Birth Control

There are many options when it comes to birth control. They all have their strong points and weak points and the decision on what to use is very personal. The following table is a brief summary of the methods available to help start the discussion of what method is best for you. Further discussion with a healthcare provider is encouraged to gain a better understanding of the options being considered.

Behavioral Methods
Method Description Strong Points Weak Points
Abstinence There is some variation on the definition of abstinence varying from no sexual contact to no intercourse only. It is the only method, if used in a stricter sense, that will prevent spread of STIs and pregnancy. No pregnancy risk

Little/no risk for STI

No side effects/health risks

Free
May experience difficulty resisting pressure to have sexual contact

Requires self-discipline
Fertility awareness This refers to a woman’s recognition of the fertile days of her cycle. This can be done by measuring body temperature, charting mucus changes, or the calendar method. Detailed discussion with a healthcare provider can help define these techniques. No health risks/side effects

Very low cost

Helps a woman understand her body better
Typically, only 75% effective against pregnancy

Difficult for women with irregular cycles
Hormonal Methods
Method Description Strong Points Weak Points
Depo-Provera Depo-Provera is an intramuscular shot of hormones given once every three months. It acts by stopping ovulation and thickening cervical mucus, making it harder for sperm to travel into the uterus. A prescription is required to get this medicine. 94-99+% effective against pregnancy

Easy to use

Does not interfere with sex

May decrease menstrual cramps, bleeding, and PMS

No protection from STIs

Requires shot (provider visit) every 3 months

May take several months to leave system after stopping

Long term use can decrease bone density (calcium supplements recommended)

Possible side effects of weight gain, depression, headaches, or dizziness

Birth control pills Birth control pills (BCPs) release hormones that halt ovulation, as well as thicken cervical mucus making it hard for sperm to get into the uterus. There are many different pills that vary with regard to the hormone(s) they contain and the length of time they allow between cycles. BCPs must be taken at the same time every day to be optimally effective. A prescription is required. 91-99+% effective

Easy to use Does not interfere with sex

May lighten periods and make them more regular

May decrease menstrual cramp
No protection from STIs

Must remember to take the pill at the same time every day

Health side effects: very small chance of blood clots, heart attacks, strokes, HBP (esp. if smoker)

May cause weight gain, spotting,headaches, nausea, depression, or moodiness

Most side effects go away or lessen after 3 months

Vaginal ring This is a soft flexible ring that a woman inserts in her vagina for three weeks, then removes it for the fourth week during which she has her menstrual period. The ring releases hormones that halt ovulation and thickens cervical mucus. A prescription is required to get this medicine. 91-99+% effective

Easy to use

Does not interfere with sex

Lightens menstrual periods and cramps

Helps prevent ovarian and endometrial cancer

No protection from STIs

Must be worn whether having sex or not

Health side effects: very small chance of blood clots, heart attack, stroke, and HBP (esp. if smoker)

May cause weight gain, spotting, headaches, nausea, depression, moodiness, blurred vision, oily skin, or breast tenderness

Most side effects go away or lessen after 3 months
Birth control patch The birth control patch is a thin plastic square that is applied to the skin and works much like BCPs, releasing hormones that stop ovulation. The patch stays in place for 3 weeks, then is removed for the 4th week when menstruation takes place. A prescription is required to get the patch. 91-99+% effective

Easy to use

Does not interfere with sex

Lightens menstrual periods and cramps

No protection from STIs

Must be worn whether having sex or not

Health side effects: very small chance of blood clots, heart attack, stroke, and HBP (esp. if smoker)

May cause weight gain, spotting, headaches, nausea, depression, moodiness

Reports of blurred vision, oily skin, and breast tenderness

Most side effects go away or lessen after 3 months
Long Acting and Reversible
Method Description Strong Points Weak Points
IUD There are two types of intrauterine devices (IUDs), hormonal and copper. IUDs are small, T-shaped devices that are placed inside the uterus, and work to prevent sperm from reaching the uterus. The copper IUD can stay in place 10 years. The hormonal IUD releases a small amount of hormone daily and can stay in place 3-5 years. IUDs must be inserted and removed by a health care provider. 91-99+% effective

Always in place

Does not interfere with sex

Long term protection
Hormonal IUD may cause light/no periods

Can be removed at any time by health care provider

No protection from STIs

May cause menstrual changes or spotting between periods

Copper IUD may cause increased menstrual bleeding/cramping

Must be removed by health care provider
Implant An implant is a tiny plastic rod that a health care provider inserts just under the skin, usually on the inner upper arm. It releases progestin, a hormone, which stops ovulation and thickens cervical mucus. The implant lasts for 3 years. 91-99+% effective

Always in place, does not interfere with sex

Can be removed at any time by health care provider
No protection from STIs

Must be inserted and removed by health care provider

May cause spotting, lighter periods, longer periods, or no period at all
Barrier Methods
Method Description Strong Points Weak Points
Diaphragm A diaphragm is a small, flexible latex or silicone cup that is placed over the cervix providing a block so sperm cannot get into the uterus. It can be inserted up to 6 hours prior to intercourse, and must be left in place 6 hours after. Spermicide is usually coated on the cup, and if intercourse is repeated, spermicide can be reapplied. A woman must be fitted for a diaphragm by a health care provider. 88-94% effective

Can be inserted 6 hours prior to sex so will not interrupt

Only used when needed
No protection from STIs

Latex or spermicides can cause irritation or allergic reaction

Some experience difficulty with insertion/removal

Messy

Must be left in place for 6 hours after intercourse
Male condom A male condom fits over an erect penis and serves to prevent sperm from entering the vagina. If used properly, they help prevent the transfer of bodily fluids. Latex and plastic condoms protect against STIs, but are not 100%. Condoms cannot be re-used, a new one must be used each time. 82-98% effective

Reduces the risk for STIs

Readily available

Easy to use/carry

Used only when needed

Can be used with other birth control methods as additional protection

No prescription needed

Single use only, must use a new condom with every episode of intercourse

Must be used properly for optimal effectiveness

May interrupt sex

Must plan ahead, make sure condoms are available

Female condom The female condom is inserted into the vagina during sex, and prevents sperm from entering the vagina. They also reduce exchange of bodily fluids, thus reducing the risk for STIs. They cannot be used with a male condom as they will both break. 79-95% effective

Reduces the risk for STIs

Readily available

Easy to use/carry

Used only when needed

Is not dependent on a male being erect to stay in place
May be awkward to insert

May be distracting/noisy during intercourse

Must be used properly for effectiveness

Must plan ahead, make sure it’s available when needed
Other Methods
Method Description Strong Points Weak Points
Spermicides Spermicides are creams, films, foams, gels, or suppositories that contain chemicals that kill sperm. A woman inserts spermicides into her vagina prior to sex, and can be used alone or with other methods of birth control. They are available at most drug stores. 72-82% effective when used alone

Readily available without a prescription

Easy to use/carry

Used only when needed
No protection for STIs

May interrupt sex to insert right before intercourse

Can be messy

May cause irritation to either partner
Emergency contraception Emergency contraception is used after unprotected sex. In most cases, it is a morning after pill (MAP) that contains hormones that prevent ovulation or implantation. It must be used within a few days. Some MAPs are available without a prescription. There is also an IUD (ParaGard IUD) available as emergency contraception, and must be inserted by a health care provider. 98% effective if used properly (3-5 days after unprotected sex)

Some MAPs are available without a prescription
No protection for STIs

Side effects: feeling sick/dizzy, headaches, or breast soreness