Choosing a form of contraception is a highly individualised process that often requires consideration of multiple factors to align with a person’s unique health, lifestyle, and personal preferences. If you are considering implementing a form of contraception, it’s important to be informed about your options. Contraception should be discussed with your primary healthcare provider to identify the most suitable option based on individual circumstances, health, and lifestyle needs.
Often when I quiz my patients in the clinic about what methods of contraception they are aware of, three major players come to mind more frequently than others; the infamous Condom, the IUD and the Oral Contraceptive Pill; there are, in fact, several other hormonal, barrier, long-term, and non-hormonal methods of contraception that have been around for years that may be effective for some individuals and couples to consider.
Here’s a list and a breakdown of some common types of contraception;
Hormonal Methods ~
Oral Contraceptive Pills
Daily pills containing hormones (either combined estrogen and progestin or progestin-only). The contraceptive pill is best for: Those who can remember to take a daily pill and are looking for non-permanent contraception.
Contraceptive Patch
A patch that delivers hormones through the skin. Worn for a week at a time and are changed weekly for three weeks with a week off. This form is best for those who prefer a weekly method rather than daily.
Vaginal Ring (NuvaRing)
A flexible ring inserted into the vagina, releasing hormones for three weeks at a time. This option is useful for those who prefer not to take daily pills but still want something they control themselves.
Injectable Contraceptive (Depo-Provera)
A hormone shot given every three months. This option is best for Those who want a low-maintenance option that doesn’t involve daily or weekly upkeep.
Hormonal IUD (e.g., Mirena, Kyleena)
A small T-shaped device inserted into the uterus, releasing hormones to prevent pregnancy for 3–7 years. This option is useful for those looking for an effective, long-term, low-maintenance option.
Emergency Contraception ~
Morning-After Pill (Plan B, Ella)
Used within a few days after unprotected sex to prevent pregnancy. This is not a long-term form of contraception but can be used in emergency situations when another method has failed, or no contraception was used.
Non Hormonal Barrier Methods of Contraception ~
Condoms (Male and Female)
A barrier method that prevents sperm from reaching the egg. It’s also the only method that protects against sexually transmitted infections (STIs).
Diaphragm
A dome-shaped cup inserted into the vagina before sex, used with spermicide to block sperm from reaching the egg. This option is best for those who want a hormone-free option and are comfortable with using a device before each encounter.
Cervical Cap
Similar to a diaphragm, but smaller and fits over the cervix, the cervical cap is best for those who want non-hormonal, on-demand contraceptive option.
Long-Term Non-Hormonal Methods of Contraception ~
Copper IUD (e.g., Paragard)
A hormone-free IUD that works by can prevent pregnancy for up to 10–12 years, by creating changes in the cervical mucus and creating a subtle inflammatory reaction that impedes sperm. This method can also be used within five days of unprotected sex to prevent pregnancy, however it should not be relied upon.
Natural Methods ~
Fertility Awareness-Based Methods (FAM)
Tracking menstrual cycles to avoid sex during fertile periods. It involves tracking three primary aspects; your basal body temperature, observing cervical mucus changes and monitoring cervical position which should generally feels softer, higher, and more open around ovulation. The FAM is best for those who prefer hormone-free methods of contraception. It encourages body awareness and understanding of the menstrual cycle and some of the benefits of the FAM, is that it requires minimal tools, whilst fostering shared responsibilities with partners in family planning.
Some Key Considerations When Making Your Choice ~
When selecting a method of contraception that is appropriate for you, it is important to consider some key factors; including, the effectiveness and reliability of the method, any pre-existing health conditions and unwanted side effects associated with the method, ie. certain methods are better for those with blood clot risks or migraines. The duration and reversibility of the contraceptive method is also a significant consideration, as some people may prefer short-term methods like condoms for flexibility or long-term options like IUDs for convenience; in addition those planning to conceive soon may select a choice that has less of an impact on their hormones and regularity of their ovulation or fertile window.
Personal beliefs and lifestyle factors, such as cultural or religious beliefs, may also influence contraceptive choice, and additionally cost and accessibility can also be a deciding factor. Lastly, partner involvement is important to those who may prefer shared responsibility methods like condoms or FAM.
Other Uses of Hormonal Contraceptives: Endometriosis Management ~
For women with endometriosis, hormonal forms of contraception are often offered as a first-line of treatment in an effort to control the body’s high hormonal environment, which can be effective in managing the severity of symptoms, such as pain, and slow the progression of endometrial tissue. Its important that you talk to your primary health care physician and gynaecologist about what options may be best suitable to your individual preferences and circumstances.
Some of the most common hormonal management options are as follows;
Hormonal IUD (e.g., Mirena, Kyleena)
Effectiveness: Hormonal IUDs release a small amount of progestin locally in the uterus, which thins the endometrial lining and can reduce endometriosis symptoms.
Benefits: It can significantly reduce pain and heavy menstrual bleeding associated with endometriosis, and it lasts 3–7 years depending on the type.
Best for: Those who prefer a long-term, low-maintenance option that provides pain relief and controls bleeding.
Combined Oral Contraceptive Pill (COCP)
Benefits: The combined pill can help reduce menstrual pain, bleeding, and the frequency of periods if taken continuously. It also prevents endometrial tissue from thickening, which can help manage endometriosis progression.
Best for: Those comfortable with taking a daily pill, who prefer more control over their menstrual cycle and those with persistent ovarian cysts or endometriomas that are causing pain with ovulation.
Progestin-Only Contraceptives
Options: These include the progestin-only pill, the contraceptive injection (Depo-Provera), and the implant (Nexplanon).
Benefits: Progestin can reduce the growth of endometrial tissue, thus managing pain and bleeding.
Best for: Those who prefer a non-estrogen option due to contraindications or side effects.
GnRH Agonists and Antagonists
Use: Not typically considered contraception, but these medications can suppress ovulation and reduce endometriosis symptoms. They induce a temporary menopausal state, reducing estrogen levels and alleviating endometriosis-related pain.
Benefits: Often used in more severe cases of endometriosis to manage symptoms when other hormonal options aren’t effective.
Best for: Those with moderate to severe endometriosis who haven’t responded to other hormonal treatments, though they are usually not a long-term solution due to side effects.
Continuous or Extended-Cycle Hormonal Options
Options: The combined pill, patch, or ring used continuously (without taking placebo days or breaks) to suppress menstruation.
Benefits: Continuous use can reduce or eliminate periods, which can prevent the pain associated with endometriosis.
Best for: Those who prefer hormonal contraceptives and want to avoid monthly menstruation.
If you or someone you know is interested in learning more about how acupuncture can be used safely with or without a hormonal form of contraception for endometriosis pain management, please see Elizabeth’s Dao Does Journal entry; How Acupuncture Reduces Endometriosis related Pelvic Pain.
There is never a sized-fits-all approach to choosing a contraceptive option for the avoidance of an unwanted pregnancy or the management of endometriosis and a person’s unique health, lifestyle, and personal preferences play a major role in their decision making. Stay informed about your options and talk you your health care practitioner about what may be most appropriate for you.
