Everything You Ever Wanted to Know About Birth Control

Imagine that you're standing all alone on a football field. You can choose to stand anywhere you want to, but once you pick your spot, you can't move again.

Now imagine that, somewhere over by the entrance, about a million people are massed and waiting, about to be released onto the field. They're participating in a contest and the first one to touch you wins a brand new HDTV, a trip to Tahiti, and their very own pony. Granted, they're all blindfolded. But once they're free to run around the stadium's enclosed space, how long do you really think it will take for one of them—or 20 of them—to slam right into you?

That, in a nutshell, is sex—from the perspective of an egg. When you think about it that way, it's almost tempting to reverse the old adage about conception. Having a baby isn't a miracle: Preventing one is.

Without any means of contraception, the average sexually active woman of childbearing age would have an 80-85 percent chance of getting pregnant within a year. In most cases, those odds are going to catch up to you eventually. Luckily, we live in a time where women who don't want to have a baby have access to reliable means of contraception, many of which can be more than 90 percent effective in preventing pregnancy.

On the other hand, we also live in a time where there are so many options that it's easy to end up overwhelmed. And that can lead to women making decisions that maybe aren't the best ones for them, simply because they don't have time to weed through all the information. If you've ever picked your contraceptive method because it was the only one you knew about or because that was what all your friends used, you may not be using the one that’s best for you. We're breaking down almost every form of birth control available, to help you understand what it does, how well it works, and who can benefit the most.

The Pill

What it does:  The pill you're probably most familiar with is also called a “combination pill,” because it releases two different synthetic hormones into your body. Together, the artificial hormones work by preventing you from ovulating—releasing a mature egg cell from your ovaries. They have some other effects, as well, including thickening the mucus around your cervix, which makes it more difficult for sperm to actually get inside your uterus.
What it doesn't do:  Protect you from sexually transmitted diseases. The pill also doesn't work 100 percent of the time. It's rare—the failure rate is lower than 2 percent if used correctly—but some women can and will get pregnant, even if they're following instructions to the letter. On the plus side, getting pregnant while on the pill isn't harmful to you or the fetus. 

How to get it: You need a prescription. However, you don't need a parent's permission. Although most medical professionals encourage underage patients to talk to their parents about health choices, there are no state or federal laws requiring it. According to a 2005 article in the Journal of the American Medical Association, 60 percent of teenagers who visited a family planning clinic say their parents knew about the visit.
Is it reversible?  Yes. Your body begins to return to normal hormone levels (and with that, normal ovulation) after a couple of days off the pill. Once you stop taking it, your chances of getting pregnant become about the same as a woman who's never used hormonal contraception.

Side effects: The most common are breast tenderness, nausea, weight gain, mild headaches, and changes to mood or sex drive. For most women, these disappear after the first three months. If they don't, you and your doctor may be able to manage them by switching to a pill with a different types or amounts of hormones.
Who can benefit the most:  Women who tend to be detail-oriented. In order to use the pill correctly and keep your risk of pregnancy at a minimum, you need to know and follow its use instructions pretty closely. That usually means taking the pill at the same time every day, knowing exactly what you're supposed to do if you miss a pill or two, and following lifestyle recommendations like not smoking (mixing cigarettes and the pill greatly increases your risk of heart attack and stroke).

Who should consider a different method: Smokers, definitely. Also: women who have to use specific antibiotics or other prescriptions.

If you're over the age of 35, you should also check with your doctor to make sure that you don't have any of the health complications that can make the pill less effective and more dangerous. Most older women can continue using the pill without problems, but if you are diabetic or obese, for instance, the pill might not be for you.

You might not know: Combination pills can differ a lot from one brand to another. For instance, Yasmin—one of the newer pills on the market—is the only one that uses a specific type of progestin called drospirenone. This new progestin has been shown to work better for some women who have unacceptable side effects while using other pills. On the downside, though, drospirenone can also cause potassium to build up in your bloodstream, leading to possible complications. Women with a history of jaundice and kidney or liver diseases should not take this medication.