Non-prescriptive barriers that prevent sperm from joining with an egg.
Have been used for 12,000 years. Example: Empty halves of pomegranates were used as diaphragms in ancient Greece.
Condoms are the most popular worldwide.
Other options include female condoms, sponges, and spermicides like creams, films, foams, jellies, and suppositories.
Historical Contraceptives
Included pessaries made of elephant or crocodile dung and animal membrane condoms.
Male Condom
A sheath of latex or polyurethane worn on the penis during intercourse.
Collects semen before, during, and after ejaculation.
Often used with spermicide, foam, jelly, cream, suppository, or film.
Helps protect against STIs.
Effectiveness: 80-90%; up to 98% with perfect use.
Advantages:
Protects against STIs.
Inexpensive and easy to get.
Lightweight and disposable.
Does not require a prescription.
Can be used with other methods.
Disadvantages:
Dulls pleasure.
Must be put on while the penis is erect.
Possible allergy.
Store in a cool, dry place.
Check the expiration date.
Use water-based lubricants (KY Jelly, Astroglide), not oil-based lubricants.
Female Condom
A flexible polyurethane pouch with rings at each end that is inserted up against the cervix.
The ring at the closed end holds the pouch in the vagina; the ring at the open end hangs outside of the vagina.
Collects semen before, during, and after ejaculation.
Protects against STIs.
Effectiveness: 79 – 95%.
Advantages:
May use oil or water-based lubricants.
Can be used by people allergic to latex.
Does not have an effect on women’s hormones.
Does not require a prescription.
Disadvantages:
Vaginal irritation.
May slip into the vagina during intercourse.
Reduced feeling.
Noisy.
Sponge (Today Sponge)
Non – prescriptive.
Made of foam, inserted into the vagina to block the cervix, and releases spermicides.
Can insert up to 24 hours before sex.
Must stay in for 6 hours after sex.
Average cost is 7.50–9.00 per box.
Effectiveness: 88-91% if never gave birth, 76-80% in women who have given birth.
Advantages:
Easily carried in a pocket or purse.
Does not interrupt sex.
Generally not felt by either partner.
Does not affect women’s hormones.
Disadvantages:
Difficult to insert/remove.
Vaginal irritation.
Spermicides
Creams, film, foams, jellies, suppositories which are liquids or solids that melt once inserted.
Foams block the entrance to the uterus and contain spermicide to immobilize sperm.
Creams, films, foams, jellies, and suppositories melt into a thick liquid in the vagina and block the entrance to the uterus.
Nonoxynol-9: a chemical that kills sperm.
Effectiveness: 71 – 85%.
How to obtain:
Available at drugstores, family planning clinics, and some supermarkets.
Applicator kits of foams and gels are approximately 8.00, refills cost 4.00–8.00.
Large cans of foam contain between 20-40 applications.
Advantages:
Easy to get and use.
Does not require a prescription.
Does not affect women’s natural hormones.
Disadvantages:
Messy.
May irritate the penis or vagina.
How to use:
Follow directions on packages.
Most require waiting 10 minutes after insertion for sexual intercourse.
Typically active for 1 hour after insertion.
More spermicide must be inserted each time vaginal intercourse is repeated.
Prescription Methods
Medically prescribed hormones, barriers, or devices.
Includes diaphragms, cervical caps, the pill, the patch, the ring, the shot, the implant, and IUDs.
The Diaphragm
Dome-shaped latex cup with a flexible rim. Worn inside the vagina, covers the cervix, and prevents sperm from entering.
Used with spermicides.
Fitted by a doctor.
Can be put in several hours before sex and must stay in 6 hours after.
Effectiveness: 80 – 95%.
How to obtain: Prescription.
Available in different sizes.
A new size is needed after pregnancy, weight gain/loss of 20 pounds, miscarriage or abortion, abdominal/pelvic surgery.
Replace every 2-3 years.
Cost: between 30.00−80.00.
Advantages:
Easily carried.
No effect on women’s hormones.
Can’t be felt by either person.
Disadvantages:
May require fitting.
Can’t use during menstruation.
Difficult to insert.
Can be pushed out of place.
Doesn’t protect against STIs.
Can increase the risk of TSS (Toxic Shock Syndrome).
Cervical Cap
A small firm latex or silicone cup that suctions to the cervix, similar to a diaphragm.
Used with a spermicide to kill sperm.
Requires fitting by a doctor.
Comes in different sizes.
Lasts one year.
Effectiveness: 80%.
Advantages:
Doesn’t affect women’s hormones.
Doesn’t require as much spermicide as a diaphragm.
Can be left in for 48 hours.
Unnoticeable by both partners.
Disadvantages:
Must be fitted by a doctor.
Difficult to insert.
Doesn’t protect against STIs.
Can increase the risk of TSS.
The Pill
Combination Pill: Works to suppress ovulation (release of an egg).
The extra estrogen and progesterone work to thicken cervical mucus, which makes it more difficult for sperm to reach an egg.
Causes lining of uterus to thin.
Effectiveness: 99%.
Advantages:
Easy and effective.
Lighter and shorter periods.
Less menstrual cramps.
Helps with acne.
Protects against ovarian and endometrial cancer.
Disadvantages:
Must take at the same time every day.
Spotting.
Increased headaches.
Mood changes.
Breast tenderness.
Depression.
Decrease in sex drive.
Weight gain.
Major problems associated with the pill (very rare but possible):
Increased hormone levels can cause:
Blood clots in legs, lungs, heart, or brain.
High blood pressure.
Liver tumors (very rare).
Combination with smoking can lead to an increased risk for heart attack, as well as those over 35.
Factors that decrease efficiency:
Taking antibiotics or medications.
Having diarrhea or vomiting.
Not taking it at the same time every day.
Combination pills come in packs with 28 or 21 pills.
Both have 21 “active” pills which contain hormones.
The last 7 pills are reminder pills and do not contain hormones.
The Patch (Ortho Evra)
A thin beige, plastic patch placed on the skin once a week for 3 weeks.
Releases estrogen and progestin to prevent the release of an egg.
Thickens cervical mucus and thins the lining of the uterus.
Effectiveness: 99% with perfect use.
How to obtain: Available by prescription.
Average cost is between 30.00−40.00 a month.
Advantages:
Simple, safe, easy.
More regular, lighter, and shorter periods.
Helps against certain cancers.
Helps with acne.
Helps with PMS.
Disadvantages:
Depression.
Skin reaction.
Releases more estrogen than the pill, increasing the chance of effects.
May cause serious side effects, similar to the pill.
How to use the patch:
Apply one patch to the skin once a week.
Designate a “patch day.”
Will use the patch for 3 weeks; the 4th week will be the menstrual period.
Can be worn on the buttocks, arm, or back.
The Shot (Depo-Provera)
Injectable progestin-only prescription.
Prevents pregnancy for 12 weeks.
Works to prevent ovulation, thicken cervical mucus, and thin the lining of the uterus.
30−75 per injection.
Effectiveness: up to 99%.
Advantages:
Effective for 12 weeks.
No pill to take daily.
Helps prevent cancer of the lining of the uterus.
Disadvantages:
Loss of monthly period.
Change in appetite.
Weight gain.
Depression.
Hair loss or increased hair on face/body.
May cause a delay in getting pregnant after stopping.
Loss in bone density.
How to use the shot:
Meet with a doctor every 12 weeks.
Receive shot in arm or buttocks.
Periods become lighter and fewer and often stop altogether.
Increased spotting.
The Implant (Implanon)
A thin plastic implant, about the size of a matchstick, inserted under the skin of the upper arm.
Releases progestin, which prevents ovulation and thickens the mucus.
Effectiveness: up to 99% for 3 years.
How to use the implant:
Meet with a doctor.
How it’s administered:
Numbs the arm and inserts the implant just under the skin. You can feel it, but won’t see it.
Only takes a few minutes.
Protection against pregnancy is immediate within the first 5 days of the menstrual cycle.
Advantages:
No medicine taken every day.
Nothing needs to be put in the vagina before intercourse.
Long-lasting birth control without sterilization.
Quickly become pregnant after removal.
Disadvantages:
Irregular bleeding.
Fewer and lighter periods or may stop all together.
Acne.
Depression.
The Ring (Nuva Ring)
A small flexible ring inserted into the vagina once a month (left in for 3 weeks, taken out the 4th).
Releases estrogen and progestin, which prevent ovulation, thicken mucus, and thin the lining of the uterus.
Effectiveness: up to 99%.
Cost: 30–35.00 a month.
How to use the Ring:
Meet with a doctor.
First-time use: insert between day 1 – day 5 of your period.
Wash hands, press sides of the ring together, and insert in the vagina.
Remove in 3 weeks; the same day it was inserted; wrap and throw away.
The 4th week will be your period.
Advantages:
Simple, safe, convenient.
No daily pill is required.
Regular lighter periods.
Disadvantages:
Spotting.
Weight gain/loss.
Mood changes.
Nausea.
Vaginal irritation/infection.
Severe problems: same as the pill.
Can’t use diaphragm/cap.
Intrauterine Devices (IUD)
Small “T-shaped” plastic devices available only by prescription.
Two types:
Paragard (Copper T 380A): contains copper and can be left in for up to 10 years.
Mirena: continuously releases small amounts of progestin; effective up to 5 years.
Both work to keep sperm from meeting the egg.
Effectiveness: 98% - 99%.
How to use an IUD:
Will use a speculum to hold the vagina open, and then measure the cervix and uterus.
The IUD is inserted through a tube (like a tampon); the “T bars” then open, and the IUD is left in place with the string hanging 1-2 inches outside the cervix.
Can cause cramps and discomfort.
Check for strings regularly.
Follow-up visit within 3 months.
Cost: 175−400 for exam insertion and follow up visit.
Advantages:
The most popular form of reversible birth control in the world.
Pregnancy can be quick after stopping.
Disadvantages:
Copper: increased cramps, more bleeding.
Mirena: irregular bleeding/spotting.
Infection or puncture of the uterus during insertion.
Ectopic pregnancies (in the fallopian tube).
Emergency Contraception
Morning after pill/Plan B.
Over the counter for 17 and older; under 17 requires a prescription (Ohio Law).
Gives the body a short, high burst of hormones, which disrupts plans needed for pregnancy.
Take two pills:
The first one within 72 hours of intercourse (earlier is more effective).
The second one 12 hours after the first.
Reduces the risk of pregnancy by 89%.
Must take with food.
Side effects: Nausea, vomiting, breast tenderness, dizziness, fluid retention, and irregular bleeding.
Behavioral Methods
Most often used by people who have few alternatives.
Complete abstinence: Refraining from any intimate genital contact.
100% effective.
Protects against STDs.
Important decision.
Can still have a relationship without sex.
Many alternatives to sex.
Withdrawal
Removal of the penis from the vagina before ejaculation.
No cost.
Effectiveness: 50 – 80%.
Advantages: no hormones or devices.
Disadvantages: not very effective, requires a lot of self-control.
Fertility Awareness/Rhythm
Methods are based on charting fertility patterns.
Include: checking temperature daily, checking cervical mucus daily, recording menstrual cycles on a calendar, and keeping very accurate records of the monthly period.
Not effective against STDs; use condoms to reduce risk.
Effectiveness: 75 – 99%.
Cost: 5−8 and up/temperature kits.
Advantages:
No medical or hormonal side effects.
Disadvantages:
Expert training is needed.
Risks during “unsafe” days.
Poor record-keeping.
Illness or lack of sleep affect body temp.
Vaginal infections can cause changes with mucus.
Permanent Methods
Sterilization: the most popular method of birth control in the US.
Tubal sterilization: Blocks women’s tubes that carry sperm.
Vasectomy: Blocks men’s tubes that carry sperm.
Both are often used for men and women who have completed having children.
Cost: 2,000–6,000 for tubal sterilization; 240−520 for vasectomy.
Effectiveness: 99%.
Tubal Ligation (Female)
Fallopian tubes are cut and tied.
Essure uses micro-inserts which are put up the vagina, uterus, and tubes that cause scar tissue to grow and block the tubes.
A test is taken in 3 months to check for blockage; use a different method of control till then.
Vasectomy (Male)
Each vas deferens is located through an incision in the scrotum, and is tied off or blocked.
Need to get a check-up in 3 months for semen analysis.
Will still ejaculate after the operation, but will not contain sperm.