How to Choose the Best Birth Control with the Least Side Effects

There are surprising long-term side effects of birth control pills.
Getting pregnant is something you definitely want to be ready for before it happens (if you want it to happen at all). So if you’re sexually active and not currently interested in raising a child (or having more children!), you want an effective form of contraception. There are a dizzying array of options when it comes to preventing pregnancy, from good-old condoms to a new natural family planning app, but more and more we are realizing that many of them come with a downside for our health. Here at WellBe we care a lot about your long- and short-term health, so we made it our mission to help you find the best birth control with the least side effects. Read on to learn important health info about all your different options, from the long-term side effects of birth control pills to some shocking stats on the effectiveness of certain contraceptives.

Our Criteria for Choosing the Best Birth Control with the Least Side Effects

When it comes to choosing the best birth control with the least side effects, there are a number of factors to consider. When parsing all the different options, we looked at:
  • How effective it is at preventing pregnancy
  • How convenient it is
  • The short-term side effects
  • The long-term side effects
  • The potential benefits
Of course, each birth control option has its own enthusiastic fans and detractors. After all, we all have different bodies, medical histories, sensitivities, and lifestyles. We also all have our own risk profiles for getting pregnant. We’ve ranked the contraceptive options below from most side effects to least, in our view, but remember that ultimately it’s all about finding what works best for you. Read on to find out the short- and long-term side effects of the most common birth control options out there. 

The Short- and Long-Term Side Effects of the Sponge

Made famous by Seinfeld, the sponge is a soft, foam disk that’s inserted into the vagina before sex and removed afterward. It also contains spermicide, so it blocks as well as kills sperm.
The sponge has a number of benefits that make it a super convenient form of contraception: it doesn’t require a prescription or fitting, it protects against pregnancy for 24 hours, and it doesn’t require a partner’s cooperation. 
However, the side effects definitely outweigh the convenience factor. The sponge can cause vaginal irritation or dryness, increase your risk of contracting a UTI, and even put you at risk for toxic shock syndrome. Some people are sensitive to the spermicide in the sponge (because let’s face it, spermicide is definitely not organic or natural — it’s meant to kill sperm! The toxic chemical used in spermicide is nonoxynol-9). Additionally, iff irritation occurs, it’s not only painful, but it can also increase your risk of HIV and other STDs.
Another big drawback of the sponge is that it’s very hard to use correctly, and thus has a very high failure rate. Among women who have never had a baby, 12% will get pregnant within one year of using the sponge; and among women who have given birth before, that number rises to 24%. 

The Short- and Long-Term Side Effects of Birth Control Pills

The pill is the most common form of birth control, with 10.6 million American women choosing it as their form of contraception. Most of the side effects you hear about are short-term things, like headaches, breast tenderness, nausea, or fatigue. Some women also experience spotting between periods, bloating, weight gain, lightheadedness, acne, or mood changes. Many women need to try a few different pills before they find one that doesn’t have side effects, and many women give up on the birth control pill all together because they get side effects from all of them.
There’s less conclusive research on the long-term side effects of birth control pills (after all, it’s only been around for a few decades), but there’s enough out there to make us concerned about being on the pill indefinitely, or at all. This is because the birth control pills alters the natural hormone levels of your body, which has to have some consequences. 
So what are the potential long-term side effects of the birth control pill? Let’s start off with hormones. Oral contraceptives essentially act like a testosterone sponge, so they can lower your testosterone levels, which can have a negative impact on your libido (which sort of defeats the main purpose of birth control, no?). To put it simply: the birth control pill makes your body believe it’s pregnant when it’s not (so that you don’t get pregnant). It also creates a “fake” period, which means the very important process of having a monthly period is now being taken away. 
Taking the pill and getting a fake period also means that if something goes wrong in your body that causes your period to stop, you wouldn’t know. When your body stops menstruating normally at an age when it should be (roughly 12-51 years old), it’s a cry for help, a symptom of an underlying issue. Taking the birth control pill stifles those cries. You can’t hear them. As time goes on, those problems become bigger, those cries louder, and still, you cannot hear them.  
Long-term use of the birth control pill can also deplete your levels of certain vital nutrients, including vitamin C, B vitamins, folate, magnesium, selenium, and zinc. 
Crohn’s disease is another one of the surprising long-term side effects of the birth control pill, since the pill has an impact on your gut permeability. The pill can also increase your risk of inflammation as well as blood clots (according to this research only if you’re over 35, but we would suspect your risk would increase at any age).
Then there’s cancer. We’re not going to say that cancer is one of the definitive long-term side effects of the birth control pill, because the research is still limited and conflicting. However, it’s worth noting that, according to the American Cancer Society, people who have taken birth control pills are more likely to develop breast cancer than those who never used them, and that taking the pill for more than five years can increase your risk of cervical cancer. In both cases, the longer you take the pill, the higher the risk
But there’s also research suggesting that the pill can actually decrease your risk of other cancers, like ovarian, endometrial, and colorectal cancer, which I realize is super confusing Ultimately, you should look at your own family history of cancers (and other inflammation-related diseases) if you’re considering going on the pill.

The Short- and Long-Term Side Effects of the Hormonal Patch 

The patch is a contraceptive that sticks onto your skin and delivers the hormones progestin and estrogen into your bloodstream. Because these are the same hormones in oral contraceptives, the list of potential side effects are largely similar: headache, weight gain, bloating, tender breasts, impacted libido. Again, these side effects don’t happen to everyone who uses the patch, and some women might only experience side effects temporarily, but the same issues we discussed with the hormonal pill apply to the hormonal patch.
Like the pill, the patch has a shorter list of more serious — but much more rare — potential side effects. These include things like increased risk for blood clots, heart attack, stroke, and liver tumors. 

The Short- and Long-Term Side Effects of a Hormonal IUD

An IUD (intrauterine device) is a t-shaped device that is inserted into the uterus. There are two FDA-approved types, one made of copper and it doesn’t emit any hormones, and the other is a synthetic device that emits a small level of the hormone progestin. 
For both types of IUDs, there’s a very slight chance of serious complications. About 1% of women get pelvic inflammatory disease after getting an IUD, which is a bacterial infection that requires antibiotics (which we try to avoid at all costs!) and can leave scar tissue that blocks the fallopian tubes and causes future infertility. In rare cases, the IUD can actually push through the wall of the uterus (ow!). 
For the hormonal IUD, there are many of the same side effects you see with other hormonal contraceptives, such as weight gain, hair loss, mood changes, and acne. But since the dose of progestin in the IUD is only 20% the dose of progestin in the birth control pill and patch, these side effects are less common and less intense.
In the plus column for hormonal IUDs, they’re super effective for not getting pregnant — 99% — they last for anywhere from three to 10 years, and they can apparently reduce your risk of endometrial cancer. Sadly, the risks we described associated with infection, inflammation in the area, and hormonal interference from taking synthetic hormones are linked to a variety of other cancers and diseases including breast cancer, cervical cancer, and endometrial cancer.

The Short- and Long-Term Side Effects of the Copper IUD

The non-hormonal IUD uses copper wire to create an inflammatory reaction that is toxic to sperm and eggs. Because it doesn’t contain any hormones, it doesn’t have any of the side effects of the hormonal IUD, but is just as effective in preventing pregnancy. It has the added benefit of being effective as emergency contraception: it can actually prevent pregnancy if it’s inserted within five days after having unprotected sex. 
The copper IUD does, however, have a few side effects not related to hormones that concern us. It can be pretty painful upon insertion and cause cramps and backaches for a few days after. It can also lead to bleeding between periods, cramps, severe menstrual pain, and heavy bleeding, but these side effects can go away within 3-6 months of insertion. 
The same issue with hormonal IUDs exists with copper IUDs: namely, that you’re putting a foreign object inside your body, which your body is of course going to fight like hell to get OUT of your body — that’s its job! This often leads to localized inflammation, which can then lead to chronic inflammation, since you’re not removing this object. Chronic inflammation can lead to a whole host of diseases including heart disease, diabetes, and cancer
Remember we talked about pelvic inflammatory disease from either kind of IUD and though it’s rare, an IUD can actually push through the wall of the uterus (ow!). Lastly don’t forget that it’s also possible for bacteria to get in when the copper IUD is inserted, which can cause a bacterial infection that can require antibiotics (which we try to avoid at all costs!) and reduce your chance of getting pregnant in the future.

The Short- and Long-Term Side Effects of Nontoxic Condoms

It might seem obvious that condoms are the best birth control with least side effects — after all, they’re just a physical barrier, and they don’t stay in you long-term, so how could they have any impact on your health? 
Unfortunately, certain kinds can. In fact, many condoms on the market contain the known carcinogen nitrosamine, which is pretty terrifying when you consider the sensitive and permeable place they’re going. Conventional condoms can also cause skin irritation due to latex sensitivity, or allergic reactions caused by spermicides, fragrance, lubricant, or other chemicals used in the condoms. 
The good news is that there’s now an increasing number of nontoxic condoms out there. These organic, vegan options don’t contain any harmful chemicals or potential skin irritants. However, they do have the one side effect that all condoms have: higher failure rate. While condoms are 98% effective when used perfectly, human error means that they’re actually only 85% effective in real life
Again our recommendation is to understand what is important to you and whether you can use this birth control effectively. Non-toxic condoms are one of the best forms of birth control methods for your health, but of course they have to be used every time you have sex and put on properly for them to be an effective birth control method! 
Remember that your health is more important than how it might feel or how convenient it might be for your partner. Take a firm stance and explain the importance of using this birth control method for your short and long term health and you may be surprised how well your partner responds and complies.
The Short- and Long-Term Side Effects of the Natural Family Planning App 
Ovulation trackers have been around for a while, but it wasn’t until recently that a natural family planning app was actually approved by the FDA for use as a form of contraception. This is actually a pretty big deal since the FDA requires drugs and medical devices to go through lots of hoops to get approval. The fact that an app could be approved is pretty new and remarkable.
 The app, called Natural Cycles, pairs with a thermometer to track a woman’s temperature every day, and uses that data to predict when she’ll ovulate. Based on that prediction, the app will tell women whether or not it’s okay to have unprotected sex. 
The potential benefits of this app are pretty obvious: it doesn’t require you put anything on or in your body, it uses no synthetic hormones or chemicals, and it won’t cause you any sort of pain or require a medical procedure. 
However, if a side-effect-free natural family planning app seems too good to be true, that’s because it might be. While the app claims that it’s 93% effective with standard use and 98% effective with perfect use, there’s been a major backlash of women who ended up with unwanted pregnancies after trusting the app’s predictions. 
The natural family planning app option is still super new, and it might improve with advancements in technology. Our recommendation here is again to know yourself: will you be able to use something like this perfectly and how much do you not want to be pregnant? How important is it to you to use a side-effect free and natural birth control method? Once you ask yourself these questions, this may be a good option for you (or not!).
(BTW — if you want recommendations for WellBe-approved modes of contraception and other health-boosting items to have in your home, check out the WellBe Non-Toxic Product Lists! You’ll find 1,200+ vetted and researched non-toxic products, from food to sleep to beauty to home and more.)

Conclusion: Choosing the Best Birth Control for You

Finding an effective and safe birth control method can be challenging, and there are a ton of different options out there, so it can be difficult to decide between them. The info above is a lot to remember, so here’s a handy little cheat sheet with everything you need to know about finding the best birth control with the least side effects:
  • Most methods of birth control use synthetic (meaning not natural) hormones. Specifically, they use the hormones estrogen and progestin to prevent ovulation. These hormones can cause side effects like weight gain, breast tenderness, nausea, and bloating. Examples of hormonal birth control include the pill, the hormonal IUD, and the patch. There are enough long- and short-term health impacts of hormonal contraception that it is not considered the best method for your health, even if hormonal birth control is an effective and convenient birth control method.
  • The sponge is a device that can be inserted into the vagina, and it also has a lot of drawbacks. It can cause vaginal irritation and dryness, and increase your risk of getting a UTI or toxic shock syndrome. Some people are sensitive to spermicide in the sponge, and if irritation occurs, it can increase your risk of contracting an STD. In addition, the sponge isn’t all that effective at preventing pregnancy.
  • The non-hormonal copper IUD is an effective, no-hormone option for contraception. The drawbacks include pain upon insertion; the potential to have heavier, more painful periods; and an increase in inflammation in your uterus, which can lead to chronic inflammation and raise your risk of getting an infection requiring antibiotics. All of which means the copper IUD is not the best birth control option for your long- and short-term health, even if it is an effective and convenient birth control method.
  • Condoms come with lower rates of effectiveness, as they’re easy to misuse, and conventional versions contain chemicals, spermicides, and fragrance that can cause irritation and raise the risk of serious health issues, like HIV or cancer. However, non-toxic condoms get rid of these risks, and are one of the two best birth control methods out there for your long and short term health, but remember they have to be used properly or you risk a potentially high failure rate.
  • A new FDA-approved natural family planning app, called Natural Cycles, is an option with zero side effects — but there are issues with effectiveness at the moment. Some women have ended up with unwanted pregnancies while using the app as their sole form of contraception. Still, given that there are zero side effects or health risks, if you believe you can use this method properly, we consider it one of the two best birth control options for your short- and long-term health.
  • Ultimately, choosing a method of birth control is extremely personal. When deciding, consider not just the effectiveness and ease of a certain kind of birth control, but also the impact on your body and your short- and long-term health. Often things that seem too easy or too good to be true, are just that.
Citations:
1. Zimmerman, Y. Human Reproduction Update 2014; 20(1): 76-105
2. Felix, A. Int J Cancer. 2015 Mar 1; 136(5): E410–E422.
3. Ortiz, ME. Obstet Gynecol Surv. 1996 Dec;51(12 Suppl):S42-51

 

Have you used any of the contraceptive methods listed above? What was your experience? Tell us in the comments below!

 

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    1. Hi Katherine, thanks for reaching out and asking! Nexplanon is similar to an IUD, but is implanted in the upper arm, and typically has a shorter duration of contraception than IUD’s. It is a form of hormonal birth control, and you can refer to the section of the article for the WellBe take on that. Be sure to subscribe to our newsletter!
      XX Adrienne & Team WellBe

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