Birth Control Options For Women Who Cannot Or Prefer Not To Take Hormones
Some women cannot use hormones because of health reasons, breastfeeding, side effects or a host of other reasons. Some women prefer to avoid hormones in general. Still, other women may only need occasional pregnancy protection and prefer not to use a full-time birth control method. There are many other birth control options that do not contain hormones, that are effective is used correctly, and that are affordable.
Barrier methods, such as the condom, sponge, cervical cap, or diaphragm, spermicide, the copper IUD, and natural family planning are all hormone-free methods of birth control. However, it is important that women review the effectiveness rates of these birth control methods and discuss with their healthcare provider which might be best for their personal situation. In general, spermicide should always be used with a condom or diaphragm to increase its effectiveness.
A male latex condom is the best way to protect against any form of sexually transmitted disease (STD), including HIV and AIDS. A male latex condom or female condom should be used in combination with any other birth control option (pill, patch, shot) if protection against STDs is needed.
- can be used intermittently if the need for birth control is only occasional
- for women who cannot use hormones for medical, breastfeeding, or other reasons, barrier methods, such as the cervical cap, condom, diaphragm, contraceptive sponge, spermicide, copper IUD are all hormone-free methods
- many methods are inexpensive, but may not be covered by insurance because they are over-the-counter (OTC)
- some methods are easily accessible without a prescription at retail stores, and are easily transportable
- except for the copper IUD, these methods require diligent and consistent use to prevent pregnancy
- except for the copper IUD, these methods may be associated higher failure rates when compared to birth control pills or other hormonal birth control options
- some methods cannot be used during menstruation
- some women may not like placing or leaving devices in the vaginal canal
- some methods may interfere with sexual spontaneity
Common Side Effects
- Non-hormonal barrier method birth control has few side effects, although there may be some side effects with the copper IUD
- some women or men may have irritation, dryness, or allergies associated with devices placed in vaginal canal, such as the condom, cervical cap, diaphragm, contraceptive sponge or spermicides. If side effects occur with use, contact your healthcare provider.
Serious Side Effects
- serious side effects are rare with the Non-hormonal barrier method of birth control
- serious side effects with the copper IUD may include: pelvic inflammatory disease (PID), uterine perforation, ectopic pregnancy, and IUD expulsion. Discuss these side effects with your healthcare provider.
Other warnings and side effects may occur with the use of birth control. It is important to review the specific consumer information for the birth control of choice and discuss any questions or concerns with your healthcare provider. Tell your healthcare provider about all other medications you take, including prescription, over-the-counter, vitamin and herbal supplements.
Despite the fact that today the number of effective hormonal contraceptives is large, many women prefer non hormonal birth control methods.
Everyone can use nonhormonal birth control
Although many birth control methods do contain hormones, other options are available.
Nonhormonal methods can be appealing because they are less likely to carry side effects than hormonal options. You may also want to explore nonhormonal forms of birth control if you:
- don’t have frequent intercourse or don’t need ongoing birth control
- don’t want to change your body’s natural cycle for religious or other reasons
- have had changes in your health insurance, making hormonal methods no longer covered
- want a backup method in addition to hormonal birth control
Keep reading to learn more about each method, including how it works, how effective it is at preventing pregnancy, and where to get it.
An intrauterine device (IUD) is a T-shaped device that’s placed into the uterus by your doctor. There are two types of IUDs available — hormonal and nonhormonal — and each prevents pregnancy in a different way.
The nonhormonal option contains copper and goes by the name ParaGard. The copper releases into the uterus and makes the environment toxic to sperm.
Copper IUDs are over 99 percent effective at preventing pregnancy. Although the IUD can protect against pregnancy for up to 10 years, it can also be removed at any time, giving you a fast return to your normal fertility.
Many insurance carriers cover the cost of the IUD and insertion. So does Medicaid. Otherwise, this form of birth control may cost you up to $932. Patient assistance programs are available, so talk to your doctor about your options.
Common side effects include heavy bleeding and cramps. These typically decrease over time.
Sometimes, IUDs may become expelled from the uterus and need to be replaced. This is more likely to happen if:
- you haven’t given birth before
- you’re younger than 20 years
- you had the IUD placed too soon after childbirth.
Barrier birth control methods physically prevent the sperm from reaching the egg. Although condoms are the most common option, other methods are available, including:
- cervical caps
You can typically purchase barrier methods over-the-counter at your local drugstore or online. Some may also be covered by your health insurance, so talk with your doctor.
Due to the chance of human error, barrier methods aren’t always as effective as some other birth control methods. Still, they are convenient and worth exploring if you don’t want to use hormones.
Condoms are the only birth control method that protects against sexually transmitted infections (STIs). They also happen to be one of the most popular and widely available methods. You can find condoms easily, and they don’t require a prescription. They can cost as little as $1 each, or you may be able to get them for free at your local clinic.
Male condoms roll onto the penis and keep sperm inside the condom during sex. They come in a wide variety of options, including nonlatex or latex, and spermicide or nonspermicide. They also come in an array of colors, textures, and flavors.
When used perfectly, male condoms are up to 98 percent effective at preventing pregnancy. “Perfect use” assumes that the condom is put on before any skin-to-skin contact and that it doesn’t break or slip off during intercourse. With typical use, male condoms are about 82 percent effective.
Female condoms fit into the vagina and prevent sperm from reaching your cervix or uterus. They’re mostly made from polyurethane or nitrile, which is great if you have an allergy to latex. However, they’re slightly more expensive and can cost up to $5 each.
As far as effectiveness goes for female condoms, perfect use is around 95 percent and typical use dips down to 79 percent.
Spermicide is a chemical that kills sperm. It usually comes as a cream, foam, or gel.
Some popular brands include:
- Encare Vaginal Contraceptive Inserts
- Gynol II Contraceptive Gel
- Conceptrol Contraceptive Gel
When used alone, spermicide fails around 28 percent of the time. That’s why it’s a good idea to use it along with condoms, sponges, and other barrier methods.
On average, using spermicide can cost up to $1.50 each time you have intercourse.
You may not experience any side effects with spermicide, but some people get skin irritation. All spermicides sold in the United States contain what is called nonoxynol-9. Nonoxynol-9 may cause changes in the skin in and around your genitals, making you more likely to contract HIV.
Talk with your doctor if you experience redness, itching, or burning or have concerns about HIV.
The contraceptive sponge is made from plastic foam. It’s inserted into the vagina before sexual intercourse, acting as a barrier between sperm and your cervix. This single-use method is meant to be used with spermicide, which kills sperm.
You can leave a sponge in for up to 24 hours and have sexual intercourse as many times as you want during this time period. The important thing to remember is that you need to wait at least six hours after the last time you had sexual intercourse before you take it out. You shouldn’t leave a sponge in for any longer than 30 hours total.
With perfect use, the sponge is 80 to 91 percent effective. With typical use, that number drops a bit 76 to 88 percent.
Sponges cost anywhere from $0 to $15 for three sponges, depending on whether or not you can find them for free at a local clinic.
You shouldn’t use the sponge if you’re allergic to sulfa drugs, polyurethane, or spermicide.
A cervical cap is a reusable silicone plug that can be inserted into the vagina up to six hours before intercourse. This prescription-only barrier method blocks the sperm from entering the uterus. The cap, which goes by the name FemCap in the United States, can be left in your body for up to 48 hours.
There’s a wide range in efficacy, with a failure rate between 14 and 29 percent. As with all barrier methods, the cap is more effective when used with spermicide. You’ll also want to check the cap for any holes or weak points before using it. One way you can do this is by filling it with water. Overall, this option is more effective for women who haven’t given birth before.
Caps can cost up to $289. Payment is split between the actual cap and getting fit for the correct size.
A diaphragm is shaped like a shallow dome, and it’s made of silicone. This reusable barrier method is also inserted into the vagina before intercourse. Once in place, it works by keeping the sperm from entering the uterus. You’ll need to wait at least six hours to take it out after the last time you have sex, and you shouldn’t leave it in for more than 24 hours overall.
With perfect use, a diaphragm is 94 percent effective at preventing pregnancy. With typical use, it’s 88 percent effective. You’ll want to fill the diaphragm with spermicide for the most protection against pregnancy. You’ll also want to inspect the silicone for any holes or tears before inserting it into your body.
The two brands of this device on the market in the United States are called Caya and Milex. Depending on whether your insurance covers it, a diaphragm may cost up to $90.
Natural family planning
If you’re in tune with your body and don’t mind spending some time tracking your cycles, natural family planning (NFP) may be a good option for you. This option is also referred to as the fertility awareness method or rhythm method.
A woman can only get pregnant when she’s ovulating. To practice NFP, you identify and track your fertile signs so that you can avoid having sex during ovulation. Most women find that their cycles are between 26 and 32 days long, with ovulation somewhere in the middle.
Timing intercourse away from ovulation can help prevent pregnancy. Many women experience a lot of cervical mucus in the most fertile time of their cycles, so you may want to avoid intercourse on the days when you see lots of cervical mucus. Many women also experience a spike in temperature around ovulation. You must use a special thermometer to track, and best results are obtained often from the vagina, not the mouth.
With perfect tracking, this method can be up to 99 percent effective. With typical tracking, it’s closer to 76 to 88 percent effective. Using an app to help you track your cycles, like Fertility Friend or Kindara, may be beneficial.
Current non hormonal birth control methods include:
- natural methods
- intrauterine devices
- surgical sterilization
- barrier and spermicidal
Natural methods of contraception are methods of birth control without the use of hormonal pills, surgery, spermicides, condoms, cervical caps. These methods are based on the physiological characteristics of the fertile and infertile phases of the menstrual cycle. These include the method of interrupted sexual intercourse, periodic abstinence and lactational amenorrhea method.
The main drawback of these non hormonal birth control methods is the fact that they are effective only in regular menstrual cycle. Uncertainty about the effectiveness of these methods makes couples worry each time, when waiting for the onset of the cycle.
When used properly, the efficacy of this contraception method varies between 75-90%.
Intrauterine device (IUD) is one of the most effective, simple and easy to use non hormonal birth control methods.
IUD is recommended for women, who are sensitive to hormonal birth control or are unwilling to take any additional contraceptive measures every time after a sexual intercourse.
The global pharmaceutical market offers a large IUD number of many shapes and sizes. The American women have the opportunity to buy a copper IUD under the trade name ParaGard.
Despite the fact that the IUD has a high efficiency (about 98%), this type of non hormonal birth control should not be used in infections, sexually transmitted diseases. Typically, IUD is well tolerated by patients, but such side effects, as heavy menstruation, and abdominal pain may manifest in some women.
The most reliable non hormonal birth control method is surgical sterilization.
Female sterilization is a surgical procedure, during which the litigation or intersection is made on the lumen of the fallopian tubes. Male sterilization lies in the blockade of vas deferens.
Sterilization does not result in hormonal or physical changes. However, the great disadvantage of this non hormonal birth control method is its irreversible fertility loss.
In addition, sterilization of women implies a risk of complications, associated with surgery and anesthesia, while in men the risk of prostate cancer may increase.
This method of contraception is permanent, so before deciding to take this step, both men and women should assess its benefits and potential risks.
The barrier method of contraception is one of the most popular among men and women of all ages. Its principle of action is to block the penetration of sperm into the uterus. Concurrent use of barrier method with spermicides contributes to the best possible barrier method protection. This non hormonal birth control method includes male and female condoms, diaphragms/ cervical caps and spermicidal foam, sponges, and film. Spermicides are substances that destroy the sperm, thus enhancing the effectiveness of the barrier method of contraception.
Experts recommend the joint use diaphragms/ cervical caps with spermicides for reaching the highest efficiency in pregnancy prevention. The main disadvantage of the diaphragm and the cervical caps is that they might cause urinary tract infections and inflammatory processes in the places of their contact with the vaginal walls.
The condom is the only barrier contraceptive, which is used by men. Its advantage is that it protects against sexual infections and HIV and is easy to use. According to statistics, the effectiveness of the male condom is 15 pregnancies per 100 women. Unlike other non hormonal birth control methods, the barrier method is used immediately before the sexual intercourse.
Age, presence of labor, regularity of sexual life and peculiarities of the female and male organisms should be taken into account, when choosing a non hormonal birth control method.
Non-hormonal Birth Control Options
|Generic Name||Brand Name||Description|
|Cervical Cap||FemCap||Barrier method; flexible cap placed over cervix; must be fitted and prescribed by a health care provider; used with spermicide; cap must stay in place 6 hours after intercourse, but do not leave in vagina for more than 48 hours; do not use during menstrual period due to higher risk for toxic shock syndrome; may cause vaginal irritation; cost $60-$80 per cap; 15-30% failure rate; does not protect against STDs|
|Condom (male)||Available without a prescription at retail stores and pharmacies||Barrier method; prevents sperm from entering the uterus; made of latex; protects against STDs if used correctly; 15-20% failure rate; to increase effectiveness rate use with spermicide; may cause irritation; inexpensive; not covered by insurance (OTC); do not use with female condom due to chance for condom tearing|
|Condom (female)||Available without a prescription at retail stores and pharmacies||Barrier method; thin lining that goes into vagina to protect uterus from sperm; can place up to 8 hours prior to sex; can protect against STDs if used correctly; made of polyurethane and synthetic latex; 20% failure rate; may cause irritation, burning, rash; do not use with a male condom due to chance for condom tearing|
|Diaphragm||KoroFlex, Ortho-Diaphragm||Barrier method; silicone cup placed over cervix prior to sex; must be fitted and prescribed by a health care provider; used with spermicide; must remain in place 6 hours after intercourse; use additional spermicide if have intercourse again or more than 6 hours after diaphragm originally inserted; do not leave the diaphragm in place for more than 24 hours; costs $15-$75, can last up to 2 years; 6-12% failure rate; may cause vaginal irritation; does not protect against STDs|
|Contraceptive Sponge||Today Sponge||Barrier/spermicide method; do not use if sulfite allergy; foam-like vaginal insert embedded with spermicide (nonoxynol-9); wet with small amount of water prior to use; may insert up until 24 hours before sex; sponge must remain in place for at least 6 hours after last intercourse; do not leave in place longer than 30 hours; $15-$20 for package of 3 sponges; 9-16% failure rate (may be higher if previous pregnancy); do not use during menstrual period due to higher risk for toxic shock syndrome; may cause irritation; does not protect against STDs|
|Spermicide||Examples: Encare Vaginal Inserts, Gynol II, Conceptrol; available without a prescription at retail stores/ pharmacies; most spermicides containnonoxynol-9||Spermicidal creams, jellies, foams, films, vaginal suppositories contain nonoxynol-9, a chemical that kills sperm. Sperm cell membrane ruptures, and sperm is unable to fertilize the egg. Spermicides are inserted into the vagina shortly before intercourse; may cause irritation; to increase effectiveness should always use with a condom or diaphragm; cost $5-$20 for multi-pack; failure rate 15-30%; may be irritating; not covered by insurance (OTC); does not protect against STDs|
|Intrauterine Device (copper)||Paragard; must be prescribed and inserted by a health care provider;||Non-hormonal IUD; inserted by healthcare provider within 7 days of menses onset; replace after 10 years; common side effects include longer and heavier periods or spotting; these may subside after 2 to 3 months; serious side effects may include pelvic inflammatory disease (PID), uterine perforation, and IUD expulsion. If a period is missed, promptly be evaluated for pregnancy; do not use in pregnancy, PID, postpregnancy or postabortion uterine infection in the past 3 months; cancer of the uterus or cervix; infection in the cervix; Wilson’s disease; <1% failure rate; does not protect against STDs|
|Natural Family Planning||not applicable||Must avoid sex when fertile/ovulating; must monitor bodily changes such as cervical mucous changes, body temperature; high rate of failure, 20% failure rate; involves no hormones or devices; inexpensive; does not protect against STDs|
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