7 Non-Hormonal Birth Control Options For Perimenopause

June 23, 2020.
Hormonal birth control options are not ideal for everyone. Some women may prefer to avoid hormones and their side effects, whereas others may not be able to take them for health conditions or because they are breastfeeding. But if you are sexually active and are not in menopause (i.e., you have not been period-free for 12 months), you are still at risk for getting pregnant. While conceiving is harder as you get closer to menopause, it is still possible to become pregnant in perimenopause. Let’s take a look at some of your non-hormonal birth control options for perimenopause.

1. Male and Female Condoms

Male condoms are one of the most common barrier methods to prevent entering a woman’s body. Condoms must be applied correctly and used every time you have sex to prevent pregnancy. They are also effective at preventing the spread of sexually transmitted infections (STIs) between partners. The CDC offers a thorough guide on how to use a condom that is accessible here.
Female condoms also prevent pregnancy and may prevent STIs, although not as well as male condoms. When used correctly, it prevents pregnancy in 95% of women. However, with regular use (as in how women are really using this method) the female condom pregnancy rate is 21%

2. Diaphragms

This type of barrier method involves a woman placing a small silicone cup over the cervix each time before intercourse. For the diaphragm to be effective, spermicide must be applied to the diaphragm and its edges to be most effective. Women must be fitted by a medical provider for a diaphragm before use but can use the same diaphragm for up to two years. Diaphragms do not protect against STIs and are ineffective during your period. They must be left inside you for at least 6 hours after intercourse. With perfect use, diaphragms have a pregnancy rate of 6% (that is, 6 women out of 100 who use it correctly will still get pregnant). However, the real pregnancy rate with diaphragms is 12% in the U.S.
There is also a cervical cap, which is smaller than a diaphragm and does not contain hormones. Known by the brand name FemCap, a health care provider must prescribe cervicals caps. These devices have similar requirements for use as diaphragms. However, the cervical cap pregnancy rate is between 17-23%.

3. ParaGuard

Known by its brand name, this hormone-free intrauterine device (IUD) has a pregnancy rate of 0.8%. For women who do not want to worry about using or applying a birth control method before sex, ParaGuard can be quite effective. This IUD is made of copper, lasts up to 10 years, and works by preventing sperm from entering through your cervix. A doctor must place an IUD, and it can be removed any time should you wish to get pregnant. Side effects of ParaGuard include mild cramping, spotting between periods, and heavy periods.

4. Spermicide

Before intercourse, women place spermicide in their vagina, which works to immobilize sperm so they cannot pass through the cervix. Spermicides in the U.S. contain the chemical nonoxynol-9 and comes in different forms, including jelly, foam, cream, tablet, suppository, or film. With correct use, 28% of women can get pregnant using this hormone-free birth control

5. The Sponge

This non-hormonal birth control method is a plastic sponge covered in spermicide placed in front of the cervix. It can be purchased from drug stores and is a one-time use product. The pregnancy failure rate of the sponge is 12-24%, and the likelihood of failure is increased in women who have had a baby.

6. Withdrawal Method

Presenting the oldest form of birth control, the withdrawal method, or coitus interruptus, is when the penis exits the vagina just before ejaculation to prevent sperm from entering the uterus. While this method is free, it does not prevent STIs and carries at least a 20% pregnancy failure rate.

7. Sterilization

For men and women who do not wish to have children, or who are done having children, sterilization is an effective, permanent, and hormone-free birth control option. Indeed, these procedures can be challenging to reverse. The male sterilization procedure is called a vasectomy, and female sterilization is called a tubal ligation.
If you are looking for reliable birth control for perimenopause, meet with your doctor to discuss the best options for you and your partner. You can ask questions ranging from the benefits of non-hormonal birth control in perimenopause to using a hormonal birth control patch for perimenopause pregnancy prevention. Whereas non-hormonal options include barrier methods, spermicides, sterilization, and ParaGuard, hormonal options include implants, patches, pills, IUDs, and vaginal rings.

What are your experiences with birth control in perimenopause?

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Disclaimer: This is not medical advice, does not take the place of medical advice from your physician, and is not intended to treat or cure any disease. Patients should see a qualified medical provider for assessment and treatment.

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Julia Walker
perry expert Julia (RN, BSN, BA) is a registered nurse based in Colorado. Julia's nursing background in women’s health has ranged from neonatal and postpartum care to labor and delivery, to outpatient gynecological medicine for both adolescent and adult populations. She specializes in helping women optimize their health during perimenopause and beyond.

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