Recommendation # 1. Consider your priorities.

There are many factors to consider. I’ve listed some of the most important ones below. Think about all of them before deciding. No method of birth control is perfect. Which issues are most important to you? Ask yourself these questions:

– — — — — — — –Questions to consider when choosing a birth control method (BCM)
Do I want kids someday? Should I choose a permanent or a temporary method? Am I sure about my decision to have or not have children?
Impact of a pregnancyHow would an unplanned pregnancy affect my life? Could I handle having a baby or an abortion?
EfficacyHow effective is this method at preventing pregnancy?
ConvenienceHow easy is this method to use?
CostWhat can I afford? Do I have insurance? What does it cover?
ControlDo I want to rely on my partner to use the BCM or do I want to be in control?
AccessibilityCan I buy it at the drug store or do I need to go to a doctor?
Side effectsWhat kinds of unwanted side effect might occur? What can I put up with in order to prevent pregnancy? Could there be side effects I would like?
STI protectionDoes this BCM provide protection against sexually transmitted infections – what is my risk?
ReversibilityIf I use it now, can I get pregnant later? How soon will I be able to get pregnant after I stop using this method?
Effect on my periodsWill it make my period heavier or lighter or gone away completely? Is that a good thing or a bad thing?
Are there physical advantages to some methods, like an effect on my period, acne, menstrual cramps and my risk of getting cancer in the future?
ContraindicationsDo I have medical conditions that might affect my choice like breastfeeding, obesity, allergies to latex, blood disorders?
PreferencesSome people don’t like to use hormones. Some prefer methods that prevent conception rather than implantation. Some can’t remember to take a pill every day; others don’t like getting shots. What other preferences might you and your partner need to talk about?

Recommendation 2. Choose the most effective method of birth control that you are likely to use successfully.

Stopping a method of contraception because you or your partner don’t like to use it or because of side-effects causes a significant number of unintended pregnancies each year. There are many methods to choose from. Really think about which one fits your personality and your life-style the most. Generally speaking, the methods that need the smallest amount of energy on your part are the ones that people use successfully the longest.

For example, here is a list of some of the birth control methods that are currently available. The number represents the percentage of women (and men) who started to use this method and continued to use it for at least one year:

Birth Control MethodPercent of couples who still used this BCM after 1 year
Hormonal rod implant 84%
Hormone IUD 80%
Copper IUD 78%
Hormone pills, patch, or
vaginal ring
Diaphragm 57%
Depo-Provera shot 56%
Fertility Awareness 47%
Male condom 43%
Female (internal) condom 41%

Trussell J. Contraceptive failure in the United States. Contraception. 2011;83(5):397.

As you can see, the methods that couples used for the longest period of time required the least amount of their attention. Keep that in mind when choosing your method.

Recommendation #3. You can always change your birth control method, but try using it for at least three to six months before deciding you don’t like it.

When starting a new BCM, it may take some time before you are comfortable using it, especially if it is a method that you need to learn how to track, insert, put on, or change periodically. As with all new things, it takes a little time to get used to. If you experience side-effects from your BCM that are severe or unexpected, call or visit your health care provider for advice. Find out what the common side effects are – you’ll be reassured if that’s what you’re dealing with too. Many side-effects go away completely or become less bothersome over time. If, at the end of three to six months, you are still uncomfortable with the symptoms you are experiencing, you can always change your method. It is nice to know that you now have many options to choose from – and you don’t need to rely on lambskins and herbs to control your fertility!

Recommendation #4. Your health care provider is your friend.

Find a clinic, a physician, or a nurse practitioner who you feel comfortable with discussing your birth control needs. Health care providers are highly trained experts who discuss these matters with patients every day. While you may feel a bit awkward discussing personal issues, they will not – that’s their job. Especially if you are having any problems with your BCM, if you are having trouble paying for your BCM, or if you have any symptoms of a sexually transmitted infection (STI). If you are experiencing genital burning, irritation, discharge, odor, or pain, contact them quickly to resolve the problem. They are there to help you.

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Excerpted from the upcoming book, The Vulva Owner’s Manual on Birth Control: How to Find Your Best Option for Contraception. Watch for it on Amazon!

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