly place for sperm to swim through. Today, there are many methods for delivering these hormones, including pills, patches, shots, and implants.

Just remember that while hormonal birth control helps prevent pregnancy, it won’t prevent STI transmission. To do that, you’ll need to use a barrier method in addition to one of these methods.

Birth control pills

You might know these as “the pill.” Most birth control pills deliver a combination of the hormones estrogen and progestin. For folks who can’t take estrogen, a progestin-only pill is available.

Birth control pills are a pretty reasonably priced option at $0 to $50 per pack. Your insurance might cover the cost. They’re 93% effective with typical use, but it’s important to remember to take them every day — usually at the same time of day.

Any hormonal birth control method can cause side effects like:

• headache
• mood changes
• period changes
• breast soreness
• weight gain

The pill also comes with a risk of more serious complications such as blood clots, heart attack, and stroke, although they are rare. Smoking and being over 35 can increase your risk of complications.

But there are some positive side effects too: The pill can make your periods lighter and help prevent breakouts.

Patch

You stick a patch on your belly, arm, or butt, and it stays there for a week, releasing estrogen and progestin into your system. You replace it at the end of the week. After you’ve worn a patch for 3 weeks in a row, you leave it off for a week and get your period.

The patch is about as effective as the pill. A month’s supply of patches can cost up to $150, depending on your insurance coverage.

Vaginal ring

In this case, you don’t put a ring *on* it but *in* it. You stick the ring into your vagina and leave it there for 3 weeks to do its hormone-releasing thing. Then you take it out, wait a week while you get your period, and put in a new ring.

The ring prevents pregnancy about 91% of the time. Expect to spend up to $200 per ring if you don’t have insurance to cover it.

Implant

Implants fall into the category of long-acting reversible contraceptives (LARCs). One tiny little rod lets you forget about birth control for up to 3 years.

Your doctor places the matchstick-size implant under the skin of your upper arm, and it continuously releases the hormone progestin. Depending on your insurance coverage, the hormonal implant could cost you up to $800. But with a success rate of more than 99%, it offers good peace of mind.

Shot

The birth control shot (brand name Depo-Provera) is a progestin-only shot that’s around 94% effective. You get it once every 3 months from your doctor at a cost of about $240 per year. It comes with a slight risk of bone density loss, but your bone strength should rebound once you stop taking the shot.

IUDs are another type of LARC. Once your doctor places one of these T-shaped devices in your uterus, it can stay there for up to 10 years, depending on which type and brand you choose. There are two types of IUD:

• Hormonal IUDs release a small amount of progestin each day to prevent pregnancy. They’re more than 99% effective and stay in for up to 7 years.
• Copper IUDs prevent pregnancy without hormones. They can keep working for up to 10 years and have a success rate of more than 99%.

Side effects such as spotting between periods and irregular periods are common with IUDs. The copper IUD can also make your periods heavier or longer. IUDs do not prevent STI transmission.

An IUD costs more than $1,000 without insurance, but considering how long it lasts, it could be a bargain compared with other methods. Still, many people who could benefit from LARCs don’t use them. Research suggests that Women of Color, in particular, often don’t take advantage of these devices.

If you’re not into paying for birth control or you want a more natural method, you could try getting to know your menstrual cycle a whole lot better. You have to track your periods, take your temperature, and get up close and personal with your cervical mucus. In other words, it takes some work on your part.

The upside to fertility awareness is that it’s free. But TBH, you need a super regular cycle for it to work, not to mention enough self-control to abstain on your fertile days. Nearly 1 in 4 people who can get pregnant will get pregnant each year when using this method.

Life doesn’t always go according to plan. Mistakes happen. If you forget to take your pill or a condom breaks, emergency contraception could save the day.

You can buy emergency contraceptive pills (aka morning-after pills) without a prescription. You’ll need to take them within 5 days of having sex. The sooner you take them, the better they work at preventing pregnancy. Having your doctor implant a copper IUD within 5 days after you’ve had sex will do the same thing.

Note: Emergency contraception works like birth control pills to stop you from ovulating. It won’t end a pregnancy if you are already pregnant.

You may be 100% sure that parenting isn’t your vibe. If so, a permanent solution to pregnancy prevention might be in order. We’re talking sterilization. Which procedure you’ll undergo depends on the reproductive organs you have.

If you have a uterus and fallopian tubes, you can undergo a tubal ligation — a procedure that involves cutting your fallopian tubes so sperm and eggs can’t meet up.

If you have a penis, you can get a vasectomy, which involves cutting the tubes that carry sperm to your penis. You can still orgasm after vasectomy, but your semen will be sperm-free.

Sterilization is more than 99% effective, but it’s a big decision. Both surgeries are reversible, but there’s no guarantee of pregnancy after a reversal.

Every kind of birth control has its pros and cons. Condoms are cheap and easy to get, but they can make sex less spontaneous. You can get an IUD or an implant and then forget about it for years, but it won’t help prevent STIs.

Think about what you want from a birth control method. Something that’s cheap? Easy to use? Has few side effects?

Have an open and honest convo about birth control with your doctor. They can help you figure out which method is right for you.

When it comes to birth control, you have a lot of options. Whether you want something you can put in and forget about for a few months or years or something to use only when you need it, there’s a method out there for you. Ask your doctor for more info to help you figure out your birth control plan.