The types of contraception available have grown in number over the last 50 years, providing women with an array of viable options for preventing pregnancy. With so many choices, knowing which method is best for you can be confusing. Where do you begin? By understanding the contraception effectiveness, benefits and risks of each method , and weighing the importance of factors, like convenience, spontaneity and comfort, you can choose the method that is best for you.
Oral contraceptives, commonly referred to as birth control pills or simply The Pill, work by preventing ovulation (the cyclical release of an egg from the ovaries for fertilization). Two kinds of oral contraceptives are commonly prescribed: those that use the hormone combination of estrogen and progesterone and those that use progesterone only. The latter is often called the Mini Pill. When taken correctly, both pills have a 98 to 99% effectiveness rate. Neither pill however, protects against sexually transmitted diseases (STDs).
Women have reported side effects from The Pill ranging from nausea, weight gain and, for nursing mothers, a reduction in breast milk production. Risks include increased blood pressure, potential for blood clots and greater chance of stroke. Women who take The Pill should not smoke, especially if they're over the age of 35. Smoking while taking The Pill increases your chances of developing blood clots and/or having a stroke. On the upside, birth control pills can regulate an irregular menstrual cycle, improve acne, reduce cramping and lessen PMS symptoms.
The Mini Pill is generally considered safer than combination pills for women over the age of 35 and/or women who are already at risk for blood clots. If you're taking the Mini Pill, you're still encouraged not to smoke, especially after the age of 35. You may also experience shorter, lighter periods. Side effects include light bleeding or spotting between periods.
Hormone Patches, Shots and Rings
The hormone patch is a small patch you place on your buttocks, abdomen or upper body (not breasts) that releases estrogen and progesterone just like the birth control pill. Unlike The Pill, which must be taken every day, the patch only needs to be replaced every two weeks. The hormone released through the skin works like birth control pills to prevent ovulation.
Hormone shots work much like the birth control pill and the patch, only your doctor administers the hormones via injection each month or in some cases, only every three months (frequency depends on the brand name hormone prescribed for you). Most women are attracted to this option for its convenience-after your injection, there's nothing you need to do until your next one.
The advantage of hormone patches and shots is that you don't need to remember to take your pill each day. Side effects are similar to the Pill and neither option will protect you from STDs.
The vaginal contraceptive ring is made from a flexible material that is inserted into the vagina where it remains for up to three weeks. During this time, it releases hormones, just like oral contraceptives or the hormone patch. The side effects are similar to the other hormone-based contraceptives, but many women like the convenience and that once the ring is in place, you don't have to think about your birth control for a few weeks.
Barrier methods of contraception work by preventing sperm from entering the uterus. Popular forms of the barrier method contraceptives include male and female condoms, the diaphragm and the cervical cap. All of these methods must be used every single time you have sex for them to be effective and the effectiveness of each is increased when used in combination with spermicidal gels or lubricants.
Condoms. Condoms are thin sheaths of latex that fit either on a man's erect penis (male condom) or line a woman's vagina (female condom). They are not as effective as some methods of contraception (11 pregnancies per 100 women using male condoms for a year, 21 pregnancies per 100 women using female condoms for a year), but they are inexpensive, widely available and help protect against STDs. The disadvantage for some women is that sexual activity must be stopped to put the condoms into place properly which, for some, dulls the romance.
The Diaphragm and Cervical Cap. The diaphragm and cervical cap are both thin cap-like sheaths that fit snugly over the cervix. Both require you to insert the apparatus into your vagina prior to engaging in intercourse, although the diaphragm can be inserted up to two hours prior to having intercourse.
The diaphragm must remain in place for three to four hours after intercourse, and it is recommended that you use a spermicidal lubricant with this method. Once the diaphragm or cervical cap is in, most women don't feel it, making it a pleasant option.
Your doctor will need to fit you for these methods, but the side effects are minimal. However, the failure rate is rather high-17 pregnancies for every 100 women using a diaphragm or cervical cap for a year.
Intrauterine Device (IUD)
An IUD is a piece of flexible plastic that is inserted into the uterus by your doctor. It works by preventing the egg from attaching to the wall of the uterus. Although IUDs have the advantage of not using hormones to prevent pregnancy, two common side effects are heavy bleeding and painful cramping during menstruation. However, the IUD is highly effective: the failure rate is about 1% (one pregnancy occurs in every 100 women using an IUD for a year).
Fertility Awareness. Also known as natural family planning, fertility awareness is a contraceptive method based on documenting your menstrual cycle, with an emphasis on ovulation. Using a calendar, a vaginal thermometer and a watchful eye for changes in your vaginal mucus secretions, you'll record changes in your body throughout the month to identify your fertile time.
Based on this information, you'll determine when to abstain from sexual intercourse to prevent pregnancy. Of all the contraceptive methods, fertility awareness has the highest failure rate-20 pregnancies per 100 women practicing this method for one year.
Permanent Methods. Some women and/or couples have either made a firm decision not have children or have completed their families and no longer wish to deal with contraceptive methods. These options are best for long-term partners who are certain they do not and will not desire more children in the future. In some cases, these procedures can be reversed, but success rates vary and subsequent fertility can be affected.
Women may opt for a tubal ligation (having the their tubes tied), where the fallopian tube is surgically cut and tied, or full sterilization where the tubes are cut and cauterized for a permanent seal to prevent eggs from being fertilized. Men can opt for vasectomy-another surgical procedure-which involves cutting and cauterizing the tubes that carry sperm into the seminal fluid.
Because so many contraceptives work by injecting hormones into your body (usually estrogen and/or progestin), these contraceptives have side effects that mimic pregnancy or PMS.
The contraceptive sponge is a simple form of birth control that works much like a diaphragm without a prescription.
If you want a form of birth control you won't have to think about, that does not put unwanted hormones into your body and is highly effective, you may want to consider using the IUD or Intrauterine contraceptive device.