Path to improved health
There are many options for preventing a pregnancy. Whether it’s a method, a medicine, or a device, each has its pros and cons. Some choices are permanent. Others are reversible.
- Abstinence: This means not having sexual intercourse. This is the only foolproof method of preventing a pregnancy.
- Birth control pill: This is a popular form of birth control. Taken every day by mouth, the pill is 99% effective in preventing pregnancy when used as prescribed. There are two types of birth control pills: the combination pill and the mini-pill. The combination pill works by combining the hormones estrogen and progestin to prevent ovulation (which is necessary for a pregnancy to happen). These hormones make your cervical mucus thicker, which makes it harder for sperm to move). They also thin the lining of your uterus, which makes it harder for an egg to attach there. Women who are sensitive to estrogen can take the mini pill. The mini pill only contains the progestin hormone. It prevents pregnancy by thickening cervical mucus and thinning the lining of the uterus.
- Other hormone-based methods: These include a patch, shot, implant (under the skin in the arm), and a vaginal ring that releases the hormones. These methods are 91% to 99.95% effective.
- Intrauterine devices (IUDs): A doctor inserts this small, T-shaped device into a woman’s uterus. There are two kinds: copper and hormonal (progestins). You may have pain and cramping when inserting and removing IUDs. Copper IUDs might increase menstrual cramping as well. IUDs change the mucus inside a woman’s cervix (the lower end of a woman’s uterus). This prevents the sperm from meeting with the egg. They are more than 99% effective when used properly.
- Vaginal barriers: Several birth control products can create a barrier between sperm and the uterus. This includes condoms (male and female), diaphragms, cervical caps, and contraceptive sponges. Male condoms are worn by the man. Women can insert a female condom, diaphragm, cervical cap, or contraceptive sponge directly into their vagina on their own. These methods are between 79% to 88% effective.
- Sterilization: Several surgical procedures can prevent pregnancy. These include female tubal ligation (some people refer to this as having their tubes tied). This procedure surgically blocks a woman’s fallopian tubes. This prevents sperm from entering the fallopian tube. A female hysterectomy (surgically removing the uterus) prevents pregnancy, as well. However, this particular surgery is never performed for birth control.
- For men, a vasectomy is a form of birth control. This surgical procedure prevents sperm from mixing with a man’s semen when he ejaculates. Neither surgical procedure interferes with sexual intercourse. Both are considered permanent methods of birth control. There are rare instances when the procedures can be reversed. However, it depends on age, circumstances of the first surgery, and potential health complications. Sterilization is more than 99% effective.
- Spermicides: These foam or gel-like substances kill sperm. A woman can apply them directly into the vagina. These are around 72% effective.
- Natural family planning: There is no medicine or device with this form of birth control. It relies on avoiding sexual intercourse in the days leading up to when you are more likely to be ovulating. Ovulation is the time when a woman is most likely to become pregnant. Sperm can live for a short period of time in the vaginal area. So you need to avoid sexual intercourse prior to and during ovulation. Ovulation kits and fertility monitors can help you determine if you are ovulating. Even the visual presence of vaginal discharge (clear or cloudy, stretchy mucus) can mean that you are ovulating. However, natural family planning isn’t an exact science. This method is effective about 76% of the time.
- Emergency contraception: This is not considered a typical method of birth control. It is used in cases where no birth control was used during sexual intercourse. It also is used in cases when a woman knows immediately that birth control has failed (such as when a condom breaks). Emergency contraception comes in the form of a pill (taken up to 5 days after unprotected sex) or with a copper T IUD. This must be inserted by a doctor within 5 days of unprotected sex. It is more than 99% effective.
Things to consider
Your choice of birth control should consider several things. This includes your age and overall health. You also should consider the risks and possible non-contraceptive benefits of the method, medicine, or device. Estrogen-containing contraceptives, for example, can increase your risk of blood clots. Some hormonal methods can help with painful periods or heavy menstrual bleeding. Your choice should consider how well it works for your needs. That includes thinking about whether or when you might want to start a family in the future.
Finally, your choice should consider how frequently you have to manage your birth control. For example, birth control pills must be taken daily. If you are not able to take a pill at the same time each day, you may want to consider another form. Some options (such as hormonal injections and vaginal rings) will last for up to a few months. Spermicides must be applied at least 1 hour prior to having sex. If you are not able to plan ahead or wait, that method would likely not be good for you. Some vaginal rings can be left in for a few months. Barrier methods, such as diaphragms and cervical caps, have to be removed after 6 to 8 hours. Condoms are immediately removed. However, intrauterine devices can stay in place for 3 to 10 years before having to be changed.
Questions to ask your doctor
- How do I know which method is best for me?
- Do certain birth control options cause cancer or other chronic diseases?
- Are certain forms better based on a woman’s age?
- Other than a male condom, can any other form of birth control prevent sexually transmitted disease?
- Are certain forms of birth control uncomfortable?
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.