What are the different methods of birth control?
Sterilization is a surgical procedure done for men
or women who decide that they do not want to have any or more children.
Sterilization is one of the most effective forms of birth control.
Sterilization is intended to be permanent, and while you can try to reverse it
with another surgery, reversal is not always successful. Methods
- Tubal ligation or implants. The
fallopian tubes , which carry the eggs from the ovaries
to the uterus, are tied, cut, or blocked. A new type of procedure, using a
device (called Essure) to block the fallopian tubes, is done without an
incision and on an outpatient basis.
- Vasectomy. In
this minor procedure, the vas deferens-the tube that carries sperm from the
testicles to the seminal fluid (semen)-from each
testicle is cut and blocked so that
sperm are no longer present in the semen.
Hormonal methods are very
effective means of birth control. Hormonal methods use two basic
- Combination hormonal methods contain
estrogen and progestin (synthetic
progesterone). Combination methods include
pills, skin patches, and rings .
- Progestin-only hormonal methods include pills (also
called the "mini-pill"), an implant (Implanon), and injections (Depo-Provera).
Progestin-only methods are an option for women who cannot take estrogen.
intrauterine device (IUD) is a small device that is
placed in your uterus to prevent pregnancy. There are two main types of IUDs:
copper IUDs (such as Paragard) and hormonal IUDs (such as Mirena). IUDs can
provide birth control for 5 to 10 years.
include the diaphragm, cervical cap, Lea's Shield, male condom, female condom, spermicidal foam, sponges, and film . Barrier methods
prevent sperm from entering the uterus and reaching the egg. Typically, barrier
methods are not highly effective, but they generally have fewer side effects
than hormonal methods or IUDs. Spermicides and condoms should be used together
or along with another method to increase their effectiveness. Barrier methods
can interrupt lovemaking because they must be used every time you have sex. (A
diaphragm, cap, or shield can be put in a few hours beforehand, if you can plan
Fertility awareness, or natural family
planning, requires that a couple chart the time during a woman's
menstrual cycle that she is most likely to become pregnant and avoid intercourse
or use a barrier method during that time. Fertility awareness is not a highly
effective method of preventing pregnancy.
If you are at risk of
getting or spreading a
sexually transmitted disease (such as
AIDS), use a condom . To most
effectively prevent pregnancy, combine a condom with a highly effective birth
How effective are birth control methods?
implants, injections (Depo-Provera), and the hormonal and copper IUDs are
very highly successful methods of birth control. These
methods are 97% to 99.9% effective. That means fewer than 1 to 3 women out of
100 women who are using these methods will become pregnant during the first
year of use.
Birth control pills (both combination and
progestin-only) have a high success rate of 92%. But if
taken properly (every day or at the same time every day), birth control pills
can be highly successful. The hormonal skin patch and vaginal ring are thought
to be about as effective as birth control pills, but how well they actually
work has not been well studied.
Barrier methods, such as the
diaphragm or condom, are moderately successful at
preventing pregnancy. The diaphragm and cervical cap are 84% effective for
women who have not had children or who have had a
cesarean section. Women who have delivered children
vaginally have lower rates of success with diaphragms and cervical caps. They
are more effective when used consistently and fitted correctly, although not
all women are able to achieve this.
Doctors often recommend that
you use spermicides and condoms together or along with another method to
increase their effectiveness. The male condom is 85% effective. The female
condom is 79% effective. Spermicide is 71% effective. In real numbers, this
means that of women who use male condoms alone for birth control each time they
have sex, 15 out of 100 will become pregnant in the first year of use. Consider
carefully whether this risk is acceptable to you.
awareness takes organization, good record keeping, close observation of your
body changes, and cooperation from your partner. Even when practiced carefully
and consistently, fertility awareness is not a reliable method of birth
control. Of women who use fertility awareness for birth control, 20 to 25 out
of 100 will become pregnant in the first year of use.
See a table
failure rate of each method.
how comfortable you feel about using a particular method of birth control. If
you are not comfortable or will not consistently use a birth control method for
any reason, that method may not be effective. A
reality check for birth control methods can help you
determine which method is right for you.
- The patch delivers more estrogen than the low-dose birth
control pills do. The U.S. Food and Drug Administration (FDA) warns that women
using the patch are slightly more likely to get dangerous blood clots in the
legs and lungs than women using birth control pills. So talk to your doctor
about your risks before using the patch.
- Direct sunlight or high
heat can increase, then lower, the amount of hormone released from a patch.
This can give you a big dose at the time and leave less hormone for the patch
to release later in the week. This increases your risk of pregnancy.
Avoid direct sunlight on the hormone patch. Also avoid
using a tanning bed, heating pad, electric blanket, hot tub, or sauna while you
are using a hormone patch.
- Most spermicides contain a chemical called
nonoxynol-9 (N9). The U.S. Food and Drug Administration (FDA) warns that N9 in
vaginal contraceptives and spermicides may irritate the lining of the vagina or
rectum. This may increase the risk of getting HIV/AIDS from an infected
What are health risks that may affect my choices?
Some health conditions may limit your choice of birth control methods.
Discuss appropriate methods of birth control with your doctor if you:
- Have a chronic illness, such as
diabetes or heart disease.
- Have a history
of cardiovascular problems, such as
high blood pressure (hypertension),
high cholesterol, or
- Have a history of nervous
system problems, such as seizures or headaches.
- Have a history of
- Have a history of cancer.
- Use prescription
medicines. Certain antibiotics,
antiretrovirals, and anticonvulsants, as well as
St. John's wort, make certain hormonal birth control
- Are overweight. The pill
and the patch may not work as well if you are overweight, so talk with your
doctor about the type of birth control that will be best for you.
Bone thinning. Using Depo-Provera
for 2 or more years can cause bone loss, which may not be fully reversible
after stopping the medicine. This concern may be greatest during the teen
years, when young women should be building bone mass. Depo-Provera use is not
recommended to be used for longer than 2 years unless you are protecting your
bones with daily calcium and regular weight-bearing exercise, such as walking
or running.3, 4 Talk to your
doctor about your risks if you have been using Depo-Provera for longer than 2
Sexually transmitted disease. If a
sexually transmitted disease is present at the time an IUD is inserted, a woman
is at increased risk for
pelvic inflammatory disease (PID) in the 20 days after
insertion. Pelvic inflammatory disease can lead to
infertility.5 This is why a
test for STDs is important before inserting an IUD.
information, see the topic
Exposure to Sexually Transmitted Diseases.
Will some temporary birth control methods prevent me from having children when I want them?
Consider how soon, if ever, you would
like to become pregnant. Except for sterilization methods, which permanently
prevent pregnancy, all currently available birth control methods allow you to
become pregnant again, although some may cause a delay.
Depo-Provera. For some women, it may take 3 to 18 months to
get pregnant after the last Depo-Provera (a progestin-only hormonal method)
Implanon . You can get pregnant
right away after you have the implant removed. The implant provides birth
control for 3 years and must be inserted and removed by a trained health
The estrogen-progestin pill.
If you take monthly cycles of birth control hormones for a long time, your
periods might stop. You might not start periods again for several months after
you stop taking hormones. But it isn't permanent. You will start ovulating and
having your periods, and your fertility will get back to the pattern you had
before you started the pill. Since it is common to
ovulate before your first period comes back, it is
possible to get pregnant sooner than you expect. So if you aren't in a rush to
get pregnant, use some form of birth control after you stop birth control
What can I do if I have unprotected sex?
Emergency contraception is a backup method for unprotected intercourse. This would
be when you have not used a birth control method or have reason to believe that
your method has not protected you as it should. For example, you could use
emergency contraception if the condom breaks during sex.