Board-certified gynecologist reveals 'most effective' method of birth control available: 'It is very very effective'

Alex Lasker
·16 min read

Having been on birth control for just under a decade now, I can confidently admit that I really didn’t know too much about it when I asked my doctor for a prescription, aside from the fact that it would both regulate my periods and keep me un-pregnant (which, to be fair, felt like all I needed to know at the age of 18).

But a lot has changed since then — options truly abound these days for those seeking contraceptives. There’s a product out there for everyone, which is amazing since no single product can meet the myriad needs of all patients.

If you are unsure about which contraceptive is right for you, board-certified gynecologist Dr. Nicole Sparks has given us the scoop on seven popular types of birth control, including each product’s usage, effectiveness and side effects.

Let’s take a look at some options, shall we?

1. The Pill

Credit: Getty
Credit: Getty

What is it?

One of the most widely used types of birth control on the market, the pill is a daily oral contraceptive that contains hormones — typically a combination of estrogen and progestin — that work to stop ovulation, which is when a mature egg is released from the ovary. No egg = no fertilization = no pregnancy.

“The way [the pill] works is it usually will suppress some of the hormones that help ovulation,” Dr. Sparks explained. “So, of course, if you stop ovulation, then that will keep you from getting pregnant.”

How do you use it?

The pill is simply taken once a day by mouth. Although it has the potential to be 99 percent effective at preventing pregnancy, it loses its effectiveness if you don’t take it perfectly (i.e. if you forget to take it for a day or two). Timing is crucial, as taking the pill at the exact same time each day helps keep hormone levels from fluctuating.

So go ahead and set yourself a phone alarm right now, pill-takers! I’ll wait.

Where can I get it?

You can talk to your gynecologist about getting a prescription for the pill, or even schedule a virtual visit with a physician through sites like BedSider and SimpleHealth and have the pill mailed directly to your house, Dr. Sparks suggested.

What are the side effects?

The pill has its fair share of positive health benefits, Dr. Sparks noted.

“It can prevent things such as ovarian cancer [and] it can make your periods lighter,” she said. “If you have really painful periods, it can make those better; if you have really bad acne, it can make your acne better.”

However, first-time pill-takers may experience certain unpleasant side effects like nausea, vomiting, breast tenderness and irregular periods. The good news is that after about three months of your body getting used to the hormones, those symptoms should subside.

Dosage timing is also a huge pitfall for the pill, which has a 7 percent failure rate because some users do not take it regularly.

“You have to remember to take it at the same time every day, which some people sometimes have an issue with,” Dr. Sparks added. “If you’re really good at taking it, then it has a failure rate of closer to 1-2 percent.”

2. The IUD

Credit: Getty
Credit: Getty

What is it?

An intrauterine device (IUD) is a little T-shaped device that is inserted into the uterus to prevent pregnancy. There are two types of IUDs available on the market: hormonal, which stop ovulation, and copper, which alter the way sperm cells move so they cannot get to an egg.

Touting an over 99 percent rate of effectiveness, IUDs are one of the most effective methods of birth control on the market.

How do you use it?

An IUD must be put in by a health care provider. Although the procedure is mildly painful, the good news is that certain IUDs can remain effective at preventing pregnancy anywhere from three to 12 years after they are inserted, depending on the brand. Talk about set and forget.

“[The IUD] falls into the class of contraception that we classify as a LARC, or a long-acting reversible contraceptive,” Dr. Sparks explained. “And the reason why we really like this is because, as opposed to the birth control pill, you do not have to remember to take this every day.”

Of course, an IUD can be removed at any time (hence the “reversible” part of LARC). So, say you committed to a 12-year-effective product, only to decide you wish to get pregnant six years in. No problem — just see your doc again to have it taken out.

“It’s pretty simple to remove in the office,” explained Dr. Sparks. “Basically, as long as we can see the strings, we can go and pull them and it usually will come right out. There’s actually an immediate return of fertility, so I usually advise users not to remove it unless you want to get pregnant right away.”

Where can I get it?

You will need to contact your gynecologist to find out more about getting an IUD.

What are the side effects?

The ultra-effective birth control method has a few side effects worthy of consideration.

When an IUD is inserted, it typically causes a mild-to-medium amount of pain — often compared to heavy period cramps — that lasts for about 1-2 minutes.

“We usually will tell you to take some ibuprofen or some pain pills before you come in, because you should expect just a fair bit of cramping and bleeding after we place it in in the office,” said Dr. Sparks.

After that, patients may experience pelvic pain, “a fair amount of irregular spotting,” and, occasionally, a condition known as amenorrhea, where a period stops altogether, according to Dr. Sparks.

There’s also a chance that an IUD can spontaneously fall out after it is placed in, although the odds of that happening are “small,” said Dr. Sparks.

But again, an IUD is super effective at preventing pregnancy — so review all options with your gynecologist before making a decision.

3. The Implant

Credit: Nexplanon
Credit: Nexplanon

What is it?

The implant is a small, tubular hormone-releasing birth control device that is placed inside your arm. A popular generic implant brand is Nexplanon, which claims to provide up to three years of continuous pregnancy prevention at a 99 percent success rate.

“It is very very effective,” Dr. Sparks said. “It is actually the most effective reversible form of contraception that we have.”

How do you use it?

During an office visit, your gynecologist will insert the 4-centimeter-long rod just underneath the skin on the inner side of your non-dominant upper arm. It’s done right in your gyno’s office, not in an operating room.

Sounds scary? Not so much, Dr. Sparks assures.

“It’s easily placed in the office and also easily removed in the office,” she said. “When you’re getting the implant inserted, we will lay you down on the table, and like I said, we will use the non-dominant arm. So most people will be using their left arm. We’ll usually bend your arm … and there is a device that we use and we place it right under the skin to make sure that we don’t place it too deep.”

“As far as how we remove the implant in the office, usually we’ll lay you down on the table and we’ll make a little incision right around the place where we inserted it and then we can usually just push the rod out.”

Where can I get it?

Since the implant requires a minor medical procedure, you have to consult your gynecologist to decide if it’s right for you.

What are the side effects?

According to Dr. Sparks, one of the main complaints she receives from patients with the implant involves unscheduled and irregular bleeding.

“This usually will get better the longer you have it in, but usually, if it’s not better by the 6-month to 1-year mark, please talk to your doctor about why that may be and some solutions that we may have for you,” she added.

That being said, Dr. Sparks said the implant can also be a lifesaver for patients who regularly experience heavy periods.

“If you have heavy periods, it can make your periods lighter, and if you have really painful periods it can make those better, too,” she explained.

4. The Shot

Credit: Getty
Credit: Getty

What is it?

The shot is an injection of the hormone progestin that provides birth control for three months at a time.

Depo-Provera, a well-known brand name of the shot, works in a two-fold method — by preventing ovulation and by making cervical mucus thicker so that sperm cannot pass through.

How do you use it?

Every three months, the shot can be administered either by a health care professional at your doctor’s office or by yourself at home.

Much like the pill, you need to take care to get your shots on time and not miss appointments or home injections, as this can decrease the effectiveness of the product.

“We find that the Depo injectable shot works really well for people who are just starting to use contraception because it’s really easy administration,” Dr. Sparks said. “You don’t have to remember to take something every day, and you don’t have to have a procedure in the office.”

Where can I get it?

You’ll need a prescription for the shot, so talk to your gynecologist to see if it’s a good fit for you, based on your individual needs.

What are the side effects?

As with any other shot, patients may experience some pain during administration and discomfort or tenderness at the injection site the next day or two, although that should subside quickly, explained Dr. Sparks.

She also noted that some users may experience weight gain and irregular spotting, “similar to all of the other [forms of] hormonal contraception.”

If you are considering having a child within the next year, Dr. Sparks says the Depo injectable might not be for you. But of course, consult your doctor before making any calls.

“If you’re someone who’s trying to get pregnant, I would actually get off of the Depo sooner [rather] than later,” she said. “We’ve seen that it takes as long as 12 to 18 months for some people to get pregnant after they get off the Depo shot, but remember that this is not the same for everybody, and some people may get pregnant within just a few months of stopping.”

5. The Condom

Credit: Getty
Credit: Getty

What is it?

The tried-and-true method of both preventing unplanned pregnancies and preventing sexually transmitted infections (STIs), the condom is a physical barrier device used during sexual intercourse.

“Even if you’re on another form of contraception, you actually still want to use a condom to make sure that you don’t get any sexually transmitted infections,” Dr. Sparks explained.

How do you use it?

A condom can be placed over your partner’s penis during sex to prevent sperm from entering the vagina. There are also condoms that can be inserted into a vagina to the same effect.

When used properly, condoms boast a 98 percent effective rate at preventing pregnancy, and about the same rate at preventing certain common STIs, like HIV, HPV, chlamydia and gonorrhea.

“You have to also make sure that you’re using it correctly,” Dr. Sparks noted. “You want to make sure that it’s placed correctly and that there are no holes in it. Also, make sure that after sex you don’t notice any holes in the condom.”

While condoms are the only birth control method effective at preventing STIs, it’s good to note they still leave you vulnerable to certain infections like herpes, genital warts and syphilis, which can all be spread via skin-to-skin contact.

Where can I get it?

Pharmacies, drug stores, bodegas, Amazon.com — you name it! Condoms are easy to find. They’re also very inexpensive. So, use ’em!

“The great thing we love about condoms is that you don’t need a prescription for them,” Dr. Sparks said. “You can pretty much walk into any store and get them. And like I said, we love it because it also protects you against STIs.”

What are the side effects?

The most commonly used variety of condom is made from latex, which may present a problem for those with relatively rare latex allergies.

Some alternative options are lambskin condoms — which Dr. Sparks does not recommend, as they’re more porous than latex and, therefore, less effective at preventing STIs — and synthetic condoms.

Additionally, “sometimes people just don’t want to use [condoms,]” said Dr. Sparks, because they don’t want to “pause before intercourse.”

“But we do want to encourage you to try to use [a condom] with every form of intercourse that you have because it is very effective and it really prevents STIs,” she added.

6. The Ring

Credit: Getty
Credit: Getty

What is it?

The ring is a small, flexible piece of plastic that can be inserted into the vagina once a month. The circular deceive then releases two hormones — estrogen and progestin — that are absorbed by the body to suppress ovulation and prevent pregnancy.

According to Planned Parenthood, popular ring brand NuvaRing is 99 percent effective if you use it perfectly. However, since people aren’t perfect and it can be easy to make a mistake, the ring is closer to 91 percent effective in reality.

How do you use it?

Dr. Sparks recommends thinking about inserting a ring as you would a tampon, except it needs to be placed a bit higher up.

First, you’ll want to wash your hands with soap and water. Then, take your ring out of its packaging and squeeze the sides of the device together with your fingers before gently inserting it into your vagina. According to Planned Parenthood, if you can’t feel the ring when you’re walking around, it’s probably in correctly.

The device typically contains the right dose of hormones to stay put for three weeks, and it does not need to be removed before sex or any other physical activity.

“It will not interfere with sex or anything like that,” Dr. Sparks said. “And then you actually take the ring out during the fourth week to have a period. And you do this every single month.”

To remove your ring, wash and dry your hands before hooking your finger through the device and gently pulling it out of your vagina.

“You can either lay down flat on your bed [or] you can squat and you can reach in and grab the device and it simply comes out and then the hormone is out of your body,” Dr. Sparks noted.

Then, wrap it in tin foil and throw it in the trash. (The foil helps keep any hormones that are left in the ring from getting into the soil and water. Never flush your ring down the toilet.)

Where can I get it?

Talk to your physician to decide if the ring is a good fit for you. Those who are prescribed the ring are able to simply pick up the doses they need regularly at their local pharmacy.

What are the side effects?

The ring is similar to other types of hormonal contraception (like the pill) in that it has both estrogen and progesterone, meaning it can help alleviate heavy or painful periods, Dr. Sparks explained. The ring can even mitigate endometriosis pain and hormonal acne.

However, Dr. Sparks noted that the device comes with a “learning curve,” which may impact its effectiveness.

“It may not be very intuitive with how to place the ring,” she said. “There are pictures on the packet that show you how to place it. There is a big learning curve at first, but once users get use to it, they actually do really well.”

7. Emergency Contraceptive

Credit: Getty Images
Credit: Getty Images

What is it?

Maybe the condom broke. Maybe in the heat of the moment, you and your partner forgot to use one. Maybe alcohol was involved and you’re just not 100 percent certain you were protected during a sexual encounter.

Enter emergency contraception, which is commonly called “the morning-after pill” since it is taken the day after sex to prevent pregnancy.

One of the EC’s Dr. Sparks recommends is Plan B, which is so prevalent it has become somewhat of a synonym for the more broad medical term “emergency contraceptive.”

How do you use it?

Plan B is a single pill taken orally that works by delaying ovulation. It is most effective when taken up to 72 hours after unprotected sex — and the sooner it is taken, the better.

“It’s just one pill and you have to take it within three days [of having unprotected sex],” Dr. Sparks explained. “Again, the sooner you take it the better, so if you’ve had unprotected sex and you actually don’t know what to do, go ahead and get this pill and take it as soon as possible.”

Where can I get it?

You can purchase Plan B over-the-counter at most pharmacies and it will cost around $40-$50, depending on the store.

What are the side effects?

Besides the lofty price tag, Plan B does carry with it a few unfavorable side effects. However, they still pale in comparison to having an unplanned pregnancy.

“Usually, users complain of having nausea, vomiting, headaches,” Dr. Sparks said. “Those usually will subside. Sometimes you will also notice that you have some unscheduled or abnormal bleeding. Usually, your menses will come within one week of taking the pill.”

There’s also no guarantee the pill will be successful, especially if you delay taking it after sex. The company’s website states that if you take the pill within 24 hours of unprotected sex, it is 95 percent effective. If you take it between 48 and 72 hours after unprotected sex, the efficacy rate falls to 61 percent.

“There’s no definite way to tell that it has worked,” Dr. Sparks said. “The best thing you want to do is take the pill as close to the time of unprotected sex as possible.”

“Also, if you’re really worried, wait about a week and take a pregnancy test and just make sure that it’s negative,” she added.

Editor’s note: There’s only one way to make sure any of the options discussed above are actually right for you — talk to your doctor! They understand your health needs best and can provide more specific guidance before you actually make a decision.

If you liked this article, check out this revamped model of the antiquated “baseball” sex metaphor.

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