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Contraception: What Are Your Options?

contraceptive options
With the advancement of science, there are many options for preventing pregnancy. Learning about each type can help you make an educated decision about which method to choose.

What Is the Best Birth Control Method for Me?

Take your time when it comes to determining which birth control method you'll use. Do your homework. Research what is available. Talk to your close friends and see what methods they use and how they like them. Talk to your doctor about which options might be right for you. Factors that are important to your decision include:

  • Your health
  • Frequency of sexual activity
  • Number of partners
  • Desire to have children in the future
  • Possible side effects
  • How comfortable you would be with the method

Note: Abstinence is the only 100% effective way to avoid pregnancy and sexually transmitted diseases (STDs), including HIV infection. Abstinence is not having sexual intercourse.

Hormonal Contraception

The Pill

The pill, also known as the oral contraceptive pill or birth control pill, is a popular form of reversible contraception. It uses a combination of estrogen and progestin (female hormones) to suppress the monthly release of an egg from the ovaries. Taken daily, the chance of becoming pregnant is very low. The pill does not protect against STDs, and is not advised for women who smoke, have a history of blood clots , or have certain types of cancer.

Mini-pills

These are progesterone-only pills that are a popular choice for women right after giving birth. While these mini-pills are less effective than combination pills, they are often used after delivery because the combination pills can increase your risk of blood clots. If you are nursing, there is insufficient evidence to show that birth control pills will affect your milk supply.

Contraceptive Patch

The patch, worn on the skin, delivers the hormones estrogen and progestin to the bloodstream. The patch is changed weekly. It is as effective as the pill.

Contraceptive Implant

This type of device is surgically implanted in the arm. The small implant releases a progestin hormone and can provide birth control for three years before it needs to be replaced.

Vaginal Ring

This is a thin, flexible ring that is inserted into the vagina and worn for three-week periods. The ring delivers estrogen and progestin. It is also as effective as birth control pills.

Emergency Contraception

Emergency contraception refers to a series of contraceptive pills taken soon after sexual intercourse to prevent pregnancy. It does not prevent STDs. This method of birth control is not designed for long term use like the other birth control methods.

Condoms

The Male Condom

Male condoms prevent pregnancy by blocking the passage of sperm to the woman. Except for abstinence, latex condoms are the only kind of birth control that also reduces your risk of getting HIV and other STDs. If you use other forms of birth control, and also want protection against STDs, the man should also use a latex condom. Using a spermicide with a condom will further reduce the chance of pregnancy.

The Female Condom

Female condoms work in a similar way as the male condom in preventing the passage of sperm. It may help reduce your risk of getting STDs, but not as effectively as the male condom.

Barrier Devices

Intrauterine device (IUD)

An IUD is a T-shaped device inserted through the vagina and into the uterus by a doctor. It prevents fertilization and is a convenient and highly effective form of contraceptive, but it does not protect against STDs. Depending on what type of IUD is used, it can be effective for up to 10 years. IUDs are a good option for women who are being treated for cancer, because they are effective and reversible.

Diaphragms or Cervical Caps

These devices are available by prescription. They are used with spermicides and are inserted in the vagina against the cervix to block the passage of sperm.

Sponge

Available over-the-counter, the sponge is made of plastic foam and has a spermicide. The device is inserted into the vagina before having sex, then removed after. The sponge does not protect against STDs. Compared to the diaphragm, the sponge may not be as effective in preventing pregnancy.

Surgery

Tubal Ligation

Tubal ligation is surgery to block a woman's fallopian tubes so they do not release eggs. If eggs are not released, then pregnancy cannot occur. This surgery is permanent contraception for women who don’t want children in the future. It does not protect against STDs.

Vasectomy

A vasectomy is surgery to block a man's vas deferens tubes so they do not release sperm. If sperm is not released, then pregnancy cannot occur. This surgery is permanent contraception for men who do not want children in the future. It does not protect against STDs.

Talk with your doctor to find out what options would work best for your individual situation.

RESOURCES:

American Congress of Obstetricians and Gynecologists
http://www.acog.org

WomensHealth.gov—US Department of Health and Human Services
http://www.womenshealth.gov

CANADIAN RESOURCES:

Sex Information and Education Council of Canada
http://www.sieccan.org

The Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org

References:

Birth control for breastfeeding mothers. Utah Department of Health website. Available at: http://health.utah.gov/mihp/pregnancy/preged/afterpreg/breastfeeding_and_contraception.htm. Accessed July 30, 2014.

Birth control guide. United States Food and Drug Administration website. Available at: http://www.fda.gov/downloads/ForConsumers/ByAudience/ForWomen/FreePublications/UCM356451.pdf. Accessed July 30, 2014.

Birth control sponge (Today sponge). Planned Parenthood website. Available at: http://www.plannedparenthood.org/health-topics/birth-control/birth-control-sponge-today-sponge-4224.htm. Accessed July 30, 2014.

Kuyoh MA, Toroitich-Ruto C, et al. Sponge versus diaphragm for contraception. Cochrane Database Syst Rev. 2002;(3).

Medical eligibility criteria for contraceptive use – 4th ed. 2009. World Health Organization Website. Available at http://whqlibdoc.who.int/publications/2010/9789241563888_eng.pdf. Accessed July 30, 2014.

Nexplanon (etonogestrel implant). Merck website. Available at: http://www.merck.com/product/usa/pi_circulars/n/nexplanon/nexplanon_ppi.pdf. Updated July 2014. Accessed July 30, 2014.

Schwarz E, Hess R, et al. Contraception for cancer survivors. J Gen Intern Med. Nov 2009;24(Suppl 2):401-406.

Sterilization for women (tubal sterilazation). Planned Parenthood website. Available at: http://www.plannedparenthood.org/health-info/birth-control/sterilization-women. Accessed August 4, 2014.

Vasectomy. Planned Parenthood website. Available at: http://www.plannedparenthood.org/health-info/birth-control/vasectomy. Accessed August 4, 2014.

9/23/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Kuyoh M, Toritich-Ruto C, Grimes DA, Schulz KF, Gallo M, Lopez LM. Sponge versus diaphragm for contraception. Cochrane Database Syst Rev. 2008;CD003172.

6/7/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Department of Health and Human Services Centers for Disease Control and Prevention. US medical eligibility criteria for contraceptive use, 2010. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/mmwr/pdf/rr/rr59e0528.pdf. Published May 28, 2010. Accessed July 30, 2014.

8/23/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: US Food and Drug Administration. FDA approves ella tablets for prescription emergency contraception. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm222428.htm. Updated August 13, 2010. Accessed July 30, 2014.

1/28/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed : Truitt S, Fraser A, Gallo M, Lopez L, Grimes D, Schulz K. Combined hormonal versus nonhormonal versus progestin-only contraception in lactation. Cochrane Database Syst Rev. 2010;(12):CD003988.

4/15/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Kuyoh M, Toroitich-Ruto C, Grimes D, Schulz K, Gallo M, Lopez L. Sponge versus diaphragm for contraception. Cochrane Database Syst Rev. 2011;(3):CD003172.

3/8/2012 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: In brief: etonogestrel (Nexplanon) contraceptive implant. Med Lett Drugs Ther. 2012;54(1383):12.

3/31/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Patel A, Schwarz EB, et al. Cancer and contraception. Release date May 2012. SFP Guideline #20121. Contraception. 2012 Sep;86(3):191-198.



Last reviewed August 2014 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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