Birth Control (Contraceptive) Methods

Continuous Abstinence

This means not having sex (vaginal, anal, or oral) at any time. It is the only sure way to prevent pregnancy and protect against sexually transmitted infections (STIs), including HIV.

Natural Family Planning/Fertility Awareness

This method is when you do not have sex or use a barrier method on the days you are most fertile (most likely to become pregnant). A woman, girl, and all other people who experience a menstrual cycle has about 9 or more days each month when they are able to get pregnant. These fertile days are about 5 days before and 3 days after ovulation, as well as the day of ovulation.To have success with this method, you need to learn about your menstrual cycle. Then you can predict which days you are fertile or whether it is “unsafe" to engage in sexual activity. To learn about your cycle, keep a written record of:

• When you begin menstruating.
• What it is like (heavy or light blood flow).
• How you feel (sore breasts, cramps, etc.).

This method also involves checking your cervical mucus and recording your body temperature each day. Cervical mucus is the discharge from your vagina. You are most fertile when it is clear and slippery like raw egg whites. Use a basal thermometer to take your temperature and record it in a chart. Your temperature will rise 0.4 to 0.8° F on the first day of ovulation. You can talk with your doctor or a natural family planning instructor to learn how to record and understand this information.

Check out Natural Cycles for a user friendly app to help track your menstrual cycle.

Failure Rate (the number of pregnancies expected per 100 women) is 25.

Some side effects and risks: none

Contraceptive Sponge

This barrier method is a soft, disk-shaped device with a loop for taking it out. It is made out of polyurethane (pah-lee-YUR-uh-thayn) foam and contains the spermicide (SPUR-muh-syd) nonoxynol-9. Spermicide kills sperm. Before having sex, you wet the sponge and place it, loop side down, inside your vagina to cover the cervix. The sponge is effective for more than one act of intercourse for up to 24 hours. It needs to be left in for at least 6 hours after having sex to prevent pregnancy. It must then be taken out within 30 hours after it is inserted. Only one kind of contraceptive sponge is sold in the United States. It is called the Today Sponge. Women who are sensitive to the spermicide nonoxynol-9 should not use the sponge

Failure Rate (the number of pregnancies expected per 100 women) is 16-32.

Some side effects and risks:

• Irritation
• Allergic reactions
• Hard time taking it out
• Toxic shock if left in too long

Diaphragm, Cervical Cap, and Cervical Shield

These barrier methods block the sperm from entering the cervix (the opening to your womb) and reaching the egg. The diaphragm is a shallow latex cup. The cervical cap is a thimble-shaped latex cup. It often is called by its brand name, FemCap. The cervical shield is a silicone cup that has a one-way valve that creates suction and helps it fit against the cervix. It often is called by its brand name, Lea’s Shield. The diaphragm and cervical cap come in different sizes, and you need a doctor to “fit” you for one. Visit your doctor for a proper fitting because diaphragms and cervical caps come in different sizes. The cervical shield comes in one size, and you will not need a fitting. Before having sex, add spermicide (to block or kill sperm) to the devices. Then place them inside your vagina to cover your cervix. You can buy spermicide gel or foam at a drug store. All three of these barrier methods must be left in place for 6 to 8 hours after having sex to prevent pregnancy. The diaphragm should be taken out within 24 hours. The cap and shield should be taken out within 48 hours.

Failure Rate (the number of pregnancies expected per 100 women) is 12.

Some side effects and risks:

• Irritation
• Allergic reactions
• Hard time taking it out
• Toxic shock if left in too long

Female Condom

This condom is worn by the woman inside her vagina. It keeps sperm from getting into her body. It is made of polyurethane and is packaged with a lubricant. It can be inserted up to 8 hours before having sex. Use a new condom each time you have intercourse. And don’t use it and a male condom at the same time.

Failure rate (the number of pregnancies expected per 100 women) is 20.

Some side effects and risks: 

• Irritation
• Allergic reactions

Male Condom

Male condoms are a thin sheath placed over an erect penis to keep sperm from entering a woman’s body. Condoms can be made of latex, polyurethane, or “natural/lambskin”. The natural kind do not protect against STIs. You need to use a new condom with each sex act.

Condoms are either:

• Lubricated, which can make sexual intercourse more comfortable
• Non-lubricated, which can also be used for oral sex. It is best to add lubrication to non-lubricated condoms if you use them for vaginal or anal sex. You can use a water-based lubricant, such as K-Y jelly. You can buy them at the drug store. Oil-based lubricant like massage oils, baby oil, lotions, or petroleum jelly will weaken the condom, causing it to tear or break.

Keep condoms in a cool, dry place. If you keep them in a hot place (like a wallet or glove compartment), the latex breaks down. Then the condom can tear or break. 

Failure rate (the number of pregnancies expected per 100 women) is 18.

Some side effects and risks: allergic reaction

SPERMICIDES

These products work by killing sperm and come in several forms—foam, gel, cream, film, suppository, or tablet. They are placed in the vagina no more than one hour before intercourse. You leave them in place at least six to eight hours after intercourse. You can use a spermicide in addition to a male condom, diaphragm, or cervical cap. They can be purchased at drug stores.

Failure rate (the number of pregnancies expected per 100 women) is 28.

Some side effects and risks:

• Irritation
• Allergic reactions

Prevent pregnancy by interfering with ovulation, fertilization, and/or implantation of the fertilized egg.

Oral Contraceptives - Combined pill ("The pill")

The pill contains the hormones estrogen and progestin. It is taken daily to keep the ovaries from releasing an egg. The pill also causes changes in the lining of the uterus and the cervical mucus to keep the sperm from joining the egg. Some women prefer the “extended cycle” pills. These have 12 weeks of pills that contain hormones (active) and 1 week of pills that don’t contain hormones (inactive). While taking extended cycle pills, women only have their period three to four times a year. Many types of oral contraceptives are available. Talk with your doctor about which is best for you. Your doctor may advise you not to take the pill if you:

• Are older than 35 and smoke
• Have a history of blood clots
• Have a history of breast, liver, or endometrial cancer

Antibiotics may reduce how well the pill works in some women. Talk to your doctor about a backup method of birth control if you need to take antibiotics.

Failure rate (the number of pregnancies expected per 100 women) is 9.

Some side effects and risks:

• Failure Dizziness
• Upset stomach
• Changes in your period
• Changes in mood
• Weight gain
• High blood pressure
• Blood clots
• Heart attack
• Stroke
• New vision problems

Oral Contraceptives - Progestin-only pill ("Mini-pill")

Unlike “the pill,” the mini-pill only has one hormone –– progestin. Taken daily, the mini-pill thickens cervical mucus, which keeps the sperm from joining the egg. Less often, it stops the ovaries from releasing an egg. Mothers who breastfeed can use the mini-pill. It won’t affect their milk supply. The mini-pill is a good option for women who:

• Can’t take estrogen
• Are older than 35
• Have a risk of blood clots

The mini-pill must be taken at the same time each day. A backup method of birth control is needed if you take the pill more than 3 hours late. Antibiotics may reduce how well the pill works in some women. Talk to your doctor about a backup method of birth control if you need to take antibiotics.

In addition, being overweight may increase the chance of getting pregnant while using the mini pill.

Failure rate (the number of pregnancies expected per 100 women) is 9.

Some side effects and risks:

• Spotting or bleeding between periods
• Weight gain
• Sore breasts

The Patch

Also called by its brand name, Ortho Evra, this skin patch is worn on the lower abdomen, buttocks, outer arm, or upper body. It releases the hormones progestin and estrogen into the bloodstream to stop the ovaries from releasing eggs in most women. It also thickens the cervical mucus, which keeps the sperm from joining with the egg. You put on a new patch once a week for 3 weeks. You don’t use a patch the fourth week in order to have a period.

In addition, the patch may not work as well in women weighing more than 198 pounds

Failure rate (the number of pregnancies expected per 100 women) is 9.

Some side effects and risks:

• Failure Dizziness
• Upset stomach
• Changes in your period
• Changes in mood
• Weight gain
• High blood pressure
• Blood clots
• Heart attack
• Stroke
• New vision problems
• Greater exposure to estrogen than with other methods

Shot/Injection (Depo-Provera)

The birth control shot often is called by its brand name, Depo-Provera. With this method you get injections, or shots, of the hormone progestin in the buttocks or arm every 3 months. A new type is injected under the skin. The birth control shot stops the ovaries from releasing an egg in most women. It also causes changes in the cervix that keep the sperm from joining with the egg.
 
The shot should not be used more than 2 years in a row because it can cause a temporary loss of bone density. The loss 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.

Failure rate (the number of pregnancies expected per 100 women) is less than 1.

Some side effects and risks:

• Bleeding/Spotting between periods
• Weight gain
• Sore breasts
• Headaches
• Bone loss with long-term use

Vaginal Ring (NuvaRing)

This is a thin, flexible ring that releases the hormones progestin and estrogen. It works by stopping the ovaries from releasing eggs. It also thickens the cervical mucus, which keeps the sperm from joining the egg. It is commonly called NuvaRing, its brand name. You squeeze the ring between your thumb and index finger and insert it into your vagina. You wear the ring for 3 weeks, take it out for the week that you have your period, and then put in a new ring.

Failure rate (the number of pregnancies expected per 100 women) is 9.

Some side effects and risks:

• Dizziness
• Upset stomach
• Changes in your period
• Changes in mood
• Weight gain
• High blood pressure
• Blood clots
• Heart attack
• Stroke
• New vision problems
• Swelling of the vagina
• Irritation
• Vaginal discharge

Devices that are inserted into the body and left in place for a few years.

Implantable Rod (Implanon)

This is a matchstick-size, flexible rod that is put under the skin of the upper arm. It is often called by its brand name, Implanon. The rod releases a progestin, which causes changes in the lining of the uterus and the cervical mucus to keep the sperm from joining an egg. Less often, it stops the ovaries from releasing eggs. It is effective for up to 5 years.

In addition, it may not work as well for women who are overweight or obese.

Failure rate (the number of pregnancies expected per 100 women) is less than 1.

Some side effects and risks:

• Acne
• Weight gain
• Ovarian cysts
• Mood changes
• Depression
• Hair loss
• Headache
• Upset stomach
• Dizziness
• Sore breasts
• Changes in period
• Lower interest in sex

Intrauterine Device or IUDs

An IUD is a small device shaped like a “T” that goes in your uterus. There are two types:

• Copper IUD: The copper IUD goes by the brand name ParaGard. It releases a small amount of copper into the uterus, which prevents the sperm from reaching and fertilizing the egg. It fertilization does occur, the IUD keeps the fertilized egg from implanting in the lining of the uterus. A doctor needs to put in your copper IUD. It can stay in your uterus for 5 to 10 years.
• Hormonal IUD: The hormonal IUD goes by the brand name Mirena. It is sometimes called an intrauterine system, or IUS. It releases progestin into the uterus, which keeps the ovaries from releasing an egg and causes the cervical mucus to thicken so sperm can’t reach the egg. It also affects the ability of a fertilized egg to successfully implant in the uterus. A doctor needs to put in a hormonal IUD. It can stay in your uterus for up to 5 years.

Failure rate (the number of pregnancies expected per 100 women) is less than 1.

Some side effects and risks:

• Cramps
• Bleeding between periods
• Pelvic inflammatory disease
• Infertility
• Tear or hole in the uterus