Contraception Explained

Contraception Explained

I want you to be empowered - to live the life you want.

Whatever your goals, there is a contraception option right for you.

Some options you may have heard about or tried, while others might be new to you. Finding the contraception that works best for your personal lifestyle can be very rewarding, allowing you to take control of your future and live the way you want.

Don't have time to read? You can listen to Sky Women Podcast: Episode 81 Contraception

Things to consider when choosing your contraception?

  • When do I want to get pregnant?
  • How far apart do I want my pregnancies?
  • Do I need sexually transmitted infection (STI) protection?
  • How effective is the birth control?
  • Is it convenient for me and my lifestyle?


Six categories of birth control methods:

  • Short-term
  • Long-term
  • One-time use
  • Fertility awareness-based methods
  • Permanent
  • Emergency

Short-term Contraception:

Combined Hormonal Contraception – they release two hormones into the whole body: estrogen and progestin. These hormones prevent pregnancy mainly by stopping ovulation (the release of an egg from one of the ovaries). They also cause other changes in the body that help prevent pregnancy: the mucus in the cervix thickens, making it hard for sperm to enter the uterus, the lining of the uterus thins.

  • Birth control pills
  • Birth control patches
  • Vaginal birth control rings


  • Possibility of a more regular, lighter, and shorter period
  • Reduction of menstrual cramps
  • Lowered risk of cancer of the uterus, ovary, and colon
  • Possible improvement of acne and reduction of unwanted hair growth
  • Treatment for certain disorders that cause heavy bleeding and menstrual pain, such as fibroidsand endometriosis
  • Used continuously, they can reduce the frequency of migraines associated with menstruation (although they should not be used if you have migraines with aura). They also can be used to treat heavy bleeding and pain by stopping the menstrual period.

Possible Risks: higher in some women, including women older than 35 years who smoke more than 15 cigarettes a day or women who have multiple risk factors for cardiovascular disease, such as high cholesterol, high blood pressure, and diabetes; a history of stroke, heart attack, or DVT; or a history of migraine headaches with aura.

  • Deep vein thrombosis (DVT)
  • Heart attack
  • Stroke


Progestin-Only Pill – Slynd® is an example. Unlike combination birth control pills, the minipill, also known as the progestin-only pill, doesn't contain estrogen.

Slynd is different than the typical minipill given in postpartum period that has lower dose of progestin than in a combination birth control pill. The minipill thickens cervical mucus and thins the lining of the uterus (endometrium) which prevents sperm from reaching the egg. The minipill also suppresses ovulation, but not consistently. For maximum effectiveness, you must take the minipill at the same time every day.

*Your healthcare provider may recommend the progestin-only pill if:

  • You’re breastfeeding
  • You have certain health problems
  • You’re concerned about taking estrogen

24-Hour Missed Pill Window – While the goal is to always take your birth control at the same time every day, if you miss a pill, you have a more forgiving 24-hour missed pill window with Slynd®—unlike with other estrogen-free pills. Slynd® has a 24 + 4 dosing schedule, similar to most estrogen-containing birth control pills. This way, you can easily manage your bleeding days to suit your lifestyle.


Injection or “shot” – Depot medroxyprogesterone acetate (Depo). Women get shots of the hormone progestin in the buttocks or arm every three months from their doctor. The injection is slightly more effective than progestin-only pills. With typical use, 6 in 100 women will get pregnant during the first year of using the injection. With perfect use—meaning people get repeat shots on time every 13 weeks—fewer than 1 in 100 women will get pregnant during the first year of using the injection.


  • Reducing the risk of cancer of the uterus if used long term
  • Reducing pelvic pain caused by endometriosis
  • May relieve certain symptoms of sickle cell disease and seizure disorders
  • May reduce the bleeding associated with uterine fibroids
  • May protect against pelvic inflammatory disease (PID)

Possible Risks:

  • Bone loss
  • Increased risk of cardiovascular disease
  • Slower return to ovulation (not recommended if planning pregnancy in next 12 months)


Long-term Contraception - Long acting reversible contraception (LARC):

Intrauterine Devices (IUD) – a small, T-shaped device that’s placed inside your uterus to prevent pregnancy. Five IUDs are currently marketed in the United States: the copper-containing IUD and four levonorgestrel-releasing intrauterine devices (LNG-IUDs).


  • More than 99% effective in preventing pregnancy
  • Long-lasting
  • Safe to use if breastfeeding
  • No medications stop them from working
  • Mirena has an indication for heavy vaginal bleeding and most users will have lighter flow, fewer periods and may not have periods at all.

Possible Risks:

  • Some women may experience hormone-related effects, such as headaches, nausea, breast tenderness, mood changes, and ovarian cyst formation
  • Expulsion 2-10% in first year
  • Perforation is rare, approximately 1 per 1,000 IUD insertions


Single-Rod Contraceptive Implant – a single, thin rod that is inserted under the skin of a woman’s upper arm. The rod contains a progestin that is released into the body over 3 years. 

The primary mechanism of action of the implant is suppression of ovualtion, thickening of cervical mucus and thinining of the endometrial lining. 


  • Most effective reversible contraception (pregnancy rate 0.05%
  • May not have periods
  • Effective regardless of weight

Possible Risks:

  • Changes in menstrual bleeding patterns are common - amenorrhea or infrequent, frequent, or prolonged bleeding are all possibilities
  • Headaches, breast pain, and vaginitis 
  • 12% of implant users in contraceptive studies report weight gain


One Time Use Contraception:

Diaphragm or cervical cap – Both of these barrier methods are placed inside the vagina to cover the cervix to block sperm. The diaphragm is shaped like a shallow cup. The cervical cap is a thimble-shaped cup. Before sexual intercourse, you insert them with spermicide to block or kill sperm.

Visit your doctor for a proper fitting because diaphragms and cervical caps come in different sizes.

Typical use failure rate for the diaphragm: 17%.

Sponge – The contraceptive sponge contains spermicide and is placed in the vagina where it fits over the cervix. The sponge works for up to 24 hours and must be left in the vagina for at least 6 hours after the last act of intercourse, at which time it is removed and discarded.

Typical use failure rate: 14% for women who have never had a baby and 27% for women who have had a baby.

Male condom – Worn by the man, a male condom keeps sperm from getting into a woman’s body. Latex condoms, the most common type, help prevent pregnancy, and HIV and other STDs, as do the newer synthetic condoms. “Natural” or “lambskin” condoms also help prevent pregnancy, but may not provide protection against STDs, including HIV.

Typical use failure rate: 13%. 

Female condom – Worn by the woman, the female condom helps keeps sperm from getting into her body. It is packaged with a lubricant and can be inserted up to eight hours before sexual intercourse.

Typical use failure rate: 21%

Spermicides – These products work by killing sperm and come in several forms—foam, gel, cream, film, suppository, or tablet. They are placed in the vagina no more than one hour before intercourse. You leave them in place at least six to eight hours after intercourse. You can use a spermicide in addition to a male condom, diaphragm, or cervical cap.

Typical use failure rate: 21%.

Phexxi – A vaginal contraceptive gel for women who are simply seeking pregnancy prevention without the use of hormones. It is the only vaginal pH modulator (VPM) that works by maintaining an acidic vaginal pH and decreasing sperm motility.


Fertility Awareness-Based Methods:

Fertility Awareness-Based Methods – Understanding your fertility pattern can help you plan to get pregnant or avoid getting pregnant. Your fertility pattern is the number of days in the month when you are fertile (able to get pregnant), days when you are infertile, and days when fertility is unlikely, but possible. If you have a regular menstrual cycle, you have about nine or more fertile days each month. If you do not want to get pregnant, you do not have sex on the days you are fertile, or you use a barrier method of birth control on those days.

Failure rates vary across these methods. Range of typical use failure rates: 2-23%.

Lactational Amenorrhea Method – For women who have recently had a baby and are breastfeeding, the Lactational Amenorrhea Method (LAM) can be used as birth control when three conditions are met:

1) amenorrhea (not having any menstrual periods after delivering a baby),

2) fully or nearly fully breastfeeding,

3) less than 6 months after delivering a baby.

LAM is a temporary method of birth control, and another birth control method must be used when any of the three conditions are not met.


Permanent Contraception:

Tubal Ligation – Relatively simple surgical procedure for women intended to make pregnancy impossible. With tubal ligation, the fallopian tubes are tied, cut or sealed to prevent eggs from reaching the uterus. Recovery time from this procedure usually takes only a few days. The procedure can be done in a hospital or in an outpatient surgical center. You can go home the same day of the surgery and resume your normal activities within a few days. This method is effective immediately. Typical use failure rate: 0.5%.

Salpingectomy – Relatively simple surgical procedure for women intended to make pregnancy impossible. With salpingectomy, the fallopian tubes are removed, which has an added benefit of reducing lifetime risk of ovarian cancer by about 50%. Recovery time from this procedure usually takes only a few days. The procedure can be done in a hospital or in an outpatient surgical center. You can go home the same day of the surgery and resume your normal activities within a few days. This method is effective immediately. Typical use failure rate: 0.5%.

Male Sterilization-Vasectomy – This operation is done to keep a man’s sperm from going to his penis, so his ejaculate never has any sperm in it that can fertilize an egg. The procedure is typically done at an outpatient surgical center or urologist office. The man can go home the same day. Recovery time is less than one week. After the operation, a man visits his doctor for tests to count his sperm and to make sure the sperm count has dropped to zero; this takes about 12 weeks. Another form of birth control should be used until the man’s sperm count has dropped to zero. Typical use failure rate: 0.15%.


Emergency Contraception (EC):

Certain IUDs – There are certain IUDs you can get within 120 hours (five days) after having unprotected sex. This is the most effective type of emergency contraception. These IUDs work as well on day one as on day five.

Emergency Contraception Pill (AKA the morning-after pill) – Take within 120 hours (five days) after having unprotected sex. The sooner you take it, the better it works.

  • Pill with ulipristal acetate – one brand: Ella
  • Pill with levonorgestrel – Brand names include: Plan B One Step, Take Action, My Way, Option 2, Preventeza, AfterPill, My Choice, Aftera, EContra, and others

The sooner you take EC, the better it works.

  • Helps prevent pregnancy before it starts
  • No ID, no Rx required to purchase
  • Won’t hurt your chances of getting pregnant in the future

Possible side effects include:

  • A period that’s lighter, heavier, early, or late
  • Nausea
  • Lower abdominal cramps
  • Tiredness
  • Headache
  • Dizziness
  • Breast tenderness


Conclusion: Because everyone is different, the contraception that works best for your friends or family members may not be convenient or most effective for you. Regardless of the birth control method you end up choosing, use it as directed for the lowest chance of pregnancy.


Of course, you’ll want to talk to an OB-GYN, certified nurse-midwife (CNM), or nurse practitioner (NP) to get personalized birth control advice. Your care provider can give you more details about each option, and they’ll help you make a choice (or choices) you’ll feel great about.

I hope you walk away with a better understanding of your options and have your common questions answered.

At Sky Women's Health, we support your choice and are available for contraception consults in person and via telehealth.

Call: (817) 915-9803

Request an appointment on our website.