3. With so many options,
choosing a form of birth
control can be daunting.
Begin with a few questions:
Do you need to protect
against STDs? How
important are convenience
and cost? What about
effectiveness? Only
abstinence is 100% effective,
but other methods come
close -- as our effectiveness
chart shows in a glance.
Review this slideshow, then
ask your doctor which
options are best for you.
4. Also called natural family
planning, fertility
awareness means avoiding
sex when the woman is
most fertile. The most
reliable way to do this is to
watch for changes in
cervical mucus and body
temperature. To use this
method correctly, it’s best
to get training from a health
care professional.
Pros: No drugs or devices,
inexpensive.
Cons: Limits spontaneous
sex, 25% of typical users
get pregnant.
5. Spermicide contains a
chemical that kills sperm. It
comes in the form of foam,
jelly, cream, or film that is
placed inside the vagina
before sex. Some types
must be put in place 30
minutes ahead of time.
Frequent use may cause
tissue irritation, increasing
the risk of infections and
STDs. Spermicides are most
often used along with other
birth control methods.
Pros: Easy to use,
inexpensive ($1 per use).
Cons: May increase the risk
of STDs, 29% get pregnant.
6. The latex condom is the classic
barrier method. It prevents
sperm from entering the
woman’s body, protecting
against pregnancy and most
STDs. Of couples who rely only
on male condoms, 15% get
pregnant in a year.
Pros: Widely available, protects
against most STDs,
inexpensive (under $1 each).
Cons: Only effective if used
correctly every time. Can’t be
reused
7. The female condom is a thin
plastic pouch that lines the
vagina and can be put in place
up to 8 hours before sex. Users
grasp a flexible, plastic ring at
the closed end to guide it into
position. It's somewhat less
effective than the male condom.
Pros: Widely available, some
protection against STDs,
conducts body heat better than a
male condom.
Cons: Can be noisy, 21% of
users get pregnant, not
reusable. Should not be used
with a male condom, to avoid
breakage.
8. The diaphragm is a rubber
dome that is placed over the
cervix before sex. It is used
with a spermicide.
Effectiveness compares to
the male condom – 16% of
average users get pregnant,
including those who don’t
use the device correctly
every time.
Pros: Inexpensive (a $15-
$75 device lasts two years.)
Cons: Must be fitted by a
doctor, no STD protection.
Can’t be used during your
period due to a risk of toxic
shock syndrome.
9. A cervical cap is similar to a
diaphragm, but smaller. The
FemCap slips into place
over the cervix, blocking
entry into the uterus. It is
used with spermicide. The
failure rate for the cervical
cap is 15% for women who
have never had children and
30% for those who have.
Pros: Can stay in place for
48 hours, inexpensive.
Cons: Must be fitted by a
doctor, no protection against
STDs. Can’t be used during
your period.
10. The birth control sponge, sold as the Today
Sponge, is made of foam and contains
spermicide. It is placed against the cervix
up to 24 hours before sex. The sponge is
about as effective as the cervical cap, with
a failure rate of 16% for women who have
never had children and 32% for those who
have. But unlike the diaphragm or cervical
cap, no fitting by a doctor is required.
Pros: No prescription, effective
immediately.
11. The most common type of birth
control pill uses the hormones
estrogen and progestin to prevent
ovulation. When taken on schedule,
the pill is highly effective. About 8%
of typical users get pregnant,
including those who miss doses.
Like all hormonal contraceptives,
the pill requires a prescription.
Pros: More regular, lighter periods,
or no periods, depending on the
type of pill. Less cramping.
Cons: Cost ($15-$50 per month),
no STD protection. May cause side
effects, including breast
tenderness, spotting, serious blood
clots, and raised blood pressure.
Some women should not use birth
control pills.
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12. Women who have trouble
remembering a daily pill may want
to consider the birth control patch.
The Ortho Evra patch is worn on
the skin and changed only once a
week for three weeks with a fourth
week that is patch-free. The patch
releases the same types of
hormones as the birth control pill
and is just as effective.
Pros: More regular, lighter periods
with less cramping, no need to
remember a daily pill.
Cons: Cost ($15-$50 per month),
may cause skin irritation or other
side effects similar to birth control
pills. Doesn’t protect against
STDs.
13. The NuvaRing is a soft
plastic ring that is worn
inside the vagina. The ring
releases the same
hormones as the pill and
patch and is just as
effective. But it only needs
to be replaced once a
month.
Pros: Lighter, more
regular periods, only
replaced once per month.
Cons: Cost ($30-$50 per
month), may cause
vaginal irritation or other
side effects similar to pills
and the patch. Doesn’t
protect against STDs.
14. The birth control shot, known as Depo
Provera, is a hormonal injection that
protects against pregnancy for three
months. For the typical couple, it is more
effective than the birth control pill -- only
3% of users get pregnant in a year.
Pros: Only injected four times per year,
highly effective.
Cons: Cost (about $240 per year), may
cause spotting and other side effects.
Doesn’t protect against STDs.
15. Birth Control Implant
The birth control implant (Nexplanon) is a
matchstick-sized rod that is placed under
the skin of the upper arm. It releases the
same hormone that's in the birth control
shot, but the implant protects against
pregnancy for 3 years. The failure rate is
less than 1%.
Pros: Lasts three years, highly effective.
Cons: More expensive upfront ($400-$800
for exam, implant, and insertion), may
cause side effects, including irregular
bleeding. Doesn't protect against STDs.
16. IUD stands for intrauterine
device, a T-shaped piece of
plastic that is placed inside the
uterus by a doctor. The copper
IUD, ParaGard, works for as
long as 10 years. The hormonal
IUD, Mirena, must be replaced
after 5 years but can lighten
periods and ease cramps. Both
types make it more difficult for
sperm to fertilize the egg. Fewer
than eight in 1,000 women get
pregnant.
Pros: Long-lasting, low-
maintenance.
Cons: Irregular or heavier
periods with ParaGard. More
expensive upfront, may slip out,
may cause side effects.
17. Tubal Ligation
If you're sure you won't
want biological children in
the future, you may be
ready for permanent birth
control. The traditional
method for women is called
tubal ligation or "having
your tubes tied." A surgeon
closes off the fallopian
tubes, preventing eggs
from making their journey
out of the ovaries. (The
banding method is shown
here.)
Pros: Permanent, nearly
100% effective.
Cons: Requires surgery,
may not be reversible,
expensive. Doesn't protect
against STDs.
18. Tubal Implants
A newer procedure makes it
possible to block the fallopian
tubes without surgery. Small
implants of metal or silicone
are placed inside each tube.
Scar tissue eventually grows
around the implants and
blocks the tubes. Once an X-
ray confirms the tubes are
blocked, no other form of birth
control is needed.
Pros: Permanent, no surgery,
almost 100% effective.
Cons: Takes a few months to
become effective. May raise
the risk of pelvic infections,
irreversible, expensive.
19. Vasectomy
Besides condoms, a
vasectomy is the only birth
control option available to
men. It involves surgically
closing thevas deferens – the
tubes that carry sperm from
the testes, through the
reproductive system. This
prevents the release of
sperm but doesn’t interfere
with ejaculation.
Pros: Permanent, cheaper
than tubal ligation, almost
100% effective.
Cons: Requires surgery, not
effective immediately, may
not be reversible.
20. Emergency
Contraception
Emergency contraception
works after sex to help
avoid pregnancy. This is an
option if no birth control
was used or if a woman
suspects her usual method
failed. Plan B, Plan B One-
Step, and a generic version
of Plan B called Next
Choice all contain a high
dose of a hormone found in
many birth control pills.
These types must be used
within 72 hours. Ella uses a
non-hormonal drug and
requires a doctor's
prescription. It can be
taken up to five days after
sex.
21. Options for Older Women
Age and lifestyle are
important factors in choosing
a form of birth control. If
you're over age 35 and
smoke or are obese, the
combination birth control pill,
patch, and ring are not
recommended. It's best to
consult your doctor about
safe alternatives. If you're
approaching the age of
menopause, the birth control
shot has an added benefit: It
may relieve some of the
symptoms of perimenopause.
22. Withdrawal
Nearly six in 10 American women report
that a partner has used "pulling out," the
age-old method that relies on the man
withdrawing his penis from the vagina
before ejaculation. Newer reviews show
that when it's done correctly every time,
about 4% of users get pregnant in a year.
With more typical use, about 18% get
pregnant.
Pros: Free, no need for devices or
hormones.
Cons: May be hard to do correctly. No
protection against STDs.
23. Least Effective Methods
Without using any form of birth
control, 85% of sexually active
couples will get pregnant within a
year. Even the least effective birth
control options reduce that number
considerably.
