How to the find the right contraception for you
Finding the right contraception and protection for you can be a bloody minefield. Everything from cost, accessibility, and the side effects of each options can play into this decision. Unfortunately for those of use who want to have sex and (if you’re having sex with cis men) not get pregnant and avoid STIs – which, tbh, I hope is all of us – no contraceptive is currently 100% effective in preventing pregnancy or protecting you from STIs. Sorry I don’t have better news for you, babe. Not to sound like a sex ed teacher in a Catholic school, but the only 100%, surefire way to avoid both getting pregnant and contracting an STI or STD is abstinence. But where’s the fun in that, right?
So, we’ve already covered in pretty extensive detail (if I do say so myself) the pros and cons of different hormonal contraceptives so check that out to find out what’s on the menu if you do want to go down that route. If you’re looking to avoid the side effects of hormonal contraceptives, opting for a barrier method could be the best option for you. Just remember that the type of contraception – hormonal or otherwise – that’s right for you will depend on your unique needs and medical history, so it’s vital that you speak to a doctor and make an informed decision.
Are barrier contraceptives better than hormonal birth control?
That’s kind of a trick question, because the honest answer is that it will vary person-to-person which form of birth control or protection works best for them. An advantage of hormonal birth control methods is that they don’t interrupt penetrative sex (or, well, any form of sex). You can be fooling around, having oral sex, washing the dishes (whatever floats your boat) and just start going at it without first locating the condoms, pulling out your fertility tracking app, or having a debate over the merits of the pullout method (obligatory reminder to please be mindful that you can still get pregnant from precum!)
However, there are many side effects associated with hormonal birth control options, such as blood clots, breast tenderness, weight gain, decreased sex drive, mood swings, hair loss, headaches, vomiting, and irregular bleeding, to name just a few. There is really limited research into most birth control options, meaning that we’re kind of feeling around in the dark here. In my opinion, considering the anecdotal evidence suggesting some kind of link between the pill and depression presenting in some folks, it’s pretty staggering that this hasn’t been more extensively researched. But just another day under patriarchy, hey kids?!
Barrier contraceptives may interrupt sex, but an advantage of this is it’s a really great way to establish continued, enthusiastic consent. Having to ask “shall I grab a condom?” is a way to check in with your partner about the kind of sex acts they want to be engaging with – and not assuming that just because they wanted penetrative sex yesterday they’re going to want it today as well. Another advantage of non-hormonal contraceptives is that the responsibility for them can be more equally shared between both partners rather than just the person taking the pill or maintaining an implant, IUD, or other form of hormonal birth control. And, the big hitter: that person doesn’t have to carry the side-effects baggage, either.
In short: there is no right or wrong. It all boils down to personal preference, accessibility and availability, and any medical limitations you may have (e.g. some medical conditions will preclude you from taking certain hormonal contraceptives).
It’s also important to note that if you’re planning to have sex with a lot of people or people whose sexual health status you don’t know, it’s always safest to use a barrier contraception method such as…
What are the different types of barrier contraception?
AKA what most people think of when they just hear ‘condoms’. A male condom is a sheath-shaped barrier device worn over a penis. It can only be used once.
Society seems to have a love-hate relationship with condoms. On the one hand, they’re widely available both free and for purchase from places such as sexual health clinics, pharmacies, and supermarkets, but on the other hand, lot’s of people with penises don’t like wearing them because of how they affect the sensations during penetrative sex. Most articles you read these days will tell you that anyone who says condoms ruin sex is an immature or even sexist liar – and, sure, anyone who refuses to wear one is being immensely immature and short-sighted. But I think it’s important to acknowledge that, yes, you can feel it, and if you’re used to unprotected sex, it will feel different. And that is okay. You’re both/all still going to enjoy it!
The main advantage of using condoms is that they are one of the few forms of contraception that help prevet the transmission of STIs and STDs.
Effectiveness: condoms are about 98% effective with perfect use but only 87% effective with typical use. So if you’re confident you’re using a condom perfectly right every time, you could hypothetically get pregnant 2 out of every 100 times you have sex. But do you know how to use a condom perfectly? It means putting it on, all the way to the base, before there’s any genital-to-genital contact. It needs to be removed after the person wearing the condom cums, before their penis goes soft. If you want it to be effective in protecting against STIs, it needs to go on before there’s any oral sex or other kinds of foreplay, too. Yeah, I made that exact same face when I found this shit out too.
The lesser-known sister to the male condom, a female condom is also a sheath-shaped barrier device used during sexual intercourse to reduce the probability of pregnancy or STI, only it differs from a male condom in that it is worn internally inside the vagina. It has two ‘rings’, one of which is inserted into the cervix, the other sits outside the vaginal opening. The main advantage of the female condom – AKA Femidom – is that you can insert it up to eight hours before you actually have sex. Which is a pretty good counter-argument to the #1 shitty excuse people give for not using protection, “it ruins the mood.” It’s also a great preventative measure if you’re prone to having sex when drunk and often forget to use a condom or don’t trust your drunk self to put it on/in correctly.
Effectiveness: the female condom is less effective than its male counterpart, at 95% effectiveness with perfect use. With typical use, this goes down to 79% effective. Again, it’s still a better option than nothing at all, but those odds do feel a bit worrying, don’t they?
This is an intra-uterine device that does not release hormones and is not to be confused with it’s sister contraceptive option, the hormonal coil, which does release progesterone. The copper coil is the most effective form of non-hormonal contraception out there and works by releasing copper ions, which generate an inflammatory response in the body, creating an environment that is totally inhospitable to sperm.
Disadvatages of this contraceptive option include: some people’s bodies will reject the device (this occurs to about 10% of people who try it out), heavier periods, pain, and increased risk of pelvic inflammatory disease. Advantages? As mentioned, it’s super effective, can be worn for a long time, and is easily removed. It can also double up as an emergency contracpetion if inserted within 5 days after the unprotected sex occurs.
Effectiveness: three cheers for the coil, which is over 99% effective with both ‘perfect’ and ‘typical’ use. the big reason for the lack of discrepancy here is that it’s not managed by the wearer – it’s inserted by a doctor, which is hopefully a pretty bloody reliable way to be using it ‘perfectly’!
The sponge is something I have never seen with my own two eyes but which, much to my dismay, looks nothing like Spongebob when he’s on land and a lot more like a soap on a rope in the pictures. Do with that what you will. It works to prevent pregnancy by killing sperm; it’s coated in spermicide which kills the sperm and prevents it from entering the uterus. It must be inserted before sex and worn for 6 hours after sex to ensure that all those sneaky lil guys are caught.
Effectiveness: With typical use, it’s 86% effective, 91% effective with perfect use. Please note, however, that if you’ve had a pregnancy before, these numbers drop: with typical use, it’s only about 73% effective in people who have previously had a pregnancy that lasted for over 22 weeks.
Cervical caps and diaphragms
Diaphragms and cervical caps are barrier contraceptives that act as literal barriers: you apply spermicide to them, insert them into into the cervix, and remove anywhere between 6 hours and two days (!!) after sex. The biggest advantage of these options is they’re reusable, but you have to apply the spermicide yourself, so it’s a little more fiddly.
Effectiveness: 83% effective with typical use, 84% with perfect use – not a huge amount of difference here, which is reassuring, though still not incredibly reliable.
Fertility Awareness Method (FAM)
This one’s a big topic that we promise to cover in way more depth down the road (one of our own on the ohne team, Naomi, is actually a qualified FAM practitioner!) but for now, here’s a brief rundown. The fertility awareness method is a form of non-hormonal birth control that doesn’t require and devices, gadgets n gizmos, or suffering moans of ‘but it feels so much woooorse with a condom!’ It’s all about tracking your cycle to predict when you’re ovulating and avoiding sex (or using one of the above methods when you have sex) around the days in which you could conceivably conceive. It’s a hell of a lot more complicated that just counting your cycle days and guessing, however. It involves using your cervical mucus, body temperature, and monitoring the position of your cervix to pin point your fertile window (AKA when you’ll be ovulating).
Effectiveness: Used perfectly, it’s more than 99% effective and with typical use, it’s between 77% and 98% effective. Confused? Understandable. It’s obviously worth noting that it’s hard to pin down the typical effectiveness of the FAM as, unless you intended to practise abstinence on fertile days, you’ll be mixing this method with one of the above barrier protection options above, which complicates the maths on the likelyhood of getting pregnant somewhat!
That’s a lot to choose from! Which one should I use?
Again, that’s got to be your call I’m afraid babe. Only you know your body and can make the call on what you’re comfortable with, whether that’s hormonal birth control, barrier methods, or an alternative route such as FAM. Talk to your doctor about your various options if you’re interested in exploring contraception beyond your run of the mill condoms and be prepared to try out a couple of methods before you find the one that works perfectly (or at least best) for you – especially if you’re using hormonal birth control methods, it can take a while for your body to adjust to them. Stay safe out there!