With a new gel and patch to join the existing range of contraceptive options, women today seem to have many options to prevent pregnancy.

At first glance, yes. Condoms, spermicides, IUDs, the pill, a neck cap, a diaphragm, and the gel are part of the list. But the birth control that a woman chooses has to suit her life, according to experts. And their personality. A woman with sticky notes all over her computer screen may not be the best candidate for daily medication.

Bottom line: If you want your birth control to be effective, make sure your choice is realistic and doable.

“The vast majority of women will be able to find a method of contraception that works,” he said

Bethany Golden, a certified midwifery nurse and graduate student at the University of California at San Francisco, “but we still have women who don’t … if someone can’t be on hormonal birth control, we only have a few options.”

The pill, the band-aid and the shot, oh my god!

It can be difficult to find the right birth control for you. So how can you make it straightforward?

First, rate the product. How does it work, how is it used, and how effective is it from two angles: its effectiveness for the typical user and when used exactly as the manufacturer says. Typical use is a user error, e.g. B. Genital contact before putting on a condom or forgetting to take the pill on a weekend. However, the perfect usage number shows how good the method is.

Knowing the differences between these two numbers and what this typical mistake that can lead to pregnancy is, can help you choose the best prophylaxis. The author of one study said, “Perhaps the most important user characteristic is the incomplete application of the method.”

The attached table can help you make a decision.

How do some of the birth control options stack up? Sabrina Emms

Good birth control has to be something you will use and it can mean different things to different people. It could mean it suits your price, or it could be discreet. Maybe you like getting your period, maybe you hate it.

Golden declared people can change and adapt. “We all have the option to incorporate different forms of birth control if we so choose. So the question is, is the desire there, is the motivation there, and is there a tip and trick that someone can do. “Finding the right birth control fit means balancing a range of needs and wants, and personality will help. “People’s personalities play a role, but again, it may not be the most critical factor in selection,” Golden said.

Type A.

Does that sound like you? As a condom user, do you always have a condom on hand, check its expiry and always put it on the right path?

If you said “yes” then this is a perfect user.

Or the pill? Have you set a timer to take the pill and always have the next pack ready? Or do you keep the pills near your toothbrush?

Perfect user.

But what if it’s not you What if you are the woman with sticky notes on her computer?

Forgetful or spontaneous

For the person who rarely finds their keys and prefers intuition to GPS, methods such as IUDs, ring or intrauterine devices and recordings have little user error. The user has little control over these types as a healthcare professional will take care of either the placement or the shot and therefore the perfect and typical use is similar. The shot and most IUDs are hormonal, although the Paragard IUD, a non-hormonal contraceptive, is made of copper.

The uptake takes about 3 months and the copper coil about 10 years.


Frequency is another point to consider when determining what type of birth control you are using. You may rarely have sex but want to be protected by something like an IUD or implant all the time. Or you are more sexually active and would like to be protected in the long term, but also use condoms with different partners.

This is not a one size fits all. “You could have two people with completely different frequencies choosing the same method,” Golden said.

Other options: The ring is a hormonal contraceptive that sits in the vagina below the cervix. There is also the diaphragm and neck cap, called barrier contraception, and are used with spermicide.

Narrow the selection

The next decision is hormonal or non-hormonal. The pill, the plaster, the shot, the ring and the IUDs are predominantly hormonal. Condoms, spermicides, the gel, the sponge, and the diaphragm are all non-hormonal.

All methods of contraception have advantages and disadvantages. And if a doctor is not involved in the method of contraception – the IUD insertion, for example – then ineffective, inconsistent use is a big reason why contraception isn’t as effective as it can be.

Some hormonal contraceptives, such as pills, can cause mood swings, spotting, nausea, and chest pain, although these can get better over time. On rare occasions, women have developed blood clots, although in the past this was a bigger problem when the pill had a higher dose of estrogen.

“There are effects that birth control methods have on women’s bodies,” Golden said. “They differ from person to person, however.”

Patches are other types of hormonal birth control. Xulane, approved in 2014, and Twirla, approved in February 2020, each have the same shortcoming: the heavier the woman, the less effective the patch is.

For people who don’t want to use hormonal birth control, a gel offers a DIY option, much like spermicides.

Phexxi, which was approved by the FDA last spring, is an acidic gel that is used before sex and lasts for an hour. While the idea of ​​sprinkling an acidic gel inside your vagina may not seem appealing, science backs its effectiveness. The vagina is usually a little bit acidic and the semen is a little bit basic. By keeping the vagina acidic, the gel slows down sperm and prevents pregnancy.

The gel requires a prescription. For comparison with unprotected sex, sperm can reach their destination within minutes of ejaculation and hang around for days.

In a clinical study, 101 pregnancies occurred in 1,183 women over a seven-month period, bringing the cumulative pregnancy rate to 13.7%. The organizers of the study did not include menstrual cycles in which the women used an extra contraceptive. The pearl rate, a measure of how many pregnancies occur in 100 women, was 27.5.

This gel also has some side effects, including mostly minor burns. However, this side effect can be a common experience: 9.8% of the male partners reported some mostly mild discomfort. The study participants reported that the side effects decreased with the use.

The effectiveness of the patches is based on the weight of the woman. Xulane is only effective in women who weigh less than 198 pounds. Likewise, Plan B and Ella, both emergency contraceptives, have weight limits above which they are less effective. Plan B is 165 pounds and Ellas is 195 pounds.

Discuss other differences

What is the difference between spermicide and gel? Good question. As the gel slows down the sperm, it damages the spermicide. Spermicide can also increase the risk of vaginal irritation and cause itching and burning. Vaginal irritation, in turn, can make women more susceptible to STDs and HIV. Spermicide is a laundry detergent, and just as hands can become dry and cracked when washing or washing lots of dishes frequently, repeated use of spermicide in the vagina can damage the skin there.

Condoms, men and women, and spermicides come from the drugstore, even the grocery store. This can be a factor in which method you can best access. Another point about condoms: they are the only method of contraception that can protect against sexually transmitted diseases.

There is no such thing as 100% effective birth control. The only way not to get pregnant is to keep the ejaculate out of the vagina.

If you decide to go without protection, keep this in mind: Penetrative intercourse without contraception in 100 women can result in 85 pregnancies.

Intimate choice

Doctors and providers at many low-cost clinics and safety net clinics can help explain the options and answer questions. Golden said if a provider isn’t talking about a type of birth control you’re interested in, speak to them. Ask how often they prescribe it. Not all providers are as familiar or familiar with certain types of birth control. The trick is to find the one that works best for you.

References for the graphic

  1. Contraceptive failure rates. In contraception technology. 2013; (26): 844- 845.
  2. Birth control. Planned parenting. Accessed April 1, 2021. https://www.plannedparenthood.org/learn/birth-control
  3. Reprinted with special permission from The Medical Letter on Drugs and Therapeutics, Aug. 24, 2020; Vol. 62 (1605): 129-13; 132. Reprinted with special permission from The Medical Letter on Drugs and Therapeutics, Feb. 8, 2021; Vol. 63 (1617): 17- 18th