Birth control options: Things to consider

If you want to use birth control, there are many choices. To help pick the right method of birth control, also called contraception, think about the following questions.

Birth control types include:

• Barrier methods. These include male and female condoms, the diaphragm, a cervical cap, and the contraceptive sponge.
• Short-acting hormonal methods. These include birth control pills, vaginal rings (NuvaRing, Annovera, others), skin patches (Xulane, Twirla) and the contraceptive shot (Depo-Provera). You must use these short-acting types daily, weekly or monthly, depending on the type.
• Long-acting reversible methods. These include the copper IUD (ParaGard), hormonal IUDs (Mirena, Skyla, others) and the contraceptive implant (Nexplanon). A long-acting type lasts for 3 to 10 years after being put in or until you decide to have the device removed. How long birth control lasts depends on the device.
• Sterilization. This is a lifelong, or permanent, method of birth control. Tubal ligation and vasectomy are two types of sterilization.
• Spermicide or vaginal gel. These are birth control methods that don't have hormones. Spermicide kills sperm or makes it hard for sperm to reach an egg. Vaginal pH regulator gel (Phexxi) is a prescription gel that stops sperm from moving, so they can't get to an egg to fertilize it. These products go into the vagina right before sex.
• Fertility awareness method. For this method, you need to know which days of the month you can get pregnant, which means you're fertile. Basal body temperature and cervical mucus can tell you when you're fertile. This method also is called the rhythm or calendar method.

To keep from getting pregnant, you don't have sex on or around the days you are fertile. Or you use a barrier method of birth control on those days.

There's also birth control that can be used in an emergency. These include the morning-after pill (Plan B One-Step, Aftera, others). You can use this to keep from getting pregnant after having sex without using birth control.

Depending on the type, birth control methods may:

• Keep sperm from reaching an egg.
• Damage sperm.
• Keep the ovaries from releasing an egg each month.
• Change the lining of the uterus so that a fertilized egg doesn't attach to it.
• Thicken cervical mucus so that sperm can't pass through it easily.

For any birth control to work, you must use it right all the time or every time you have sex. Birth control methods that don't need you to do anything after they're in place are linked with lower pregnancy rates. These include IUDs, contraceptive implants and sterilization. Types that need you to watch your fertility or not have sex at certain times are linked with higher pregnancy rates.

If you want to get pregnant anytime soon, you may want a method that you can stop quickly. Such methods include short-acting hormonal methods or barrier methods. If you want to keep from getting pregnant for a longer time, you might choose a long-acting method, such as an IUD.

You might want different types of birth control at different times in your life. If you know that you don't want to get pregnant ever, you may prefer a lasting method, such as sterilization.

Some religions and cultures don't accept some forms of birth control. Weigh the pros and cons of a birth control method against your own beliefs.

Choose a type of birth control that suits your lifestyle. Some people want birth control that's easy to use, that has no side effects that bother them, or that they don't have to stop sex to use. Others don't want to have to get a prescription for birth control. When choosing birth control, think about how willing you are to plan or to take medicine on a schedule.

Some methods of contraception don't cost much. Others do. Ask what your insurance will cover. Then think about the cost as you decide what to use.

Learn the side effects that a birth control method might cause. Decide whether you'd be OK with them if they happened. Talk with your healthcare professional about your medical history and how it might affect your choice of birth control.

Condoms are the only methods of birth control that help protect against sexually transmitted infections. Use condoms unless you know that neither you nor your partner are having sex with anyone else and you've both been tested for sexually transmitted infections. Use a new condom every time you have sex. You can use condoms with any other method of birth control you use.

Besides preventing pregnancy, some birth control methods do other good things. Some might give you easy-to-predict, lighter menstrual cycles. Some reduce the risk of some cancers. Think about all the reasons for choosing a birth control method.

You and your partner may not agree on the type of birth control you want to use. Discuss birth control choices with your partner to help find a method that's good for both of you.

The best method of birth control for you is one that is safe, that you are OK using, and that you can use right all the time. Your chosen method of birth control may change over time. And the following factors affect your choice:

• Your age and health history.
• Whether you want to have children, how many you want, and when you want to get pregnant.
• The people you have sex with, including how many sexual partners you have, how often you have sex, and what a partner prefers.
• Your religious beliefs and cultural practices.
• How well a birth control method prevents pregnancy, side effects, cost, and whether the method prevents sexually transmitted infections.

To decide which type of birth control is right for you, know your choices, know yourself, and know your partner.