Birth Control Methods
 
 


About one half of all pregnancies are unplanned. Birth control helps a woman plan her pregnancies. Today, there are many choices of birth control. Birth control methods work in a number of ways. They may block the sperm from reaching the egg, kill sperm, keep eggs from being released each month, change the lining of the uterus (the endometrium), or thicken the mucus in the cervix so sperm cannot easily pass through it.

Barrier methods: 

  • Spermicides are chemicals that kill sperm. They are placed in the vagina close to the cervix. They include tablets, foam, cream, and jelly. There is a 26% failure rate resulting in pregnancy with this method.
  • The male condom is a thin sheath made of latex (rubber), polyurethane (plastic), or animal membrane. It is worn by the man over his erect penis. Only water-based lubricants should be used with a condom. It is unsafe to use oils, lotions, petroleum jelly, olive oil, or cold cream. The pregnancy rate with this form of birth control is 14%.
  • The female condom is a thin plastic pouch that lines the vagina. It is held in place by a closed inner ring at the cervix and an outer ring at the opening of the vagina. The failure rate with this form of birth control is 21%.
  • The diaphragm is a small, round rubber dome that fits inside the woman’s vagina and covers her cervix. The failure rate with this form of birth control is 20%. The diaphragm must be prescribed by a doctor and fitted to your body.
  • The cervical cap is a small, thin rubber or plastic dome shaped like a thimble. It fits tightly over the cervix and stays in place by suction. The failure rate with this form of birth control is 20%. The cervical cap must be prescribed by a doctor and fitted to your body.

Spermicides are chemical barriers. The other methods listed above are physical barriers; they keep the sperm from getting to the egg. Combining spermicides with physical barrier methods provides more protection. Some barrier methods, such as the diaphragm or cervical cap, rely on spermicides for their full effectiveness and should be used with each act of intercourse. Barrier methods are effective when used the correct way every time you have sex. Even one act of intercourse without birth control can result in pregnancy.

Hormonal contraception: 

With this type of birth control a woman takes hormones similar to those her body makes naturally. These hormones prevent ovulation. As long as there is no egg to fertilize, pregnancy cannot occur. The hormones can also cause changes in the cervical mucus and the uterus. Hormonal birth control pills, injections, patches, and rings are all very effective. There are some risks involved, though typically those risks are small. However, for women over the age of 35 who smoke there is an increased risk of heart attack and stroke.

  • Birth control pills are one of the more popular methods of hormonal birth control. Most birth control pills contain a combination of the hormones estrogen and progestin. There are many different types of pills containing differing levels of hormones. Talk to your doctor to determine which pill will be best for you.
  • Birth control can also be done as an injection, or shot. One type of injectable hormone is called Depo-Provera and it provides birth control for three months with each injection. That’s only four shots each year. There is usually a slight weight gain for women on this type of birth control method and most women have some spotting when starting.
  • The vaginal ring, called Nuva Ring, is a flexible, plastic ring that is placed inside the vagina. The ring releases estrogen and progestin to prevent pregnancy. It is worn for 21 days (3 weeks) and is then removed for 7 days. During the week without the ring in place a woman has her period. After the 7 days, a new ring is inserted. The risks and benefits of the contraception ring are similar as those of birth control pills.
  • The contraceptive patch, called Ortho Evra, is a small adhesive patch worn on the body. A new patch is worn each week for 3 weeks, then on the fourth week no patch is worn and menstruation occurs. Again, the risks and benefits of this method are similar to birth control pills.

The Intrauterine Device (or IUD): 

The IUD is a small device that is placed inside the uterus to prevent pregnancy. Only two types of IUD are available in the United States: the hormonal IUD and the copper IUD. Both types are shaped like a ‘T’, but they work in different ways.

  • The copper IUD, called ParaGard, releases small amounts of copper into the uterus. A copper IUD does not affect ovulation or the menstrual cycle. It causes a reaction in the uterus and fallopian tubes, which can prevent the egg from being fertilized or attaching to the wall of the uterus. It also can reduce sperm’s ability to fertilize the egg.
  • The hormonal IUD, called Mirena, releases the hormone progestin, which thickens the cervical mucus. This can block the sperm from entering the cervix. It also thins the endometrium (the lining of the uterus) so that a fertilized egg will not implant. The hormonal IUD can also make your menstrual periods lighter.

A doctor must insert and remove the IUD. The ParaGard (copper) IUD can remain in place for 10 years, the Mirena (hormonal) IUD for 5 years. It is important to remember that the IUD does not protect against STD’s. The IUD works immediately after insertion and when the IUD is removed, pregnancy is possible again.

Emergency Contraception:

If a woman has intercourse without any type of birth control or if she thinks her birth control method has failed (i.e. the condom broke), she may be interested in emergency contraception. Talk to your doctor right away if you think you may need this option. If used within 72 hours of unprotected sex, your chance of getting pregnant is greatly reduced. Emergency contraception is not a replacement for regular birth control.

  • Plan B, an emergency contraceptive, is now available over the counter, without a prescription. It is still advisable to contact your doctor's office to discuss the use of this medication and any possible side effects.

Natural Family Planning: 

Natural Family Planning may be referred to as “the rhythm method” or “fertility awareness.” It isn’t just one method, but a variety of methods. It does not require drugs or devices, but the success of this method depends on you knowing when you ovulate and that you do not engage in intercourse during that fertile period, or that you use another method during that time.

  • Basal body temperature monitoring requires that you take and chart your temperature every morning in order to detect the slight increase in temperature that indicates ovulation has occurred.
  • The ovulation/cervical mucus method is just as it sounds. A woman notes the changes in her cervical mucus that indicates ovulation.
  • Keep a menstrual calendar in order to chart your menstruation and fertile periods.

Withdrawl:

  • The withdrawal method prevents pregnancy by not allowing sperm to be released into the woman’s vagina. This requires the man to take his penis out of the woman prior to ejaculation. For this method to be successful, he must withdraw every time the couple has sex. It is important to note that sperm can be present in the fluid produced by the penis before ejaculation, and that some men fail to withdraw completely or in time.

Sterilization: 

This method works by permanently blocking the pathways of egg and sperm. This is done through surgery, either a tubal sterilization in women, or a vasectomy in men.

  • Tubal sterilization is done by closing the fallopian tubes. This can be done by tying, banding, blocking, or cutting them. The surgery is most often done under general anesthesia.
  • Vasectomy involves cutting a man’s vas deferens so that sperm cannot mix with semen. These “tubes” are cut or clamped so that the ends do not join. This procedure is usually done with a local anesthetic and is done in the doctor’s office or clinic.

Sterilization is meant to be a permanent form of birth control, so if there is a chance you may want another child, this is not the option for you. Attempts at reversal may not work and reversals require major surgery, are expensive, and are rarely covered by insurance companies.

Choosing a birth control method:

Most women use many methods of birth control over the course of their lifetime. Some methods will suit your needs better than others, and the choice is very personal. Remember that all methods have a chance of failure. Choose a method you will be able to use consistently in order to lower the failure rate. When choosing a birth control method, you should also think about preventing STD’s. The use of condoms is the best protection against STD’s, and can be used with any other form of birth control as an added protection against these diseases.

No matter what form of birth control you choose, be sure that you know how it works, how to use it, and what side effects it may have. Even with methods that do not require a prescription you should learn how to use them, and your doctor or nurse practitioner can teach you. The more you know about birth control and your own needs, the easier it will be to choose a method that’s right for you.



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