Your Quick Guide to Birth Control
Updated: Jun 14
By Christie Vernon.
Illustrations by Alexandra Roceanu.
Before we begin this article, it’s important to note the difference between using birth control and practicing safe sex. Most birth control methods do not protect you from sexually transmitted diseases, they prevent pregnancy. If you are having sex, make sure you take measures such as using condoms, getting the HPV vaccine, and getting tested regularly.
Keep in mind this article isn’t an exhaustive list - these are just the most common and “basic” methods. If none of the following work for you, don’t hesitate to ask your doctor to explore other types. That’s exactly what they are there for. Now, without further ado, let’s dive into the basics of birth control.
There are many types of contraceptive pills. They contain lab-made versions of two hormones found naturally in the human body: estrogen and progesterone. They can either use both (as in combination pills) or only progestin (synthetic progesterone); combination pills are the more common of the two. By changing the level of hormones in a woman’s body, the pill prevents the release of an egg. It is highly effective in preventing pregnancy, but only works properly if you remember to take the pill every day around the same time. Furthermore, they may also improve cramps, acne, or health issues such as polycystic ovary syndrome.
If you are just starting to use the pill, take the first one on the first day of your period for the best protection. If you do not do so, another form of birth control will have to be used as well for that cycle. If you miss a day, you should also use a backup method. Some drugs may also prevent the pill from being absorbed into the body, so always tell your doctor that you are using the birth control pill if they are prescribing you medication. Keep in mind, your cycle will regulate 3 to 6 months after you are off the pill, but getting pregnant is possible immediately afterwards.
The birth control pill does have side effects, like any other medication. These include nausea, headaches, and mood swings. More rarely, it can even lead to blood clots, high blood pressure, and strokes. If someone in your family has a blood-clotting disorder, or if you are at risk of stroke, consider using a different type of birth control, despite the fact that even then the risk is very small. Pills containing levonorgestrel and a low dose of estrogen are shown to have a decreased chance of blood clots, according to multiple studies such as that conducted by Astrid van Hylckama Vlieg, PhD, of Leiden University.
Condoms are a barrier method of protection, meaning they stop sperm from entering the body. When used properly, they are effective about 98% of the time in impeding pregnancy. They are one of the very few methods that prevent STDs and pregnancy. Both female and male condoms exist, although the male condom may be slightly more successful in limiting the spread of disease. Condoms are available without a prescription, are relatively cheap when compared to other types of protection, and are the only currently available reversible method of birth control for men.
If you decide to use condoms as birth control, make sure that beforehand you always check for damage to the packaging, for an expiration date, and for rips and tears. Do not use if expired or if the packaging is damaged. When putting on the condom, ensure you do so before any contact between the penis and vagina, that you leave space for sperm to collect, and that no air is trapped between the penis and the condom (this can cause rips). If you are allergic to latex, try a polyurethane condom instead. Finally, always have a couple condoms handy when you need them; not doing so heightens the chance of unprotected sex.
IUD (Intrauterine Device)
An IUD is a small, plastic T-shaped device, either containing progestin or wrapped in copper, which is inserted into the uterus by a medical professional. Copper IUDs, once inserted, can protect you from pregnancy for up to 12 years, with most hormonal IUDs providing protection for about 3-7 years. It is one of the most effective available methods of birth control.
IUDs work by changing the way sperm moves upon entering the uterus - copper repels sperm, and the hormones cause the mucus on the cervix to thicken, blocking the sperm’s entrance. Hormonal IUDs may also prevent ovulation. The IUD is inserted through the cervix into the uterus using a special device. The process may be uncomfortable despite numbing and relaxing agents, but it usually only lasts a couple minutes. It is suggested that someone comes with you and drives you home to make the experience more comfortable overall.
IUDs have many advantages: they are effective, convenient and cheap. Copper IUDs can be used as emergency contraception (although there are some tests required beforehand that may take time); if inserted within 3-5 days after unprotected sex, they are up to 99.9% effective, depending on the brand. In Romania, an IUD is fairly inexpensive, and long-term is the most cost-effective method of pregnancy prevention.
Immediately after insertion, you may experience back pain, cramping, or spotting. There is an extremely small chance that an IUD can slip out of place after being placed, most commonly during the first 3 months. Despite the infinitely small chance of getting pregnant with an IUD in, if you do happen to become pregnant have it taken out immediately, as it can cause ectopic pregnancies. Copper IUDs can make your periods heavier and worsen cramps. If you experience pain or bleeding during sex, unexplained fever, different vaginal discharge, etc, go see your doctor as soon as possible.
You may not be able to get an IUD if you have certain STDs, such as chlamydia or gonorrhea, at least until the infection is treated. Pregnancy, untreated cervical or uterine cancers, and certain pelvic infections may also make you unable to have an IUD inserted, as can a copper allergy or Wilson’s Disease.
The patch is a type of birth control you stick on yourself once a week. It is safe and very effective if used properly. It releases hormones through your skin that stop ovulation and thicken the mucus on your cervix so that sperm cannot get through. When using it, stick a new patch to clean, dry skin on your stomach, upper arm, buttocks, or back. The patch is worn for 7 days, then taken off and a new one is put on. Be sure to put on a new patch on the same day every week, and not to wear your patch more than 7 days. If you put it on within the first 5 days of your cycle, it will work immediately - if not, it will work fully by about the 7th day after application.
There are some mild side-effects, such as headaches or nausea, but these go away within 2-3 months. Some medication can stop the patch from working properly; these include the antibiotics Rifampin, Rifampicin, and Rifamate, the antifungal Griseofulvin, and some HIV and anti-seizure drugs. If you get migraines, have severe diabetes, high blood pressure, or a family history of blood clots, the patch may not be for you. You should see a doctor if you’re on the patch and have sudden back pain, nausea, migraines, or chest pain.
The patch is known for helping with acne and easing period cramps, preventing ovarian cysts (similar to the pill) and pelvic infections in the uterus, ovaries or fallopian tubes.
For the patch to be effective, you must use it regularly. Forgetting to apply or buy it may be an issue, so if you decide to use it, make sure you have a reminder to stick on the new patch. The patch is 99% effective in preventing pregnancy, but due to human error it is about 91% effective in practice.
The implant is a small, matchstick-shaped device which is inserted into your arm and protects you from pregnancy for up to 5 years. It uses progestin, and prevents pregnancy in the same way as the patch and the hormonal IUD. Similar to IUDs, it has the large advantage that it’s “mistake proof” - once it is in your arm, you don’t have to worry about it anymore. The insertion only takes about two minutes, and a numbing agent is used. There may be some bruising, tenderness or slight swelling, but it goes away within a few days. Your doctor will explain how you should take care of your arm for the week or so after implantation.
Like all medication, the implant does have a few side effects, such as spotting, headaches or weight gain. Additionally, 1 in 3 people completely stop having their period after the first year. However, it is an extremely effective method of birth control, and convenient as it means you’re always protected.
Emergency Contraception (a.k.a. Plan B)
Although emergency contraception isn’t necessarily a form of birth control, it is still worthy of inclusion in this list. It isn’t as effective as other forms of birth control, and may not work if you weigh above 71 kg. Emergency contraception can be taken within 48-120 hours depending on the brand, but it is more effective if taken as soon as possible after unprotected sex. It can be bought over the counter at most pharmacies in Romania, and is usually around 40-60 lei, but may cost more.
As we said earlier, the copper IUD can be used as emergency contraception. However, a pill can also be taken. Most pills use levonorgestrel, a synthetic progestin. Be careful not to use multiple types of emergency contraception within a week of each other, as they may cancel each other out, and taking more than one of any type can make you sick.
Emergency contraception works by temporarily stopping ovulation. Where you are in your cycle matters, since if you have already ovulated, you may still become pregnant despite taking the pill. Emergency contraception pills are not abortion pills, as they prevent pregnancy, not end it.