Choosing the right method can be challenging in light of the fact that there is no ideal or perfect method that will be the “right fit” for everyone. Just because your friend does well on a hormonal method doesn’t mean that you will too. In the end, we are all guinea pigs- until we actually try to use a certain method we cannot know how it will affect us.
If no method has an actual efficacy of 100% (except abstinence and maybe tubal ligation and vasectomy), then the most you can hope for is a “good enough” method that will more or less meet your needs in terms of body-mind health, your sexual relationship/s and your lifestyle.
In an ideal world, gynecologists would be trained as counselors and they would have extensive knowledge about and experience with all methods, including natural ones. Medical students would be better trained in communication and counseling skills. Gynecologists can only recommend a method that they know and trust, but they shouldn’t be the ones to make important decisions about your sexual health- that’s your responsibility.
Soul-Searching about Sex and Safety
Often, we find ourselves torn between different needs and competing desires. On one hand, certain methods are considered to be highly effective (like hormonal, IUDs) but on the other, they exert a price- side effects and risks that can interfere with health and quality of life. This is why it’s super important to conduct a kind of “soul-search” to figure out what really matters the most to you. The following questions (and your answers to them) will help you move closer to making the right decision:
- What are your goals now, at this point in time?
- What kind of sexual relationship/s are you in right now? And is that relationship serious and stable enough to have this “heart-to-heart” conversation?
- Have you spoken to your partner? Do they understand your dilemma?
- Does your partner want to take an active role in sharing the birth control goal with you? (this can affect the choices you will make)
- How important is it that you not get pregnant in the next 3-6-12 months? Do you need close to 100% protection or can you settle for 80+ or 90+ %)
- Do I have enough information about the various options to make an informed choice?
- How motivated are you to use the method/s you are considering?
- What has experience taught you so far about birth control/methods?
- Who do you feel the most comfortable with in terms of getting information and advice from a doctor? Your mom? Your partner? Best friend? Your own intuition?
- Have you ever had an unplanned pregnancy (using or not using a method) and what did you learn from that experience?
- What are your priorities and needs? What are your partner’s priorities and needs?
- What methods will enable you to enjoy intimacy, “let go,” and experience full-blown pleasure?
- What do you do if you and your partner don’t see things “eye to eye?”
- How do you feel about trying something new?
Every method has its advantages and disadvantages and every method exacts a price. The important question is: Is the price I will/am willing to pay- the right price for me in terms of my mind-body, health, lifestyle, relationship/s?
Types of contraceptive methods
There are nearly 20 kinds of birth control methods (not all available everywhere) and they can be divided roughly into seven groups:
- Hormonal methods (pills, vaginal ring, patch, injection, implant, IUD (Mirena)
- Non-hormonal IUDs (Paraguard, MonaLisa, Copper T, ballerina, gynefix)
- Non-hormonal spermicides (one-time use): ovules, film, foam, cream, gels, dosed applicators, sponge
- Non-hormonal, multi-use methods: (Flex and Caya diaphragms, Fem-Cap)
- Natural Methods: calculation methods (“Safe Days” or calendar methods); sympto-thermal methods (based on charting at least 2 fertility signs); apps and fertility devices (based on algorithms)
- Male methods: withdrawal, condom, vasectomy (surgical)
- Long-term methods: Tubal ligation (women) and vasectomy (men)
The secret no one told you
Personal characteristics and behaviors are what ultimately determine actual efficacy rates of birth control methods. Most people never learn about this and most physicians/gynecologists are not trained to understand the behavioral and psychological aspects of birth control use, misuse, and non-use.
- The following factors play a huge role in determining how effective a method will be:
- Having some familiarity with the method and receiving professional instruction in its use
- Understanding how the method works and what it means to use it correctly and consistently
- If it’s a non-hormonal method /non-IUD, then having skill and experience with the method (before actual use) is vital (Diaphragms, spermicides, caps)
- High motivation to prevent pregnancy
- Does the method interfere with you or your partner’s sexual pleasure
- Degree of satisfaction about the method you are using
- Partner support and cooperation
- Trust and confidence in the method you are using.
Values Clarification Excersize for Couples
If a method of contraception is going to work for you, it needs to fit not only your lifestyle, relationship needs, and overall health but also your personal values. Your values reflect the core of who you are and they influence the choices you make. When you know what is important to you then your chances of making the right decision and reaching your goals will be higher. If there is poor sync between your values and choices, then you might find yourself on a slippery slope. If you are confused, uncertain, or feeling pressured and uncomfortable (by your physician, partner, or peers), you will benefit from professional counseling.
The values listed below represent some of the main considerations involved in choosing a method. While all of them may be important, each person needs to clarify and prioritize what values are the most relevant for them. Then, they need to evaluate the degree of “sync” between them and their partner. All values cannot “fit” into first or second place. There is no right answer!
You and your partner are invited to separately rank each of these values on a scale of 1 to 11, with “1” being the most important and “11” being the least important (You will need 2 copies of this sheet). After you complete the exercise, set a time together so you can sit, discuss, and compare your preferences. Feel free to add additional values.
_____ Natural (does not interfere with cycle or hormones)
_____ Cost (monetary and emotional)
_____ Health and safety (side effects and risk factors)
_____ Convenience and relative ease of use
_____ Spontaneity and freedom
_____ Ideological acceptability; faith/belief this is right for me
_____ Enjoyment and pleasure (does not alter mood, libido, cause pain or disrupt pleasure)
_____ Partner cooperation and joint responsibility
_____ Peace of mind
_____ Ecological concerns (method is environment-friendly)