In a lot of ways, choosing the perfect birth control can be just as stressful as buying a home: there are a plethora of options, you need to do a lot of legwork figuring out if it’s right for your needs, and you can have some bad experiences. Finally, you hope that you can find one that you can live with.
Whether you’re new to using birth control, or you’ve been using the same method for years, figuring out the right birth control option takes a bit of self-observation. Some people are perfectly fine taking hormonal birth control, but for others, it might not be the best option. Hormones can play a large role in our mental (mood swings, for starters) and physical (e.g. nausea, headaches, and weight gain) health, so a doctor can help you figure out if a non-hormonal option can give you better control over the state of your well-being.
There’s also, of course, the pandemic that’s changing the way people are approaching family planning, too, says Dr. Iris Kerin Orbuch, the director of the Advanced Gynecologic Laparoscopy Center in LA. According to research from the Kinsey Institute at Indiana University, people are having less sex since the start of the pandemic, which means a hormonal option that you have to take every single day might not make sense for you anymore. Furthermore, a recent study shows that one-third of their participants wanted to delay pregnancy or wanted fewer children as a result of the pandemic — perhaps wanting to avoid the added stress of being pregnant during COVID-19 times. “I also believe that since hormonal birth control can increase the risk of depression and the pandemic has increased isolation and worsened depression for some people, non-hormonal birth control will appeal to more people during this time,” says Orbuch.
Finding the right birth control can be an essential part of your wellness and self-care by keeping your sexual health top of mind. Last year, Cirqle Biomedical surveyed more than 1,500 women and nearly half said it’s important or extremely important that their contraceptive doesn’t contain hormones. So if you’re in the same camp, first talk to your doctor. Meanwhile, it could be helpful to be informed on some of the newest and most popular versions on the market today to discuss with your healthcare provider if any of them are a right fit:
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What it is: Phexxi is the first FDA-approved hormone-free vaginal gel.
How it works: “It can be used spontaneously just before sex or even one hour prior to sex. It is effective immediately. It comes in an applicator similar to a tampon applicator,” says Orbuch. It uses a mixture of lactic acid, citric acid, and potassium bitartrate to lower the pH of the vagina, “which lowers sperm mobility — making it less likely for the sperm to reach the egg,” she adds.
Efficacy: It’s 86% effective at preventing pregnancy, which is more effective than condoms.
Why it’s buzzy: Since it’s a vaginal gel, it doesn’t require you to commit to a daily or regular regimen, nor does it require anything to be implanted. It’s great for those who aren’t having as much partnered sex and want an on-demand birth control option to give them more freedom. Plus, you can have Phexxi delivered to you via mail after a telehealth appointment with one of their doctors to see if you qualify.
What it is: It’s the first FDA-approved birth control app.
How it works: The app uses an algorithm that can identify your fertility status using your daily basal body temperature. Based on your morning body temperature using the Natural Cycles thermometer, “red” days in the app mean you’re fertile while “green” days mean you’re not fertile (and hence don’t need to use protection during sex). This method can also help you figure out the best days to conceive or prevent pregnancy, depending on what your family planning goals are.
Efficacy: It’s 93% effective in preventing pregnancy with perfect use, which is the same average as the pill.
Why it’s buzzy: Your temperature rises slightly after ovulation, and while documenting body temperature isn’t a new method, this app pairs it with an algorithm that helps you be more in tune with the patterns of your body’s unique cycles and fertile windows. The app can also warn you about days you might have heightened PMS to learn even more about your body.
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What it is: The Paragard IUD is FDA-approved copper intrauterine device.
How it works: This T-shaped device made of soft, flexible plastic is also placed in your uterus by your doctor. In just a few minutes, it uses just one simple, active ingredient — copper — to prevent pregnancy. It has two thin threads so that your doctor can easily remove them whenever you want to, but it also provides continuous pregnancy prevention for up to a decade (at which point you can get it replaced). It’s reversible at any point, so if you decide to take it out, your doctor can do so at any point, While it’s in, you’ll continue to get your monthly period. It may be heavier at first but will decrease over time.
Efficacy: It’s over 99% effective.
Why it’s buzzy: FDA-approved for over 30 years, it’s one of the most common forms of contraception. Most insured people can get Paragard without any co-pays, deductibles, or out-of-pocket costs, which attribute to its popularity. Also, if you get one within 120 hours of having unprotected sex, it’s 99% effective against pregnancy, according to Planned Parenthood.
What it is: the IUB Ballerine is a hormone-free intrauterine ball.
How it works: “It releases small amounts of copper and provides continuous birth control. The copper interferes with sperm motility, fertilization of an egg and possibly even prevents implantation,” says Orbuch. An IUB needs to be inserted into your uterus during an office visit with your doctor. After they measure your uterus, they insert the IUB with a thin tube, remove the tubing (leaving the IUB behind), and check to make sure it’s correctly in place with an ultrasound. Like a standard IUD, it has two threads so that your healthcare provider can remove it if you decide to remove it at any point. After it’s inserted, you might experience heavier or longer periods, which usually go away after about three months.
Efficacy: Effective for up to five years (after it expires, you can choose to get it replaced), it has over 99% efficacy at preventing pregnancy.
Why it’s buzzy: It works similarly to a standard copper IUD, but because of the special size (it’s about half the size of an IUD) and material (the frame is coated in polyethylene terephthalate), it conforms to your uterus so it reduces the risk of any irritation or damage.
What it is: Oui is a vaginal capsule (not yet on the market).
How it works: “It dissolves once inserted in the vagina that makes cervical mucus thicker and does not allow penetration of the sperm. It starts working one minute after insertion [ and lasts for up to one day],” says Orbuch. Similar to Phexxi, it creates an environment in the vaginal cavity where the low pH deactivates sperm.
Efficacy: The European startup company behind the product, Cirqle Biomedical, has so far raised $4.5 million from investors to begin trials in testing efficacy and safety, but so far in animal testing, it established a 100% effective barrier for sperm cells.
Why it’s buzzy: The mucus engineering approach means that Oui only interacts with the mucus layer that sits on top of the mucosa. Since it’s technically topical, it minimizes any side effects (in addition to being hormone-free). Like Phexxi, it’s an on-demand approach so you use it when you need it and you don’t need anything implanted into your body.