Everything You Need to Know About Birth Control

Type of Contraception: Hormonal Birth Control

Contraceptive methods that use hormones prevent pregnancy by altering how your body works. These range from daily-use options, such as birth control pills, to long-term-use approaches, such as hormonal IUDs, which can stay in place for several years, says Keosha T. Bond, EdD, MPH, EdD, an assistant medical professor at The City University of New York (CUNY) School of Medicine in New York City.

Birth Control Pills

Two types of birth control pills are available:

Combination Pills These contain both estrogen and a form of progesterone called progestin.
Progestin-Only Pills These are also known as the mini pill.

The pills work by preventing ovulation so that your ovaries don’t release an egg for sperm to fertilize, or by thickening cervical mucus so sperm can’t travel to an egg.

You’ll need to take birth control pills every day as directed. Take most types of progestin-only pills within the same three-hour time window every day. A doctor might also prescribe some pills to stop your period.

How effective are birth control pills? Combined and progestin-only birth control pills are more than 99 percent effective with perfect use and 91 percent effective with typical use.

How much do they cost? You need a prescription to get birth control pills. They may cost nothing or up to $50 a month and can be free or low-cost with most types of health insurance, Medicaid, or other government programs.

The Shot, Depo, or Depo-Provera

An injection of medroxyprogesterone (Depo-Provera), also known as the birth control shot, can prevent pregnancy for three months.

The shot contains high-dose progestin to prevent ovulation, and it also makes cervical mucus thicker to prevent sperm from reaching the egg.

In most cases, your doctor or nurse will give you the shot every quarter. But in some cases, you may be able to bring the shot home to give it to yourself.

How effective is the shot? Injectables are more than 99 percent effective with perfect use and 96 percent effective with typical use.

How much does it cost? It can cost nothing or up to $150, and it can be free or low-cost with many health insurance plans, Medicaid, and some government programs.

Birth Control Implant, or Nexplanon

The birth control implant (Nexplanon) is a small rod about the size of a matchstick that a doctor places into your upper arm. It releases progestin to prevent pregnancy for up to five years.

Nexplanon stops ovulation and makes your uterus lining thinner, making it harder for the egg to attach to the wall of your uterus. It also thickens the mucus in your cervix, which makes it less likely that the sperm will reach the egg.

The implant must be inserted by a trained healthcare professional. You can request its removal at any time if you want to get pregnant.

How effective is the implant? The implant is more than 99 percent effective.

How much does it cost? It can cost anywhere between $0 and $2,300. But it’s totally free with most health insurance plans, Medicaid, and some government programs.

Vaginal Ring (NuvaRing or Annovera)

Like combination birth control pills, the vaginal ring contains both progestin and estrogen. It’s a small ring that you wear inside your vagina, and the hormones work to prevent ovulation and pregnancy.

There are two types of vaginal rings:

Ethinyl estradiol and etonogestrel (NuvaRing)
Ethinyl estradiol and segesterone (Annovera)

Each NuvaRing lasts for up to five weeks. You take the old one out and put in a new one about once a month, and it can be used to safely skip your period. Each Annovera ring lasts for one year, but you must put it in your vagina for three weeks, then take it out for one week every month, during which time you’ll typically have a period.

How effective is the vaginal ring? Vaginal rings are more than 99 percent effective

if used perfectly and 93 percent effective if used typically.

How much does it cost? You need a prescription to get the vaginal ring, and the ring can cost anywhere from $0 to $200. But vaginal rings can be free or low-cost with most health insurance plans, Medicaid, and some government programs.

The Patch (Xulane or Twirla)

Like the vaginal ring, the patch (Xulane or Twirla) also releases estrogen and progestin, but through a patch worn on your stomach, buttocks, or back.

The patch needs changing once a week for three weeks, and then you skip a week and have your period. You can also use Xulane to prevent your period if you add a new patch on the fourth week instead of skipping a week.

How effective is the patch? The patch is more than 99 percent effective if used perfectly and 94 percent effective if used typically.

How much does it cost? You need a prescription to get the patch. One pack of three patches lasts for up to one month and can cost from $0 to $150. It is free with most health insurance plans, Medicaid, and some government programs.

Hormonal Birth Control Side Effects

Some people have uncomfortable side effects from hormonal contraception. “Each woman is different, and you have to understand your body,” says Bond. Let your doctor know if you get one or more of these side effects:

Nausea
Weight gain
Headaches
Changed menstrual cycles, including spotting

Who Shouldn’t Take Hormonal Birth Control?

For some people, the use of estrogen-based birth control is not recommended. “The pill is easy and awesome, but if you have migraines with aura (vision changes during a bad headache) or have a history of deep vein thrombosis, stroke, or other cardiac changes,” talk to your doctor to learn if you should consider another birth control option, says Dr. Greves. Hormonal options containing only progestin don’t carry the same risks and are suitable for people with these underlying health issues.

What’s more, if you have a blood-clotting disorder, it’s safest to avoid taking estrogen. And if you have breast cancer, it’s best to avoid taking estrogen or progestin. If you smoke or have overweight or obesity, you can ask your doctor about which contraceptives are recommended for you.

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