Contraceptive Methods
Here is a quick overview of some of the different types of contraceptive methods, including a description, effectiveness*, cost, pros, and cons of each method.
*Note: Effectiveness is measured in terms of failure rate and refers to the percentage of couples who will become pregnant after a year of using that method. For example, a rate of 2-15% means that of 100 women using that method, 2 will become pregnant during the first year with perfect use of that method, and 15 will become pregnant with typical use.
BARRIER METHODS
- Male condom
What is it?
A male condom is what people typically think of when they imagine a “condom.” It is a barrier usually made of latex that prevents pregnancy and protects against STI’s. Male condoms can also be made from polyurethane, polyisoprene, or animal tissue.
Effectiveness (failure rate): 2-15%
Cost: ~$1 per condom. Prices vary.
Pros: reduces likelihood of pregnancy and STI’s, cheap, easy to obtain in drugstores and supermarkets, comes in many styles and varieties (flavored, ribbed, studded, lubricated, etc), no prescription required
Cons: possible allergies to latex (though polyurethane and polyisoprene options are available), may “ruin the mood,” risk of tearing during intercourse (about 1 in 165 condoms wearers experience tearing of the condom)
- Female condom
A female condom is a pouch with flexible rings at each end. It is inserted into the vagina before intercourse to prevent pregnancy and reduce the risk of STI’s. Female condoms are made from polyurethane, nitrile rubber, or latex.Effectiveness (failure rate): 5-21%
Cost: ~$3.60 per condom
Pros: reduces likelihood of pregnancy and STI’s, easy to obtain in drugstores and supermarkets, can be inserted up to 8 hours before intercourse, doesn’t “ruin the mood,” good for people with latex allergies, no prescription required
Cons: less effective than male condoms, more expensive and harder to find than male condoms, may cause vaginal irritation, polyurethane condom may squeak during intercourse
CHEMICAL METHODS
- Spermicide
What is it?
Spermicide is a substance that immobilizes sperm to prevent the sperm from joining with an egg. Spermicide is present in contraceptive foams, creams, jellies, and suppositories. It is inserted deep into the vagina right before intercourse and can be used in combination with the diaphragm, cervical cap, or condom.
Effectiveness (failure rate): 15-29% (when used by itself as a contraceptive method)
Cost: ~$8 for applicator kits and foam
Pros: reduces likelihood of pregnancy and non-viral STI’s, easy to obtain in drugstores and supermarkets, no prescription required, no effect on women’s hormones, cheap, immediately effective and reversible
Cons: nonoxynol-9 (the active ingredient) may actually increase the risk of viral STI transmission*, may cause vaginal irritation, high failure rate, can be messy, may be objectionable if used before oral sex
*IMPORTANT NOTE: Nonoxynol-9, the active ingredient in spermicides, may actually increase the risk of STI’s by tearing holes in the walls of the vagina or rectum. This should be an important consideration when choosing a contraceptive method. In addition, some condoms come pre-lubricated with spermicide, although studies have shown that these types of condoms are no more effective than non-spermicidal condoms. Be sure to look at the package when buying condoms to make sure you are choosing the type of condom that you want.
COMBINATION METHODS
- Diaphragm
What is it?
The diaphragm is a shallow, round, latex cup that covers the cervix, acting as a physical barrier to prevent sperm from joining an egg in the uterus. It must be used with contraceptive foam or jelly. The diaphragm can be used for up to two years, and should be washed with soap and water in between uses. Obtaining a diaphragm requires an examination with a doctor for a pap smear, pelvic exam, and diaphragm fitting.
Effectiveness (failure rate): 6-16%
Cost: Examination: $50-$200, Diaphragm: $15-$75, Spermicidal jelly/cream: $8-17 per kit
Pros: reduces likelihood of pregnancy and some STI’s, can be carried in pocket or purse, is not felt by woman or her partner, can be inserted up to six hours before intercourse, immediately effective and reversible, no hormonal effect
Cons: more expensive than condoms, cannot be used during a woman’s period, can be difficult to insert, may be pushed out of place during sex, may increase risk of urinary tract infections or toxic shock syndrome
- Cervical cap
What is it?
The cervical cap is a silicone, dome-shaped device that is smaller than the diaphragm. It is inserted into the vagina before intercourse and fits snugly over the cervix, acting as a physical barrier to prevent sperm from entering the uterus. It must be used in combination with spermicide, which is held against the cervix and acts as a chemical barrier by killing any sperm that get around the cap. The cervical cap lasts up to two years and should be washed with soap and water between uses. Obtaining a cervical cap requires an examination with a doctor for a pap smear, pelvic exam, and cervical cap fitting.
Effectiveness (failure rate): 14-29%
Cost: Examination: $50-$200, Cervical caps: $60-$75, Spermicide: $8-$17 per kit
Pros: reduces likelihood of pregnancy and some STI’s, can be carried in pocket or purse, is not felt by woman or her partner, can be worn for up to 48 hours, immediately effective and reversible, no hormonal effect
Cons: more expensive than condoms, cannot be used during a woman’s period, can be difficult to insert, may be pushed out of place during sex, may increase risk of urinary tract infections or toxic shock syndrome
HORMONAL METHODS
- “The Pill”
What is it?
The typical birth control pill commonly known as “the pill” is an oral contraceptive that is a combination of the synthetic female sex hormones estrogen and progestin. The pill prevents the releases of eggs (ovulation) and thickens the cervical mucus to prevent sperm from entering the uterus. Basically, the pill “tricks” the body into thinking it is pregnant so further fertilization does not occur.
Effectiveness (failure rate): <1-8%
Cost: $15-50 per month
Pros: one of the most effective ways to prevent pregnancy; reversible after stopping pills; increased menstrual regularity; lighter periods; can be used in combination with other non-hormonal methods (such as condoms); offers some protection against pelvic inflammatory disease, ectopic pregnancy, some cancers, and PMS
Cons: does not protect against STI’s; must be taken every day; cannot be taken by women with histories of blood clotting, strokes, breast cancer, abnormal liver function, or coronary disease; may lead to high blood pressure, blood clots, jaundice, weight gain, depression, headaches, breast tenderness, nausea, spotting between periods
- Mini pill
What is it?
The mini pill is an oral contraceptive that contains the synthetic female sex hormone progestin (no estrogen). Progestin thickens the cervical mucus to prevent sperm from joining with an egg.
Effectiveness (failure rate): <1-8%
Cost: $15-50
Pros: one of the most effective ways to prevent pregnancy; reversible after stopping pills; increased menstrual regularity; lighter periods; can be used in combination with other non-hormonal methods (such as condoms); offers some protection against pelvic inflammatory disease, ectopic pregnancy, some cancers, and PMS
Cons: does not protect against STI’s; slightly less effective than combination pills; must be taken every day; cannot be taken by women with histories of blood clotting, strokes, breast cancer, abnormal liver function, or coronary disease; may lead to high blood pressure, blood clots, jaundice, weight gain, depression, headaches, breast tenderness, nausea, spotting between periods
- Nuva Ring
What is it?
The Nuva Ring is a ring inserted into the vagina once a month for three weeks to prevent pregnancy. It releases a low dose of the synthetic sex hormones estrogen and progestin, which prevents ovulation. The ring is removed during the week of your period then a new ring is inserted after the week of menstruation. Must see a doctor for a prescription.
Effectiveness (failure rate): <1-8%
Cost: Exam: $35-250, Nuva Ring: $15-30
Pros: one of the most effective ways to prevent pregnancy; reversible; increased menstrual regularity; lighter periods; can be used in combination with other non-hormonal methods (such as condoms); offers some protection against pelvic inflammatory disease, ectopic pregnancy, some cancers, and PMS
Cons: does not protect against STI’s; cannot be taken by women with histories of blood clotting, strokes, breast cancer, abnormal liver function, or coronary disease; may lead to high blood pressure, blood clots, jaundice, weight gain, depression, headaches, breast tenderness, nausea, spotting between periods
- IUD
What is it?
The IUD, or intrauterine device, is a T-shaped plastic device that comes in two types: ParaGard, which contains copper, and Mirena, which contains progestin. The IUD is inserted by a physician into the uterus and prevents pregnancy by affecting the way the sperm moves so it does not join the egg. The ParaGard IUD can remain in the uterus for up to twelve years, while the Mirena IUD can remain in the uterus for up to five years. In addition, the ParaGard IUD can be used as emergency birth control and can reduce the risk of pregnancy by 99.9% if inserted within five days after intercourse.
Effectiveness (failure rate): <1%
Cost: Exam + IUD + insertion fee + follow-up visits: $175-650
Pros: one of the most effective forms of contraception, one-time insertion, immediately effective, reversible once removed, long-term protection against pregnancy, ParaGard doesn’t change hormone levels, Mirena can reduce period cramps
Cons: spotting between periods is common, ParaGard can cause heavy menstrual flow, expulsion of IUD can occur (but rare), no protection against STI’s, must be inserted and removed by a physician
- “The Shot” – Depo-Provera
What is it?
Depo-Provera is a shot administered in the arm once every three months to prevent pregnancy. The shot contains progestin, which prevents ovulation and thickens women’s cervical mucus.
Effectivenss (failure rate): <1-3%
Cost: $35-75 per injection, plus exam fees
Pros: one of the most effective ways to prevent pregnancy, doesn’t have to be taken daily or inserted, can be used by women who cannot tolerate estrogen, can help prevent uterine cancer
Cons: may increase risk of osteoporosis after long-term use; doesn’t protect against STI’s; not easily reversible; may cause irregular bleeding, nausea, or sore breasts
- “The Patch” – Ortho Evra
What is it?
Ortho Evra is a small patch that adheres to the skin and is usually attached to the buttocks, back, or lower abdomen. It releases a low dose of hormones and is changed once per week for three weeks then is removed for the week of the period.
Effectiveness (failure rate): 1-2%
Cost: $15-30 per month
Pros: one of the most effective ways to prevent pregnancy; reversible after stopping; increased menstrual regularity; lighter periods; offers some protection against pelvic inflammatory disease, ectopic pregnancy, some cancers, and PMS
Cons: does not protect against STI’s; cannot be taken by women with histories of blood clotting, strokes, breast cancer, abnormal liver function, or coronary disease; may lead to high blood pressure, blood clots, jaundice, weight gain, depression, headaches, breast tenderness, nausea, spotting between periods
