Contraception

Abstinence

Continuous Abstinence is not having sex play with a partner. Abstinence is 100% effective in preventing pregnancy. It also prevents sexually transmitted infection.

Advantages:

• Has no medical or hormonal side effects.
• Any woman or man can abstain from sex play.

Disadvantages:

• People may find it difficult to abstain for long periods of time.
• Women and men often end their abstinence without being prepared to protect themselves against pregnancy or sexually transmitted infection.

Birth Control Pills

Oral Contraceptive Pills (Birth Control Pills) work by preventing the egg from being released by the ovary (ovulation). Pills also make the fluid in the cervix and fallopian tubes thick and sticky. Sperm need thin fluid to be able to fertilize an egg and cause pregnancy. Most oral contraceptive pills contain the two hormones that regulate the menstrual cycle, estrogen and progestin. The differences between brands of pills are usually in the amount of each hormone, and the type of progestin. Generally, the differences are small. Most women can use any oral contraceptive pill safely and with few problems. The Contraceptive Patch and Ring are really the same as Oral Contraceptives, but the medication is absorbed through the skin instead of the stomach.

Advantages:

• "The Pill" is easy to use, popular and safe for the majority of women.
• "The Pill" can make menstrual periods predictable and regular, and reduce the amount of bleeding and cramping. Birth control pills may help improve acne and reduce premenstrual syndrome (PMS).
• Women usually do not gain weight from using birth control pills.
• Birth control pills do not cause cancer or birth defects.
• Birth control pills are very effective if used correctly.

Disadvantages:

• You must remember to take a pill every day at the same time every day.
• If you smoke or have problems with high blood pressure or some types of migraine headaches, your provider will discuss health risks with you. Some of these women should not use birth control pills.
• A few women have mild nausea or headaches while using birth control pills. This usually resolves after several months, if not a different type of pill can be tried.
• Spotting between periods is common in the first 1-3 months of use. This is not harmful.

How effective is this method?

• 99% effective

Contraceptive Patch

The contraceptive patch contains the same hormones as the birth control pill and it works the same way, but in a patch form. The hormones are absorbed through the skin instead of from the stomach

Advantages:

• Hormone levels are steady for 7 days at a time.
• The patch is applied to the skin, and left in place for one week. It stays even with swimming or sweating for nearly all women.
• A new patch is applied every 7 days for 3 weeks.
• No patch is worn on week 4 and bleeding or a period occurs.
• The following week, a new patch is applied again.

Disadvantages:

• Women who should not use birth control pills should also not use the patch.

How effective is this method?

• 99% effective may actually be slightly higher than the pill due to compliance.

Contraceptive Ring

The contraceptive ring contains the same hormones as the birth control pill, and patch. It works the same way. A flexible ring is worn inside the vagina and the hormones are absorbed through the vaginal skin.

Advantages:

• The ring is worn continuously for weeks 1-3.
• The ring cannot be felt by the woman or her partner when it is in place.
• The ring is removed during week 4, and the "menstrual period" occurs.
• Hormone levels are steady for 3 weeks at a time.

Disadvantages

• Women who should not use birth control pills should also not use the ring.
• Some women do not feel comfortable inserting the ring.

How effective is this method?

99% effective may actually be slightly higher than the pill due to compliance.

Depo-Provera Injectable ("3-month shot")

Depo-Provera works by making the fluid in the cervix and fallopian tubes very thick and sticky. Sperm cannot swim through the fluid when it is not thin. Depo also makes ovulation (release of an egg from the ovary) less likely, and changes the lining of the uterus. All of these changes prevent fertilization of an egg which leads to pregnancy.

Advantages:

• Depo-Provera is convenient and safe for most women—only 4 shots per year.
• Very reliable and effective in preventing pregnancy.
• "Depo" is safe to use while breastfeeding.
• Depo-Provera can reduce menstrual bleeding and cramping for some women. Many women stop having periods. This is not harmful - the uterus is "resting" and does not make a monthly period.
• You don't have to remember to use it daily.

Disadvantages:

• Depo-Provera usually causes menstrual periods to be irregular - this might be no period at all, bleeding sometimes, or spotting nearly every day. After several injections (about 1 year) many women stop having periods. This is not harmful in any way. Some women feel this is an advantage.
• Many women notice an increased appetite. Weight gain can occur if you eat more calories that you burn during the day. Depo-Provera ITSELF causes little or no weigh gain.
• Some women notice mood swings or mild depression.
• Women at risk of having decreased bone density (low body weight due to anorexia or intense athletic training) should not use depo.

How effective is this method?

• 99% effective, may actually be slightly higher than the pill due to compliance

Intra-uterine device or system (IUD or IUS)

How the IUD works is not completely known. It is believed that the Copper IUD in the uterus changes the fluid in the uterus, which makes the sperm unable to fertilize an egg. If a pregnancy has already attached to the uterus, the IUD does not cause an abortion. The Mirena IUS contains a progestin hormone which also makes the fluid of the cervix and fallopian tubes thick and sticky. Mirena may also reduce ovulation (release of the egg from the ovary).

• The IUD or IUS is very convenient and safe for most women.
• IUD and IUS do not have hormone effects on the rest of the body. Women do not gain weight or notice mood changes when using the IUD or IUS.
• The Copper-T IUD is effective up to 10 years. You can become pregnant as soon as it is removed.
• The Mirena IUS is effective up to 5 years. You can become pregnant soon after it is removed.
• The Mirena IUS contains a progestin hormone that reduces the amount of bleeding and cramping with menstrual periods. Some women stop having periods after several months. This is not harmful. The uterus is "resting" and does not make a period.

Disadvantages:

• The IUD and IUS do not cause infection by itself but does increase the risk of serious infection if a woman is exposed to an STD. This infection could lead to infertility.
• Women should feel inside their vagina after each menstrual period to feel the IUD string.
• Some women notice somewhat heavier periods and slightly more cramping for a few months after the Copper-T IUD is placed.
• Even though IUDs and IUS are very effective in preventing pregnancy, some rare failures do occur. If pregnancy occurs while the device is in the uterus, it must be removed. Removing the IUD or IUS could cause a miscarriage.

How effective is this method?

• 99% effective

Spermicides (sperm-killing)

Spermicides are available in several forms. The most common is in contraceptive jelly and in the lubricant on condoms. There are also spermicidal foams and suppositories.

Advantages:

• Some couples find the lubrication of spermicidal creams to be helpful.

Disadvantages:

• Some women and men are sensitive to spermicidal creams. They may notice a rash, itching or burning. It is possible this irritation could increase the risk of the woman getting a sexually transmitted infection, if she is exposed. If a woman could possibly be exposed to sexually transmitted infection, it is now recommended that she use condoms without a spermicide.
• Spermicides ALONE are not very effective in preventing pregnancy. It is recommended that a spermicidal foam, gel or suppository be used along with condoms or a diaphragm.

How effective is this method?

• 94% effective, effectiveness increases with barrier method added.

Condoms

Condoms work by preventing the sperm in the man's semen from entering the vagina, cervix, uterus and tubes.

Advantages:

• Condoms are easy to use, and available to buy without a prescription.
• There are no hormonal effects, such as weight gain or mood changes.
• Condoms are the only method of birth control that also reduces (but does not eliminate) the risk of sexually transmitted infection, including HIV or AIDS. Condoms are recommended always if there is any chance of exposure to infection.
• Condoms can be used along with another type of birth control, such as pills or diaphragm to reduce the possibility of pregnancy as well as infection.

Disadvantages:

• Using condoms requires the cooperation of the man. They must be used correctly EVERY time you have sex, or you may become pregnant.
• Condoms alone are less effective in preventing pregnancy than the IUD or hormonal methods like the shots or birth control pills. In "real life", people often make mistakes and do not use the condom correctly. Women are more likely to become pregnant by accident when condoms are used as the only method of birth control. Using a spermicide (sperm-killing jelly) with condoms improves effectiveness in preventing pregnancy, but spermicide is not recommended if exposure to sexually transmitted infection is possible.
• Some women are sensitive to the latex or spermicide in condoms. It is possible this irritation could increase the risk of the woman getting a sexually transmitted infection, if she is exposed. If a woman could possibly be exposed to sexually transmitted infection, it is now recommended that she use condoms without spermicide.
• The failure rate for condoms alone is about 10-20%
• The condom must be cared for correctly, or it could leak or break. Condoms should not be exposed to heat or cold for long periods (not carried in the back pocket!).
• Only water-based products should be used with condoms. Contact with petroleum based products (Vaseline, lotion, etc.) can make the condom weak and cause it to break.

How effective is this method?

• 97% effective, when used correctly and condom doesn't break.
  

Diaphragm

The Diaphragm works by holding spermicide (sperm-killing jelly) next to the cervix for several hours so that sperm are killed before they can enter the cervix and uterus to fertilize an egg.

Advantages:

• The diaphragm has no hormonal effects such as weight gain or mood changes. It does not change the normal menstrual cycle.
• It is easy to use. For women who are not frequently sexually active, it is only used when needed and not at other times.
• The diaphragm cannot be felt when it is in place. The man usually does not feel it either.

Disadvantages:

• The diaphragm must be fitted at an office visit.
• The diaphragm must be inserted BEFORE sex, up to one hour ahead of time.
• It must be used for EVERY act of intercourse. For intercourse more than once, you must insert additional spermicide without removing the diaphragm.
• The diaphragm must be left in the vagina for 6 hours after sex to be sure there are no live sperm left.
• It should be removed before 24 hours.
• A few women have problems with bladder infections when using the diaphragm because of pressure near the bladder.
• Rarely, a diaphragm cannot fit some women because of the shape of their pelvis or cervix.
• The diaphragm failure rate is about the same as for condoms - 10-20%.

How effective is this method?

• 94% effective

Emergency Contraception

Emergency contraception pills are hormones commonly used in birth control pills. It is believed they help prevent pregnancy by interfering with ovulation (release of the egg from the ovary) or by the changing the ability of the sperm to fertilize the egg. The hormones might also work by changing the lining of the uterus so implantation does not occur.

Emergency contraception is NOT as effective as a regular method of birth control, but it can help reduce to chance of pregnancy in an emergency.

• Do not rely on this for ongoing birth control.
• Women might use emergency contraception after forced sex (such as an assault), or if a method fails (such as a broken condom), or if a method is not used correctly (forgotten pills, late Depo Provera shot).
• Emergency contraception is sometimes called the "morning after pill", but emergency contraception can be used up to 72 hours (3 days) after unprotected sex, not just the next morning.
• Using emergency contraception can reduce the possibility of pregnancy, but it will not disrupt a pregnancy that is already implanted in the uterus (will not cause an abortion).
• Emergency contraception is usually a pill, or several pills taken as soon as possible after unprotected sex, and a second dose taken 12 hours later.
• A prescription is needed for emergency contraception.

How effective is this method?

Effectiveness varies from 76-99% depending on how soon after intercourse it is taken. It is more effective when taken as soon as possible after intercourse.