Medically reviewed by Dr. Erica Montes
In the past, the birth control dilemma seemed simple: Go to the doctor and get “The Pill.” But now that there are many options to choose from, including non-hormonal ones, it’s a little more complex. Which pill? And why? What side effects are there? What are the other options? These are each important questions to consider when choosing birth control.
We asked Dr. Erica Montes, FACOG, an OB-GYN and creator of women’s health blog “The Modern Mujer,” for some facts to help you fully understand your choices when it comes to birth control — and which method might work best for you.
What is the difference between hormonal and non-hormonal contraception?
Hormonal contraception (birth control) contains hormones — either estrogen and progesterone or just progesterone. It usually acts to prevent ovulation or thicken cervical mucus to prevent pregnancy. Non-hormonal birth control doesn’t contain any hormones and includes condoms, vaginal gel, spermicides, fertility awareness methods such as tracking fertile days, sterilization or tubal ligation, and the copper intrauterine device (IUD). Less commonly, some women opt for a cervical cap, diaphragm or sponge.
How do I know which type of contraception is better or more appropriate for me?
You will have to consider your plans for pregnancy in the future, cost, effectiveness, ease of use, side effects and whether you have any health conditions that affect which options you can use. Your healthcare professional can help answer those questions so you can determine which method will fit your lifestyle and your body.
Besides preventing pregnancy, what are some other advantages of taking/using birth control?
Birth control pills, which contain hormones, can help decrease your risk of uterine and ovarian cancer with protection that lasts more than 30 years after use. They can also help improve acne, regulate your period, ease painful menstrual cramps, reduce ovarian cysts, or control certain medical conditions like abnormal uterine bleeding or endometriosis. The benefits of non-hormonal contraception include fewer changes in menstrual bleeding patterns, no changes in sex drive and no hormonal side effects. Non-hormonal options can generally be more convenient and easy to use.
Can birth control interact with other medications?
Certain antiseizure medications can cause oral birth control pills to be less effective. Rifampin, which used occasionally to treat tuberculosis, is the only antibiotic that can cause birth control pills to be less effective. Other antibiotics do not affect your pill’s ability to prevent pregnancy.
Does birth control protect against sexually transmitted infections (STIs)?
Not necessarily. Only latex or polyurethane condoms, including internal condoms, protect against both pregnancy and STIs. For protection against STIs, it’s important to use condoms in addition to other forms of birth control that only protect against pregnancy.
How do certain health conditions affect which birth control methods I should consider?
Certain health conditions, such as high blood pressure, migraine, a history of blood clots or breast cancer can limit your hormonal birth control options. People with these conditions may opt for non-hormonal birth control, as long as it’s reliable, because pregnancy can be riskier with some of these medical issues. It is important to discuss your past medical history with your healthcare provider so they can counsel you about which options are safe.
Does birth control increase my risk for cancers (breast, cervical, etc.)?
It’s complicated. According to research from Cancer.gov, the risk of breast and cervical cancers does increase over time with the use of some types of hormonal birth control — but these can also lower risk for other types of cancers, like endometrial, ovarian and colorectal. So, it’s best to talk to your HCP about your particular risk profile. Non-hormonal options do not increase your risk of any cancers.
What are some possible side effects of birth control?
With hormonal methods, you may experience nausea, breast tenderness, headache, bloating, mood swings, melasma or irregular bleeding. Some women experience heavy menstrual bleeding or long-term spotting when using a copper IUD. Other non-hormonal methods do not carry a risk of side effects because they don’t affect any hormone levels in your body.
Is it safe to go on and off birth control?
It is not a good idea to go on and off hormonal birth control if you are trying to prevent pregnancy because inconsistent use can lower effectiveness. For example, the pill is most reliable when you take it consistently at the same time each day to keep hormone levels from fluctuating. The constant hormones ensure that there is no ovulation and create thicker cervical mucus to prevent pregnancy. Inconsistent use of hormonal methods can also create irregular bleeding that many women dislike. Non-hormonal birth control options may be ideal if you need birth control rarely or on an as-needed basis, since they are easier to start and stop than a hormonal option.
If you don’t like your current birth control method, talk to your HCP to see if there is a better option for you.
This resource was created with support from Evofem Biosciences.