Dr. J’s completely made-up alphabet of birth control options:
- Jeanette Thomas
- Apr 2, 2024
- 4 min read
Updated: Apr 3, 2024
Back to control of women’s reproductive choices. Since it seems to be everyone’s business. Yes, this is largely cis/hetero biased, since those are the women most likely to need pregnancy prevention.
I made up the list categories below, but not the information. I have no desire to contribute to the medical misinformation on the internet.
Whatever you think about Planned Parenthood, most of the care they provide for women is not abortion related. You can get the same care and education from your regular primary care provider or gyno, many times without a pelvic exam unless there's another need for one. Trusted online information at :
(As much as I want to love the ACOG website, it isn’t as easy to navigate. I just spent 15 minutes looking for a link and didn’t find one I wanted to use. Search ACOG and patient information if you want a more academic deeper dive).
When you are in a relationship where pregnancy is a possibility:
Plan A is to have a plan
Abstinence is a nice concept, but not always a plan.
Hope and prayer after the fact is not a plan.
Plan B is a plan, but not one you want to rely on regularly. It is 80-89% effective at preventing a pregnancy with each use. Kind of like sloppy condom use. Do better.
NOTHING IS RISK FREE.
EVERYTHING HAS POTENTIAL SIDE EFFECTS. MOST OF THESE GET BETTER WITH TIME AND CONSISTENT USE
THESE ARE NOT ONE SIZE FITS ALL
IN GENERAL, THE MORE OFTEN YOU HAVE TO INTERACT WITH YOUR CONTRACEPTION, THE HIGHER THE FAIL RATE.
Plan C—condoms—always a great part of the plan. The only method that also prevents other sexually transmitted conditions like HIV, syphilis, chlamydia and gonorrhea. Less effective on their own. Must use correctly, and use a new one every time. From a psychiatrist friend: "A co-ed sleepover means separate rooms. Or set out a bowl of condoms".
Plan D—diaphragm—bad plan. less effective than condoms for preventing pregnancy, lacking in STD protection. Not only do you have to use it every time, you have to place it ahead of time. And it has to be fitted in a gyno clinic, you can't just go buy one. See bowl of condoms above.
Plan IUD—intrauterine device—great plan. Inserted in the gyno office, there are a couple options with different side effects. More on this later.
Plan M—mini pill, or progesterone only pill—meh, unless you’re breastfeeding or SUPER motivated to take a pill at exactly the same time every single day. If you’re off by an hour you need a backup plan (condoms) for the rest of the pack. Now available over the counter. You’re better off with the other progesterone only methods here unless you want to get pregnant soon. Take with prenatal vitamins.
Plan N—Nexplanon—aka the rod-- great plan. again, inserted in the gyno office with a low pain, quick procedure. good for up to 3 years.
Plan OCP—oral contraceptive or birth control pills—is a great plan for many, but like the ad campaign for Nebraska, not for everyone. for some women, the risks outweigh the benefits, and they should not take them. Must take them at the same time daily. Even if you’re not having sex that day. Yes, I've been asked that.
Plan P—the patch—decent plan. You have to change the patch every week. Same hormones as the birth control pill, therefore mostly the same risks and benefits, with a little more wiggle room for when you have to think about it.
Plan Q—you're in a queer relationship—you likely don’t have to worry about pregnancy unless someone has a penis and another a uterus. STD’s still possible.
Plan R—ring—good plan. It goes in the vagina, like a tampon. If it’s in the right place, you don’t feel it. You change it once a month at home. Same hormones as the birth control pill, mostly the same risks and benefits; again you have to think about it less, so real world use is more effective than the pill.
Plan R2—rhythm method, AKA fertility awareness. Not really a plan. better for timing when you might get pregnant than for preventing pregnancy. See hope and prayer above, along with prenatal vitamins.
Plan S—the shot, aka Depo-Provera—good plan. You have to get a new shot every 3 months, or it stops working.
Plan T—testosterone—you’re transitioning. Or you’re a middle-aged woman with low libido. Or hormone blockers: Gn RH blockers or agonists, like Lupron or others—you're treating endometriosis or fibroids or delaying puberty—horrible idea. Not even a plan. These do not prevent pregnancy.
Likewise, just because you aren’t getting a period regularly doesn’t mean you can’t get pregnant. This applies to all ages, from teenagers to women in their 40’s. Those 2 groups represent the largest number of abortions for unplanned pregnancies. Most often, these people think that they can’t get pregnant with irregular periods.
Plan W—withdrawal—aka pull and pray. Not a plan. See Plan B above, and buy a jumbo box of condoms.
As I said, I made up the ABC’s of naming birth control. If you go to your doctor and ask for plan P they will have NO IDEA what you’re talking about. I bolded my favorites. Use those names.
Think about the options in 3 groups, the first 2 having hormones, all listed in order of how often you have to use/take/change them:
Progesterone only: hormonal IUD (3-8 years), rod (3 years), shot (3 months), mini-pill (daily)
Combination hormones, progesterone and estrogen: Ring (monthly), patch (weekly), pill (daily)
Non hormonal: surgical sterilization (permanent: tying of the tubes or vasectomy), copper IUD (10 years), condoms (every time)
Lots of women use hormonal birth control for reasons that have nothing to do with preventing pregnancy. These can be great tools for irregular or painful periods, even when one partner has had surgical sterilization. More on that to come.
A partner who refuses to consistently wear a condom if asked is not someone worth your time. Period. You are worth more than that.
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