Let’s Talk About
Birth Control

There’s no TMI here, just 20,759 people describing their experiences with contraception.

Shortly after Donald Trump was elected president I started noticing an interesting trend on my social media newsfeeds. And no, I’m not talking about the near-constant bickering of people with differing political opinions.

I started seeing post after post from friends publicly asking one another about their experiences with different forms of birth control. The motivation for these kinds of conversations centered around the pending rollback of copay-free contraception, but have since been re-kindled every time reproductive rights come up in the political arena.

And it’s not just talk. Many of these conversations centered around the use of long-term contraceptives like intra-uterine devices or IUDs which can protect against pregnancy for 3 - 12 years. In the months immediately following the 2016 election, AthenaHealth reported a 19% increase in IUD-related doctor’s visits and Planned Parenthood reported a 900% increase in patients seeking IUDs. Cait, 27, recently switched to a copper IUD, and said that she made the switch due to convenience and “because now in light of our current administration I’d like to have something that will continue to work and be affordable even if I end up without health insurance.”

What people seem to be looking for in discussing their options with friends and peers is some insight into what different methods are like to actually use. And since every body is different, the more insight you can get, the better. Luckily for us, the CDC has been asking people some of those questions for years. Between 2006 and 2015, they surveyed over 20,000 contraceptive users. We analyzed the data to learn more about their experiences and asked a few birth control users their stories as well.

An Important Note: The National Survey of Family Growth (where we obtained the data for this story) issues two surveys to “household members” in the US: a “Female Questionnaire” and a “Male Questionnaire”. The survey does include questions regarding sexual orientation and attraction, but does not include any questions regarding gender identity. So although contraception is utilized by a wide variety of people, this article focuses on the questions asked to anyone that self-identified as “female” (out of a binary option) and thus filled out the “Female Questionnaire”. More information on the NSFG survey and our analysis are available in the methods section.

Condoms and The Pill are Go-To’s

For many people, finding a contraceptive method that fit their body and lifestyle took a few tries. Devon, 27, has tried 6 different methods and is still looking for a good fit. The average respondent has tried between 3 and 4 different methods in their lifetime. Since the survey did not ask respondents if they have switched between different types of the same method (e.g., different brands of birth control pills or between the copper and hormonal IUDs), this average may be an underestimate. Still, some methods are more common to try than others. By far the most common methods are condoms and The Pill.

Types of Birth Control Used (Ever)

Based on Survey Results

It feels like the first time...

Part of the reason that so many people have used condoms at some point, could have to do with their first experiences with contraception. Condoms are, and have been, the reigning champs of contraception for new-users. Although, they have begun to drop in popularity for first-timers in favor of prescription options such as The Pill and injectable Depo-Provera.

First-Ever Contraceptive Use

Percentage of respondents
by decade of first use

For some people, contraceptive use started before their first sexual experience. Some forms of hormonal birth control can be used to treat a wide variety of other symptoms like irregular menstrual cycles, acne, cramps, or endometriosis. Nicole, 30, remarked that she began taking birth control pills at 16 years old to help regulate “really bad” mood swings. She remained on the pill for several years before she actually needed contraception.

Different Age, Different Method

As our lifestyles change, so too do our contraceptive choices. Easily accessible condoms are used most often by younger users, whereas surgical options (such as tubal ligation or vasectomy) are more common in older users. And although IUDs have been deemed safe for teens and people with a uterus that haven’t given birth, between 33% and 57% of members of the American College of Obstetricians and Gynecologists do not provide IUDs for these patients.

Amy, 44, was a birth control pill user until she had children. She said, “After that, my hormones changed drastically. While trying to find a pill I could safely use while breastfeeding, I ended up on a pill that caused post-partum depression.” She has since switched to an IUD and calls the experience “liberating”.

Contraceptive Use by Age

Based on methods currently in use by respondents

Double Bag It

Ok, not literally, but 23% of people have used more than one type of contraception simultaneously, at least once. Typically, they pair up two forms of contraception with differing levels of effectiveness, which, according to Planned Parenthood, can make having vaginal sex a lot safer. Using condoms in combination with non-barrier forms of birth control comes with the added protection from sexually transmitted infections.

The Most Common Contraceptive Combinations

Based on user’s monthly contraceptive use Over four years

Method Effectiveness

72 - 87%

88 - 98%

>99%

Side Effects are a Deal Breaker

In an effort to find a good contraceptive fit, patients often stopped using their old method in favor of a new one. When asked why they were dissatisfied enough to leave a particular method behind, side effects were the most common reasons to call it quits.

Reasons for Discontinuing Specific Contraceptive Use

Percentage of Users that cited a reason for stopping their contraceptive use

Side effects are not uncommon in the world of contraception. They were even the primary reason for halting research on an experimental method of birth control for people with external reproductive systems (may include testes and/or penis) in 2016.

For some users, such as Kait, 22, living with side effects may be better than having no birth control options at all. After having serious side effects from her hormonal implant, she switched to a non-hormonal copper IUD, and now says that she would only consider having it removed if “[the cramps] are completely debilitating, like can’t go to work, can’t move, vomiting all the time...”. But even then, the idea of having it removed and having no other highly effective options is worrying to her. And for Elle, 26, the benefits of her IUD were good enough that after the first perforated part of her uterus, she still decided to get a second one to replace it.

Unfortunately for nearly 6,000 (28%) of the survey respondents, side effects were enough to completely stop using a method. Weight gain, pain, and bleeding problems were common reasons to call it quits.

Side Effects that Resulted in Discontinuation of a Specific Contraceptive

Percentage of Users that cited a reason for stopping their contraceptive use

So What Do You Do?

At the end of the day, contraception is complicated. What works for your best friend may not be the best choice for you. And although we hope that expanding your sample size from the size of your friend-group to over 20,000 people has helped to give you more information, we aren’t doctors. So, whether you are interested in switching up your birth control methods due to the political climate, your own side effects, or because you’re just tired of taking the pill every day, talk to your doctor. And then keep on talking about your experiences.

Methods: All data was acquired from the CDC’s National Survey of Family Growth. I combined the results of the 2006-2010, 2011-2013, and 2013-2015 versions of the Female Questionnaire. Each of these surveys was administered “continuously”, or weekly over the course of several years instead of all at once. All survey-takers were “household residents” (i.e., not living in an institution such as prison, homes for juvenile delinquents, homes for the intellectually disabled, long-term psychiatric hospitals, and those living on military bases) living in the 50 United States or District of Columbia of reproductive age (15-44 years). The study design was intended to provide nationally representative sample that oversamples for non-Hispanic black people, Hispanic people, and teens aged 15-19. Any respondent that had never used any form of contraception was excluded from this analysis. More information about the CDC’s surveying methods is available here.

You can download the data as well as all R scripts used to process the data from here.

In this project, the phrase “internal reproductive system” refers to a system which may include uterus, ovaries, and/or a vagina and the phrase “external reproductive system” refers to a system which may include testes and/or a penis.

Many thanks are owed to Rachel Jones of the Guttmacher Institute for extensive feedback on our analyses and presentation of the data. For more analysis on these data, check out The Guttmacher Institute’s peer-reviewed publications.

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