Birth Control: What’s Safe, What’s Not

BirthControl2As a woman, you have a lot of choices today when it comes to birth control methods, giving you and your partner control over when – or if – you become parents.

But with birth control (also called contraception), different people have different needs. Each method has its pros and cons – including health risks. That’s why it’s extremely important that you have an honest discussion with your doctor about which approach to birth control is best for you, based on such considerations as your overall health and medical history, how well each method works, how often you have sex, possible side effects, and if you want to have children someday.

That said, there are 7 major categories of birth control options:

  • Abstinence  –  Avoiding vaginal intercourse altogether
  • “Natural” birth control  (also referred to as the rhythm method or fertility awareness) – You track ovulation in order to avoid intercourse when you’re most fertile
  • Barrier methods  –  The contraceptive sponge; diaphragm, cervical cap and cervical shield; and male and female condoms. They work by creating a barrier that helps prevents sperm from reaching and fertilizing an egg, and are often used with spermicide (a substance that kills sperm)
  • Hormonal methods  –  The birth control pill, patch, shot/injection, implantable rod and vaginal ring; all primarily work by using hormones to prevent ovulation (stopping the ovaries from releasing eggs)
  • Implantable devices  –  An implantable intrauterine device (IUD) is a small T-shaped device inserted into the uterus to prevent pregnancy.  There are both hormonal and non-hormonal IUDs available.
  • Permanent birth control  –  Includes surgical sterilization (tubal ligation) or a sterilization implant (Essure®), which blocks the fallopian tubes from carrying eggs to the uterus
  • Emergency contraception  –  Prevents most pregnancies when taken within a few days after unprotected intercourse, contraceptive failure, incorrect use of contraceptives, or in cases of sexual assault. There are two methods: emergency contraception pills and a copper IUD.

While the hormonal methods of birth control are up to 99% effective when used correctly, and are safe for most women, the ones that contain the hormone estrogen are associated with a slightly increased risk of deep vein thrombosis (blood clot), heart attack and stroke. So if you smoke, are 35 or older, or have risks for cardiovascular disease (such as high blood pressure or diabetes), you should talk to your doctor before deciding to use birth control containing estrogen. Also, if you get migraines, estrogen may trigger these painful headaches.

There is a progestin-only birth control pill that may be a better choice for women who cannot take estrogen. But if you have liver tumors, lupus or breast cancer, you should avoid this method.

Barrier methods of birth control can be anywhere from 71% to 98% effective when used correctly. If you’re prone to bladder infections, however, diaphragm use raises your risk of getting one. And if you’ve ever had toxic shock syndrome, you should avoid the diaphragm and the contraceptive sponge.

These are just some of the things you need to think about as you consider your birth control choices. We urge you to talk to your doctor about it; she or he can provide objective information and guidance to help you make the choice that’s right for you.

And remember: today there are more and safer birth control options than ever. And while any birth control method can fail (except abstinence), the risk of failure is less than 1% for many methods – versus an 85% chance of pregnancy if you don’t use birth control!

If you’d like to learn more about the various birth control options, please visit the website of the American Congress of Obstetricians and Gynecologists (ACOG) at