Birth Control (Contraceptive) Options

The only way to prevent pregnancy is to not have sex. However, if you are sexually active, the best way to reduce the risk of pregnancy and sexually transmitted infections (STIs) is to use birth control, plus a condom, every time. There are many birth control (contraceptive) methods available. Some methods last for years and some do not. Some methods have hormones, some do not. Birth control is safe, easy to use, and has few side effects. Finding the right method for you can help you prevent pregnancy until you want to become pregnant.

Kinds of Birth Control and Protection

• Implant
• IUD
• Shot
• Pills
• Patch
• Ring
• Condoms
• Emergency contraception

Contraceptive Implant

An implant is a small rod placed under the skin in the upper arm by a health care provider. The implant releases a progestin hormone. It prevents an egg from being released from the ovary and prevents sperm from reaching an egg. The implant is the size of a matchstick (Picture 1).

• Implants are greater than 99% effective in preventing pregnancy.
• Effects are completely reversible once the implant is removed.
• Implants last up to 3 years.
• You can get an implant right after giving birth.
• Implants are safe with breastfeeding.
• Implants DO NOT protect against STIs.

Side Effects and Risks:

• Irregular bleeding and spotting are common.
• Pain or scarring can happen at the insertion site.
• Weight gain, headache, acne, or change in mood are all possible.
• There is a small risk of getting cysts on the ovaries.
• Infection from insertion is possible, but rare.
• Moving of the implant is possible, but rare.

Intrauterine Device (IUD)

An intrauterine device (IUD) is a small, T-shaped device placed in the uterus by a health care professional.

• IUDs are greater than 99% effective in preventing pregnancy.
• IUDs are completely reversible once the IUD is removed.
• You can get an IUD right after giving birth.
• IUDs are safe with breastfeeding.
• IUDs DO NOT protect against STIs.
• There are two kinds of IUDs available: hormonal and non-hormonal.
• The non-hormonal and some hormonal IUDs work right away and can be used as emergency contraception.

Hormonal	Non-hormonal
Made of plastic with strings attached	Made of plastic and wrapped in copper wire, with strings attached.
Releases the hormone progesterone to keep sperm from fertilizing the egg	The copper on the IUD keeps sperm from fertilizing the egg. It does not release any hormones or medicine.
Lasts from 3 to 8 years.	Lasts up to 10 years.
Will have lighter periods and fewer menstrual cramps. Some women may stop having periods.	Some women may have heavier, longer periods.

Side Effects and Risks

• Spotting and irregular vaginal bleeding
• Cramping and some discomfort at insertion
• The IUD can move or come out (expulsion). You can get pregnant if this happens.
• The risk of pregnancy is very small. If it does happen, there is an increased risk of tubal pregnancy, infection, miscarriage or early labor and delivery.
• The risk of infection is very small. It is linked to pelvic inflammatory disease (PID). Most cases happen within the first three weeks and are linked to STIs, like chlamydia or gonorrhea.
• It is rare, but an IUD can be pushed into and through the wall of the uterus while it is being put in. This is called perforation. Sometimes surgery is needed to remove the IUD.

Shot

The birth control shot is given every 11 to 13 weeks in the clinic by a nurse or you can administer it yourself at home (Picture 2). The shot releases a progestin hormone. This keeps an egg from being released. It also keeps the sperm from reaching an egg.

• It is 94% effective with typical use.
• The shot lasts 13 weeks.
• You can get the shot immediately after giving birth.
• It is safe with breastfeeding.
• The shot DOES NOT protect against STIs.

Side Effects and Risks

• risk of pregnancy if you are late or miss getting your shot
• spotting, irregular periods, or periods may stop completely
• weight gain
• delay in getting pregnant after stopping the shot
• drop in bone mineral density (This usually improves after stopping the shot. There is no proof showing this causes broken bones.)

Pills

Oral contraceptive pills are birth control pills you take every day, at the same time every day, to prevent pregnancy (Picture 3). The pills have hormones that keep the egg from being released. They also keep the sperm from reaching the egg. 

• Pills are 91% effective with typical use. 
• Pills should be taken at the same time every day. 
• Pills DO NOT protect against STIs.

Side Effects and Risks: 

• breast tenderness, nausea, irregular bleeding, and headaches (Most of these symptoms improve with time.)
• interactions with certain anti-seizure and HIV medicines 
• blood clots in veins and in the lungs. This is rare, but can be life‐threatening.
• increase in blood pressure

Patch

The contraceptive patch is a thin sticker that looks a lot like a bandage (Picture 4). The patch has the hormones estrogen and progestin. These hormones keep the egg from being released. They also keep the sperm from reaching the egg. It is important to remove the old patch when putting on a new one. 

• The patch is 91% effective with typical use.
• One patch lasts for one week.
• The patch DOES NOT protect against STIs.

Side Effects and Risks:

• breast tenderness, nausea, irregular bleeding, and headaches (Most of these symptoms improve with time.)
• less effective in women weighing more than 198 pounds
• interactions with certain anti-seizure and HIV medicines
• blood clots in veins and in the lungs. (The patch has more estrogen than the pill, so the risk of blood clots is higher. This is rare, but can be life‐threatening.) 
• increase in blood pressure

Ring

The vaginal ring is a small flexible ring you put in your vagina (Picture 5). The ring has the hormones estrogen and progestin. These hormones keep the egg from being released and also keep the sperm from reaching the egg. 

• The ring is 91% effective with typical use. 
• One ring may last for 4 weeks or up to 1 year. 
• The ring DOES NOT protect against STIs.

Side Effects and Risks:

• breast tenderness, nausea, irregular bleeding, and headaches. (Most of these symptoms improve with time.)
• interactions with certain anti-seizure and HIV medicines.
• blood clots in veins and in the lungs. (This is rare, but can be life‐threatening.)
• increase in blood pressure.

Emergency Contraception

If you do not use birth control or have a birth control failure, like a broken condom, you can use emergency contraception to prevent an unplanned pregnancy (Picture 6). You can get emergency contraception in the form of pills or a non-hormonal IUD. Emergency birth control in the form of pills is available at the pharmacy or from your health care provider. You do not need a prescription. The pills must be taken within 5 days of the unprotected sex, but the sooner the better. The IUD as emergency contraception can be inserted by a healthcare provider within 5 days of unprotected sex (Picture 7).

Does not cause abortions and should not be confused with the abortion pill. 

Side Effects and Risks:

• changes in your menstrual periods
• breast tenderness, nausea, headaches, dizziness, and feeling tired

When to call your doctor

Call the doctor or your health care professional if you are having pain or side effects that are not normal.

Sexually Transmitted Infections (STIs)

Condoms should be used for EVERY sexual encounter to prevent HIV and STIs (Picture 8.) Other forms of birth control DO NOT protect against HIV and STIs. Condoms alone are only 82 percent effective at protecting against pregnancy and should be used with another form of birth control. Condoms should be used during all sexual encounters, every time, the whole time.

Making a Plan

The choices you make now can change your entire life. Staying healthy and being smart about
birth control are the best ways to achieve your goals. Nationwide Children’s Hospital has several programs where young women can talk about sex, birth control, and STIs, and to get the birth control that is right for them.

• These programs can:
  • Provide birth control to young women up to age 25.
  • Provide same-day insertions of IUDs and implants.
• Go to www.nationwidechildrens.org/BC4Teens for more birth control information.
• You can make an appointment by calling 614-722-6200. Your Nationwide Children’s health care provider can also make an appointment for you. For patients under 18 years of age, a parent or guardian must be at the first appointment.

Birth Control (Contraceptive) Options (PDF), Somali (PDF), Spanish (PDF) 

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