Should I Combine Birth Control Methods?

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While some people only think of pills when they hear the phrase “birth control,” there are many options for birth control. Choosing a birth control method is a very personal decision. There are multiple factors that can influence your birth control choice. Remember: there is no one “best method”, just the method that makes sense for you and your needs at this point in your life. You may even decide that a combination of methods is what works best for you.  

How to Choose a Birth Control Method 

When choosing a birth control method, you should always seek advice from your OB/GYN. They can help you weigh your options and make recommendations based on your health and fertility goals. When you are choosing a method, here are some questions to consider: 

  • What about a method is most important for you? 
  • How effective do you need your method to be? 
  • How much does the cost of a method matter? Would you rather pay for the method up front or build it into your monthly budget? 
  • How important is the privacy of your method? 
  • Do you need protection against sexually transmitted infections (STIs)? 
  • How much effort do you want to put into preventing pregnancy? 
  • Does it matter if your period is affected? 
  • What are your fertility goals in the next year? Next five years? 
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What Types of Birth Control are available? 

There are several categories of birth control that are available. Combining birth control usually involves choosing from two or more of the following categories. 

Hormonal 

Hormonal methods can include pills, patches, vaginal rings, shots, or devices like IUDs or implants. They work by making changes to your body that help keep your eggs from being fertilized. Most hormonal methods are over 90% effective at protecting you from pregnancy – some can even be more effective than sterilization surgeries! These methods can often be started immediately, but your doctor may recommend that you use a back-up method while you wait for the hormones to take effect. 

Intrauterine Devices (IUDs) 

IUDs are small, T-shaped devices with either hormones or copper that your doctor can place in the uterus to help prevent pregnancies. The procedure is typically quick and done in the office within 10 minutes, but many patients do find it to be uncomfortable. Once in the right place, IUDs are effective at preventing pregnancies for several years, depending on the type that you pick. Each one can have different side effects, so be sure to ask your doctor about which one is right for you. 

Barrier 

Barrier birth control methods include condoms, diaphragms, and any other device which physically blocks sperm from reaching eggs. Many barrier methods, like condoms, also protect you from STIs. 

Behavior 

Behavioral methods are the least effective in preventing pregnancy, with failure rates of 20 to 30%. Patients who choose these methods often prefer a birth control method that is hormone- or device-free. It is important to keep in mind that these methods may have a learning-curve and require increased attention by you and your partners. Common options include the rhythm or calendar method, basal body temperature monitoring, Billings’ ovulation method, and the withdrawal or “pull out” method.  

Permanent Contraception 

If reversible birth control doesn’t seem like the option for you, there are several permanent contraceptive methods available. Vasectomies and removal of all or part of the fallopian tubes are the most common permanent methods available. When considering if surgical contraception is right for you, it is important to keep in mind that these procedures are not easily reversible and should be considered permanent. Be sure to talk to your OB/GYN if permanent sterilization is a method you have been considering for you or your partner. 

Emergency Contraception (EC) 

There are several options for emergency contraception (EC) that you can use in the you’re your primary method fails or you just forgot to use a method. These may be available with or without a prescription. However, keep in mind that emergency contraception also has a failure rate. Brands of EC pills that are available over-the-counter and can be effective for up to 3 days after unprotected sex include My Way, Plan B One-Step, Preventeza, and Take Action. Additionally, ella and ellaOne are another type of EC pills, but are only available with a prescription. Finally, if you had been considering a copper IUD, this type of IUD can also work as an effective emergency contraceptive for up to 5 days after unprotected sex. 

While taking multiple birth control pills at once can also work as emergency contraception, it can be less effective and come with serious side effects. Be sure to ask your doctor for advice regarding dosages before trying this method.  

Combining Birth Control Methods 

Combining your preferred birth control methods typically means choosing one method from two of the above categories.  

For example, many patients will decide to combine a hormonal birth control method with a barrier method, such as an IUD and condoms. This allows you to protect yourself against pregnancy even if one of your methods fails. Alternatively, you may choose to pair a behavioral method, like fertility awareness, with a barrier or hormonal method.  

It’s important to remember that if you have multiple sexual partners, hormonal methods do not protect you against STIs. Making sure to add a barrier method, like male or female condoms, to your favorite hormonal or permanent contraceptive method is a great way to reduce your risk of STIs. 

Finally, ask your doctor before you choose to combine two methods that involve a medical device or hormones, such as an IUD paired with emergency contraception. Often, pairing two hormonal options won’t increase the effectiveness of either, and may result in unwanted side effects. Ultimately, you should always discuss your birth control plan with your OB/GYN to make sure your pregnancy prevention plan is best suited to meet your health and fertility goals.  

Schedule an Appointment 

To schedule an appointment with Carnegie Women’s Health, call our New York office at (315) 628-7063 or request an appointment online.  

Carnegie Women's Health

Carnegie Women's Health

At Carnegie Women’s Health, we’re more than just a gynecological practice. We’re partnered with some of the most experienced and award-winning obstetricians and maternal fetal medicine specialists in the field of women’s health.

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