contraception

Contraception          [Return Home]

 

Birth Control and Family Planning

Contraception names

Contraception; Family planning and contraception

Contraception Definition

Which form of birth control you choose depends on a number of different factors, including your health, how often you have sex, and whether or not you want children.

Contraception Information

Here are some factors to consider when selecting a birth control method:

birth controlEffectiveness -- how well does the method prevent pregnancy? Look at the number of pregnancies in 100 women using that method over a period of one year. If an unplanned pregnancy would be viewed as potentially devastating to the individual or couple, a highly effective method should be chosen. In contrast, if a couple is simply trying to postpone pregnancy, but feels that a pregnancy could be welcomed if it occurred earlier than planned, a less effective method may be a reasonable choice.
birth controlCost -- is the method affordable?
birth controlHealth risk -- learn any potential health risks. For example, birth control pills are usually not recommended for women over age 35 who also smoke.
birth controlPartner involvement -- The willingness of a partner to accept and support a given method may affect your choice of birth control. However, you also may want to re-consider a sexual relationship with a partner unwilling to take an active and supportive role.
birth controlPermanence -- do you want a temporary (and generally less effective) method, or a long-term or even permanent (and more effective) method?
birth controlPreventing HIV and sexually transmitted diseases (STDs) -- many methods offer no protection against STDs. In general, condoms are the best choice for preventing STDs, especially combined with spermicides.
birth controlAvailability -- Can the method be used without a prescription, provider visit, or, in the case of minors, parental consent?

Contraception Condoms

birth controlA condom is a thin latex or polyurethane sheath. The male condom is placed around the erect penis. The female condom  is placed inside the vagina before intercourse. Semen collects inside the condom, which must be carefully removed after intercourse.
birth controlCondoms are available in most drug and grocery stores. Some family planning clinics offer free condoms.
birth controlLatex condoms help prevent HIV and other STDs. Polyurethane condoms may give some protection against STDs, but they are not as effective as latex ones.
birth controlAbout 14 pregnancies occur over 1 year out of 100 couples using male condoms, and about 21 pregnancies occur over 1 year out of 100 couples using female condoms. They are more effective when spermicide is also used.
birth controlRisks include irritation and allergic reactions, particularly to latex.
birth controlCondoms are used only once.

Contraception Spermicides

birth controlSpermicides are chemical jellies, foams, creams, or suppositories that kill sperm.
birth controlThey can be purchased in most drug and grocery stores.
birth controlThis method used by itself is not very effective. About 26 pregnancies occur over 1 year out of 100 women using this method alone.
birth controlSpermicides are generally combined with other methods (such as condoms or diaphragm) as extra protection.
birth controlWarning: The spermicide nonoxynol-9 can help prevent pregnancy, but also may increase the risk of HIV transmission.
birth controlRisks include irritation and allergic reactions.

Contraception Diaphragm and Cervical Cap

birth controlA diaphragm is a flexible rubber cup that is filled with spermicidal cream or jelly.
birth controlIt is placed into the vagina over the cervix, before intercourse, to prevent sperm from reaching the uterus. 
birth controlIt should be left in place for 6 to 8 hours after intercourse.
birth controlDiaphragms must be prescribed by a woman's health care provider, who determines the correct type and size of diaphragm for the woman.
birth controlAbout 5-20 pregnancies occur over 1 year in 100 women using this method, depending on proper use.
birth controlA similar, smaller device is called a cervical cap.
birth controlRisks include irritation and allergic reactions to the diaphragm or spermicide, and urinary tract infection. In rare cases, toxic shock syndrome may develop in women who leave the diaphragm in too long. A cervical cap may cause an abnormal Pap test.

Contraception Vaginal Sponge

birth controlVaginal contraceptive sponges are soft synthetic sponges saturated with a spermicide. Prior to intercourse, the sponge is moistened, inserted into the vagina, and placed over the cervix. After intercourse, the sponge is left in place for 6 to 8 hours.
birth controlIt is quite similar to the diaphragm as a barrier mechanism, but you do not need to be fitted by your doctor. The sponge can be purchased over the counter.
birth controlIn April 2005, the FDA granted re-approval for the Today sponge to return to the U.S. market.
birth controlAbout 18 to 28 pregnancies occur over one year for every 100 women using this method.
birth controlThe sponge may be more effective in women who have not previously delivered a baby.
birth controlRisks include irritation, allergic reaction, trouble removing the sponge. In rare cases, toxic shock syndrome may occur.

Contraception Combination Birth Control Pills

birth controlAlso called oral contraceptives or just the "pill", this method combines the hormones estrogen and progestin to prevent ovulation.
birth controlA health care provider must prescribe birth control pills.
birth controlThe method is highly effective if the woman remembers to take her pill consistently each day.
birth controlWomen who experience unpleasant side effects on one type of pill are usually able to adjust to a different type.
birth controlAbout 2 to 3 pregnancies occur over 1 year out of 100 women who never miss a pill.
birth controlBirth control pills may cause a number of side effects including: Dizziness, irregular menstual cycles, nausea, mood changes, and weight gain. In rare cases, they can lead to high blood pressure, blood clots, heart attack, and stroke.

Contraception The Mini-Pill

birth controlThe "mini-pill" is a type of birth control pill that contains only progestin, no estrogen.
birth controlIt is an alternative for women who are sensitive to estrogen or cannot take estrogen for other reasons.
birth controlThe effectiveness of progestin-only oral contraceptives is slightly less than that of the combination type. About 3 pregnancies occur over a 1 year period in 100 women using this method.
birth controlRisks include irregular bleeding, weight gain, and breast tenderness.

Three-Month Pill (Seasonale)

birth controlIn 2003, the FDA-approved an estrogen and progestin pill called Seasonale. It is taken for three straight months, followed by one week of inactive pills.
birth controlA women gets her period about four times a year, during the 13th week of her cycle.
birth controlSeasonale is available by prescription.
birth controlFewer than 2 out of 100 women per year get pregnant using this method.
birth controlThe risks are similar to other birth control pills. Some women may have more spotting between periods.
birth controlThe pills must be taken daily, preferably at the same time of day.

Progestin Implants

birth controlImplants are small rods implanted surgically beneath the skin, usually on the upper arm. The rods release a continuous dose of progestin to prevent ovulation.
birth controlImplants work for 5 years. The initial cost is generally higher than some other methods, but the overall cost may be less over the 5-year period.
birth controlThe Norplant implant has been removed from the U.S. market.  A similar implanted rod system, Implanon, is available in Europe, but not available in the U.S.
birth controlLess than 1 pregnancy occurs over 1 year out of 100 women using this type of contraception.

Hormone Injections

birth controlProgestin injections, such as Depo-Provera, are given into the muscles of the upper arm or buttocks. This injection prevents ovulation.
birth controlA single shot works for up to 90 days.
birth controlLess than 1 pregnancy occurs over 1 year in 100 women using this method.

Contraception Skin Patch

birth controlThe skin patch (Ortho Evra) is placed on your shoulder, buttocks, or other convenient location. It continually releases progestin and estrogen. Like other hormone methods, a prescription is required.
birth controlThe patch provides weekly protection. A new patch is applied each week for three weeks, followed by one week without a patch.
birth controlAbout 1 pregnancy occurs over 1 year out of 100 women using this method.
birth controlRisks are similiar to combined birth control pills.

Contraception Vaginal Ring

birth controlThe vaginal ring (NuvaRing) is a flexible ring about 2 inches in diameter that is inserted into the vagina. It releases progestin and estrogen. 
birth controlA prescription is required.
birth controlThe woman inserts it herself and it stays in the vagina for 3 weeks. Then, she takes it out for one week.
birth controlAbout 1 pregnancy occurs over 1 year out of 100 women using this method.
birth controlRisks include vaginal discharge and vaginitis, as well as those similar to the combined birth control pill.

Contraception IUD

birth controlThe IUD is a small plastic or copper device placed inside the woman's uterus by her health care provider. Some IUDs release small amounts of progestin. IUDs may be left in place for up to ten years, depending on the device used
birth controlThe method should not be used by women who have a high risk of getting a pelvic infection.
birth controlLess than 1 out of 100 women per year will get pregnant using an IUD. 
birth controlWomen who get pregnant with an IUD in place have a higher risk of ectopic pregnancy.
birth controlRisks include cramps, bleeding (sometimes severe), pelvic inflammatory disease, infertility, and perforation of uterus.

Contraception Natural Family Planning

birth controlThis method involves observing a variety of body changes in the woman (such as cervical mucus changes, basal body temperature changes) and recording them on a calendar to determine when ovulation occurs. The couple abstains from unprotected sex for several days before and after the assumed day ovulation occurs.
birth controlThis method requires education and training in recognizing the body's changes as well as a great deal of continuous and committed effort.
birth controlAbout 15 to 20 pregnancies occur over 1 year out of 100 women using this method (for those who are properly trained).

Contraception Tubal Ligation

birth controlDuring tubal ligation, a woman's fallopian tubes are cut, sealed, or blocked by a special clip, preventing eggs and sperm from entering the tubes. It is usually performed immediately after childbirth, or by laparoscopic surgery.
birth controlTubal ligations are best for women and couples who believe they never wish to have children in the future. While viewed as a permanent method, the operation can sometimes be reversed if a woman later chooses to become pregnant.

Contraception Vasectomy

birth controlA vasectomy is a simple, permanent procedure for men. The vas deferens (the tubes that carry sperm) are cut and sealed.
birth controlA vasectomy is performed safely in a doctors office using a local anesthetic to numb the area.
birth controlVasectomies are best for men and couples who believe they never wish to have children in the future. While often viewed as a permanent method, they can sometimes be reversed.

Contraception Emergency ("Morning After") Birth Control

birth controlThe "morning after" pill consists of two doses of hormone pills taken as soon as possible within 72 hours after unprotected intercourse.
birth controlA prescription is required.
birth controlThe pill may prevent pregnancy by temporarily blocking eggs from being produced, by stopping fertilization, or keeping a fertilized egg from becoming implanted in the uterus.
birth controlThe morning after pill may be appropriate in cases of rape; having a condom break or slip off during sex; missing two or more birth control pills during a monthly cycle; and having unplanned sex.
birth controlRisks include nausea, vomiting, abdominal pain, fatigue, and headache.

Contraception Unreliable Methods

birth controlCoitus interruptus is the withdrawal of the penis from the vagina prior to ejaculation. Some semen frequently escapes prior to full withdrawal, enough to cause a pregnancy.
birth controlDouching shortly after sex is ineffective because sperm can make their way past the cervix within 90 seconds after ejaculation.
birth controlBreastfeeding. Despite the myths, women who are breastfeeding can become pregnant.

Call your health care provider if:

birth controlYou would like to further information about birth control options.
birth controlYou want to start using a specific method of birth control that requires a prescription or needs to be inserted by a health care provider.
birth controlYou have had unprotected intercourse or method failure (for example, a broken condom) within the past 72 hours, and you do not want to become pregnant.
 

Contraception Illustrations

contraception
The Cervical Cap

The cervical cap is a flexible rubber cup-like device that is filled with spermicide and self-inserted over the cervix prior to intercourse. The device is left in place several hours after intercourse. The cap is a prescribed device fitted by a health care professional and is more expensive than other barrier methods such as condoms.

 

contraception
The Diaphragm

The diaphragm is a flexible rubber cup that is filled with spermicide and self-inserted over the cervix prior to intercourse. The device is left in place several hours after intercourse. The diaphragm is a prescribed device fitted by a health care professonal and is more expensive than other barrier methods such as condoms.

 

contraception
Intrauterine Device

The intrauterine device shown uses copper as the active contraceptive, others use progesterone in a plastic device. IUDs are very effective at preventing pregnancy (less than 2% chance per year for the progesterone IUD, less than 1% chance per year for the copper IUD). IUDs come with increased risk of ectopic pregnancy and perforation of the uterus and do not protect against sexually transmitted disease. IUDs are prescribed and placed by health care providers.

 

contraception
Side Sectional View of Female Reproductive System

The female reproductive system includes the vagina, cervix, and uterus shown here in cut section.

 

contraception
The Male Condom

The male condom is a barrier contraceptive made of latex or polyurethane. The condom must be fitted over the erect penis. The condom is sold over-the-counter and when used properly is an inexpensive, effective barrier to pregnancy and sexually-transmitted disease.

 

contraception
Hormone-Based Contraceptives

The pill works in several ways to prevent pregnancy. The pill suppresses ovulation so that an egg is not released from the ovaries, and changes the cervical mucus, causing it to become thicker and making it more difficult for sperm to swim into the womb. The pill also does not allow the lining of the womb to develop enough to receive and nurture a fertilized egg.This method of birth control offers no protection against sexually-transmitted diseases.

 

contraception
Tubal Ligation

Surgical sterilization which permanently prevents the transport of the egg to the uterus by means of sealing the fallopian tubes is called tubal ligation, commonly called "having one's tubes tied". This operation can be performed laparoscopically or in conjunction with a Cesarean section, after the baby is delivered. Tubal ligation is considered permanent but reversals can be done in many cases.

 

contraception
Vaginal Ring

The vaginal ring is a flexible ring about 2 inches in diameter that is inserted into the vagina. It releases progestin and estrogen into the body to avoid pregnancy. The woman inserts it herself and it stays in the vagina for 3 weeks. Then, she takes it out for one week to have her period. Like other hormone methods, a prescription from a doctor is required.

Contraception References

Johansson ED. Future developments in hormonal contraception. Am J Obstet Gynecol. 2004 Apr;190(4 Suppl):S69-71.

US Food and Drug Administration. Birth Control Guide. Rockville, MD: FDA Office of Public Affairs; December 2003.

Shulman LP. Advances in female hormonal contraception: current alternatives to oral regimens. Treat Endocrinol. 2003;2(4):247-56.

Roddy RE, Zekeng L, Ryan KA, Tamoufé U, Tweedy KG. Nonoxynol-9 gel did not improve protection against sexually transmitted infections in condom users. Evidence-based Obstetrics & Gynecology. 2002; 4(4): 177-178.

Mishell DR Jr. State of the art in hormonal contraception: an overview. Am J Obstet Gynecol. 2004; 190(4 Suppl): S1-4.

Update Date: 2007

Updated by: A.D.A.M. editorial and Sharon Roseanne Thompson, M.D., M.P.H., Clinical Fellow, Department of Obstetrics & Gynecology, Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.

[Article from the MedLine Plus Medical Encyclopedia of the US National Library of Medicine and the National Institutes of Health.]

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