The risks and benefits of different forms of birth control are different for each person. So it’s best to decide with your doctor which form of birth control is best for you.
Diaphragm
The diaphragm with spermicide is put into the vagina before sex so that it covers the cervix, or neck of the womb. Put the spermicide into the dome of the diaphragm before inserting it. You must be fitted for a diaphragm at a doctor’s office or clinic because diaphragms come in several different sizes. The diaphragm must stay in place at least 6 hours after intercourse, but not for more than 24 hours. If you have sex more than once while wearing the diaphragm, you must add more spermicide without taking the diaphragm out. Spermicide is available without a prescription at drugstores.
Description: A dome-shaped rubber disk with a flexible rim that
covers the cervix so that sperm cannot reach the uterus. A spermicide is
applied to the diaphragm before insertion.
Failure Rate (number of pregnancies expected per 100 women per
year): 17
Some Risks: Irritation and allergic reactions, urinary tract
infection. Risk of toxic shock syndrome, a rare but serious infection,
when kept in place longer than recommended.
Protection from Sexually Transmitted Diseases (STDs): None
Convenience: Inserted before intercourse and left in place at least
six hours after; can be left in place for 24 hours, with additional
spermicide for repeated intercourse.
Availability: Prescription
Cervical Cap
The cervical cap is a soft rubber cup with a round rim that is put into the vagina to fit over the cervix, or neck of the womb. The cap is smaller than the diaphragm, but sometimes more difficult to insert. You must go to your doctor or clinic to be fitted for the cervical cap. It comes in several different sizes. The cervical cap must be used with spermicide, which is available in drugstores without a prescription. You can leave it in place for 48 hours.
Description: A soft rubber cup with a round rim, which fits snugly
around the cervix.
Failure Rate (number of pregnancies expected per 100 women per
year): Prentiff Cap--17; FemCap--23
Some Risks: Irritation and allergic reactions, abnormal Pap test.
Risk of toxic shock syndrome, a rare but serious infection, when kept in
place longer than recommended.
Protection from Sexually Transmitted Diseases (STDs): None
Convenience: May be difficult to insert; can remain in place for 48
hours without reapplying spermicide for repeated intercourse.
Availability: Prescription
Birth Control Pills
You need a doctor’s prescription to get birth control pills, also called oral contraceptives. There are two types of birth control pills: “combined oral contraceptives” and “minipills.”
Combined oral contraceptives have a combination of two hormones—estrogen and progestin. They work by keeping the ovaries from releasing an egg. The pill must be taken every day.
Description: A pill that suppresses ovulation by the combined
actions of the hormones estrogen and progestin. A chewable form was
approved in November 2003.
Failure Rate (number of pregnancies expected per 100 women per
year): 1-2
Some Risks: Dizziness; nausea; changes in menstruation, mood, and
weight; rarely, cardiovascular disease, including high blood pressure,
blood clots, heart attack, and strokes
Protection from Sexually Transmitted Diseases (STDs): None
Convenience: Must be taken on daily schedule, regardless of
frequency of intercourse. Women using the chewable tablet must drink 8 oz.
of liquid immediately after taking.
Availability: Prescription
Minipills contain only one hormone, progestin. They work by thickening the cervical mucus to keep sperm from reaching the egg.
Description: A pill containing only the hormone progestin that
reduces and thickens cervical mucus to prevent the sperm from reaching the
egg.
Failure Rate (number of pregnancies expected per 100 women per
year): 2
Some Risks: Irregular bleeding, weight gain, breast tenderness,
less protection against ectopic pregnancy
Protection from Sexually Transmitted Diseases (STDs): None
Convenience: Must be taken on daily schedule, regardless of
frequency of intercourse.
Availability: Prescription
Sometimes they also keep the ovaries from releasing an egg. You must take one pill every day. Minipills are slightly less effective than combined oral contraceptives.
Description: A pill containing estrogen and progestin, taken in
3-month cycles of 12 weeks of active pills followed by one week of
inactive pills. Menstrual periods occur during the 13th week of the
cycle.
Failure Rate (number of pregnancies expected per 100 women per
year): 1-2
Some Risks: Similar to oral contraceptives--combined pill
Protection from Sexually Transmitted Diseases (STDs): None
Convenience: Must be taken on daily schedule, regardless of
frequency of intercourse. Since users will have fewer periods, they should
consider the possibility that they might be pregnant if they miss scheduled
periods. May have more unplanned bleeding and spotting between periods than
with 28-day oral contraceptives.
Availability: Prescription
Depo-Provera
Depo-Provera is a form of progestin, similar to the hormone in the minipill. Depo-Provera must be injected with a needle into the woman’s buttocks or arm muscle by a doctor. You must get an injection every three months for the birth control to continue to work.
Description: An injectable progestin that inhibits ovulation,
prevents sperm from reaching the egg, and prevents the fertilized egg from
implanting in the uterus.
Failure Rate (number of pregnancies expected per 100 women per
year): less than 1
Some Risks (serious medical risks from contraceptives are rare):
Irregular bleeding, weight gain, breast tenderness, headaches
Protection from Sexually Transmitted Diseases (STDs): None
Convenience: One injection every three months.
Availability: Prescription
Norplant
Norplant is a form of progestin that is placed under the skin. Norplant is made of rubber rods that look like matchsticks. A doctor places the rods under the skin of the woman’s upper arm, where they slowly release progestin. A doctor must also remove the rods. There are two types of Norplant. The six-rod Norplant gives birth control for up to five years. The two-rod Norplant gives birth control for up to two years.
Description: Six matchstick-sized rubber rods that are surgically
implanted under the skin of the upper arm, where they steadily release the
contraceptive steroid levonorgestrel.
Failure Rate (number of pregnancies expected per 100 women per
year): less than 1
Some Risks: Irregular bleeding, weight gain, breast tenderness,
headaches, difficulty in removal
Protection from Sexually Transmitted Diseases (STDs): None
Convenience: Implanted and removed by health-care provider in minor
outpatient surgical procedure; effective for up to five years.
Availability: Prescription. In July 2002, Norplant's manufacturer
announced that it will no longer distribute the Norplant system. Women
using the system should contact their doctors about what their
contraceptive options will be after the five-year expiration date of their
Norplant systems.
IUDs
An IUD (Intra-Uterine Device) is inserted into the womb by a doctor. Two types of IUDs are now used in the United States: the Paragard Copper T 380A, which releases copper, and the Progestasert Progesterone T, which releases progesterone, a form of progestin. The Paragard IUD can stay in place for 10 years. The Progestasert must be replaced every year. A doctor must remove it.
Description: A T-shaped device inserted into the uterus by a health
professional.
Failure Rate (number of pregnancies expected per 100 women per
year): less than 1
Some Risks: Cramps, bleeding, pelvic inflammatory disease,
infertility, perforation of uterus
Protection from Sexually Transmitted Diseases (STDs): None
Convenience: After insertion by physician, can remain in place for
up to one or 10 years, depending on type.
Availability: Prescription
Male Sterilization (Vasectomy)
Outpatient surgery is necessary to make a man sterile, or unable to produce enough sperm to make a woman pregnant. This is done by sealing, tying or cutting the tube through which sperm travel to the penis from the testicles. The operation usually takes less than 30 minutes and is done under local anesthesia. Men who have vasectomies must be sure they will never want to father children in the future.
Description: Sealing, tying, or cutting a man's vas deferens so
that the sperm can't travel from the testicles to the penis.
Failure Rate (number of pregnancies expected per 100 women per
year): less than 1
Some Risks (serious medical risks from contraceptives are rare):
Pain, bleeding, infection, other minor postsurgical complications
Protection from Sexually Transmitted Diseases (STDs): None
Convenience: One-time surgical procedure.
Availability: Surgery
Female Sterilization
Female sterilization is usually a longer operation than a vasectomy, though it may sometimes be done as outpatient surgery. It is usually done under general anesthesia. The surgery involves tying, cutting or blocking the fallopian tubes so eggs can’t reach the womb. Women who have this surgery must be sure they will never want to have a baby in the future.
Description: Small metallic implant that is placed into the
fallopian tubes. The device works by causing scar tissue to form, blocking
the fallopian tubes and preventing conception.
Failure Rate (number of pregnancies expected per 100 women per
year): less than 1
Some Risks: Mild to moderate pain after insertion, ectopic (tubal)
pregnancy.
Protection from Sexually Transmitted Diseases (STDs): None
Convenience: Minor surgical procedure, permanent sterilization.
Device is inserted through the vagina using a catheter. Women must rely on
another birth control method during the first three months, until placement
is confirmed with an X-ray procedure.
Availability: Prescription