When it comes to contraception, there are many options on the market. While all methods of contraception are designed to prevent pregnancy, they each have different modalities and mechanisms of action. How to make sense of it all? In this article, we’ll break down the most effective forms of contraception, how they’re used, and how they work, to help you figure out which option might be right for you. (press the icon to learn more)
OCPs/ Mini-Pills
Pros
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The ability to discontinue anytime
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More control over your own fertility
Cons
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May be a hassle for people who forget to take pills; skipping reduces efficacy
Useful Info
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Physicians may recommend use for uncontrollable acne
Patch
Pros
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External administration
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Doesn't need to be changed daily but weekly
Cons
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Visible
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Can fall off
Useful Info
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Applied to the abdomen, buttock, or upper torso (the location changed w/ each patch)
Ring
Pros
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Only changed once every month
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Reported to have less side effects than OCPs
Cons
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Reports of discomfort with ring during intercourse and general usage.
Useful Info
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Acts similarly as OCPs by releasing estrogen/progesterone over days of cycle.
Contraception Injection
Pros
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Not a daily contraceptive method
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Injection is given approximately every 3 months
Cons
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After pausing/ending usage, can take up to 18 months for hormonal levels to return to normal.
Useful Info
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Can self-administer injections
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Has shown to ease menstrual cramps
The Implant
Pros
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Effective for up to 3 years
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Discrete and hands-off
Cons
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Needs to be inserted and removed in a clinic
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If improperly inserted, complications can occur
Useful Info
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Nexplanon is an implant brand that releases progesterone instead of estrogen
IUDs
Pros
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Hormonal IUD: acts locally, Mirena lasts up to 8 years
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Copper IUD: non-hormonal, lasts up to 10 years, >99% effective
Cons
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Needs to be inserted and removed in a clinic
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Copper IUD: can result in heavier periods
Useful Info
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Different brands last different lengths of time
February 14, 2023
Author: Fiona Miller, MS4
Editor: Anika Bukkapatnam
Publisher: SpotBox LLC.
There are a few different ways to think about the various methods of contraception. You can think about it in terms of
Hormonally or Mechanically
Daily, Weekly, Monthly, or Longer
(Pill, Patch, Ring, Injection, Implant or IUD)
function,
frequency of use,
or mode of delivery.
OCPs, or oral contraceptive pills, are usually packaged with 3 weeks of hormonal pills and one week of blank/placebo pills to simulate a monthly menstrual cycle. It is considered "combined" as it uses both estrogen and progesterone. In contrast, the mini-pill, contains only progestin. It must also be taken every day and functions similarly to combined hormonal pills.
OCPs
& Your Period
There's no biological reason for why you need to get a period every month so brands have shifted over to providing only hormonal pills.
You also have the option of skipping your blank "period" week and going straight to another "hormonal" week, eliminating your period altogether (called menstrual suppression).
There are two other forms of combined hormonal contraception that function exactly the same as OCPs, but are delivered in a different format and have a different frequency of use.
The first is the patch, a small sticker you apply to your body and change once a week. The patch also contains estrogen and progesterone, which it releases to be absorbed through your skin.
The other form of combined hormonal contraception is the ring, which is placed in the vagina and also releases hormones. Instead of through the skin, these hormones are absorbed through the vaginal mucosa.
There are also two other forms of progestin-only contraception which function similarly to the mini-pill. The first is the Depo-Provera injection, which is a shot you get once every 3 months; the injection also works by suppressing ovulation.
Once it’s inserted it can’t be seen, though you can feel it if you press down hard on the flesh of your inner arm.
The other form of non-pill progestin-only contraception is the implant, otherwise known as Nexplanon (Nexplanon is a brand of the implant). The Nexplanon is a small, thin plastic tube about the size and shape of a toothpick (but not sharp at the ends!) that is inserted under the skin of your inner upper arm and releases its hormone to be absorbed by the body. Insertion of the Nexplanon is a simple office procedure.
That brings us to the final form of contraception we’ll be reviewing in this article: intrauterine devices, known as IUDs for short, which are the most effective type of contraception at more than 99% efficacy.
The first type of IUD is a progestin-only device. However, unlike Depo/ Nexplanon, this IUD releases hormones that only act locally inside of the uterus, instead of systemically. It is a small, plastic T-shaped device that is placed through the cervix and into the vagina.
The second type of IUD, which is non-hormonal, can last for a decade. This IUD, called the ParaGard, is made of copper and exerts its contraceptive effects by making the uterus a very unfriendly place for a fertilized egg to implant.
No matter which type of contraception you’re considering, you should talk to your healthcare provider who can help you navigate your choices. When choosing which form of contraception is right for you, it’s important to consider what fits best for your lifestyle and needs.
