“People often have a misconception that all birth control methods are the same in terms of protection. But that’s not true. Some work better than others,” Dr. Stanwood says. “I tell patients that, aside from permanent sterilization (tubal ligation for women, vasectomy for men), what gives the most protection is an intrauterine device (IUD) or the arm implant, both of which have a less than 1% risk of pregnancy in a year.”
An IUD is a small, soft, flexible piece of plastic shaped like a “T”—it is inserted into your uterus, via your cervix, by your doctor. There are several brands (Liletta, Kyleena, Mirena, Skyla), all of which release the hormone progestin, which changes the cervix and uterus to prevent sperm from getting through to an egg. These hormonal IUDs protect against pregnancy for three to seven years, depending on which one a woman chooses. Another type of IUD (Paragard) is hormone-free and instead uses a copper coil, which also changes the cervix and uterus to prevent sperm from getting through to an egg, and it can be used for up to 12 years.
The arm implant, sold under the brand Nexplanon, is a rod about the size of a matchstick that is inserted under the skin of your upper, inner arm. It releases progestin and prevents pregnancy for up to five years by stopping ovulation and thickening cervical mucus.
The more commonly used contraception methods, including birth control pills, injections, arm patches, and vaginal rings have failure rates of about 10% in a year, Dr. Stanwood notes, noting that the problem isn’t with the method but how it’s used. “We’re not perfect. We’re human, and those methods require us to remember things. For people with hectic lives, those methods might not be ideal,” she says.
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