Condoms versus birth control pills: which method should you pick?


The pill and condoms are amongst the most popular reversible forms of birth control worldwide. Still, they represent two very different forms of contraception. One works by affecting the body’s hormones, while the other works by preventing body fluids (like semen) from getting in contact with the genital area in the first place. 

What these two methods have in common is that they rely on perfect use. With perfect use, the effectiveness of these methods is extremely high and pretty much the same (over 98% in the case of the pill and external condoms; around 95% when it comes to internal condoms). But the pregnancy rate with “typical use” (meaning “in the real world use”) is not quite the same for one and another. With the pill, it stands at about 9 percent per year; while with condoms, it’s between 18 and 21 percent annually. This of course means that, from an effectiveness standpoint, the pill is slightly better at preventing pregnancy than condoms.

However, condoms do provide extra protection against most STDs and STIs, what makes it a more effective option if the aim is to protect yourself from sexually transmitted diseases and infections.

The main factor to take into account is which one best meets your needs and lifestyle. Still, keep in mind that, from an overall protection standpoint, the best option is probably to use the birth control pill and a condom whenever you have sex, which further lowers the risk of an unwanted pregnancy while preventing the transmission of most STDs. Especially if you have multiple sex partners.

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Closer look to birth control pills

The birth control pill prevents pregnancy by releasing specific hormones into the body. While the person’s regularly taking the pill, these hormones make it more difficult for sperm to come into contact with an egg, which reduces the risk of an unwanted pregnancy. 

There are two kinds of pills. Unlike the combined type, progestin-only pills might not stop the ovulation completely, but still make the pregnancy a lot less likely by thickening the cervical mucus levels near the cervix, making it difficult for sperm to enter into the uterus and “meet eggs”. 

The pill is really easy to use. If taken at the same time every day, after about a week it is 99 percent effective to prevent pregnancy for as long as it continues to be taken on a regular basis. Plus, it might help with painful and uncomfortable periods, as these tend to get lighter and shorter. Combined pills can even smoothen acne breakouts and improve the skin.

Still, this contraceptive is not free of unwanted side effects. Like other forms of hormonal birth control, the pill can cause mild discomforts such as nausea, headaches, breast tenderness, spotting in between periods and slight fluid retention. It is also linked to a minor increase in the risk of experiencing cardiovascular issues such as stroke and blood clotting. Last but not least, the pill does not prevent STDs. 

Closer look to condoms

Cheap, really accessible in the case of the external type, and easy to use, condoms work by creating a physical barrier between your partner’s genital area and yours. This means that they also —at least to a considerable extent— protect from STDs.

However, disrupting the use of condoms is a lot more common than you might think, and, as a result, the “real life” effectiveness rate of this method is about 85 percent per year. If you happen not to be the one putting the condom on, make sure that your partner uses a proper condom and wears it correctly before you start having sex. 

On the same page, the internal condom (a lubricated polyurethane, or “plastic”, a tube that has a flexible ring at each end; one that is closed and covers the cervix, the other one that slightly covers the labia) offers control for women who don’t want to negotiate with their male partner to put an external condom on. Furthermore, it can be inserted up to 8 hours before sex.

Internal condoms are not as widely available as external condoms, so it may take a little more effort to buy them. External condoms, on the other hand, are undefeated when it comes to cost and accessibility. It is very easy to buy them on short notice at supermarkets and convenience stores, from vending machines and of course online. You can also find them free of charge at public hospitals, health centers, NGOs and even some bars and restaurants!

Condoms come in dozens of varieties: you can try out the ones that glow-in-the-dark, the textured or studded, flavored. Best of all, even the fanciest types are quite affordable. Remember that to stay protected you’ll need to use a condom every time you have sex! 

Many people report a reduced level of pleasure when using a condom. But the good news is this is often due to incorrect condom sizing or type, and can be fixed by switching to a different model or brand. It can take some time and experimentation to find the one that best suits your needs. Still, remember condoms are the only methods that protect against both pregnancy and STIs, including HIV. So don’t give up on them that easily!

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Author Bio:

Michell Mor, eHealth Content Specialist at Women First Digital, an organization helping women about contraception and sexual health.

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