Contraceptive methods – Which is best for you?

Have you ever stopped to think if the contraceptive method you use today is ideal for you?

The vast majority of women are recommended by doctors to use the hormonal pill, as it is one of the best-known and most effective methods on the market and can also help control some hormonal conditions that affect women.

However, like any other method, this one has its advantages and disadvantages and some side effects that may justify analyzing another contraceptive method that better suits the individual needs of each woman.

What are the different types of contraceptive methods?

Lifestyle :

This method encompasses all active and proactive decisions to avoid pregnancy, including methods such as abstinence, non-penetrative sex, and fertility awareness.

Barrier :

It includes all methods that use a physical barrier in the body to prevent sperm from fertilizing an egg, and is used when necessary, only during sex. These include the use of internal and external condoms, diaphragms and spermicides.

Hormonal :

This method works in a number of ways depending on the contraceptive used, such as stopping the ovaries from producing eggs, thickening the lining of the cervix, or thinning the lining of the uterus. This method includes oral contraceptives, injections, vaginal rings, and implants. It also includes hormonal IUDs (not the copper IUD, which does not work with hormones).

Doctor :

Surgical procedures such as vasectomy or tubal ligation, which modify the reproductive connections in order to prevent the body from fertilizing eggs.

Note: It is important to note that each of these contraceptive methods has different effectiveness depending on whether they are used with typical use or perfect use. This means that all of these methods are much more effective if they are used exactly as recommended, however, you should always consider their effectiveness with typical use, as this is the most likely type of use for the majority of the population.

Where to start

In order to understand which method is best for you, you should ask yourself some questions such as:

• How effective do you need your contraceptive method to be? (What level of pregnancy risk makes you comfortable)
• Do you want your method to reduce sexually transmitted infections too?
• What is your monthly or long-term budget for contraception?
• Do you want to get pregnant in the future? And in the near future (less than 18 months)?
• Are you looking for something that controls other current symptoms?
• Will you realistically use something that requires specific times to be effective?

These are important questions to consider in order to find a method that works for you. You should always talk to your doctor and let him or her clarify any questions you have about these questions or the methods, so that you can make an informed decision.

If you want to change your lifestyle

Abstinence method :

We know that the most effective method is actually sexual abstinence, considering that it is impossible to fertilize an egg this way. However, it is the rarest form of contraception and does not offer much opportunity for versatility in your sexual dynamics.

Sex without penetration of penis in vagina :

With this method you will have a little more freedom, as it can include all activities that do not involve penetration between a penis and a vagina, leaving room for all games involving external stimulation, anal penetration, oral sex, and finger penetration (always with clean hands and without having come into contact with sperm). Here, it will be up to the couple to identify what is and is not allowed for them with this method, and if they choose to avoid any type of penetration (anal, vaginal, fingers, etc.) they will be able to count on approximately 100% effectiveness, as there is no risk of the egg being fertilized.

Fertility knowledge methods :

This method may be one of the most complicated at first, time-consuming and requires a great deal of discipline to be considered effective. However, if used completely and perfectly, it can bring great advantages in terms of your self-knowledge of the menstrual and hormonal cycle. Many people still believe that it is possible to get pregnant at any stage of the month or menstrual cycle, and therefore do not have a good understanding of how their cycle works and what they need to understand in order to use this method.

This method involves guiding yourself by your menstrual cycle and fertile/non-fertile period, using information such as menstrual calendars, consistency of your cervical mucus, and the most effective of all, monitoring your basal temperature, which indicates when a woman is close to ovulating, and when ovulation has already occurred in that cycle, leaving the rest of the days in that cycle as non-fertile and therefore safe for vaginal penetration.

It is worth noting that this is a method that has been widely used for fertility treatments when women want to get pregnant and know when their most fertile times are, and in recent years it has been gaining popularity and attention from medical authorities for its use as a pregnancy prevention method, authorities who confirm that it is a very effective method, but that it is not suitable for the vast majority of people, either due to the dedication and time required, or due to the high rate of potential human errors that could result in incorrect information about the state of the cycle at that time.

With typical use (and not perfect as recommended), this contraceptive method has an effectiveness rate of 76% to 88%, that is, around 24 out of 100 people become pregnant when using this method.

If you want to use a method only during sexual intercourse (Barrier methods)

The method of removing the penis from the vagina before ejaculation is not included here because it is considered a highly ineffective method, with a failure rate of around 22% to 30% with typical use. We say with typical use because without knowledge of your fertility and menstrual cycle, the risk of getting pregnant could be very low or extremely high, depending on your fertility status on the day of the activity, and could actually have a risk rate of 2-3% or a risk rate of 70-90%, and is considered a method that has no basis for use as a pregnancy prevention.

Furthermore, we know that it is not only in a man's ejaculate that there is fluid with the potential to fertilize eggs. The fluid that many men expel during sexual arousal, called pre-ejaculate, can often contain small amounts of healthy sperm that can fertilize the egg and cause unwanted pregnancies.

Female (or internal) condom

What is it:

Female condoms are bags made of polyurethane, latex-free and hormone-free, with a similar appearance to the most common condom, the external one, but which are used inside the vagina, drastically reducing the risk of pregnancy and transmission of sexually transmitted infections.

Effectiveness: Perfect Use: 95% / Typical Use: 79%

Advantages:

• It can be applied up to 8 hours before penetration, so it offers less planning than other methods.
• Even if your partner doesn't want to use an external condom, you know that you will still be protected from pregnancy and STIs, giving you the opportunity to be in complete control of your body and its care.
• This condom also doesn't fit as tightly to the partner's penis as external condoms, which is an advantage for some people who feel that condoms are sometimes a little tight and take away some freedom of sensation or movement.

Disadvantages:

• They are much more expensive than common external condoms;
• You need to get the hang of using them, and you have to go through a learning phase. Not because they are very difficult to use, but because they require some practice to be used correctly and naturally. Very similar to products like tampons or menstrual cups, where women feel they need to practice a few times until they adjust their technique so that the process becomes comfortable and more instinctive.

 

Male (or external) condom

What is it:

This method is a classic and one of the most widely used worldwide, along with the hormonal pill. The condom is placed so that it covers the entire penis from the glans to the base, in order to capture the man's fluids, including pre-ejaculate and ejaculate.

Effectiveness : Perfect use: 95% / Typical use 86%

Advantages:

• They offer double protection, protecting against pregnancy and STIs.
• Options available for people with latex allergies and very sensitive skin
• Easy to apply

Disadvantages:

• They are not 100% effective, as there may be an exchange of fluids if the condom is not placed correctly or if it breaks during sexual intercourse.
• Some people, especially men, report feeling a lack of sensitivity and physical stimulation when using them, even with thinner condoms.

Note: Remember that external and internal condoms are the only proven methods of preventing sexually transmitted infections!

Diaphragm

What is it:

A reusable, soft, silky disc made of medical-grade silicone that must first be coated in spermicidal gel in order to work as required, and is placed close to the cervix, creating a barrier between sperm and the egg.

Effectiveness: Perfect use: Up to 96% / Typical use 88%

Advantages:

• Latex-free, hormone-free option that can be left inside the woman for up to 30 hours, and she can be protected during that entire time, as long as she reapplies the spermicide every 6 hours.

Disadvantages:

• If you enjoy more intense activities, this is not the ideal method for you, considering that the diaphragm can be moved from its place with more vigorous penetration, and it may lose its effectiveness.
• It is not a good option for those who are unable to reapply spermicide when necessary.
• It is not a good option for those who are sensitive to spermicide or have frequent urinary tract infections, as the gel may further exaggerate their symptoms.

Sponge

What is it:

The contraceptive sponge is a small, single-use sponge made of latex-free plastic that is coated with spermicide. It is moistened to activate the action of the spermicide and is placed against the cervix to create a barrier that prevents sperm from passing through.

Effectiveness: Perfect use if you have never given birth: 91% / Typical use if you have never given birth: 80%. If you have given birth, the perfect use rate is 80%, while the typical use rate is 76%.

Advantages:

• It can be applied up to 24 hours before sexual intercourse and remains effective. You can also enjoy penetration as many times as you want during those 24 hours without worrying about its effectiveness.

Disadvantages:

• You have to leave the sponge inside you for 6 hours after sex, which some people say is a little uncomfortable due to the fluids that may come out.
• There is a minimally increased risk of toxic shock syndrome, although it is still quite rare.
• Like the diaphragm, and because it is used in a similar way, it requires some practice until its use feels completely comfortable and natural.
• It has a higher risk of losing its effectiveness in women who have already given birth.

Cervical Cap

What is it:

Similar to the diaphragm and sponge, the cervical cap is also a silicone barrier placed next to the cervix to form a barrier between the egg and sperm, and spermicide is also applied. While the diaphragm and cap provide a physical barrier and also kill sperm, the sponge focuses mainly on killing sperm. The cervical cap is smaller in size than the diaphragm, and can be left inside the body for longer, as the diaphragm can be left in for up to 30 hours and the cervical cap can be left in for up to 72 hours. As for the diaphragm, it needs spermicide reapplied every 6 hours, while the cap does not require spermicide reapplication during these 72 hours.

Effectiveness: People who have never given birth: 86%. People who have given birth vaginally: 71%. The difference here is because vaginal births stretch the vagina and cervix, which can cause the cervical cap to not fit well or not as well as it should.

Advantages:

• Hormone-free option with the possibility of immediate pregnancy after stopping use.
• They can be used for up to 30 hours, without the need to reapply spermicide.
• A cervical cap lasts up to a year, making it a good choice for those who want to save on costs and know that they will only need to keep their spermicide stock for one year.

Disadvantages:

• It is not recommended for people with very sensitive skin or frequent urinary infections, as the use of spermicide can worsen these conditions.
• It must be left inside the woman's body for 4 hours after sexual intercourse for its use to be effective.

Spermicide

What is it:

In addition to being used with devices such as the diaphragm, sponge and cervical cap, spermicide can also be used on its own, although this significantly reduces the effectiveness of the method. It is applied a few minutes before sexual intercourse, creating chemicals that kill sperm.

Effectiveness : As a single method: 72%

Advantages:

• You can go to a pharmacy and easily find spermicide, as you don't need a prescription like some other methods.
• Easy to apply solution that can also provide extra lubrication during sex.

Disadvantages:

• Not recommended for people with very sensitive skin or who frequently suffer from urinary infections, as spermicide may exacerbate these conditions.
• It needs 10 to 15 minutes to dissolve before sexual intercourse, and after 60 minutes it must be reapplied to continue to be effective.

Morning after pill

The morning-after pill is considered and recommended only for emergency use, when you know that one of the other methods has failed for some reason, or if you have not used any protection and have doubts about the state of your fertility. This method requires taking the pill within a period of up to 72 hours after unprotected sex, and should never be taken routinely, as it contains very strong doses of hormones that disrupt the normal functioning of your system, creating adverse complications with its repeated use.

If you want to adhere to a consistent schedule (Short-medium term hormones)

Here we have the options that need to be used recurrently with a specific schedule, so as not to lose their effectiveness, because for example in the case of the combined pill, it only takes 1 or 2 days of forgetting to lose its effectiveness.

Hormone injection

What is it:

It is an injection containing the hormone progestin, administered by a doctor or nurse every 90 days. It prevents pregnancy by stopping the egg from forming.

Effectiveness: Perfect Use: 99% / Typical Use: 94%

Advantages:

• It is a very effective method as long as you receive the injection every 12 to 13 weeks, without fail.
• Many women report having significantly less menstrual flow or no menstrual flow at all.

Disadvantages:

• Some of the possible side effects for some people with this method include nausea, headaches, dizziness, weight gain, and depression.
• If you decide to get pregnant after using the injection, it may take up to 12 months after the last dose for its effects to wear off and for your body to be able to conceive.

Vaginal ring

What is it:

It is a plastic ring about 5cm in diameter, prescribed by a doctor. It contains estrogen and progesterone that prevent ovulation from occurring. The woman inserts the ring into the vagina, near the cervix, and leaves it in place for 3 weeks, then removes it for 1 week so that she can have her period as normal. Then, she inserts a new ring and repeats the cycle.

Effectiveness: Perfect use: 99% / Typical use 91%

Advantages:

• It has the advantage of being able to put it on and only having to remember to do it again after 3 weeks, which can be very convenient.
• Many people report experiencing lighter menstrual flow, improvements in acne, and a more regular menstrual cycle.

Disadvantages:

• The most commonly reported side effects are chest pain and headaches.
• Although you are supposedly protected during the week of your period, this may not be true if there has been a failure while using the ring.

Hormonal patch

What is it:

It is a small patch that is placed on the upper arm, buttocks or back and releases the hormones estrogen and progestin. These hormones prevent ovulation from occurring.

The patch is placed and left in place for 3 weeks, then it is removed so the person can have a normal period and then a new patch is applied and the cycle is repeated.

Effectiveness: Perfect use: 99% / Typical use: 91%

Advantages:

• It is placed on the body area and you will only have to think about it again after 3 weeks, when you remove it to have your period.
• The vast majority of people report few or no side effects.

Disadvantages

• When side effects are reported, they include nausea, headache, chest pain, and skin irritation.
• It requires weekly diligence in its use, as its effectiveness or lack thereof depends largely on human error.

Combined pill

What is it:

The combined pill has this name precisely because it is composed of two hormones, estrogen and progestin, which prevent the ovaries from creating eggs and thus preventing pregnancy. For complete effectiveness, the pill must be taken daily at the same time.

Effectiveness: Perfect use: 99% / Typical use: 91%

Advantages:

• It does not have to be inserted or implanted, it is just a pill to be taken daily.
• May reduce the severity of menstrual symptoms.
• It can also be used to treat or improve other existing pathologies such as acne, cystic ovaries, endometriosis and other hormonal conditions.

Disadvantages:

• It must be taken daily at the same time or within 2/3 hours of the usual time, as a major delay can significantly reduce the effectiveness of the pill.
• Taking antibiotics or experiencing symptoms such as diarrhea can significantly reduce their effectiveness, and in these cases it is recommended to use another method together, such as a condom, until taking the last pill of that month's cycle.

Progestin pill

What is it:

This pill may be more suitable for people who do not want to take estrogen, as this pill only contains progestin and works by thickening the lining of the cervix and preventing sperm from entering, preventing fertilization.

Effectiveness: Perfect use: 99% / Typical use: 93%

Advantages:

• Because it does not contain estrogen, it is a great option for those who are breastfeeding, those who are less than a month postpartum, those over 25, smokers and people who suffer from potential blood flow problems, or who have not adjusted to using the combined pill.
• May reduce menstrual symptoms

Disadvantages:

• It must be taken daily at the same time or within 1 hour of the usual time, as a longer delay can significantly reduce the effectiveness of the pill, and this pill is even more sensitive to time changes than the combined pill.
• Some people report sore chest and acne breakouts.

If you want something long-term and with minimal maintenance (Minimally invasive procedures)

Hormonal implant

What is it:

It is a small tube the size of a match, made of plastic, which releases the hormone progestin, preventing ovulation and pregnancy.

Effectiveness: About 99%

Advantages :

• It is one of the most effective and relatively low-maintenance options, as the implant can last up to 3 years without needing to be removed.
• It does not contain the hormone estrogen, which can be an advantage for some people.
• It does not require a pelvic exam, making it a good option for younger people.

Disadvantages :

• Although it is a quick and easy process, the implant requires local anesthesia and a needle, and you may notice that it is sore for a few days after insertion.
• It may disrupt your menstrual cycle or cause some spotting throughout the month.
• It may cause some minor side effects such as acne, sore breasts and weight gain.

Copper IUD (non-hormonal)

What is it:

The T-shaped intrauterine device is placed inside the uterus by a qualified doctor. The copper in the device blocks the passage of sperm into the uterus, preventing fertilization.

Effectiveness: Over 99.9%

Advantages:

• Once inserted by a doctor, the device can remain in the body with the same initial effectiveness for up to 12 consecutive years.
• Once the device is removed, it immediately stops working, making it an excellent option for those planning to get pregnant in the future and want the potential of a shorter process.
• You will continue to have regular periods every month as it does not interfere with your hormonal cycle.

Disadvantages:

• The insertion process can be uncomfortable and cause some cramping during or for a few days after the procedure. However, it is recommended that you take pain medication, such as ibuprofen, which effectively reduces pain.
• Side effects may include spotting during the first few days of use, stronger cramps during menstruation, and heavier menstrual flow.

Hormonal IUD

What is it:

The hormonal IUD has the same insertion process as the copper IUD, but it works through hormones, that is, it releases a small amount of progestin, which intercepts ovulation and can last from 3 to 7 years with the same effectiveness.

Effectiveness: Over 99%

Advantages:

• It can be left for 3 to 7 years with its full effectiveness.
• The progestin released by the device circulates only in the genital region and in much lower quantities than those present in hormonal pills.

 Disadvantages:

• During insertion, it is common to feel cramps, dizziness, fainting or a slow heartbeat.
• It can cause dysregulation of the menstrual cycle, making periods lighter in terms of flow, more sporadic and more inconsistent.
• Some people report spotting or occasional cramping throughout their monthly cycle, but these effects are usually only common in the first 3 to 6 months and will decrease or disappear as the device is used.

If you want something permanent (Surgical methods)

Vasectomy

What is it:

A vasectomy is a surgical procedure that involves blocking or cutting the tubes that carry sperm from the testicles to the penis. This prevents sperm from reaching the penis, so ejaculation happens without sperm.

Effectiveness: Over 99%

Advantages:

• Although it is a reversible procedure if the person so wishes, it is a permanent solution, meaning that the person can spend the rest of their life without worrying about the risk of pregnancy.

Disadvantages:

• Requires local anesthesia during the procedure
• After the procedure, there will be strict monitoring for the first 3 months, in order to confirm that sperm is not passing through the ejaculate, therefore in these first 3 months, you will have to use a second contraceptive method for prevention.

Tubal ligation

What is it:

It consists of a surgical procedure that involves blocking, tying a knot, or cutting the Fallopian tubes, which are the channels that transport the egg from the ovaries to the uterus, thus preventing pregnancy.

Effectiveness: Over 99%

Advantages:

• It is a permanent solution. There may be a chance of pregnancy if this procedure is reversed or if in vitro fertility treatments are performed, but this is very unlikely and should not be taken into account in your decision, as it is most likely to be permanent with no other option.

Disadvantages:

• It is a surgical procedure. Although it is a procedure where the patient is discharged on the same day, the vast majority of doctors perform the surgery in an invasive manner and therefore has the risks that any other invasive surgery has.

Note : There is also a myth that tubal ligation stops menstruation, which is not true.

Conclusion

Depending on the symptoms you want to alleviate, some methods will be more beneficial than others. Here is a summary of recommendations based on the symptoms you want to treat, so you can talk to your doctor and find the best method for your individual needs.

• Hormonal acne – The combined pill may be recommended.
• Polycystic ovary syndrome – The combined pill may be recommended
• Gender Dysphoria: Implantation may be recommended
• Very heavy menstrual flow: A hormonal IUD may be recommended
• Cramps – The vaginal ring, patch or combined pill may be recommended.