Modern Contraceptives - For those with a Uterus

This section is a collection of quick facts about each of the common modern birth control options for those with uteruses. While these facts don’t present like a story as the previous sections do, they show a new kind of story about each method that is told through the facts presented to the public.

Hormonal Birth Control Methods 

        One category of modern contraceptives is the hormonal birth control methods. These are the ones that use hormones to prevent pregnancy. The hormones used are either estrogen, progestin, or a combination of the two.[16]

Description: Drawings of four types of hormonal contraceptives. Vaginal ring, IUD, pills, and the contraceptive shot.

Source: Action Canada for Sexual Health & Rights website. [22]

Estrogen

Estrogen is a type of sex hormone that helps regulate and develop the female reproductive system. The hormone can also affect the urinary tract, blood vessels, bones, breasts, skin, heart, hair, brain, and other parts of the body. Besides contraception, people take estrogen to help with different medical ailments, including menopausal symptoms, protecting the heart and brain, improving sex, improving bone and muscle density, and improving mood.[8] While these are all good reasons to take estrogen, it comes with a cost as well. Some of the possible side effects of taking estrogen include: headaches, feeling ill, acne, sore breasts, mood swings, and weight gain.[16]  Like many medicines, it is a double-edged sword.

Progestin

        Progestin is the synthetic form of the hormone progesterone. Progesterone, which is produced by both ovaries and testicles, is a hormone that helps to prepare the uterus for pregnancy. The hormone does this by causing the uterine lining to change by thickening in preparation for a fertilized egg. Progestin works as a contraceptive by preventing ovulation.[1] Similar to estrogen, taking progestin also has a variety of side effects, including mood swings, spotting between periods, acne, changes to libido, and weight gain.[16] While estrogen is always combined with progestin in birth control pills, progestin can be taken in either the combination pill or by itself in progestin-only pills (mini pill).[13]

Birth Control Pill

        One of the most commonly employed methods of contraception, the pill is an oral contraceptive, taken by mouth, that is taken once a day.[5] The convenience of the daily pill is both a pro and a con. While it is easy to start or stop taking the pill, remembering to take a pill every day is challenging, and if someone forgets to take the pill, this can lead to issues with the pill's effectiveness.[21]

Combination Pill

        As the name implies, the combination pill consists of a combination of both estrogen and progestin. The pill works to prevent conception by preventing the ovaries from ovulating (releasing an egg).[14] Users take three weeks of daily pills, preventing ovulation, and then one week of placebos, which brings on a period. With consistency, these pills are about 91% effective in preventing pregnancy.[5] Some side effects of these pills include: bleeding, nausea, headaches, increased blood pressure, breast tenderness, and bloating. Medical professionals also warn that these pills could lead to liver disorders, blood clots in the legs, and strokes. Also, like other hormonal contraceptives, the pill doesn’t protect against sexually transmitted infections.[3]

        Combination pills require a prescription from a doctor. There are three different categories that a combination pill could fit. Monophasic pills, also know as one phase pills, which contain the same amount of estrogen and progestin throughout a whole month; biphasic pills, also known as two phase pills, which includes two different combinations of estrogen and progestin; and finally triphasic pills, also known as three phase pills, which contain three different combinations of estrogen and progestin hormones. Both biphasic and triphasic pills contain different combinations of hormones to try to simulate the natural changes of hormones in a menstrual cycle.[14]

        In addition to the three categories of combination pills mentioned above, there are also extended cycle pills. Extended cycle pills work to extend the menstrual cycle, so there are only about four periods a year or no periods at all. These pills also use a combination of estrogen and progestin and require a prescription.[14]

Progestin-only Pill (mini pill)

        As the title suggests, progestin-only pills, also known as mini pills or POPs, contain only the hormone progestin. In many ways progestin-only pills are quite similar to combination pills: both require a pill taken everyday, both are about 91% effective if taken correctly, neither can protect against sexually transmitted infections, both have many common potential side effects, and both for the most part work on a four week cycle with three weeks of hormone pills and one week of placebos which leads into a period.[13] The main differences between progestin-only pills and combination pills fall under the category of situational convenience or health concerns. Progestin-only pills are a safe hormonal birth control option for individuals breastfeeding. They are a better option for individuals with a history of blood clots or those who have concerns about taking estrogen. A possible side effect of progestin-only pills is ovarian cysts, which is different from combination pills.[17] Also, Opill, a type of progestin-only pill, is the first type of hormonal birth control pill that can be sold over the counter in the USA. While most progestin-only pills still require a prescription, the ability to get birth control pills without one is becoming a more available option.[18]

Vaginal Ring

        The vaginal ring is another form of hormonal birth control that contains both estrogen and progestin. It works by inserting the ring into the vaginal canal and once placed the ring releases hormones into the vaginal lining.[11] The hormones work to prevent conception by delaying the ovaries from ovulating and by affecting the cervical mucus so that sperm can’t reach the egg. The rings are designed to be worn for three weeks and then removed, which then leads to a period. After seven days without the ring, the cycle will start over when the user inserts a new ring. The rings can be worn for up to five weeks, depending on the type, so it is possible to delay a period a little longer, but there should be a discussion with a healthcare provider. The rings are about 91% to 98% effective if used correctly and do require a prescription from a healthcare provider. There are three brands of vaginal ring: NuvaRing®, EluRyng®, and Annovera®. Annovera is the only type of vaginal ring that is reusable. There are enough hormones in an Annovera ring to last a year, but the cycle of taking the ring out every three weeks is still in effect.[11]

        Like also medicines the vaginal ring comes with a list of possible side effects and health risks. Similarly to birth control pills vaginal rings also have the potential side effects of headaches, acne, weight gain, spotting, breast tenderness, depression or mood swings, nausea, changes to libido, and changes in vaginal discharge. Some of the more serious possible health risks that come with using a vaginal ring include: blood clots, toxic shock syndrome, stroke, heart attack, high blood pressure, and gallbladder disease.[16]

IUD (Intrauterine Device)

        An intrauterine device (IUD) is a T-shaped contraceptive device that is inserted by a medical professional into the uterus with the assistance of an insertion device. IUDs are a long-term contraceptive since they can be effective for three to ten years, depending on which kind of IUD is being used.[15]

Hormonal IUD containing Progestin

Hormonal IUDs contain progestin that is released into the uterus. Similar to the vaginal ring the progestin changes the cervical mucus by causing it to thicken. This thickening prevents sperm from reaching an egg, which prevents conception. The IUD also works to prevent ovulation.[3] Hormonal IUDs can last between three to eight years before being taken out by a healthcare provider. The four types of hormonal IUDs available in the USA include: Skyla®, which lasts three years; Kyleena®, which lasts five years; Liletta®, which lasts six to eight years; and Mirena®, which can last eight years. In addition to being long-term, there are many other reasons why people choose to use a hormonal IUD. Hormonal IUDs are very effective at contraception, with 99% effectiveness, they are discreet, and they are safe to use while breastfeeding.[12] Some possible side effects of the hormonal IUDs include irregular bleeding, mood changes, discomfort, and heavier periods.[16] There is also a minimal risk for infection, and of the IUD poking holes into the uterine wall.[3]

Copper IUD

        Copper IUDs are inserted in the same way that hormonal plastic IUDs are. Copper IUDs don’t contain hormones and instead use copper as the contraceptive agent. They consist of the plastic T-shaped IUD, which is wrapped in copper wire.[15] Copper is an effective contraceptive in two ways. Sperm avoid copper, and copper affects the uterine lining and cervical mucus, which makes the uterus a poor environment for sperm to exist in.[9] Copper IUDs are about 99% effective, making them one of the most effective birth control methods available. Currently, in the United States, there is only one brand of copper IUD available, Paragard. Copper IUDs can last twelve years, which for many users is a big benefit of choosing a copper IUD.[9]

        Like all of the methods discussed so far, copper IUDs have possible side effects and medical risks. Some possible side effects include: more painful periods due to increased cramping, heavier flow with longer periods, and spotting. More serious possible medical issues connected to copper IUDs include: possible tears or holes in the uterine walls, and infections.[3]

Contraceptive Shot 

        The contraceptive shot is a shot of progestin that an individual can get, in the arm or butt, once every three months to prevent conception. Like other hormonal contraception methods that use progestin, the shot prevents conception by affecting the cervical mucus to prevent sperm from reaching an egg, and by preventing the ovaries from ovulating.[16] The shot is on average 96% to 99% effective. In the United States, the only contraceptive shot available is Depo-Provera®.[7]

        Possible side effects of the shot include irregular periods, delayed fertility after stopping shots, dizziness, bloating, weight gain, nervousness, and decreased bone density.[3] Some other facts to consider if someone is thinking about using Depo-Provera® are that the shot does not protect against sexually transmitted infections, and it is recommended to only take Depo-Provera® shots for two years because they cause a decrease in bone density that can become dangerous after two years.[7]

Birth Control Implant

        The birth control implant is a small, rod-like object that is placed by a health care provider under the skin in the inner upper arm. The implant contains progestin that is released into the body for three years.[19] The progestin from the implant works to prevent conception in the same way as other hormonal birth control methods, by preventing the ovaries from ovulating and changing cervical mucus to prevent sperm from reaching the egg.[2] Implants are about 99% effective and discreet, which are two pros for using the implant. It is also safe for those breastfeeding, and it can reduce heavy menstrual bleeding. The two most common brands of implants available in the United States include Nexplanon and Implanon.[2] Some of the possible side effects that come with the implants include: acne, mood swings, spotting, sore breasts, and headaches.[3] Other medical considerations that come with implants include: how the implant might affect other medications, the lack of protection against sexually transmitted infections, and the requirement that a medical provider both put in the implant and take it out.[2]

Birth Control Patch

        The birth control patch is a small, sticker-like patch that a user places on their body for a week at a time for three weeks straight, and then on the fourth week, the user doesn’t replace the old patch and instead has their period.[16] To get the patches, a prescription is required. The patches contain both the hormones estrogen and progestin. These hormones are absorbed into the body from the patch. They work to prevent conception by delaying ovulation, changing the mucus around the cervix, making it harder for the sperm to reach an egg, and thinning the lining of the uterus, making it harder for an egg to implant. Without errors in usage, the patch can be 99% effective. The patch is relatively low maintenance and not complicated to use, which are pros.[4] Some possible side effects that come with the patch include nausea, mood changes, headaches, irregular bleeding, and sore breasts. The patch also doesn’t protect against sexually transmitted infections, and may cause blood clots.[4]

Barrier Methods

        In addition to all of the hormonal methods of birth control, there are also the barrier methods. These methods are placed by an individual in their vaginal canal against the opening of their cervix. Most barrier methods are used with spermicide, which is a chemical that interacts with sperm, preventing them from reaching an egg. Some barrier methods can protect against sexually transmitted infections, unlike the methods previously discussed.[3]

Description: Drawings of five barrier contraceptive methods, including the birth control sponge, internal condoms, vaginal diaphragm, and cervical cap.

Source: My Health Alberta Canada Website [23]

Internal Condoms

        Internal condoms, also known as female condoms, are an internal condom that goes inside the vagina or anus to protect against sexually transmitted infections and (in the case of the vagina) to prevent pregnancy. They are made of soft plastic and can be latex-free. With proper use, they are 95% effective in preventing pregnancy, but taking into account human error, the actual effectiveness is closer to 79%. In the United States, the only brand of internal condom available is FC2 Internal Condom®, which requires a prescription from a healthcare provider to get. [20]

        Internal condoms used to be called female condoms. While some sources and brands still call them female condoms, the medical world is moving away from that name, and instead, the name internal condoms is now used. This change helps to show that it is not only females who can use this form of contraception. [20]

Vaginal Diaphragm

        Another barrier method of contraception are vaginal diaphragms. Vaginal diaphragms are made out of different materials including rubber, silicon, and latex, and they are reusable. The diaphragm is used by placing it in the vaginal canal in front of the cervix.[10] While they do not protect against sexually transmitted infections, they do prevent conception when used with spermicide. Spermicide is a chemical that interacts with sperm and prevents them from reaching an egg. Together, a diaphragm and spermicide are between 87% - 94% effective in preventing pregnancy.[10] There are a few health concerns to consider if someone is thinking of using a diaphragm: possible skin irritation due to spermicide chemicals, an increased risk for UTIs, and a risk for toxic shock syndrome.[3]

Cervical Cap

        Cervical caps are another form of barrier birth control. Like the diaphragm the cervical cap is placed in the vaginal canal against the opening of the cervix, and both are reusable. Both can also be used with spermicide.[3] The cervical cap is made of silicone and is shaped like a classic sailor hat. A cap is smaller than a diaphragm, which is one reason why someone might prefer the diaphragm over the cap. However, that also means that cervical caps might not be a good option for someone who has given birth.[6] Prescriptions are required to get a cervical cap. There is one brand of cervical cap available in the United States called FemCap®. The effectiveness of the cervical cap changes depending on whether it is used properly and other health factors, but on average, the cervical cap is considered to be about 86% effective if you have not given birth.[6] The health risks associated with cervical caps are similar to those connected with the diaphragm: there is no protection against sexually transmitted infections, possible urinary tract infections, possible risk for toxic shock syndrome, and possible inflammation of the cervix.[3]

Birth Control Sponge        

        The birth control sponge, also known as a contraceptive sponge or the sponge, is another barrier contraceptive method that works by being placed in the vaginal canal at the opening of the cervix. The sponge is coated with spermicide, so there is no need to add it; however, the sponges can only be used once, and then they need to be thrown away.[3] There is also no prescription required for birth control sponges. With perfect use, the sponge is about 88% effective, but the percentage goes down with human error. Like other barrier methods, the sponge does not protect against sexually transmitted infections, and it is connected to an increased risk of toxic shock syndrome and urinary tract infections.[3]

Sources:

[1] Cable, Jessie K., and Michael H. Grider. “Physiology, Progesterone.” PubMed, StatPearls Publishing, 1 May

2023, www.ncbi.nlm.nih.gov/books/NBK558960/. Accessed 15 Apr. 2025

[2] Cleveland Clinic. “Birth Control Implant: How It Works, Side Effects & Benefits.” Cleveland Clinic, 26 Dec.

2022, my.clevelandclinic.org/health/articles/24564-contraceptive-implant. Accessed 13 Apr. 2025

[3] Cleveland Clinic. “Birth Control Options & Types: Risks & Effectiveness.” Cleveland Clinic,

my.clevelandclinic.org/health/articles/11427-birth-control-options. Accessed 13 Apr. 2025

[4] Cleveland Clinic. “Birth Control Patch: How It Works, Side Effects & Benefits.” Cleveland Clinic, 1 Dec. 2022,

my.clevelandclinic.org/health/articles/24490-birth-control-patch. Accessed 17 Apr. 2025

[5] Cleveland Clinic. “Birth Control Pill: Types, Side Effects & Effectiveness.” Cleveland Clinic, 5 July 2023,

my.clevelandclinic.org/health/treatments/3977-birth-control-the-pill. Accessed 15 Apr. 2025

[6] Cleveland Clinic. “Cervical Cap.” Cleveland Clinic, 13 May 2022,

my.clevelandclinic.org/health/articles/17979-cervical-cap. Accessed 18 Apr. 2025

[7] Cleveland Clinic. “Depo-Provera® (Birth Control Shot): How It Works, Risks & Benefits.” Cleveland Clinic, 12

May 2021, my.clevelandclinic.org/health/drugs/4086-depo-provera-birth-control-shot. Accessed 17 Apr. 2025

[8] Cleveland Clinic. “Estrogen: What It Does and 5 Benefits.” Cleveland Clinic, 4 Jan. 2022,

health.clevelandclinic.org/what-does-estrogen-do. Accessed 15 Apr. 2025

[9] Cleveland Clinic. “ParaGard® (Copper IUD).” Cleveland Clinic, 1 Jan. 2024,

my.clevelandclinic.org/health/drugs/17741-paragard-copper-iud. Accessed 16 Apr. 2025

[10] Cleveland Clinic. “Vaginal Diaphragm Contraceptive: Function & Effectiveness.” Cleveland Clinic, 1 July

2022, my.clevelandclinic.org/health/articles/23427-vaginal-diaphragm. Accessed 18 Apr. 2025

[11] Cleveland Clinic. “Vaginal Ring for Birth Control: Effectiveness & Side Effects.” Cleveland Clinic, 14 Sept.

2022, my.clevelandclinic.org/health/articles/24157-vaginal-ring. Accessed 17 Apr. 2025

[12] Cleveland Clinic. “What Are Hormonal IUDs?” Cleveland Clinic, 2018,

my.clevelandclinic.org/health/drugs/hormonal-iud-mirena. Accessed 16 Apr. 2025

[13] Mayo Clinic. “Minipill (Progestin-Only Birth Control Pill) - Mayo Clinic.” Mayoclinic.org, 13 Jan. 2023,

www.mayoclinic.org/tests-procedures/minipill/about/pac-20388306. Accessed 15 Apr. 2025

[14] Mayo Clinic Staff. “Combination Birth Control Pills - Mayo Clinic.” Mayoclinic.org, 13 Jan. 2023,

www.mayoclinic.org/tests-procedures/combination-birth-control-pills/about/pac-20385282. Accessed 15 Apr. 2025

[15] Macmillan, Carrie. “Intrauterine Devices (IUDs): What Women Need to Know.” Yale Medicine, 2023,

www.yalemedicine.org/news/intrauterine-devices-iud. Accessed 16 Apr. 2025

[16] NHS. “Side Effects and Risks of Hormonal Contraception.” NHS.uk, 29 Feb. 2024,

www.nhs.uk/contraception/choosing-contraception/side-effects-and-risks-of-hormonal-contraception/.         

Accessed 14 Apr. 2025

[17] NHS. “Side Effects and Risks of the Progestogen-Only Pill.” NHS.uk, 29 Feb. 2024,

www.nhs.uk/contraception/methods-of-contraception/progestogen-only-pill/side-effects-and-risks/.

Accessed 15 Apr. 2025

[18] “Opill®, Daily Oral Contraceptive Pill.” Opill, opill.com/products/opill. Accessed 15 Apr. 2025

[19] Planned Parenthood. “Birth Control Implants | Nexplanon Information.” Www.plannedparenthood.org, 2022,

www.plannedparenthood.org/learn/birth-control/birth-control-implant-nexplanon. Accessed 17 Apr. 2025

[20] Planned Parenthood. “Internal Condom.” Planned Parenthood, 2019,

www.plannedparenthood.org/learn/birth-control/internal-condom. Accessed 18 Apr. 2025

[21] Planned Parenthood. “Pill History Fact Sheet.” Birth Control – History of the Pill (June 2015).

https://www.plannedparenthood.org/files/1514/3518/7100/Pill_History_FactSheet.pdf. Accessed 15 Apr.

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Image Sources:

[22] “Hormonal Birth Control Methods | Action Canada for Sexual Health and Rights.” Actioncanadashr.org, 2025,

www.actioncanadashr.org/sexual-health-hub/hormonal-birth-control-methods. Accessed 19 Apr. 2025

[23] “Learning about Birth Control after Childbirth.” Alberta.ca, 2025,

myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abs7386. Accessed 19 Apr.

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