Contraceptive Methods

Contraceptive Methods

Overview of Contraceptive Options

  • Types of contraceptive methods include:

    • Hormonal

    • Surgical

    • Natural

    • Barrier

Sterilization

Tubal Sterilization (Female)

  • Effectiveness:

    • The most effective method for permanent contraception in women.

    • Measures include occlusion or removal of the fallopian tubes.

  • Benefits:

    • Hormone-free.

    • Immediately effective.

    • No ongoing maintenance required.

    • Decreased risk of ovarian cancer.

    • Salpingectomy eliminates the chances of ectopic pregnancy.

  • Risks:

    • Potential feelings of regret.

    • Heavier menstrual flow and dysmenorrhea.

    • Possible injury or bleeding during the procedure.

  • Contraindications:

    • Lack of informed consent.

    • Individual conditions increase surgical risk (Marino et al., 2024).

Vasectomy (Male)

  • Effectiveness:

    • Very effective; 1 in 2000 risk of pregnancy with a negative semen analysis.

  • Benefits:

    • Does not affect testosterone or libido.

    • Faster, cheaper, and equally as effective as tubal ligation.

  • Risks:

    • Potential surgical risks.

    • Granuloma formation.

  • Contraindications:

    • Not effective immediately.

    • Prior scrotal surgery history.

    • Ethical considerations (Stormont & Deibert, 2025).

Intrauterine Devices (IUDs)

  • Effectiveness:

    • Hormonal IUD: 99.98% effective.

    • Copper IUD: 99.92% effective.

  • Description:

    • T-shaped device is inserted into the uterus.

  • Contraindications:

    • STI presence at insertion.

    • Pelvic inflammatory disease.

    • Pregnancy or suspected pregnancy (Lanzola et al., 2025).

  • Benefits:

    • Easy to use.

    • Long-term reversible contraception (LARC).

  • Risks:

    • Increased risk of ectopic pregnancy.

    • Does not prevent STDs.

    • Major side effects include expulsion, uterine perforation, and irregular bleeding.

Natural Family Planning (NFP)

  • Definition:

    • Also known as fertility awareness, involves tracking fertility signs to avoid or achieve pregnancy.

  • Effectiveness:

    • Failure rate of 22-24% when not used properly (Sung et al., 2025).

  • Benefits:

    • No physical side effects.

    • Encourages body awareness.

    • May align with personal or spiritual beliefs.

  • Risks:

    • Requires abstinence or barrier methods during fertile periods.

    • Time-consuming and potentially inaccurate if apps used.

  • Contraindications:

    • Irregular menses or inability to track periods.

    • Conditions affecting mucus and body temperature patterns.

Barrier Methods

  • Categories:

    • Chemical vs. Mechanical.

  • Mechanical Methods Include:

    • Male condoms (87% effective).

    • Internal condoms (79% effective).

    • Diaphragms (81% effective).

    • Cervical caps (60% effective).

    • Contraceptive sponges (81% effective).

  • Chemical Methods Include Spermicide:

    • Types: Foams, creams, suppositories (81% effective).

    • Prevent sperm from reaching the cervix.

    • Effectiveness lasts 1-8 hours.

  • Benefits of Barrier Methods:

    • Can protect against STDs (only condoms).

    • Immediate effectiveness and reversibility.

    • Do not affect hormones.

Emergency Contraceptives

  • Types:

    • Plan B (Levonorgestrel).

    • Next Choice.

    • Ella (Ulipristal acetate).

  • Effectiveness:

    • 75-99% effective if taken post-intercourse (ACOG, 2024).

  • Mechanisms of Action:

    • Delay or inhibit ovulation.

    • Interferes with corpus luteum function or blocks the luteinizing surge.

  • Contraindications:

    • Not effective in confirmed pregnancies.

  • Side Effects:

    • Nausea/vomiting.

    • Headache.

    • No STD protection.

Hormonal Contraceptives

Oral Contraceptives

  • Types:

    • Combination (Estrogen & Progestin).

    • Progestin-only.

  • Effectiveness:

    • 93% effective (ACOG, 2024).

  • Mechanism:

    • Suppresses estrogen and FSH, thickens cervical mucus, alters the endometrial lining.

  • Contraindications:

    • Pregnancy and cardiovascular issues.

    • Use in women > 35 years and smokers.

  • Benefits:

    • Regulates menstrual cycles and decreases flow.

    • Increased bone density/mass and reduced acne.

  • Side Effects:

    • Breakthrough bleeding, breast tenderness, nausea, and risk of cervical cancer.

NuvaRing

  • Description:

    • A soft, flexible ring is inserted into the vagina.

  • Mechanism:

    • Releases progestin & estradiol to prevent ovulation.

    • Must be replaced after 3 weeks.

  • Effectiveness:

    • 93% effective (ACOG, 2024).

  • Contraindications:

    • Pregnancy, tobacco use, and thromboembolic disorders.

  • Risks:

    • Risk of pregnancy if removed >3 hours; backup method required for 7 days.

    • No STD protection.

Implant (Nexplanon)

  • Description:

    • A single rod implant inserted into the upper arm.

  • Effectiveness:

    • Pearl index: 0.38 pregnancies per 100 women in years of use (Darney, 2025).

  • Mechanism:

    • Inhibits ovulation, thickens cervical mucus, creates poor implantation conditions.

  • Contraindications:

    • Pregnancy, liver disease, and abnormal genital bleeding.

  • Side Effects:

    • Menstrual irregularities and site reactions.

  • Benefits:

    • Long-term effectiveness and safe during lactation.

Injection (Depo-Provera)

  • Description:

    • Progestin-only injection given intramuscularly/subcutaneously.

  • Effectiveness:

    • 0.7% failure rate over 3 years (Kaunitz, 2025).

  • Administration Frequency:

    • Every 12 weeks.

  • Benefits:

    • No daily action required; potential for amenorrhea in long-term use.

  • Risks:

    • No STD protection; requires adherence to schedule.

Patch (Ethinyl Estradiol and Norelgestromin)

  • Description:

    • A patch delivering hormones transdermally.

  • Effectiveness:

    • 95% effective (Burkman, 2025).

  • Risks:

    • Weight considerations may affect efficacy; thromboembolism risk.

Abstinence

  • Definition:

    • Total avoidance of sexual intercourse.

  • Effectiveness:

    • 100% effective in preventing pregnancy and STDs.

  • Mechanism:

    • Complete adherence required to be effective.

  • Benefits and Risks:

    • No side effects; however, educational programs have not reliably reduced teen pregnancy rates.

Least Reliable Methods

Coitus Interruptus (Withdrawal Method)

  • Mechanism:

    • Penis is withdrawn before ejaculation.

  • Risks:

    • High failure rate due to potential sperm contact with the vulva.

  • Benefits:

    • Free to practice without hormonal alterations.

Breastfeeding as Contraception

  • Mechanism:

    • Prolactin production during breastfeeding can delay ovulation, but it is not reliable as a long-term contraceptive method.

  • Risks:

    • Ovulation can occur by the 6th month postpartum, even while breastfeeding.