Birth Control Options
What is contraception?
Contraception (also called “birth control”) is any method that is used to prevent pregnancy. Most people know about options such as birth control pills and condoms. There are also other options. If you’re thinking about using birth control, talk with your family doctor about what kind of contraception might be right for you.
What kind of birth control is right for me?
Your family doctor can describe the pros and cons of each birth control option. The type of birth control you choose will depend on your health, your preferences, and your personal beliefs. It will also depend on your needs. Some people only need to prevent pregnancy. Other people may also want to protect themselves or their partners from diseases that can be passed by having sex. These diseases are called These diseases are called sexually transmitted infections (STIs).
Is saying “no” to sex really an option?
Yes. No method of birth control is 100% effective. The only way to make absolutely sure that sex won’t result in pregnancy or an STI is not to have sex at all. This is sometimes called “abstinence.”
Barrier methods of birth control
Barrier methods prevent pregnancy by blocking sperm from getting into the uterus. They include the diaphragm, the cervical cap, contraceptive sponges, and condoms. Barrier methods must be used every time you have sex. Using a diaphragm, cervical cap, or contraceptive sponge may increase the risk of bladder infections in some women. These methods also cause allergic reactions in some women.
What about the diaphragm and the cervical cap?
The diaphragm is a dome-shaped cup that is inserted into the vagina and fits over the opening to the uterus (the cervix). For effective birth control, your diaphragm has to fit well. Your doctor will do an examination to find the correct size and fit for you.
The cervical cap is a silicone cup that is inserted into the vagina and fits over the cervix. It comes in 3 sizes. Your doctor will determine which size you need.
Both the diaphragm and the cervical cap must be used with spermicide (a substance that stops sperm from moving) in order to prevent pregnancy. You can insert a diaphragm up to 6 hours before you have sex. You can insert a cervical cap up to 40 hours before you have sex. Once in place, these methods provide protection for 6 hours.
What about the contraceptive sponge?
The contraceptive sponge is a small foam sponge that contains spermicide. It is inserted into the vagina and covers the cervix. You can insert a sponge up to 24 hours before you have sex. Once in place, it provides protection for 24 hours. You do not need a prescription from your doctor to get contraceptive sponges.
Are condoms a good choice?
Yes. Condoms aren’t expensive and are widely available. Condoms can be combined with other methods of birth control. They are an especially good choice if you or your partner are also having sex with other people. Of all the barrier methods of birth control, condoms offer the most protection against STIs.
Using a spermicide with condoms can protect against pregnancy more effectively. However, it may not increase your protection against STIs. Most spermicides contain a chemical called nonoxynol-9 that can cause genital irritation, especially if you use spermicides frequently. This may actually increase your risk of getting HIV and other STIs.
Female condoms aren’t as effective as male condoms, but they may be a good choice if a man won’t use a male condom.
Hormonal methods of birth control
Hormonal methods of birth control prevent pregnancy mainly by preventing ovulation (the release of an egg by the ovaries). They do this by releasing the hormones estrogen and progestin (or progestin alone) into your body. Hormonal methods of birth control are prescribed by your doctor. They include the birth control pill, the patch, the vaginal ring, hormone shots, hormone implants, and intrauterine devices (IUDs).
What about the pill?
The birth control pill is an oral contraceptive. This means that you take it by mouth. For the pill to work, you have to take it every day. Most women who take the pill have a period every 4 weeks (1 period per month). One type of birth control pill reduces the number of periods from 1 period per month to about 1 period every 3 months.
The pill may reduce cramping and shorten the number of days of bleeding during the menstrual cycle. The pill may also help reduce the symptoms of premenstrual syndrome (PMS).
Some common side effects of birth control pills are nausea, breast tenderness, bloating, weight gain, and mood changes. Women who use the pill (especially women older than 34 years of age) should not smoke. Smoking increases the risk of serious side effects, such as blood clots. You may have to try several types of birth control pill before you find the one that is right for you.
What about the patch?
The contraceptive patch is a thin, flexible patch that you put on your upper outer arm, buttocks, stomach, or back (but not on your breasts). You put on a new patch once per week for 3 weeks in a row. On the 4th week, you don’t wear a patch and your period starts. You need a prescription from your doctor to get the patch.
The side effects of the contraceptive patch are similar to those of birth control pills. Breast discomfort is more common in the first 2 months using the patch. The area of skin where the patch is placed can become irritated. Women who use the patch (especially women older than 34 years of age) should not smoke. Smoking increases the risk of serious side effects, such as blood clots.
What is the vaginal contraceptive ring?
The vaginal contraceptive ring is a thin, flexible ring that you insert into your vagina. After you insert the ring, you leave it in your vagina for 3 weeks in a row and then take it out. It doesn’t have to be in a specific position in your vagina. During the week the ring is out, your period starts. After a week without the ring, you put in a new one. You need a prescription from your doctor to get the vaginal contraceptive ring.
If the ring is out of your vagina for more than 3 hours, it may not work effectively when you put it back in. To protect against pregnancy, you will need to use condoms or spermicide as birth control until a new ring has been in all the time for 7 days in a row. Women who use the ring (especially women older than 34 years of age) should not smoke. Smoking increases the risk of serious side effects, such as blood clots.
What about hormone shots and implants?
The hormone shot is an injection (typically in your arm). You have to visit your doctor for each shot. One shot prevents pregnancy for 3 months. Women who get hormone shots may have some side effects, such as headaches and changes in their periods, moods, and weight.
The hormone implant is a thin, flexible piece of plastic that is about the size of a matchstick. Your doctor inserts the implant under the skin of your upper arm. One implant prevents pregnancy for up to 3 years, but your doctor can remove the implant at any time. Side effects of the implant include irregular bleeding or spotting, or periods that are lighter or heavier than normal. Some women stop having periods entirely.
What about an IUD?
An IUD (intrauterine device) is a small, T-shaped device with a string attached to the end. The IUD is placed inside a woman’s uterus to prevent pregnancy. The insertion can be done by your doctor during an office visit. Once it is in place, the IUD stays in your uterus until your doctor removes it. The string on an IUD hangs down 1 to 2 inches into the vagina. This allows you to check that the IUD is in the right place and allows your doctor to remove the IUD.
Two types of IUD are available in the United States. One type contains copper. The other type releases a small amount of the hormone progestin. The copper IUD works for up to 10 years. One hormonal IUD lasts for up to 5 years. The other hormonal IUD lasts for up to 3 years.
Side effects of all IUDs may include cramping or pain when the IUD is first inserted and spotting between periods for the first 3 to 6 months. Side effects of copper IUDs include heavier bleeding and stronger cramps during periods. Side effects of the hormonal IUD include irregular periods in the first 3 to 6 months. Some women stop having periods entirely.
Sterilization is when a man or woman has surgery to permanently prevent pregnancy. If you’re sure that you don’t want to have children or you don’t want more children, sterilization may be the right choice for you.
Tubal ligation (also called “getting your tubes tied”) involves closing off a woman’s fallopian tubes so eggs can’t travel through them to reach the uterus. Your doctor can also close off your fallopian tubes by putting a soft, flexible insert into each tube.
Men are sterilized with a vasectomy. During this procedure, the doctor cuts or blocks the 2 tubes called the “vas deferens” so that sperm can’t get into the man’s semen.
Natural family planning
Natural family planning requires a couple to learn when a woman can get pregnant during her cycle (usually 5 days before ovulation and 2 days after ovulation). To prevent pregnancy, the couple must not have intercourse during those days. There are a number of ways to keep track of a woman’s ovulation. All of them require a lot of planning and commitment.
Is withdrawal effective?
No. When a man tries to pull out before ejaculating (“coming”), he usually leaves behind a small amount of fluid that leaks from the penis during sex. This fluid has enough sperm in it to cause pregnancy.
How well do these birth control methods work?
The table below shows the percent of women who have an unintended pregnancy within the first year of “typical use” for different types of birth control. “Typical use” includes inconsistent and incorrect use of the birth control method.
Failure rates for birth control methods
|(Percent of women who have an unintended pregnancy within the first year of typical use)|
|Male condom alone||18|
|Female condom alone||21|
|Diaphragm with spermicide||12|
|Cervical cap with spermicide||14 to 29|
|Sponge||12 to 24|
|Oral contraceptives (estrogen and progestin)||9|
|Vaginal contraceptive ring||9|
|Natural family planning||24|
|Surgical sterilization (female)||0.5|
|Surgical sterilization (male)||0.15|
*Contraceptive patch is less effective in women who weigh more than 198 pounds.
Information from The Association of Reproductive Health Professionals. Choosing a birth control method. Retrieved March 9, 2015 at https://www.arhp.org/Publications-and-Resources/Quick-Reference-Guide-for-Clinicians/choosing/failure-rates-table44.
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.