Birth Control

All women and men should have control over if and when they become parents. Making decisions about birth control, or contraception is not easy – there are many things to think about. Learning about birth control methods you or your partner can use to prevent pregnancy and talking with your doctor are two good ways to get started.

There is no “best” method of birth control. Each method has its own pros and cons. Some methods work better than others do at preventing pregnancy. Researchers are always working to develop or improve birth control methods.

The birth control method you choose should take into account:

• your overall health
• how often you have sex
• the number of sexual partners you have
• if you want to have children
• how well each method works (or is effective) in preventing pregnancy
• any potential side effects
• your comfort level with using the method

Bear in mind that NO method of birth control prevents pregnancy all of the time. Birth control methods can fail, but you can greatly increase a method’s success rate by using it correctly all of the time. The only way to be sure you never get pregnant is to not have sex (abstinence).

Here is a list of birth control methods with estimates of effectiveness, or how well they work in preventing pregnancy when used correctly, for each method:

• Continuous Abstinence – This means not having sexual intercourse (vaginal, anal, or oral intercourse) at any time. It is the only sure way to prevent pregnancy and protect against HIV and other STDs. This method is 100% effective at preventing pregnancy and STDs.

• The Male Condom – Condoms are called barrier methods of birth control because they put up a block, or barrier, which keeps the sperm from reaching the egg. Only latex or polyurethane (because some people are allergic to latex) condoms are proven to help protect against STDs, including HIV. “Natural” or “lambskin” condoms made from animal products also are available, but lambskin condoms are not recommended for STD prevention because they have tiny pores that may allow for the passage of viruses like HIV, hepatitis B and herpes. Male condoms are 84 to 98% effective at preventing pregnancy. Condoms can only be used once. You can buy them at a drug store.

• Oral Contraceptives – Also called “the pill,” contains the hormones estrogen and progestin and is available in different hormone dosages. A pill is taken daily to block the release of eggs from the ovaries.

• Copper T IUD (Intrauterine Device) – An IUD is a small device that is shaped in the form of a “T.” Your health care provider places it inside the uterus. The arms of the Copper T IUD contain some copper, which stops fertilization by preventing sperm from making their way up through the uterus into the fallopian tubes. If fertilization does occur, the IUD would prevent the fertilized egg from implanting in the lining of the uterus. The Copper T IUD can stay in your uterus for up to 12 years. It does not protect against STDs or HIV. This IUD is 99% effective at preventing pregnancy. You will need to visit your doctor to have it inserted and to make sure you are not having any problems. Not all doctors insert IUDs so check first before making your appointment.
• Progestasert IUD (Intrauterine Device) -This IUD is a small plastic T- shaped device that is placed inside the uterus by a doctor. It contains the hormone progesterone, the same hormone produced by a woman’s ovaries during the monthly menstrual cycle. The progesterone causes the cervical mucus to thicken so sperm cannot reach the egg, and it changes the lining of the uterus so that a fertilized egg cannot successfully implant. The Progestasert IUD can stay in your uterus for one year. This IUD is 98% effective at preventing pregnancy. You will need to visit your doctor to have it inserted and to make sure you are not having any problems. Not all doctors insert IUDs so check first before making your appointment.
• Intrauterine System or IUS (Mirena) – The IUS is a small T-shaped device like the IUD and is placed inside the uterus by a doctor. Each day, it releases a small amount of a hormone similar to progesterone called levonorgestrel that causes the cervical mucus to thicken so sperm cannot reach the egg. The IUS stays in your uterus for up to five years. It does not protect against STDs or HIV. The IUS is 99% effective. The Food and Drug Administration approved this method in December 2000. You will need to visit your doctor to have it inserted and to make sure you are not having any problems. Not all doctors insert the IUS so check first before making your appointment
• The Female Condom – Worn by the woman, this barrier method keeps sperm from getting into her body. It is made of polyurethane, is packaged with a lubricant, and may protect against STDs, including HIV. It can be inserted up to 24 hours prior to sexual intercourse. Female condoms are 79 to 95% effective at preventing pregnancy. There is only one kind of female condom, called Reality, and it can be purchased at a drug store.
• Depo-Provera – With this method women get injections, or shots, of the hormone progestin in the buttocks or arm every 3 months. It does not protect against STDs or HIV. Women should not use Depo-Provera for more than 2 years in a row because it can cause a temporary loss of bone density that increases the longer this method is used. The bone does start to grow after this method is stopped, but it may increase the risk of fracture and osteoporosis if used for a long time. It is 97% effective at preventing pregnancy. You will need to visit your doctor for the shots and to make sure you are not having any problems.
• Diaphragm, Cervical Cap or Shield – These are barrier methods of birth control, where the sperm are blocked from entering the cervix and reaching the egg. The diaphragm is shaped like a shallow latex cup. The cervical cap is a thimble-shaped latex cup. The cervical shield is a silicone cup that has a one-way valve that creates suction and helps it fit against the cervix. The diaphragm and cervical cap come in different sizes and you need a doctor to “fit” you for one. The cervical shield comes in one size and you will not need a fitting. Before sexual intercourse, you use them with spermicide (to block or kill sperm) and place them up inside your vagina to cover your cervix (the opening to your womb). You will need to visit your doctor for a proper fitting for the diaphragm or cervical cap and a prescription for the cervical shield.
• Contraceptive Sponge – This is a barrier method of birth control that was re-approved by the Food and Drug Administration in 2005. It is a soft, disk shaped device, with a loop for removal. It is made out of polyurethane foam and contains the spermicide nonoxynol-9. Before intercourse, you wet the sponge and place it, loop side down, up inside your vagina to cover the cervix. There is a risk of getting Toxic Shock syndrome or TSS if the sponge is left in for more than 30 hours. The sponge does not protect against STDs or HIV. There is only one kind of contraceptive sponge for sale in the United States, called the Today Sponge, and it can be purchased at a drug store. Women who are sensitive to the spermicide nonoxynol-9 should not use this birth control method.
• The Patch (Ortho Evra) -This is a skin patch worn on the lower abdomen, buttocks, or upper body. It releases the hormones progestin and estrogen into the bloodstream. You put on a new patch once a week for three weeks, and then do not wear a patch during the fourth week in order to have a menstrual period. The patch is 98 to 99% effective at preventing pregnancy, but appears to be less effective in women who weigh more than 198 pounds. It does not protect against STDs or HIV. You will need to visit your doctor for a prescription and to make sure you are not having problems.
• The Hormonal Vaginal Contraceptive Ring (NuvaRing) – The NuvaRing is a ring that releases the hormones progestin and estrogen. You squeeze the ring between your thumb and index finger and insert it into your vagina. You wear the ring for three weeks, take it out for the week that you have your period, and then put in a new ring. The ring is 98 to 99% effective at preventing pregnancy. You will need to visit your doctor for a prescription and to make sure you are not having problems. This birth control method is not recommended while breastfeeding because the hormone estrogen may decrease breast milk production.
• Surgical Sterilization (Tubal Ligation or Vasectomy) – These surgical methods are meant for people who want a permanent method of birth control. In other words, they never want to have a child or they do not want more children. Tubal ligation or “tying tubes” is done on the woman to stop eggs from going down to her uterus where they can be fertilized. The man has a vasectomy to keep sperm from going to his penis, so his ejaculate never has any sperm in it. They are 99.9% effective at preventing pregnancy.
• Nonsurgical Sterilization (Essure Permanent Birth Control System) – This is the first non-surgical method of sterilizing women. A thin tube is used to thread a tiny spring-like device through the vagina and uterus into each fallopian tube. Flexible coils temporarily anchor it inside the fallopian tube. A Dacron-like mesh material embedded in the coils irritates the fallopian tubes’ lining to cause scar tissue to grow and eventually permanently plug the tubes. It can take about three months for the scar tissue to grow, so it is important to use another form of birth control during this time. Then you will have to return to your doctor for a test to see if scar tissue has fully blocked your tubes. – After 3 years of follow-up studies, Essure has been shown to be 99.8 % effective in preventing pregnancy.
• Emergency Contraception – This is NOT a regular method of birth control and should never be used as one. Emergency contraception, or emergency birth control, is used to keep a woman from getting pregnant when she has had unprotected vaginal intercourse. “Unprotected” can mean that no method of birth control was used. It can also mean that a birth control method was used but did not work – like a condom breaking. Or, a woman may have forgotten to take her birth control pills, or may have been abused or forced to have sex when she did not want to. Emergency contraception consists of taking two doses of hormonal pills taken 12 hours apart and started within three days after having unprotected sex. These are sometimes wrongly called the “morning after pill.” The pills are 75 to 89% effective at preventing pregnancy. Another type of emergency contraception is having the Copper T IUD put into your uterus within seven days of unprotected sex. This method is 99.9% effective at preventing pregnancy. Neither method of emergency contraception protects against STDs or HIV. You will need to visit your doctor for either a prescription for the pills or for the insertion of the IUD, and to make sure you are not having problems.