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Methods of Birth Control

Choosing to use birth control, and choosing the method that makes the most sense for you, is a very personal decision.  We’ve provided brief information here on the different types of birth control, so that you will be informed about your choices. But it’s always best to consult your physician or other health care provider about your specific needs and concerns.

  • Barrier Methods

    Barrier methods are birth control methods that work by creating a physical barrier to try and prevent the passing of bodily fluids from one person to another. Examples of barrier methods include condoms, cervical caps, diaphragms, sponges, and dental dams. Of those, only dental dams and condoms are recommended to prevent the transmission of HIV.

  • Condoms

    The condom has many slang names, including "rubber," "wrapper," and "raincoat." All of these terms refer to a sheath typically made of rubber that is placed over the erect penis before entering the vagina to block the passage of sperm and prevent pregnancy. Aside from abstinence, latex condoms are the most effective method for reducing the risk of infection from the viruses that cause AIDS, other HIV-related illnesses, and other sexually transmitted infections (STIs).

    A condom can be used only once and is available at many stores and pharmacies (no prescription required). Some have spermicide added (usually nonoxynol-9 in the United States) to kill sperm, however, spermicide has not been scientifically shown to provide any additional protection over the condom alone. Because they act as a mechanical barrier, condoms prevent direct vaginal contact with semen, infectious genital secretions, and genital lesions and discharges.

    Some condoms are pre-lubricated. These lubricants don't provide more birth control or STD protection. Non-oil-based lubricants, such as water or K-Y jelly, can be used with latex or lambskin condoms, but oil-based lubricants, such as petroleum jelly (Vaseline), lotions, or massage or baby oil, should not be used because they can weaken the material. The overall failure rate of condoms is 3% when used according to manufacturer directions. 

  • Vaginal Ring

    Vaginal rings work similarly to oral contraceptives to prevent pregnancy.  This flexible ring is imbedded with estrogen and progesterone is inserted into the vagina and left in place for 3 weeks.  The hormones are released and absorbed into the blood stream. The ring is removed and replaced after the 4th week. 

    Failure rates are similar to the pill.

    The risks of using the ring are the same as using oral contraceptives.  The ring does not protect you against HIV or STIs

    The most common side effects are vaginal irritation, infection headache, weight gain and nausea.

  • Permanent Birth Control
    Female Tubal Occlusion and Tubal Ligation and Male Vasectomy

    Surgical sterilization is a birth control option intended for people who don't want children in the future. It is considered permanent because outcomes to reverse these procedures are poor and frequently require referrals to fertility specialists to assist with reproduction. Both men and women can be sterilized.

    Female (tubal ligation) done by various surgical techniques (to mechanically disconnect or band the fallopian tubes so the egg can't travel to the uterus.

    Tubal Occlusions block the fallopian tubes by inserting a micro insert through the uterus and into the fallopian tube. Over time the tube forms a “plug” to block the tube. A follow up test usually three months after the procedure is required to determine if both tubes are fully blocked. Until your tubes are completely blocked you will need to use alternative birth control. 

    Complications from these operations are rare, but can include infection, and bleeding. While both procedures are considered “permanent sterilization methods,” they also have failure rates of approximately .1%.

    Male sterilization is called vasectomy. This office-based procedure involves tying or cutting of the vas deferens. The vas deferens is the tube that carries sperm from the testicle to the penis. Vasectomy is a quick operation. There are minor reported complications like local bruising or infection.

  • IUDs

    An intra-uterine device (IUD) is inserted into the uterus by a health-care professional.

    An IUD can remain in place for 7-10 years, depending on the type of IUD.   It's not entirely clear how IUDs prevent pregnancy. They seem to prevent sperm and eggs from meeting by either immobilizing the sperm on their way to the fallopian tubes or changing the uterine lining so the fertilized egg cannot implant in it.

    IUDs do not protect you from Sexually Transmitted Infections.  If you have multiple partners or are at risk of STIs you should consider another form of birth control.  Risk of pelvic inflammatory disease increases with IUD use and STIs.

    IUDs have one of the lowest failure rates of any contraceptive method. The overall failure rate is 2%.

    At insertion, there is a small risk of uterine perforation.  Post insertion side effects are cramping and a reduction in bleeding.

  • The Pill

    “The pill” refers to one of the various forms of birth control that is taken orally (by mouth). Combined oral contraceptives have been on the market for more than 35 years and are the most popular form of reversible birth control in the United States. This form of birth control is called reversible because it suppresses ovulation (the monthly release of an egg from the ovaries) by the combined actions of the hormones, estrogen and progestin. Find out All about the pill here.

  • Abstinence

    Abstinence, not having sexual intercourse, is a nearly 100% effective form of birth control. There remains a remote chance of conception, if pre-ejaculatory or ejaculatory fluid is released near the vulvar or external vaginal area, especially if this is followed by digital manipulation or penetration.

  • Dental Dams

    A dental dam, like a condom, is one type of barrier method. It is a square piece of rubber that is placed over the labia or anus during oral-vaginal or oral-anal intercourse. It has not shown to be as effective as condoms for reducing sexually transmitted infection (STI) transmission in heterosexual relationships.

  • Female Condoms

    The Female Condom,  consists of a lubricated polyurethane sheath shaped similarly to the male condom. The closed end, which has a flexible ring, is inserted into the vagina, while the open end remains outside, partially covering the labia. The female condom, like the male condom, is available without a prescription and is intended for one-time use. It should not be used at the same time as a male condom because they may not stay in place. The overall failure rate of female condoms is 5% when used according to manufacturer directions.

  • Natural Family Planning

    For many reasons, some couples use fertility awareness as their main method of birth control. Also known as natural family planning or periodic abstinence, fertility awareness entails not having sexual intercourse on the days of a woman's menstrual cycle when she could become pregnant or using a barrier method of birth control on those days.

    Because a sperm may live in the female's reproductive tract for up to seven days and the egg remains fertile for about 24 hours, a woman can get pregnant within a relatively long timeframe--from seven days before ovulation to three days after. Methods to approximate when a woman is fertile are usually based on the menstrual cycle, changes in cervical mucus, or changes in body temperature.

    The overall failure rate of using natural family planning ranges from 1-9% when all directions are followed. Click here, for more information on ovulation and signs of fertility.

  • Withdrawal as a birth control method

    In this method, also called coitus interruptus, the man withdraws his penis from the vagina before ejaculation. Fertilization is prevented because the large quantity of sperm in the ejaculate, isn't released in the vagina.

    Effectiveness depends on the male's ability to withdraw before ejaculation and the pre-ejaculatory fluid having too few sperm to make fertilization likely. Failure rates vary from 4-19%, depending on the man's ability to fully withdraw from the vagina before the ejaculate is released.

    Also, withdrawal doesn't provide protection from sexually transmitted infections (STIs), including HIV. Infectious diseases can be transmitted by direct contact with surface lesions and by pre-ejaculatory fluid.

  • Contraceptive Creams and Lotions

    Vaginal creams, lotions, foams, jellies, films, suppositories, and tablets containing sperm-killing chemicals are available without a prescription in many stores and pharmacies.

    There is no definitive data on the effectiveness of these spermicides, but the failure rate for typical users may be as high as 21% . Package instructions must be carefully followed because some spermicide products require you to wait 10 minutes or more after inserting the spermicide before having sex.

    One dose of spermicide is usually effective for one hour. For repeated intercourse, additional spermicide must be applied. After intercourse, the spermicide has to remain in place for at least six to eight hours to ensure that all sperm are killed. The woman should not douche or rinse the vagina during this time.

  • Cervical Caps

    A cervical cap is a soft rubber cup with a round rim, sized by a health professional to fit snugly around the cervix. It is available by prescription only and, like the diaphragm, is used with spermicide to kill sperm.

    It protects for 48 hours and for multiple acts of intercourse within this time. Wearing it for more than 48 hours is not recommended because of the risk, although low, of toxic shock syndrome (TSS), a rare but potentially fatal infection. Symptoms of TSS include sudden fever, stomach upset, sunburn-like rash, and a drop in blood pressure. Also, with prolonged use of two or more days, the cap may cause an unpleasant vaginal odor or discharge in some women. The overall failure rate of the cervical cap (with spermicide) is 9% if you’ve had no previous births and 26% if you’ve had previous births.

  • Implantable Contraceptive Rods

    Implantable birth control is made up of a matchstick-sized  rod imbedded with progestin. This rod is  inserted under the skin of the upper arm, where it steadily releases the contraceptive.

    Protection lasts up to three years (or until it is removed The overall failure rate is 0.01%.

    The most common side effect is irregular periods (more bleeding, less bleeding or no bleeding).  Other side effects include inflammation or infection at the site of the implant, weight gain, and breast tenderness.

  • Diaphragms

    Available by prescription only and sized by a health professional to insure a proper fit, the diaphragm provides two ways to prevent pregnancy. A dome-shaped rubber disk with a flexible rim covers the cervix so sperm can't reach the uterus, while a spermicide applied to the diaphragm before insertion kills sperm.

    The diaphragm provides protection for six hours. For intercourse after the six-hour period, or for repeated intercourse within this period, fresh spermicide should be placed in the vagina with the diaphragm still in place. The diaphragm should be left in place for at least six hours after the last intercourse, but not for longer than a total of 24 hours because of the risk of toxic shock syndrome (TSS), a rare but potentially fatal infection. Symptoms of TSS include sudden fever, stomach upset, sunburn-like rash, and a drop in blood pressure.

    The overall failure rate of the diaphragm (with spermicide) is 9% when used according to the manufacturer’s directions.

  • Depo-Provera

    Depo-Provera is a hormonal injection by a health professional every three months. It prevents pregnancy in three ways: it inhibits ovulation, changes the cervical mucus to help prevent sperm from reaching the egg, and changes the uterine lining to prevent the fertilized egg from implanting in the uterus. The injection, which contains the hormone progestin, is extremely effective in preventing pregnancy.

    The overall failure rate is 0.3% when used as directed. The benefits are similar to those of the minipill and another progestin-only contraceptives, Side effects are also similar and can include irregular or missed periods, weight gain, and breast tenderness.

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