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Contraception

Women today have a wide variety of options for preventing pregnancy. Each method is different in terms of the way it’s used, its effectiveness, its side effects, and its costs.

Your choice of birth control should depend on factors such as a your health, frequency of sexual activity, number of partners, protection from sexually transmitted infections and desire to have children in the future. We can help you decide what form of birth control is best for you.

Advantages and disadvantages of each type of birth control

The pill and other hormonal methods. There are a variety of hormonal birth control methods, all of which suppress ovulation (the monthly release of an egg from the ovaries). Hormonal birth control methods include surgical implants (Implanon), injections (Depo-Provera), vaginal ring and birth control pills (“the pill”). Used properly, hormonal methods are generally very reliable in preventing pregnancy. Since they stop working when you stop taking them, these methods are often chosen by women who may want to have children in the future.

Hormonal contraception that includes estrogen, such as the pill, the ring, and the patch may increase the risk of blood clots, causing strokes or heart attacks especially in women who smoke. Methods that include progesterone, may result in menstrual cycle changes, weight gain and bone loss. Hormonal birth control methods do not prevent sexually transmitted diseases.

Intrauterine devices (IUDs). An IUD is a T-shaped device inserted into the uterus by a health-care professional. IUDs are one of the most reliable contraceptive methods. They do not protect against sexually transmitted diseases, so they are often used by women in mutually monogamous relationships. Serious complications from IUDs are rare, although IUD users may be at increased risk of developing pelvic inflammatory disease. Other side effects can include perforation of the uterus, abnormal bleeding, and cramps. Complications occur most often during and immediately after insertion. Two IUD types are available in the United States: the ParaGard Copper T 380A and the Mirena.

Barrier methods. Barrier methods work by creating a physical barrier which prevents bodily fluids from passing from one person to another. Examples of barrier methods include condoms, diaphragms and sponges. Of those, only condoms are recommended to prevent the transmission of sexually transmitted infections.

Spermicide. Vaginal creams, lotions, foams, jellies, films, suppositories, and tablets containing sperm-killing chemicals are available without a prescription in many stores and pharmacies. Effectiveness varies widely, and instructions must be carefully followed.

Natural methods. Also known as fertility awareness or natural family planning, this method entails using a barrier birth control method or abstaining from sex on the days of a woman’s menstrual cycle when she could become pregnant — from seven days before ovulation to three days after.

Surgical sterilization. Surgical sterilization, also known as “permanent birth control” is intended for people who don’t want children in the future. It has a low failure rate but it is difficult or impossible to reverse. Complications from surgery are rare but possible. Both men and women can be sterilized — women via tubal ligation or tubal occlusion, which blocks the fallopian tubes, and men via vasectomy, which involves cutting or tying the tube that carries sperm from the testicle to the penis.

Effectiveness of various types of birth control

Here is a comparison of the various types of birth control and their effectiveness in preventing pregnancy. The rates listed are the failure rates of each method (the percent of pregnancies that method did not prevent) in tests when they were used according to the manufacturers’ directions.

Method

Failure Rate

Hormonal Method
the pill (estrogen/progestin) 0.1%
minipill (progestin only) 0.5%
implant (Implanon) 0.09%
hormone shot (Depo-Provera) 0.3%
Intrauterine Devices (IUDs)
ParaGard Copper T 0.6%
Mirena 1.5%
Barrier Methods
male latex condom1 3%
diaphragm2 9%
vaginal sponge (no previous births)2 9%
vaginal sponge (previous births)2 20%
female condom 5%
Spermicide
(gel, foam, suppository, film) 6%
Natural Methods
abstinence 0%
withdrawal 4%
natural family planning (calendar, temperature, cervical mucus) 1-9%
no method 85%
Surgical sterilization
male sterilization .1%
female sterilization .5%

1- without spermicide, 2- contains spermicide

ADDITIONAL INFORMATION

Centers for Disease Control and Prevention
Center for Young Women’s Health
The Emergency Contraception Website
Healthy Women
National Campaign to Prevent Teen and Unplanned Pregnancy
Planned Parenthood Federation of America
Sexuality Information and Education Council of the United States