Contraceptives for Beginners Guide
Cover image courtesy of Myles Loftin for Them.
One of the most important aspects of sexual and reproductive health is access to affordable and safe birth control that works well for individual bodies. There are so many different options and forms of contraception that it can seem overwhelming, especially for those just getting started! The executive board of GW Voices for Choices - The George Washington University’s reproductive justice advocacy and awareness student organization - has developed this Guide to Contraceptives for Beginners.
Different forms of birth control work differently on every body and with every person’s habits. For starters, there are hormonal and non-hormonal methods and external barrier and internal methods of contraception. But don’t forget: only condoms can protect you from both pregnancy and STDs at the same time
There are a few internal options that work well for people who don’t want to commit to a lot of daily upkeep with their birth control: the implant, hormonal IUDs, and non-hormonal IUDs. While each method is effective for a different length of time, each can be removed at a doctor’s office if you decide to stop using the method for any reason, and you will be able to get pregnant right away. These methods work exceptionally well and have a less than 1% chance of getting pregnant while using them.
First up, the implant! The implant, also known as Nexplanon, is a small rod the size of a matchstick that gets inserted in your upper arm. The insertion is done safely in a doctor’s office or Planned Parenthood by a nurse practitioner and lasts for three years. Nexplanon is a hormonal form of birth control that for some women stops their period entirely, or makes their flow more regular and their pain more manageable. However, it usually takes three to six months for your body to adjust, and your period may be irregular during that time.
This form of contraception is best for someone who: wants a strong contraceptive option, does not want to think about contraception or getting pregnant for three years, is not sensitive to hormones, does not mind feeling something in their arm, and who has access to a clinician to both get it inserted and for follow-ups as needed.
Next up, hormonal IUDs! IUD stands for intrauterine device, and there are two kinds: hormonal and non-hormonal. IUDs sit in the uterus and are also inserted in a doctor’s or gynecologist’s office. The procedure is safe and quick, but insertion can be painful for those who have never had a baby, as it requires opening your cervix. Hormonal IUDs like Skyla, Mirena, and Kyleena can last between three to seven years, depending on the brand. Skyla, for example, can last three years while the Mirena lasts for five. These don’t require a lot of daily attention, but you do need to check the strings every month to make sure that your IUD is still secure and situated properly. For some people with uteruses, hormonal IUDs stop their period entirely, or makes their flow more regular and their pain more manageable. However, it usually takes three to six months for your body to adjust, and your period may be irregular during that time.
This form of contraception is best for someone who: wants a strong contraceptive option, does not want to think about contraception or getting pregnant for three to seven years, is not sensitive to hormones, is able to ensure IUD is still in place, and who has access to a clinician to both get it inserted and for follow-ups as needed.
Now for the non-hormonal IUD, or copper IUD. The non-hormonal IUD, ParaGard, is similar to hormonal IUDs in many ways. It is inserted into the uterus in a doctor's office and needs to be checked monthly. However, the non-hormonal IUDs can last for up to ten years. Some people experience worsened cramps and a heavier flow for their first three to six months with ParaGard, so keep that in mind! Additionally, this can be used as emergency contraception when inserted within five days after having unprotected sex.
This form of contraception is best for someone who: wants a strong contraceptive option, does not want to think about contraception or getting pregnant for ten years, does not want to use hormonal forms of birth control, is able to ensure IUD is still in place, and who has access to a clinician to both get it inserted and for follow-ups as needed.
If you’re not comfortable with having something inserted, aren’t looking for anything as long-term, or just don’t feel like these forms of contraception are right for you, there are plenty of other options! These options can be less effective than those in the previous section, but they are still very effective when used according to instructions by a clinician.
First up: the pill! The birth control pill is probably the method of contraception you hear about the most. There are two main categories of birth control pills: combination pills that contain progesterone and estrogen and mini pills that contain progesterone only. Within those two categories are many varieties of birth control pills with different brands, bases, and hormone variables that can affect everyone's body differently. It is common to experience a decrease in flow and cramps while using birth control pills and the mini-pill can even stop your period altogether. Finding the right birth control pill for you can take a lot of trial and error, which can be frustrating, but worth it in the end. Birth control pills are often obtained via a prescription from a doctor, gynecologist, or clinic like Planned Parenthood. Some states (Alaska, Arizona, California, Connecticut, Florida, Georgia, Hawaii, Idaho, Illinois, Maryland, Minnesota, Montana, New York, New Jersey, North Dakota, Ohio, Rhode Island, South Dakota, Texas, Utah, Virginia, Washington, D.C., and Washington state) actually allow you to get your birth control online through services like the Planned Parenthood app and Nurx. The pill requires a lot of upkeep! It must be taken around the same time each day, within a three hour time period, and you’ll have to make sure you have a new pack every month.
This form of contraception is best for someone who: is organized enough to remember to take the pill at the same time every day (alarms can help!), is not sensitive to hormones, has access to a doctor’s office or Planned Parenthood to begin the process and follow up with any needs to change methods, has access to a pharmacy or online service to receive the prescription.
Next on our list is the patch! The patch is also obtained via a prescription from a doctor, gynecologist, clinic, or Nurx. The patch is like a hormonal band-aid, you stick it on your skin and it acts as a contraceptive and regulates your period. They don't last forever, though, and you'll have to change it out every week. It is common to experience a decrease in flow and cramps while using the patch.
This form of contraception is best for someone who: can remember to change their patch every month, with access to a pharmacy or service to get new patches, who wants a more comfortable or regular period, who is not sensitive to hormones.
Next, we have the ring! The Nuva-Ring can be acquired via a prescription from a doctor, gynecologist, clinic, or Nurx. The Nuva-Ring looks like a bendable jelly bracelet which is inserted into the vagina. It remains in place for three weeks, releases hormones, and then is taken out for the fourth week, and exchanged for a new ring. You don’t have to take it out during sex unless you want to, and while users usually experience more regular or less painful periods, you have the option of safely skipping your period entirely! Be aware that you have to insert the ring yourself, so it takes practice to get comfortable with your body, and figure out what positioning works for you.
This form of contraception is best for someone who: can remember to take their ring out at the start of the fourth week and change to a new ring once a month, with access to a pharmacy or service to get new rings, who wants a more comfortable period or wants to skip their period entirely, who is not sensitive to hormones, who is comfortable with touching their vagina upon insertion.
Finally, there’s the Depo-Provera shot. The Depo-Provera shot is exactly what it sounds like: it is a hormonal shot you get every three months to keep you from getting pregnant. You can get the shot at a doctor’s office or a Planned Parenthood, and once you get it, you are safe from pregnancy for three months, and no one can tell! However, you will have to remember to go in every three months to get a new shot, as it will wear off. The shot can help regulate your flow and make your period pain more manageable.
This form of contraception is best for someone who: has access to a doctor or Planned Parenthood every three months, is not very afraid of needles, is not sensitive to hormones.
Okay, now that we’ve gone over the most reliable and effective forms of birth control, it’s time to talk about some common methods that aren’t the best. Internal and external condoms are extremely important for STD/STI protection and should always be used with another method of contraception (like those listed above!). However, be aware that internal condoms take practice to insert so they remain effective, so don’t use one during sex before you’re comfortable with insertion and placement. The diaphragm and the sponge are other barrier methods. They are both one-time use, like condoms, and don’t work very well on their own. Methods like fertility awareness tracking, and withdrawal are not effective when it comes to preventing pregnancy.
To wrap it all up - like a condom, get it? - there are a lot of potential contraceptive methods out there for you to choose from. Here’s some advice, from us to you:
Unfortunately, there is no one-size-fits-all birth control. What works for your friend, your mom, your sister, or your gynecologist won’t necessarily work for you, and that’s okay! Finding the birth control method that works best with your body, mental health, habits, and sex life is a journey, and can take a few tries to find that perfect fit. When starting the journey to find your perfect birth control method, remember to always be open and honest with your doctor or clinician, and ask as many questions as you need when discussing the best birth control option for you. When you’re trying a method out, remember to listen to your body; pay attention to changes in your period, sex drive, mood, and sleep cycle, but also remember it may take three to six months for your body to get acclimated to new hormones and substances.
If you decide you don’t like a contraceptive method, it’s completely okay to stop, switch, or get more information about other options! You never have to stay with one kind of contraceptive just because your doctor prescribed it, or because everyone else might be using it. Remember, you are never a burden on any clinician for asking to try a new contraceptive; you are the only person who knows exactly how your body feels, and you need to be your own advocate! A good idea is to track your contraceptive history by writing down what methods and brands of birth control you have used in the past (i.e. birth control pill, Lo Loestrin Fe). That way you’ll have information handy for doctors and be able to know for yourself which methods you like, and which you don’t. Self-advocacy is the most powerful tool you can have in the hunt for that perfect birth control method, so don’t lose hope, and don’t feel overwhelmed! Your doctor, your mom, your friends, or even us at Voices For Choices are here for you as you try out different methods, and there are plenty of online resources (like Bedsider and Planned Parenthood) to help you out along the way! Beginning to explore your sexuality and taking charge of your reproductive timeline is an amazing opportunity to get in touch with what your body needs—listen to it!