Choosing a Birth Control Method

Reproductive rights are the free and unbarred access to choose if, when and how to start and build a family, and having inclusive tools and resources needed to do so. This includes choosing and starting a birth control method!

The creation of birth control was a revolution – instead of having to choose between having babies and moving into careers, women (of the era, and not fully representative of the term “woman” now) were able to manage their cycles to continue building their career and engaging in sex without fear of pregnancy and the costs associated with this.

To this day, birth control still plays a huge role in reproductive health, both for folks who intend to carry pregnancies and those who don’t. However the options are so vast that it can be overwhelming to pick between them all!

Here’s your quick guide to the big considerations when choosing a birth control method.

1. Cost and access. Not all insurance companies cover birth control costs (unfortunately) and in these cases it may not be accessible for a person to use prescribed birth control. They may defer to internal and external condoms, which more often come at a lower cost and are more widely available in pharmacies and general retailers, or pay out of pocket.

There may also be situations where a person’s primary care provider and pharmacy are far from them, and selecting the option that makes the most sense for travel and prescription pick-up would make more sense. And for the more invasive birth control methods such as the intrauterine device (IUD), not all providers may insert them on-site and so having the ability to travel to and afford a specialist is a big factor.

2. Intensity of use and tracking. Some birth control methods are fairly easy to use with minimal tracking involved, such as the IUD, patch, ring, injection and implant. Products such as the implant and patch may require a low level of tracking to remember when to book provider appointments or change the birth control (e.g. change patch, change ring).

The IUD holds the lowest level of tracking as once it is inserted, it can remain in place for use between 3 to 12 years (depending on the type) – there may still be tracking appointments for follow-up and noticing symptoms that may indicate an issue with the IUD.

Other forms of birth control including the Fertility Awareness Method (FAM) require daily and more intensive tracking to identify ovulation patterns and symptoms indicating the fertile window. Oral contraceptives come with their own “built-in” tracking because they come in a pack with a set number of pills to complete before picking up a new pack.

3. Permanence. Some folks using birth control plan to stop its use to plan a pregnancy, whereas others do not plan to have children whatsoever. Birth control options that are easily reversed can be supportive to the former, such as oral contraceptives, the IUD and other internal/external products.

Procedures such as tubal ligation and hysterectomy can prevent pregnancy, but do not offer the same reversibility – vasectomies are a (somewhat) exception to this, depending on the success and outcomes of the procedure itself.

4. Side effect profile. Every birth control method is different, and every person responds to birth control differently. Some birth control options may contribute to elevated cholesterol levels, changes in menstruation frequency and quality and changes in mental health status – knowing the potential side effects of the birth control options available to you is important so you can choose what you are and aren’t willing to tolerate.

5. Period management goals. For folks with period-related pathophysiology, like PCOS, endometriosis and PMDD, birth control options are essential and a valid choice to make. Others may appreciate the convenience of a regular period on schedule, and others are looking for a way to stop periods entirely as they navigate gender dysphoria. No two goals are the same, so no two birth control plans are the same!

6. Last but definitely not least, STI protection. Not all forms of birth control effectively protect against STIs including chlamydia and gonorrhoea. Using birth control without this protection increases the risk of both these infections and others down the line, including but not limited to HPV, pelvic inflammatory disease and HIV/AIDS.

Regardless of the hormonal aspect of birth control, consider using a barrier method (dental dams, internal/external condoms) for sex to reduce your risk – and successfully prevent pregnancy too.

With the appropriate knowledge and tools in hand, you can select the best method for you and your optimal reproductive wellness!