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Looking for Nonhormonal Birth Control? You Have Options

December 15, 2021

If you are breastfeeding, have high blood pressure or a history of some cancers or blood clots, hormonal birth control might not be an option for you. 

Some women also prefer nonhormonal birth control to avoid unwanted side effects like weight gain, nausea or a lower sex drive. 

Today, there are more choices than ever for nonhormonal birth control.  

Barrier Methods

Barrier birth control methods prevent sperm from reaching the egg. Condoms are the most popular option and are the only birth control method that also helps protect against sexually transmitted infections (STIs). Other barrier methods include:

Cervical Caps. A cervical cap is a silicon plug inserted into the vagina before sexual intercourse. This method covers your cervix to prevent sperm from entering the uterus. The cap can be left in your body for up to 48 hours. Available by prescription, the only cervical cap available in the United States and is 71 percent to 86 percent effective and is best when combined with a spermicide.

Diaphragms. With an 88 percent effective rate, diaphragms are one of the most effective barrier methods for preventing pregnancy. These shallow, dome-shaped cups are made of silicone and are inserted into the vagina before sexual intercourse. The efficacy rate improves if you fill the diaphragm with spermicide before inserting it. Wait at least six hours after sexual activity before removing, but don’t leave it in for more than 24 hours.

Spermicide. Available in cream, foam or gel, spermicides contain chemicals that kill sperm. When used alone, spermicide is only 79 percent effective, so it’s best when combined with another barrier method, such as condoms or a sponge. Some women experience skin irritation when using spermicides. Spermicides sold in the U.S. contain nonoxynol-9, which can irritate the skin and increase the risk of contracting HIV and other STIs.

Sponge. Contraceptive sponges are made of plastic foam. Sponges act as a barrier to prevent sperm from reaching the cervix. Inserted into the vagina before sexual intercourse, you can leave a sponge inside of your vaginal canal for up to 24 hours. Sponges are only 76 percent to 88 percent effective and are more effective when combined with spermicide, which kills sperm. 

Copper IUD. A copper intrauterine device (IUD) is the only nonhormonal IUD available in the U.S. The T-shaped device — made of plastic and a small amount of copper — is placed in the uterus by a doctor. The shape of the device prevents sperm from entering the uterus, and copper also has spermicidal properties.

Over 99 percent effective, the copper IUD can protect against pregnancy for up to 12 years. It does not affect your period and can be removed at any time. Side effects may include heavy bleeding and cramps, which typically subside over time.

Surgical Procedures

In most cases, surgical birth control options are permanent. If you opt for one of these methods, it’s important to be certain you do not want to get pregnant in the future. 

Tubal Ligation. Commonly known as “getting your tubes tied,” tubal ligation involves cutting the fallopian tubes to prevent eggs from traveling from the ovaries to the uterus. It also blocks sperm from moving through the fallopian tubes to reach the egg. Most tubal ligations are permanent and cannot be reversed.

Bilateral Salpingectomy. A bilateral salpingectomy is the removal of both fallopian tubes. Removing both fallopian tubes means the eggs cannot travel from the ovaries to the uterus, and sperm cannot travel through the tubes to fertilize the egg. This option is permanent and cannot be reversed, though conception is still possible through in-vitro fertilization (IVF).

Vasectomy. This is a medical sterilization procedure performed on men. The procedure involves cutting and sealing the small tubes in the scrotum that carry sperm. Vasectomies are over 99 percent effective at preventing pregnancy. Reversals are possible (though not always successful), so it’s important to be aware that this is considered a permanent form of birth control. 

Potential Side Effects from Nonhormonal Birth Control 

Nonhormonal birth control methods are appealing to many women because they carry fewer side effects than hormonal birth control options. However, some methods may cause side effects, including:  

  • Allergic reaction

  • Toxic shock syndrome (TSS) from contraceptive sponges

  • Vaginal dryness or irritation

The copper IUD may cause serious side effects, including pelvic inflammatory disease, ectopic pregnancy or uterine perforation.

Talk with your healthcare provider about the best birth control for you.

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