When it comes to birth control, things can get pretty complicated. With so many different forms and methods out there, how’s a girl to know exactly what each one does and how it works—or doesn’t work? Here are some common birth control mistakes that you might be making.
1. You're skipping it entirely
There are a variety of reasons why some women choose not to use birth control during sex. Dr. Traci Brooks, the Medical Director at Cambridge Pediatrics, says that one reason is that some people are worried they could contract cancer if they do use it. However, she says that that isn't true and that some forms of it can actually prevent women from getting certain forms of cancer.
"Many people also worry that birth control causes cancer," Dr. Brooks says. "In fact, some forms of birth control actually protect you against certain types of cancer, like the pill protecting against ovarian or endometrial."
Birth control does more than just stop you from getting pregnant. It can protect you from different STIs and STDs, as well as other illnesses (like cancer) that aren't sexually transmitted.
2. You’re using the wrong lube
Lubricants are an important part of safe sex, and they can help prevent pain and condom tearing during sex. However, certain types of lube can actually be counterproductive to birth control. Petroleum- or oil-based lubricants aren’t recommended, since they can cause break latex condoms down and get microscopic holes, increasing the risk of infection. Pharmacist Sally Rafie, the Medication Safety Specialist at University of California, San Diego Health System, says water-based lubricants are best to use with condoms.
“Water-based lubricants are a lot safer to use with condoms. Dr. Rafie says. “The latex and synthetic materials used in most condoms stays strong with water-based lubricants.”
A 2011 study led by Dr. Debra Herbenick found that women who used lubricants that were water- or silicone-based were found to be less likely to suffer from uncomfortable or painful “genital symptoms” (and enjoyed sex more!).
Dr. Rafie says that for couples who aren’t trying to avoid pregnancy, it’s safe to use oil- or silicone- based lubricants, but that silicone-based sex toys may not work with silicone-based lube.
3. You think you don’t need it because you identify as LGBTQ+
Many women who identify as LGBTQ+ might feel like they don’t need to use contraceptives if it’s other women they’re sleeping with. While sex between two women can’t normally cause pregnancy, the CDC notes that women who have sex with other women are not any less likely to contract sexually-transmitted infections than women who have sex with men just because of their sexual orientation. Safer sex options for women who have sex with other women include dental dams and female condoms.
4. You’re relying on the pull out method
By now, it’s commonly accepted that using condoms is a way to have safer sex. According to a study from the New England Journal of Medicine, they can decrease the risk of contracting HPV and other sexually transmitted infections, along with pregnancy. Other forms of birth control like patches, pills or IUDs are also effective at the same things. Unprotected sex increases the risk of any of those things occurring by a very large amount, and although Family Fertility Plan states that the “pull out” method is used by 35 million couples worldwide, it’s not largely reliable. Sometimes it can work, but not always.
“Withdrawal is not completely ineffective,” Dr. Rafie says. “Some couples use it to effectively prevent unplanned pregnancy. But the failure rate is high. There can be sperm in the fluids prior to ejaculation.”
While different forms of birth control are more likely to prevent pregnancy or infection, it's also a matter of choice.
"Some couples are highly motivated to avoid an unplanned pregnancy, whereas others are open to the idea of a surprise pregnancy," Dr. Rafie said. "It's up to each woman to decide what works best for their needs at the time."
5. You’re listening to myths, not talking to your doctor
Dr. Jared Heathman, a Texas physician, says that a lack of sexual education leads to young people believing rumors they hear about sex and contraception, which can often be harmful. Even past grade school, people still pass around false information about sex and misinformation about what’s safe and what isn’t is a huge problem.
“In medical school, I was once asked by an almost adult female if opening a coke bottle into the vagina would truly help kill all of the sperm,” Dr. Heathman says. “Thankfully, she was critical of the information and had an open conversation with a professional prior to testing the hypothesis.”
He adds that talking to your doctor is really important because different forms of birth control work better for different women (but make sure to skip the DIY method he mentions above!).
6. You’re using spermicides exclusively
Spermicides are a form of birth control where a diaphragm is used to insert sperm-stopping chemicals into the vagina.
Dr. Rafie says that using spermicides in combination with other forms of birth control can increase effectiveness because they act as physical barriers between the sperm and the cervix.
“Spermicide doesn’t work very well on its own, but using a lubricant with spermicide can really boost the effectiveness of barrier methods,” Dr. Rafie said.
A study published in the New England Journal of Medicine, led by Dr. Lut Van Damme found that using cellulose sulfate gel, a form of spermicide, didn’t decrease women’s chances of catching HIV. The researchers concluded that it might actually increase the risk of catching the virus, though they didn’t state it definitively. Another study, led by Dr. Thomas M. Hooten found that women using a diaphragm with spermicides were more likely to contract urinary tract infections.
Like Dr. Rafie, both studies note that when used in combination with another form of birth control, like condoms or pills, spermicides are more effective at preventing both infection and pregnancy.
7. You're scared of the effects of long-active, reversible contraception
Birth control methods like hormonal implants, which are tiny rods inserted into your arm, or IUDs, which are T-shaped contraceptives that doctors place inside of your uterus, can sound pretty scary. However, Dr. Brooks says that hormonal implants or IUDs are among the most effective forms of birth control. She says that one of the reasons they're so reliable is that unlike condoms or birth control pills, you don't need to remember to use these methods each time you have sex.
"After [abstinence and sterilization] it would be the IUD or the hormonal implant (Implanon or Nexplanon)," Dr. Brooks says. "The most effective methods are the ones least dependent on needing to remember to use them."
Once they're implanted, most hormonal implants are good for up to three years, and IUDs last for three to six years.
8. You’re taking the pill irregularly
A lot of women miss their birth control pills on certain days or end up taking them at different times every day. Dr. Rafie says that can make them less effective or even create a hormone imbalance in the body.
“Missing two pills or more can lead to reduced effectiveness—and that’s a good time to consider taking emergency contraception (aka “the morning after pill”),” Dr. Rafie says. It’s important to take the pill at the same time every day to keep the hormone levels in the body consistent.”
She adds that there’s nothing wrong with missing just one pill and taking it ASAP. If it's more frequent than that, though, the pill could be less likely to stop a pregnancy, so make sure to stay on top of when and at what time you're taking your pills.
It’s extremely important to make sure the form of birth control you’re using is right for you. “There are many types of birth control, and some are more suited for some people than others,” Dr. Heathman says. “Discuss the available options with your physician.” The future of birth control is changing right now with things like a male-birth control pill possibly on the way. Have fun and be safe, collegiettes!