Veera | Health Insights

Contraception 101: Which Birth Control Option is Right For You?

Reviewed by Dr. Mansi Verma
  • 21 July
  • 10 min read
  • 1498
  • 2
  • 0

With so many contraception methods out there, the choice can be confusing! To make the right contraceptive choices for your lifestyle, we have this handy guide to all your contraception options.

Contraception helps you plan out your life, making sure your pregnancy is on your own terms and when you’re ready. Not sure about which type of contraception is the most effective? How does each one work? Do I need to see a doctor to use this one? Does it protect against sexually transmitted infections (STIs)? With so many contraception methods out there, the choice can be confusing! To make the right contraceptive choices for your lifestyle, we have this comprehensive guide to all your contraception options.


Natural Methods

These methods do not require buying any medications or supplies, but require discipline and knowledge. Other than abstinence, these are the most unreliable forms of contraception.


Abstinence

How it works: Abstinence means not having sex with your partner. Obviously, if you don’t have sex you can’t get pregnant, but really consider if this is a realistic choice for you. There are other ways to be intimate with your partner if you’re not ready to do the deed, like kissing and oral sex instead. And there are plenty more contraception options if this doesn’t work for you and your partner…read on!
Ease of Use: Pretty good, since you can decide to not have sex .
How to get it: You make the decision!
Cost: Free!
Common Side Effects: None .
STI Protection: Yes – unless you still have sexual contact (e.g. genital contact, oral sex, etc.) then you can still get an STI like HPV.
Effectiveness:
  • Perfect Use: 100%
  • Typical Use: Depends on your self-control ;)



The Withdrawal aka the Pull-Out method

How it works: This is when your partner pulls out his penis prior to ejaculation to avoid any semen in the vaginal area. It can be challenging to do because even some pre-ejaculate fluid (the clear fluid prior to more white, cloudy semen) can contain sperm, therefore you have to trust your partner to pull out at the right time – EVERY. SINGLE. TIME. Sometimes this method is called “coitus interruptus” – kind of sounds like a Harry Potter spell to us!
Ease of Use: No preparation needed, just do it in the moment .
How to get it: Communication with your partner.
Cost: Free! But not if you get pregnant…
Common Side Effects: None .
STI Protection: None.
Effectiveness: Honestly, not great.
  • Perfect Use: 96%
  • Typical Use: 79%




Fertility Tracking

How it works: This method requires you to have regular, predictable, monthly periods and the ability to track your menstrual cycle. There are lots of digital female health applications like Flo, Period Tracker and Natural Cycles that will help you predict when you will ovulate, which is when you are most fertile. If you avoid having sex during this small window, it can be an effective contraception method, however, if you miscalculate or if your cycles are not always perfect you may become pregnant. There are also over-the-counter ovulation kits where you can track your body temperature every day or analyse urine samples to predict when you will ovulate. The days you ovulate are the days to avoid having sex; if you do end up having sex on those days, use a barrier contraception method instead.
Ease of Use: Digital Apps are easy to use, the ovulation kits require you to take your temperature daily, and then there is the small window where friskiness is banned .
How to get it: In your App Store; Ovulation Kits are available at pharmacies or online .
Cost: Many apps are free, ovulation kits vary in price.
Common Side Effects: None .
STI Protection: None .
Effectiveness:
  • Perfect Use: 95-99%
  • Typical Use: 77-98%




Barrier Methods

These methods work by preventing the sperm and egg from meeting, if they can’t meet – no baby!



The Male Condoms

How it works: Maybe you’ve seen ads on TV or packets hanging in street-side stores, but it’s basically a rubber sock that slips over the penis before intercourse. Your partner has to use it every time and there’s always a chance of it slipping off, leaking or tearing that then would put you at risk of pregnancy. There are all different types: various materials (usually latex, but non-latex ones for those with allergies), styles (ribbed – for her pleasure), with or without spermicide, and even different colours and flavours!
Ease of Use: Easy to use, but partner has to use one every time .
How to get it: Buy from any drug store or pharmacy, no prescription needed .
Cost: Cheap, starting at Rs. 1 per packet.
Common Side Effects: Possible allergy or irritation to either you or your partner, decreased sensitivity.
STI Protection: Yes! Use it with other methods to protect yourself .
Effectiveness:
  • Perfect Use: 98%
  • Typical Use: 87%






The Female or Internal Condoms

How it works: Works the same way as a male condom but instead of having your partner wear it, you place it inside your vagina before having sex. It can be a little bit tricky to place, but you can place it hours before sex to avoid interrupting the heat of the moment or it can be a fun foreplay activity. Plus, they are hypoallergenic so they can be great if you have a latex allergy. A warning, however, do not use this with a male condom, as the friction can increase the chances of tearing.
Ease of Use: Tricky to place, and you have to use one every time .
How to get it: Some drug stores, otherwise order from Amazon with brands like FC2, Velvet, and Durex .
Cost: Cheap , Rs. 100/pack
Common Side Effects: Irritation, decreased sensitivity .
STI Protection: Yes!
Effectiveness:
  • Perfect Use: 95%
  • Typical Use: 79%




The Diaphragm

How it works: Popular in the 90s, but have now fallen out of favour. This is a shallow, silicone cup that you can fold to insert into your vagina and it covers your cervix to prevent semen from entering. It’s eco-friendly, washable and reusable if that’s your thing, and you can place it a few hours before sex so that it doesn’t interrupt the mood. It should be inserted high enough that your partner cannot feel it during intercourse, probably not a great option if you’re not comfortable placing your fingers in your vagina. You also have to use spermicide with this option for it to be effective. It comes in different sizes so a doctor will have to fit you for one and then give you a prescription to buy one at the pharmacy. However, not all pharmacies carry them so it may have to be ordered online.
Ease of Use: Tricky to place, and you have to wash it after every use .
How to get it: See a doctor for a fitting and prescription, then get one from a pharmacy . May not be available in all regions of India.
Cost: Highly variable plus the cost of spermicide.
Common Side Effects: Vaginal irritation, can increase risk of UTIs, do not use if allergic to silicone .
STI Protection: None .
Effectiveness: Use with spermicide .
  • Perfect Use: 84%
  • Typical Use: 83%



Spermicides

How it works: Not a barrier method, but it usually is used with one of the above types of contraception. Spermicides come as gels, foam, or dissolvable strips that are inserted deep in the vagina and kill sperm. Some condoms come with spermicide already on them.
Ease of Use: Depends on the form, and used with another type of contraception .
How to get it: Drug store or online .
Cost: Depends.
Common Side Effects: Irritation to you or your partner's genitals .
STI Protection: None .
Effectiveness: Needs to be used with another form, however, if used alone .
  • Perfect Use: 84%
  • Typical Use: 79%




Hormonal Methods

These are highly effective methods of birth control and aren’t as invasive as some of the long-acting methods.



The [Birth Control] Pill (aka Oral Contraception Pills or OCPs)

How it works: Known by different names, but these are daily pills containing hormones that you take every day to regulate your periods and prevent ovulation. It’s one of the most effective and least invasive methods, which is why it’s the most popular form of hormonal birth control around the world. There are many different types of pills so it’s important to work with your gynaecologist to find the right kind for you. Sometimes, hormonal pills are used to treat conditions like PCOS, acne, PMS and abnormal vaginal bleeding. If you are on the pill, you must take it at regular times, so set a daily alarm on your phone. If you’re taking antibiotics, antifungal, or anti-seizure medications, it can make the pill less effective, therefore use a back-up form of contraception(e.g condom) while on these medications. Read more about how to the pill works, the types, and what to do if you miss a pill on Veera.
Ease of Use: Need to think about and take it every single day. Doesn’t interrupt bedroom time .
How to get it: Prescription from a doctor, then available at all pharmacies .
Cost: Low-cost starting at Rs. 100, but recurring every month, sometimes for free through government programmes (e.g Mala-N).
Common Side Effects: nausea, headaches, mood changes, decreased libido, sore breasts, mild increase in blood pressure, spotting between periods. Most side effects subside after a few months of use. Some benefits are decreased acne, cramping, and period flow.
STI Protection: None .
Effectiveness:
  • Perfect Use: 99.7%
  • Typical Use: 93%




The Patch

How it works: The patch contains oestrogen and progesterone hormones that get absorbed into your system through your skin. It can be a good alternative if you don’t want something invasive, but also can’t remember to take a pill every day. You place the patch on your stomach, butt, arm or back and change the location each week with a new patch.
Ease of Use: Just stick on like a Band-Aid, but sometimes it comes off in the shower or with sweat, and it’s pretty discrete (unless you’re naked…) .
How to get it: Prescription from a doctor, then available at some pharmacies .
Cost: More expensive than pills, starting at Rs. 300, recurring every month .
Common Side Effects: Similar as the pill, some skin irritation around the site of the patch.
STI Protection: None.
Effectiveness: This form is not effective if your weight is over 90 kgs.
  • Perfect Use: 99.7%
  • Typical Use: 93%







The Ring

How it works: Sold under the brand, Nuvaring, it is a less common form of contraception used these days, but works similar to the Patch and Pills. Here, a flexible, transparent ring is inserted into the vagina to secrete progesterone and oestrogen and prevent ovulation. You keep the ring in for 3 weeks, take it out for a week when you’ll have your periods, then replace it again the week after. It is unlikely the ring will be felt by your partner during sex, but it has been known to fall out from time to time, and you have to be comfortable placing it with your fingers in the vagina.
Ease of Use: Don’t have to think about it for 3 weeks at a time, doesn’t interrupt the mood.
How to get it: Prescription from a doctor, but may not be available in all regions of India .
Cost: More expensive than pills and the patch, starting at Rs. 750, recurring every month.
Common Side Effects: Similar as the pill, increased vaginal discharge.
STI Protection: None .
Effectiveness:
  • Perfect Use: 99.7%
  • Typical Use: 93%




The Shot (aka Depo Provera or Antara)

How it works: This is a birth control shot given every three months and is very effective at preventing unwanted pregnancy. It only contains the hormone progesterone, therefore is safe for people who can’t take oestrogen, and works by preventing ovulation and thickening your cervical mucus to block sperm from entering the uterus. Probably not a great option if you’re scared of needles, but one shot every 3 months instead of taking a pill every day or getting pregnant may be worthwhile! If you’re late to get your shot, you are at risk for pregnancy, so be sure to use a back-up contraception option till you can get it.
Ease of Use: Easy! Nothing to do in between shots, does require an in-person visit to a clinic every three months.
How to get it: By prescription from a doctor, usually for a year, then quick nurse/clinic visit to get the shot every 3 months.
Cost: Starting at Rs. 1,400 per shot, some are free through government programmes like Antara , and covered by insurance
Common Side Effects: Nausea, headache, sore breasts, mood changes including depression, decreased libido, skin and hair changes, irregular bleeding and increased appetite which can lead to weight gain (on average only 2-3 kgs over 1 year). Many of these subside after 6 months.
STI Protection: None .
Effectiveness: Better than the pill!
  • Perfect Use: 99.8%
  • Typical Use: 96%


Long-Acting Reversible Contraception (LARCs)

These types of contraception contain hormones that are released slowly, over a long period of time so they're highly effective and hassle-free. Once removed, fertility immediately returns to normal. They are newer, modern, and great for all lifestyles!




The Implant

How it works: It’s a matchstick-like, piece of plastic that is placed under the skin, usually in the upper arm. Once the implant is inserted, it releases a steady stream of hormones that prevent the ovaries from releasing eggs and thickening cervical mucus, thus preventing unwanted pregnancies. Previously marketed as Implanon, with the newest generation called Nexplanon, both are approved for use for 3 years, but follow-up studies have shown it to be effective for up to 5 years! Imagine not having to worry every day about your birth control for 5 years and it’s the most effective birth control out there (more than tying your tubes…).
Ease of Use: One of the best - It’ll be just under the skin so you can feel it, and as long as it’s there you know it’s working. Nothing to think about every day or every time you have fun ;)
How to get it: See a gynaecologist trained to place and remove the implant.
Cost: Expensive, starting at Rs. 15,000, but a one-time investment for up to 5 years!
Common Side Effects: Sore breasts, nausea, headaches, mood changes, skin and hair changes and irregular bleeding, most of which subside after 6 months .
STI Protection: None.
Effectiveness:
  • Perfect Use: 99.9%
  • Typical Use: 99.9%



The IUD (Intrauterine Device)



Hormonal IUD

How it works: The hormonal IUD is a small ‘T- shaped’ device that slowly releases a type of progesterone and acts locally on your uterus, ovaries and cervix, which reduces the systemic side effects common with other options. It works by thickening cervical mucus which blocks sperm and preventing the lining of the uterus from growing. Sometimes, it blocks ovulation which is why many women may not have their period with this form of birth control (could be an added bonus!), but it is not the main mechanism of action. There are different brands on the market including Eleanor, Mirena, and Lilleta that last anywhere from 3 to 7 years. It’s sometimes used to treat heavy periods, PCOS and has the added benefit of protection against endometrial cancer. It’s fool-proof, convenient without too many side effects that has quickly made it fan favourite throughout the world!
Ease of Use: 5 Stars! Once it’s placed, you occasionally should check that the device is in place, but otherwise nothing to remember every day or worry about every time you have sex!
How to get it: See a gynaecologist to have it placed and removed. See our article about what to expect with an IUD insertion.
Cost: More expensive that Copper IUD, cheaper than the implant, can be covered by insurance, but one-time investment for 5 to 7 years!
Common Side Effects: Nausea, headaches, skin and hair changes, changes in libido, temporary bloating, irregular periods or no periods and cramping around the time of insertion .
STI Protection: None.
Effectiveness:
  • Perfect Use: >99%
  • Typical Use: >99%





Copper IUD (IUCD or CuT)

How it works: The Copper IUD is a non-hormonal intrauterine device also shaped as a “T” and is placed in the uterus. It works by creating a hostile environment for sperm and lasts for 5-10 years depending on the dosage of the one you choose. It’s a great long-term option if you’re done having kids, but even young women can get it if they’d like. If placed within five days of unprotected sex, it can also act as emergency contraception.
Ease of Use: 5 Stars! Once it’s placed, you occasionally should check that the device is in place, but otherwise nothing to remember every day or worry about every time you have sex!
How to get it: See a gynaecologist to have to it placed and removed. See our article about what to expect with an IUD insertion.
Cost: Starting at Rs. 300, and lasts for 5 yrs, often covered by government programmes . Best value for your money!
Common Side Effects: No hormonal side effects, but this has been known to make periods heavier and crampier.
STI Protection: None .
Effectiveness:
  • Perfect Use: >99%
  • Typical Use: >99%




Permanent Sterilization

These require a procedure in either the woman or man and are for all intents and purposes irreversible, so you have to be certain you do not want any more children.


Tubal Ligation

How it works: Done with kids? Tried everything else? This is a permanent sterilization surgery meaning it is irreversible and commonly known as "getting your tubes tied." This is a surgical procedure that blocks or removes your fallopian tubes so that the egg and sperm cannot meet. This is usually a laparoscopic procedure meaning it is done with small incisions and a camera under full anaesthesia, and usually you are discharged from the hospital on the same day or next day. It can either be done immediately postpartum or at least six weeks later. Talk to your doctor about timing this around the time of Caesarean section or delivery.
Ease of Use: Other than getting surgery and the recovery, never have to worry about getting pregnant again .
How to get it: Talk to a doctor about whether this is a good option for you .
Cost: Expensive, starting at Rs. 15,000, insurance may be required to cover it, however, can be included with delivery fees if planned in advance, and covered by government programmes .
Common Side Effects: Common surgical risks such as bleeding, infection, and injury to surrounding organs.
STI Protection: None.
Effectiveness:
  • Perfect Use: >99%
  • Typical Use: >99%




Vasectomy

How it works: This one is for the gentleman! It’s a sterilization procedure, where the tube carrying sperm is snipped and blocked. It is a much simpler procedure than the female sterilization, only takes about 20 minutes in the office, with some local anaesthesia and 1-2 small incisions in the scrotum. It does take several months for this to be effective and for the tube to clear out sperm, so a back-up option is necessary in the meantime (~3 months).
Ease of Use: One snip and done (for the guy).
How to get it: See a general practitioner or urologist for an in-office procedure.
Cost: Expensive, but may be covered by insurance or government programmes .
Common Side Effects: Procedural risks – bleeding, infection, but overall very low risk .
STI Protection: None .
Effectiveness:
  • Perfect Use: >99%
  • Typical Use: >99%



Emergency Contraception

This is a different breed of birth control that should be reserved for times when you accidentally have unprotected sex or your primary method fails (i.e the condom breaks) and is not recommended to be your primary form of birth control. There are different types of Emergency Contraception (EC) including placing the copper IUD within 5 days of unprotected sex and Ulipristal Acetate (EllaOne) which is equally effective every day up to 5 days after unprotected sex. These two types are discussed elsewhere. In this article, we will focus on the morning-after pill as it is the most common and prevalent form of EC.





The Morning After Pill

How it works: This is a pill or series of two pills that should be taken within 3-5 days of unprotected sex, however each day that you wait decreases its effectiveness. The “morning-afer pill” has many brands like i-Pill, Plan B, Next Choice, EContra EZ, Unwanted 72 while the hormone it contains is Levonorgestrel. It works by disrupting your menstrual cycle, however its effectiveness depends on where you are in your cycle, how soon you take it after unprotected sex, and your weight.
Ease of Use: Easy, just have to take a pill right after. However, if you’re worried you might be delayed getting your hands on the pill, you might just want to stock up beforehand.
How to get it: If under 18, you need a prescription, otherwise pills are available over the counter. Copper IUD, you have to see a gynaecologist.
Cost: Cheap, starting at Rs. 80.
Common Side Effects: Nausea, headache, tiredness, and irregular bleeding and disruption to menstrual cycle .
STI Protection: None.
Effectiveness: Varies on type and when you take it .


Have more questions about different methods? Explore the site for lots more information about each method. Have questions about which one is right for you? Book a contraception counseling session with a Veera gynaecologist today!


Reviewed by Dr. Shailly Prasad, MD/MBA. Resident Physician. Obstetrics & Gynecology.


Disclaimer: Content on Veera is provided for informational purposes only and is not intended as medical advice or as a substitute for medical advice given by a physician or trained professional.


Sources:
  • Bedsider.org
  • Reproductive Access Project
  • Ministry of Health & Family Welfare, Family Planning Division, Govt of India (https://humdo.nhp.gov.in/)
  • Reproductive Health Supplies Coalition for Images


Are you struggling with Birth control?

Schedule a free online visit

Subscribe to our newsletter

Subscribe to our newsletter to keep up with the latest content about women’s healthcare