With all the contraceptive methods available to women today, how do you know which is best for your body? Your choice will depend on your health, sex life, comfort level, and plans for pregnancy. You also need to consider effectiveness, cost and side effects. Find out which form of birth control is right for you. Plus: How much do you know about women’s health?
There are four types of birth control: hormonal, barrier, natural, and surgical. Most are reversible, but not all. Here’s what you need to know about each of them.
Birth Control Pill
What it is: An estrogen and progestin pill taken daily to block the release of eggs from the ovaries.
Effectiveness: 99.9% when used correctly.
Advantages: May reduce premenstrual symptoms, acne and risk of pelvic inflammatory disease (PID), ovarian cancer, and benign ovarian cysts.
: Taken daily; may increase risk of heart disease
, high blood pressure, blood clots, and artery blockage, especially for smokers; does not protect against STDs or HIV.
*The Mini-pill, an oral contraceptive alternative for women who can’t take estrogen, contains only progestin. It works in the same way the combination pill does to prevent pregnancy. It’s also good for women who are breastfeeding, women who are over 35 and women who smoke. It must be taken every day, even during menstruation, and is 97% effective.
The Patch (Ortho Evra)
What it is: A patch that is worn on the upper outer arm, upper torso, abdomen, or buttocks and releases progestin and estrogen; prevents the ovary from releasing an egg to be fertilized; thickens the cervical mucous, making it difficult for the sperm to enter the uterus.
Effectiveness: 99% when used correctly.
Advantages: Discreet form of birth control; needs to be changed only once a week.
Drawbacks: Releases about 60% more estrogen than birth control pills, increasing the risk of blood clots and other serious side effects; may be less effective for women who weigh more than 198 pounds; does not protect against STDs or HIV.
What it is: Time-released synthetic progesterone injected into the buttocks or arm every three months to stop the ovaries from releasing eggs; thickens cervical mucous.
Advantages: Discreet form of birth control; injections needed infrequently; can be used by nursing women and women who cannot take estrogen.
Drawbacks: Using Depo-Provera for more than two years can trigger bone calcium loss, which may not return after usage stops; can cause irregular or heavy menstrual bleeding; can result in absence of periods after one year; triggers weight gain (about 5 pounds on average); does not protect against STDs or HIV.
What it is: A soft, flexible ring worn inside the vagina for three weeks each month; it releases a combination of estrogen and progestin that is continuously absorbed into the bloodstream.
Effectiveness: 99% when used correctly.
Advantages: Discreet; can be worn during sex; regulates menstrual period; creates lighter menstrual flow.
Drawbacks: Increased vaginal discharge; may cause irritation; requires a prescription; ring must be self-inserted and removed, and replaced monthly; does not protect against STDs or HIV.
What it is: A thin sheath of latex or polyurethane fitted over an erect penis to prevent ejaculated semen from entering the vagina.
Effectiveness: 88%. With spermicide: 85-98%.
Advantages: Inexpensive; non-prescription; one of the only contraceptives that reduces the risk of STDs.
Drawbacks: Some people are allergic to latex; reduces sensations for some people during sex.
What it is: A sheath made of polyurethane that lines the vagina to prevent sperm from entering the cervix.
Advantages: Non-prescription; reduces the risk of STDs; can be inserted up to 8 hours before sex.
Drawbacks: Sheath may move; can be noisy and uncomfortable; outer ring is visible.
Intrauterine Devices (IUDs)
What it is: A “T-shaped” device inserted into the uterus by a doctor to prevent sperm from fertilizing an egg. There are two types: Paragard (or Copper T), which contains copper and can be left in the uterus for 10 years, and Mirena, which releases a progestin-like hormone continuously for up to five years.
Effectiveness: Paragard/Copper T: 99% in first year, though effectiveness dwindles over time; Mirena: 99.9%.
Advantages: Long-lasting; Mirena may reduce risk of PID; can be used while breastfeeding; cost-effective over time; reduces risk of ectopic pregnancy.
Drawbacks: May cause menstrual discomfort (especially true of Copper-T); risk of accidental expulsion; slight risk of perforating uterine wall during insertion; neither device protects against STDs or HIV.
What it is: A solid polyurethane foam that contains spermicide.
Effectiveness: 84-91% for women who haven’t had children, 68-80% for those who have.
Advantages: Non-prescription; inexpensive; doesn’t contain hormones; often undetected by partner.
Drawbacks: Difficult to insert and remove; must be left in 6 hours after sex; may cause vaginal irritation or dryness during sex; does not protect against STDs or HIV.
What it is: A soft, shallow rubber dome that fits over the cervix, blocking sperm from fertilizing an egg. It must be used with a spermicide every time.
Effectiveness: 86-94% when used properly with a spermicide.
Advantages: Inexpensive; effective immediately; can be inserted hours ahead of time; few side effects.
Drawbacks: Must be fitted by a doctor; must remain in place 6 to 8 hours after sex; difficult to insert; may cause allergic reactions; increases risk of urinary tract infection; does not protect against STDs or HIV.
*Cervical caps fit over the cervix and are used with spermicide; 84-91% effective for women who have not had children, 68-74% effective for those who have. Lea’s Shield is a rubber disk that covers the cervix and is 85% effective. Both must remain inserted for 8 hours after intercourse, require a prescription and do not protect against STDs or HIV.
What it is: Abstaining from sex or using a barrier method on the days of the menstrual cycle when a woman is ovulating.Effectiveness: Up to 92%, depending on how meticulously it’s practiced, how regular a woman’s menstrual cycle is and what type of barrier method is used during ovulation.Advantages: No hormones; no side effects.Drawbacks: Requires that you keep track of your cycle, often by testing basal body temperatures and changes in cervical mucous, which makes it inconvenient; does not protect against STDs or HIV.
What it is: Female: Fallopian tubes are blocked, preventing the sperm from getting to the egg. Male: Vas deferens are cut to prevent sperm from traveling to the penis.
: Permanent; few to no side effects. Female: allows sexual spontaneity; cost-effective in the long run. Male: low-risk procedure; no effect on erectile function.Drawbacks
: Permanent. Female: requires abdominal incision. Male: small risk of infection. Does not protect against STDs or HIV.
Of course, the most effective contraceptive of all is abstinence. For more information on contraceptives, consult your doctor.
Published February 23, 2007
*Reviewed by Dr. Edward C. Geehr, MD