Birth Control Options

"The pill" is the common name for oral contraception. There are two basic types — combination pills and progestin-only pills. Both are made of hormones like those made by a woman's ovaries. Combination pills contain estrogen and progestin. Both types require a medical evaluation and prescription. Both can prevent pregnancy.

Combination pills usually work by preventing a woman's ovaries from releasing eggs (ovulation). They also thicken the cervical mucus, which keeps sperm from joining with an egg.

Progestin-only pills usually work by thickening the cervical mucus. Less often, they prevent ovulation.

The hormones in combination and progestin-only pills also thin the lining of the uterus. In theory, this could prevent pregnancy by interfering with implantation of a fertilized egg. But there is no scientific evidence that this occurs.

Taking the pill daily maintains the level of hormone that is needed to prevent pregnancy.

Effectiveness

The pill is one of the most effective reversible methods of birth control. Of 100 women who use the pill, only eight will become pregnant during the first year of typical use.* Fewer than one will become pregnant with perfect use.** Maybe slightly less effective for overweight women.

STERILIZATION

For women, the tubes are sealed, tied or clamped (tubal ligation). This is permanent form of birth control and should not be considered unless absolutely sure on not having more children.

Sterilization is 99% effective and is usually performed under general anesthesia.

CONDOMS

Condoms prevent pregnancy by blocking sperm from entering the vagina. Condoms are 88 to 98% effective when used correctly. Effectiveness is increased when used with spermicide. Advantages: can purchase over the counter, good method for preventing STD's. Disadvantages: reduced sensation, less sexual spontaneity, and possible breakage.

The letters "IUD" stand for "intrauterine device." IUDs are small, "T-shaped" contraceptive devices made of flexible plastic. IUD's work by preventing the sperm from fertilizing the egg. Mirena IUD's last up to five years. Copper IUD's last up to ten years. 97 to 99% effective. Side effects: menstrual cramps, infection, irregular bleeding. This form of birth control is for a person in a monogamous relationship and is not planning on trying to conceive for several years.

DIAPHRAGM

A soft, rubber dome shaped cup that is stretched over a flexible wire ring. The diaphragm blocks sperm from entering the uterus. The diaphragm must be filled with spermicide before insertion. Diaphragm can be placed up to six hours before intercourse. Effectiveness: 82-94%

Diaphragm should be checked yearly at your annual exam. Size may need to be altered due to weight gain or weight loss.

SPERMICIDES

Creams, foams, jellies, and suppositories. 79 to 97% effective. More effective if used with another barrier method. Disadvantages: insertion has to be within 1/2 hour of intercourse. Need to reapply for repeated intercourse.

VASECTOMY

Seals off ducts that carry sperm. 99% effective. Permanent form of birth control for males.

The patch — Ortho Evra — is a reversible prescription method of birth control. It is a thin, beige, plastic patch that sticks to the skin. A new patch is placed on the skin of the buttocks, stomach, upper outer arm, or upper torso once a week for three weeks in a row. No patch is used in the fourth week. The patch releases synthetic estrogen and progestin to protect against pregnancy for one month.

The hormones in the patch work by preventing a woman's ovaries from releasing eggs (ovulation). They also thicken the cervical mucus, which keeps sperm from joining with an egg. The hormones also thin the lining of the uterus. In theory, this could prevent pregnancy by interfering with implantation of a fertilized egg. But there is no scientific evidence that this occurs.

The patch works best when it is changed on the same day of the week for three weeks in a row. Pregnancy can happen if an error is made in using the patch — especially if

it becomes loose or falls off for more than 24 hours
the same patch is left on the skin for more than one week

If either of these things happens, follow the directions in your package insert, and call your clinician.

Effectiveness

The patch is a very effective reversible method of birth control. With typical use,* although no studies have yet been published, it is assumed that the patch will be more effective than the pill — eight out of every 100 pill users become pregnant with typical use. Fewer than one woman out of every 100 women who use the patch will become pregnant with perfect use.**

The patch may be less effective for women who weigh more than 198 pounds.

The patch does not protect against sexually transmitted infections. Always use a latex or female condom with the patch to reduce the risk of infection.

The Ring — NuvaRing — is a reversible prescription method of birth control. It is a small, flexible ring that is inserted into the vagina once a month. It is left in place for three weeks and taken out for the remaining week. The ring releases synthetic estrogen and progestin to protect against pregnancy for one month.

The combination of hormones works in two ways. Usually, it keeps the ovaries from releasing an egg (ovulation). Less often it thickens the cervical mucus, which prevents sperm from joining with an egg. The hormones also thin the lining of the uterus. In theory, this could prevent pregnancy by interfering with implantation of a fertilized egg. But there is no scientific evidence that this occurs.