With school systems’ emphasis on abstinence-forward education, it’s no surprise that most students enter college with little-to-no formal knowledge on safe-sex practices. This leaves many in the dark about what options are available to them and how these options work.
Birth control is measured on two scales of effectiveness: practical and potential. Practical effectiveness is a measure of how successful the method is at preventing pregnancy with realistic use, meaning some mistakes and variances occur in usage. Potential effectiveness is a measure of how successful the method is with perfect intended use.
Whether for pregnancy prevention, protection against STIs, hormone control or other purposes, many find themselves interested in birth control but don’t know where to begin. This is a breakdown of the most common types of birth control to help you pursue what’s best for your lifestyle.
- Condoms
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Standard condoms are worn over a penis and can be used for any kind of sex involving a penis. Internal condoms are worn inside a vagina or anus. In practice, condoms are 87% effective, with a potential of 98%. Internal condoms are 79% effective in practice, with a 95% potential.
Pros: Condoms are a non-hormonal method of birth control that protect from both pregnancy and STIs. They can be purchased over-the-counter, are inexpensive and are widely available. Condoms can be used on their own or in conjunction with most other forms of birth control. They can also be turned into a makeshift dental dam.
Cons: Condoms must be used every time, thus a supply needs to be kept on hand. They are also only single-use and require more vigilance than other forms of birth control in order to make sure they are being used correctly.
- The pill
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The pill is one of the most popular methods of birth control, taken orally every day. In practice, it is 93% effective, with a potential of 99%.
Pros: The pill is on the more affordable and accessible end of birth control methods. Because it’s a hormonal method, it can be used to reduce menstrual flow, menstrual pain and acne. It also allows for control of the menstrual cycle.
Cons: Birth control pills typically require a prescription and don’t protect against STIs. They must be taken consistently daily and may produce a variety of side effects, including headaches, nausea, and mood swings.
- The patch
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The patch is an adhesive that releases hormones through the skin to prevent ovulation. The patch is 93% effective in practice, with a 99% potential rate.
Pros: The patch is only administered weekly, unlike the pill. Due to the hormonal changes produced, the menstrual cycle can be controlled, and its negative symptoms, such as cramps and heavy bleeding, can be reduced. It can also help reduce acne.
Cons: A prescription is needed to get the patch. It must be applied correctly, checked on regularly to ensure it’s intact and reapplied weekly in order to be most effective. It also varies in effectiveness depending on user weight and doesn’t protect against STIs. As with the pill, there are several potential side effects, such as headaches, nausea, and dryness around the area of adhesive.
- The shot
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The shot is administered by a doctor every three months to inject hormones into the body. In practice, it is about 96% effective, and it has a potential of being over 99% effective.
Pros: The shot is lower maintenance than many options; once getting the shot, it’s not a worry for three months. It also may lighten or stop the menstrual cycle and negative symptoms associated with it.
Cons: A doctor’s visit is needed for each administration. It doesn’t protect from STIs. It may also result in side effects such as headaches, nausea, weight gain, and depression.
- The implant
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The implant is inserted in the arm and releases hormones into the body. Because the implant does not depend on user practice, it only has a potential effectiveness, which lies at over 99%.
Pros: The implant lasts for up to three years, making it one of the lowest maintenance methods, and it’s one of the most effective at preventing pregnancy. It can also reduce negative menstruation effects.
Cons: Without insurance, the implant is high on the expensive end of birth control (although this cost may equal or overcome that of other birth control if the implant is used for an extended time). It requires a doctor to administer and does not protect against STIs. It may have side effects, including irregular bleeding, headaches, nausea, weight gain, and pain.
- iuds
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An intrauterine device (IUD) is a small, T-shaped device that is placed inside of the uterus. IUDs are either copper- or hormonal-based. Depending on the brand, IUDs work for 3-12 years. Like the implant, IUDs don’t have a practical effectiveness rate, and their potential effectiveness is over 99%.
Pros: IUDs are one of the most effective and lowest-maintenance forms of birth control. Copper IUDs are a non-hormonal option for those who want a long-term method. Hormonal IUDs may reduce negative menstrual symptoms.
Cons: Like the implant, IUDs can be expensive without insurance and must be inserted by a doctor. Insertion may be painful or dizzying, but this should be short-lasting. There is a small chance an IUD may become dislodged or fall out, particularly in the first several months. Copper IUDs may increase negative menstrual symptoms. Both types of IUDs may cause spotting or irregular bleeding. IUDs also don’t protect against STIs.
- Vaginal Inserts
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Vaginal inserts are included in this list as a broad category of self-administered birth control rather than a specific method. Vaginal inserts are quite literally inserted into the vagina for pregnancy prevention. There are hormonal and non-hormonal options within this category.
Pros: The vaginal ring is a specific type of vaginal insert that uses hormones and lasts from five weeks to a year, depending on the brand. It may reduce negative menstrual symptoms. The vaginal ring is 93% effective in practice, with a potential rate of 99%. Non-hormonal options, including a diaphragm, sponge and cervical cap, range from 86-87% effectiveness in practice and 86-94% effectiveness in potential for those who have not given birth (Otherwise, these rates decrease). Cervical caps last up to a year with proper care, while diaphragms last up to two years. The sponge can be purchased over-the-counter.
Cons: Costs of certain vaginal inserts can be on the higher end of birth control methods without insurance. They require regular maintenance, and non-hormonal methods must be used every time. The sponge is single-use. Non-hormonal methods may also be more difficult to use correctly. Many types of vaginal inserts are recommended to be used alongside spermicide; this is necessary for the cervical cap. Others, like the vaginal ring, are averse to some types of gels or creams. The vaginal ring, diaphragm, and cervical cap require a doctor’s prescription. Significant changes in the body require new diaphragm and cervical cap fitting. The vaginal ring and the sponge may produce side effects. Finally, vaginal inserts do not protect against STIs.
Depending on the level of privacy, maintenance and hormonal influence you desire, there are a number of options available to you. These can be found at a doctor’s office, women’s clinic or drugstore, depending on the type. Generally, most health insurance plans cover the costs of birth control.
It should be noted that most side effects are temporary and that condoms are the only method effective against STIs. Moreover, pregnancy prevention is extra-ensured when more than one method is used. This breakdown focused on methods of protection for vaginal sex, but safe-sex precautions should also be practiced for oral, manual, and anal contact.
I encourage you to explore more about these, other methods of birth control and sex education as a whole. If you are a student at Virginia Tech and are curious about this topic, Human Sexuality is a Pathways course in the department of Human Development. Otherwise, Planned Parenthood provides a plethora of online information about sexual topics and resources you can consult.