Getting Clear About Hormonal Birth Control
As teenagers, we are thrown into a world of options: what to wear to school, what to eat for dinner, which series to watch on Netflix. It’s a never-ending choose-your-own-adventure novel. However, when it comes to sexuality education, it seems the options we’re presented with are slimmer than we’re used to. In health classes across the country, words like “condom,” “the Pill” and “abstinence” are tossed around, but there are actually lots of other birth control options out there.
There are three categories of birth control—barrier, hormonal and behavioral. Barrier methods put a physical barrier between partners during sex, like condoms, female condoms (also known as internal or receptive condoms) and cervical caps. Behavioral methods refer to actions you can take to prevent pregnancy, like abstinence and pulling out. Hormonal methods trigger changes in the menstrual cycle that prevent the ovaries from releasing eggs (ovulation) so a pregnancy can’t happen.
In health classes across the country, words like “condom,” “the Pill” and “abstinence” are tossed around, but there are actually lots of other birth control options out there.
There are lots of birth control options that are safe, accessible, affordable and reversible. We could spend pages talking about different birth control options, but in this issue, we want to make sure you’re clear about several hormonal birth control methods and how they work. Hormonal birth control methods come in pills, patches, shots, rings and implants. They all work by releasing hormones that alter ovulation and thicken cervical mucus. In layman’s terms, hormonal birth control prevents the release of eggs that could in turn be fertilized by sperm and makes it harder for the sperm to get to the egg in the first place. Keep in mind that hormonal birth control methods require a prescription that can be obtained by a visit to your health care provider, clinic or local Planned Parenthood health center.
Hormonal Birth Control Effectiveness
There are two ways to measure how effective birth control is: typical use and perfect use.
Perfect use is the percent of the time birth control works in a controlled setting—like in a lab—where every procedure is followed precisely, no corners are cut and no accidents happen. Perfection, however, is hard to achieve, so it’s important to understand typical use, which refers to how effective each method is in an actual or typical setting—one where things might be forgotten, like forgetting to take your pill every day at the same time.
Now that we’ve cleared that up, let’s discuss some specific hormonal birth control options:
The Pill
Brand Names
There are tons of brands of birth control pills out there, and your doctor or health care provider can help you figure out which one is right for you.
Effectiveness
Typical Use: 91%
Perfect Use: 99.7%
How to Use It
Take one pill every day at the same time from the monthly pack for maximum effectiveness.
How to Get It
Once you get a prescription from your doctor or health care provider, you can purchase the Pill at your local pharmacy or get it free or at reduced cost at Planned Parenthood.
Price*
The Pill typically costs about $15 to $20 per month.
The Patch
Brand Name
Effectiveness
Typical Use: 91%
Perfect Use: 99.7%
How to Use It
Ortho Evra, the only FDA-approved birth control patch in the U.S., looks a lot like a large Band-Aid. A girl or woman places the Patch on her lower abdomen, buttocks, upper back, arm or shoulder (but not on the breasts). The Patch releases continuous doses of hormones into the bloodstream through the skin. Each patch is replaced once a week on the same day each week for three weeks. During the fourth week, no patch is worn to allow for a menstrual period.
How to Get It
Once you get a prescription from your doctor or health care provider, you can purchase the Patch at your local pharmacy or get it free or at reduced cost at Planned Parenthood.
Price*
The Patch can cost anywhere from about $15 to $80 per month.
The Ring
Brand Name
NuvaRing
Effectiveness
Typical Use:91%
Perfect Use: 99.7%
How to Use It
NuvaRing is a flexible, plastic, one-size-fits-all vaginal ring that a girl or woman inserts into her vagina once per month. Once inserted, the Ring is kept in the vagina for three weeks and taken out the fourth week on the same day of the week that it was inserted. Once the ring is removed, a girl or woman will have her period in two to three days.
How to Get It
Once you get a prescription from your doctor or health care provider, you can purchase the Ring at your local pharmacy or get it free or at reduced cost at Planned Parenthood.
Price*
NuvaRing costs about $15 to $80 dollars a month.
The Shot
Brand Name
Effectiveness
Typical Use:94%
Perfect Use: 99.8%
How to Use It
Depo-Provera is injected into a girl or woman’s buttocks or upper arm every three months from by a doctor or health care provider. The Shot becomes effective 24 hours after initial injection.
How to Get It
Not only will you need a prescription from your doctor, but you will also have to visit him or her to receive the shot.
Price*
The shot itself costs between $35 and $100 per injection.
The Implant
Brand Names
Implanon or Nexplanon
Effectiveness
99.95% for three years
How to Use It
The implant is a thin rod that is inserted under the skin on the inside of a woman’s upper arm by a medical professional.
How to Get It
A gynecologist or health care provider at a health center that specializes in women’s health, like Planned Parenthood, will be able to implant and remove it.
Price*
The total cost of the implant and its insertion ranges from $400 to $800, with another $100 to $300 fee when it’s time for removal. Keep in mind that since this birth control method is effective for up to three years, the cost may be similar to what a person would pay over the course of three years for a monthly hormonal birth control method.
The IUD
Brand Names
Mirena orSkyla
Effectiveness
99.8% for three years for Skyla and five years for Mirena
How to Use It
An intrauterine device (IUD) is a small T-shaped device that is inserted in the uterus by a doctor. Mirena and Skyla are hormonal IUDs that release progestin.
How to Get It
An IUD must be inserted by a health care provider.
Price*
The IUD, insertion and exam can cost anywhere from $200 to $1000. Since this birth control method is effective for up to three or ten years, the cost may be similar to what a person would pay over the course of several years for a monthly hormonal birth control method.
Birth Control that’s Right for You
All of these hormonal birth control methods have very high effectiveness rates. While human error, such as forgetting to take the Pill one day, can make some of these birth control methods less effective, using a barrier method, such as a condom, is a great way to back up your birth control. Backing up your birth control helps prevent unplanned pregnancy and protects against sexually transmitted diseases, which hormonal birth control methods do not protect you from.
Taking all of this into consideration is important when choosing a birth control method. Although not all hormonal methods are talked about frequently, all of them are dependable, affordable and reversible options for most teens. Even so, figuring out which birth control method you actually want to use means deciding what factors are most important to you, whether it is the price of the birth control or effort required to use it. In the end, it’s a matter of what works best for you.
Birth Control & the Affordable Care Act
* The Affordable Care Act requires that all health insurance providers cover FDA-approved hormonal birth control, when filled at a network drugstore, without charging the person who is insured a co-payment. Keep in mind that if you’re on your parents’ health insurance, their insurance will report what prescriptions have been covered.
In addition, for those methods and/or brands that are not covered by health insurance, many Planned Parenthood locations and local clinics allow women to pay for their birth control at a reduced rate.