Think Beyond the Pill

4 Contraceptives You Should Consider

The IUD is one underused — and highly effective — method of birth control. (Science Photo Library/Getty Images)

Since the Pill first swept onto the scene in the 1960s, the perception of contraception has gone from controversial to common sense. Yet many women have never advanced beyond their pill packet— even as science has proven there are a number of viable alternatives to oral contraception, some of which are actually more effective. “When you look at the methods that are used most often — the Pill, the condom — it’s only what’s popular,” said Dr. Carrie Cwiak, director of family planning at Emory University School of Medicine. “It has nothing to do with what’s most effective.” 

 

And while the “Will it work?” question should (obviously) come first, there are also other factors to consider when picking your method: Are you willing to use a daily or weekly contraceptive? One that contains hormones? One that’s placed inside you? “There is no perfect method. So even having methods that are seldom used, like the cervical cap, in the mix is really a positive,” Dr. Eve Espey, president-elect of the Society of Family Planning. “Somebody is going to love that method.”

Following, four baby-blocking approaches you may want to consider:

LONG-ACTING REVERSIBLE CONTRACEPTIVES 

Known as the “LARC” methods — or long-acting reversible contraceptives — the intrauterine device (IUD) and implant are widely considered the most effective options on the market, said Espey. Although the Pill actually works better than the IUD or implant if you use it perfectly, most women fail to take the meds exactly as instructed. Translation: When it comes to “typical” use — the way women use contraceptives in the real world —  the LARC methods far outshine the Pill, which has a failure rate of 9 percent, according to the CDC. 

Yet most women still opt for oral contraception over the IUD or implant. “The Pill has always been the fallback,” Espey said. “It’s time-tested, and it’s got a ton of name recognition. But the IUD and the implant are far superior.” Why? They last for years, you don’t have to remember to pop a pill on a daily basis, and there are no fatal complications (like blood clots) associated with these methods, she said. 

INTRAUTERINE DEVICES (IUDs) 

Hormonal IUD typical use failure rate: .2%

Copper IUD typical use failure rate: .8%

There are two classes of IUDs: hormonal (Mirena or Skyla) and copper (ParaGard). After being inserted into your uterus — a procedure that may cause a little cramping — both types act a spermicide, “so the sperm and egg don’t get together,” Espey explained. The hormonal version has a second mechanism, too: It helps thicken your cervical mucus, preventing any sperm from slipping past.

And don’t worry, there are no long-term effects on fertility: After five to 12 years — the copper IUDs last longer — your doctor simply tugs the IUD string to remove the device, and you’re able to become pregnant immediately. (Keep in mind, you can take it out at any time, if you so choose.)  

Although the two types of IUDs work in a similar way, there are differences, since the copper version doesn’t contain any hormones. “It doesn’t really change your bleeding pattern that much,” said Cwiak. You may notice your periods become heavier for the first three to six months after insertion, but after that, your cycle will return to its normal pattern, she said. With the Mirena IUD, “your bleeding can go away altogether,” Cwiak said. The not-so-fun part: If you do spot, it will happen randomly — not at a predictable time of the month. “The tradeoff is that it’s significantly lighter,” she said.