Different Birth Control Options: What to Know

Different birth control options suit different people and different stages of life. Some use hormones, some are barriers, some last for years and two are permanent. This guide sets out how each one works, how well it works in everyday life and what to weigh up, so you can talk through different birth control options with a doctor. Methods that need a small procedure, such as an implant or an IUD, are fitted in person.

Key takeaways

• The implant and IUDs prevent more than 99 in 100 pregnancies, and both are fitted in person.
• Only condoms protect against STIs, so many people use them with another method.
• Emergency pills are sold by pharmacists without a prescription and work better the sooner they are taken.
• A doctor can help match a method to your health, your periods and your plans for children.

Emergency Contraception After Unprotected Sex

Emergency contraception lowers the chance of pregnancy after unprotected sex, a missed pill or a condom that broke. It is a backup, not one of the different birth control options for regular use, and it does not cause an abortion. There are three kinds: the copper IUD and two pills that use hormones to delay the release of an egg.

If you vomit within a few hours of an emergency pill, ask a pharmacist about another dose. Do a pregnancy test if your next period is more than a week late or unusually light.

Choosing a Method That Suits You

The right method depends on your health, your body and your plans. Ask how well it works with everyday use, whether you want hormones, and how often you want to think about it: daily for the pill, monthly for a ring, every three months for a jab, or years for an implant or IUD. What suits you can change, so it helps to look at different birth control options again as life changes.

Health matters too. Methods with oestrogen, the combined pill and the ring, are not suitable for people who get migraine with aura, have had a blood clot, or smoke and are over 35. Think too about your periods, whether you want protection from STIs, which only condoms give, and when you might want children. Some methods stop sperm, others stop an egg being released. Permanent methods such as tubal ligation and vasectomy suit only people who are sure they want no more children.

What Causes Different Birth Control Options to Fail?

Most pregnancies on contraception come from how a method is used rather than the method itself. The oral pill fails most often when doses are missed or taken late, when vomiting or severe diarrhoea stops it being absorbed, or when another medicine, such as some epilepsy treatments or St John's wort, lowers its effect. The same medicines can weaken an implant. A vaginal ring fails when it stays out too long, and a late jab leaves a gap.

A condom fails when it slips, tears or goes on too late, after some sperm has already been released. A vasectomy does not work straight away, because sperm stay in the tubes for weeks: another method is needed until a semen test about three months later shows none. If you think a method has failed, emergency contraception and a later pregnancy test protect you, and a doctor can help you weigh up different birth control options that are easier to use.

Different Birth Control Options, From Hormonal to Permanent

Birth control, also called contraception, is any method that stops you falling pregnant, mostly by keeping sperm and egg apart or by stopping an egg being released. There are several types: hormonal methods, devices placed in the uterus, barriers, fertility awareness and permanent methods.

Hormonal methods include contraceptive pills, the vaginal ring, a three monthly injection and the implant, a small rod placed under the skin of the arm that lasts three years. The pills come as the combined pill, with an oestrogen and a progestogen, and the progestogen only pill. Hormonal methods mainly stop ovulation or thicken the mucus at the cervix. The pill, the ring and the jab are only available on prescription in Australia.

An intrauterine device, or IUD, is a small device placed in the uterus. The hormonal IUD releases a progestogen, lasts five years or more and often makes periods lighter. The copper intrauterine device has no hormones, lasts five or ten years depending on type, and can make periods heavier. Both are fitted in person. Barrier methods, condoms and the diaphragm, are used each time you have sex. Permanent methods are tubal ligation, which blocks the fallopian tubes, and vasectomy, which blocks the tubes that carry sperm.

Typical Use Effectiveness Compared

Typical use means everyday life, with the odd late dose or forgotten condom, and it is the fairest way to compare contraceptive methods. Out of every 100 people who use a method for a year, more than 99 avoid pregnancy with the implant, either kind of IUD in the uterus, tubal ligation or a vasectomy, because there is little to remember. About 96 avoid it with the jab, 93 with the pill or the vaginal ring, 88 with external condoms and 82 with a diaphragm.

Perfect use, every time and on time, lifts most shorter acting methods to 98 in 100 or more, which is why a method that fits your routine matters as much as the method itself. Fertility awareness, tracking your cycle to avoid sex on fertile days, varies most from person to person. A doctor can talk through which contraceptive fits how you live.

Methods That Prevent Pregnancy and Protect Against STIs

Condoms are the only methods that both prevent pregnancy and protect against sexually transmitted infections. Both kinds, the external condom worn on the penis and the internal condom worn inside the vagina, stop the exchange of fluids that carry most STIs. Every other contraceptive, from hormonal methods to an IUD, gives no protection from infection.

Because a condom works less well as contraception than a long acting method, many people use both: a condom with a hormonal method or an IUD. This is often called dual protection, and it suits anyone with a new partner or more than one partner.

A condom lowers the risk of most STIs but not all, because herpes and genital warts can spread through skin contact. A regular STI test is sensible with a new partner, even when your contraceptive is reliable, and a doctor can arrange one with a pathology request.

Planning a Pregnancy After Stopping Contraception

Most contraception can be stopped whenever you are ready for a pregnancy, and with most methods the body returns to its usual cycle quickly. After the pill or the ring is stopped, or a long acting method is removed, fertility usually comes back within weeks. The injection is the exception: periods and ovulation can take up to 18 months to return after the last dose, so stop it well ahead if you plan to conceive soon.

Start a folic acid supplement at least one month before you try to conceive and keep taking it for the first three months of pregnancy. A check with a doctor beforehand covers vaccinations, medicines and any health conditions. Reversible methods leave no lasting effect on your chance of falling pregnant, and you can conceive in the first month after stopping, so keep using a contraceptive until you are ready.

Talking to a Doctor About Contraception

A doctor can help you compare methods, check your health and start one that suits you. In a phone consult, the doctor asks about your periods, your health and medicines, migraines, smoking, any blood clots, and your blood pressure, so have a recent reading handy. Where the doctor thinks it right, the pill or the ring can be sent as an eScript, and the injection, once prescribed, is given by a nurse or doctor.

Long acting reversible contraception, the implant and IUDs, needs a small procedure, so it is fitted in person by a trained doctor or nurse, which a phone consult cannot do. A doctor can give you a referral to a clinic that fits them and explain what to expect. Medio's doctors consult by phone only, so if you need an examination, the doctor will tell you where to go.

Summary

Different birth control options range from a daily tablet to a device that lasts years, and from hormone free devices to permanent methods. This guide covered emergency contraception, how to pick a method, why methods fail, the types, how well each works, STIs, planning for a baby and talking to a doctor. A Medio doctor can talk through different birth control options by phone and, where the doctor thinks it right, send an eScript or a referral for a fitting in person.

Frequently asked questions

Which birth control has the least side effects?

No method is free of side effects for everyone, so the answer depends on you. Barrier methods and the copper IUD have no hormones, though the copper IUD can make periods heavier and more painful. The hormonal IUD releases a small dose mostly inside the uterus. The contraceptive implant often changes bleeding patterns. Many side effects settle within three months, and a doctor can help you find a method that agrees with you.

How does birth control work?

Birth control works by keeping sperm away from an egg. Hormonal methods mostly stop the ovaries releasing an egg and thicken the mucus at the cervix so sperm cannot get through. The copper IUD makes the uterus hostile to sperm, barrier methods block them, and permanent methods close the tubes an egg or sperm travels along. Emergency pills mainly delay the release of an egg.

Can a doctor help with different birth control options?

Yes. In a telehealth consult by phone, a Medio doctor can talk through your health and preferences, explain each method and, where the doctor thinks it right, send an eScript for the pill or the ring. An implant or IUD needs a fitting in person, which a phone consult cannot do, so the doctor can refer you to a clinic that fits them.

Is it healthier to be on birth control or not?

It depends on your health and what you need. For most healthy people, modern birth control is safe, and some methods bring benefits such as lighter, less painful periods. Being on birth control for a long time, even 20 years, is not a problem for most people, as long as a doctor reviews it now and then. There is no best age to stop taking the pill: many people can stay on it until about 50 if they are healthy and do not smoke.

What birth control has the worst side effects?

No method is worst for everyone; each has side effects that some people notice. The combined pill and the ring carry a small risk of a blood clot, higher in people who smoke. The three monthly jab can cause weight gain and a slow return of periods after stopping. The implant can cause irregular bleeding. Severe leg pain or swelling, chest pain, sudden breathlessness or a sudden severe headache needs urgent care: call 000.

Which is the healthiest form of birth control?

There is no single healthiest form; the right one fits your health, your body and your plans. Other forms of pregnancy prevention, such as a barrier method or tracking your cycle, have no hormonal effects but work less well. Something else to know: only a condom protects against STIs, so pairing one with your main method covers both. A doctor can help you weigh it up and review it as your needs change.