What is birth control?
Birth control is a way for men and women to prevent pregnancy. There
are many different methods of birth control. By learning more about the
options, you can decide which method is right for you and your partner.
If you are sexually active and don't want a baby, don't
wait to use birth control. An unwanted pregnancy can happen any time you
have unprotected sex.
What are the types of birth control?
The following information describes many different birth control
methods. Before you choose a method, you should discuss birth control
with your partner and your health care provider.
Birth control methods only are effective if used
properly. Make sure that you understand how to correctly use the method
you choose.
Male condom
What is it? — The male condom, or "rubber," is a
thin covering made of latex, plastic or animal membrane that is rolled
over an erect penis. The covering prevents semen, the fluid that
contains sperm, from entering a woman's vagina. Latex condoms are best
for most people. Use plastic (Avanti®) condoms if you or your partner is allergic to latex. Condoms made from animal skins may not provide good protection from sexually transmitted
diseases.
How is it used? — The condom is rolled over the
erect penis before sexual activity begins. If the condom does not have a
built-in nipple, leave 1/4-inch of the condom free at the tip of the
penis so that semen has a place to collect. A new condom must be used
each time you have sex. For the best protection, condoms should be used
with a spermicidal foam or jelly. The condom must be in place before the
penis gets near the vagina.
How can I get it? — Condoms can be purchased at most
drug stores. Condoms also are sold in vending machines in restrooms.
How effective is it? — Condoms are about 85 percent
effective if used correctly. With careful use, they are even more
effective.
You should know — Latex condoms provide protection
from sexually transmitted diseases by preventing the infected area from
coming into contact with the partner. Use only water-based lubricants,
such as K-Y Jelly®. Oil-based lubricants (Vaseline®) can cause condoms to leak or break.
Female condom
What is it? — The female condom is a lubricated
polyurethane (plastic) tube that has a flexible ring at each end. One
end of the tube is closed.
How is it used? — Before sexual activity begins, the
woman inserts the condom into her vagina so that the closed end of the
tube covers the cervix, and the other end slightly covers the labia
(lips on the outside of the vagina). The condom blocks sperm from
entering the womb.
How can I get it? — Like the male condom, the female
condom is available at drug stores without a prescription.
How effective is it? — The female condom is about 75
percent effective if used correctly.
You should know — Female condoms provide some
protection against sexually transmitted diseases, but the male condom
provides the best protection.
Spermicides
What is it? — Spermicides are foams, jellies,
tablets or suppositories that a woman places in her vagina and up next
to the cervix (the opening leading from the vagina to the womb) before
sex. Spermicides block the cervix and paralyze the sperm, making them
unable to travel into the womb.
How is it used? — The woman places the spermicide
inside the vagina within an hour before intercourse. More spermicide
must be used each time you have sex. Follow the directions on the
package carefully.
How can I get it? — Spermicides can be bought at
most drug stores. Be careful not to confuse them with feminine hygiene
products, such as douche or lubricants.
How effective is it? — Spermicides are 70 percent to
80 percent effective. Spermicides have a high failure rate because they
often are used incorrectly. Used correctly and together, spermicides and
condoms are about 97 percent effective.
You should know — Do not douche for at least eight
hours after sex when using a spermicide. You can wear a feminine pad to
absorb spermicide that comes out. Spermicides alone may not protect
against some sexually transmitted diseases (STDs), including HIV (the
virus that causes AIDS). The male condom provides the best protection
from most STDs.
Contraceptive foam
What is it? — Contraceptive foam is a spermicide.
How does it work? — The contraceptive foam is placed
into a woman’s vagina with an applicator. The spermicide kills the
sperm, and the foam blocks the opening to the cervical canal. The foam
may be put into the vagina up to 20 minutes before intercourse and is
effective immediately.
How is it available? — Contraceptive foam is
available without a prescription at most drug stores and supermarkets.
How effective is it? — If vaginal spermicides are
used consistently and correctly, they are about 94 percent effective.
You should know — Contraceptive foam may not protect
against some sexually transmitted diseases (STDs), including HIV (the
virus that causes AIDS). The male condom provides the best protection
from most STDs.
Sponge
What is it? — The sponge is a small, donut-shaped
device that is coated with spermicide.
How does it work? — The sponge is moistened with
water and inserted into the vagina. It is made of polyurethane foam that
feels like natural vaginal tissue. The sponge protects against pregnancy
in three ways:
-- The sponge releases a spermicide to kill sperm cells.
-- The sponge is constructed to trap and absorb semen before the sperm
have a chance to enter the cervix.
-- It acts as a barrier between the sperm and the cervix.
How is it available? — The sponge is available
without a prescription at most drug stores.
How effective is it? — With correct and consistent
use, the sponge is 89 percent to 91 percent effective.
You should know — The sponge provides a continuous
presence of spermicide throughout a 24-hour period, allowing for
multiple acts of intercourse within that time without the need for
additional spermicide. Spermicides alone may not protect against some
sexually transmitted diseases (STDs), including HIV (the virus that
causes AIDS). The male condom provides the best protection from most
STDs.
Vaginal contraceptive film
What is it? — Vaginal contraceptive film is a
paper-thin translucent film that contains a spermicide.
How is it done? — The film is placed in the vagina
on or near the cervix, where it dissolves in seconds.
How is it available? — Vaginal contraceptive film is
available without a prescription in most drug stores.
How effective is it? — Used consistently and
correctly, vaginal contraceptive film is 75 percent to 94 percent
effective.
You should know — Vaginal contraceptive film is
effective for one hour, and you must wait at least 15 minutes after
inserting the film before having intercourse. You must use a new film
each time you have intercourse. Spermicides alone may not protect
against some sexually transmitted diseases (STDs), including HIV (the
virus that causes AIDS). The male condom provides the best protection
from most STDs.
Diaphragm
What is it? — A diaphragm is a round piece of
flexible rubber with a rigid rim. The woman places the diaphragm in her
vagina and against her cervix. The diaphragm prevents semen from
entering the womb. Spermicide must be used with a diaphragm.
How is it used? — Spermicide is put in and around
the rim of the diaphragm no more than two hours before intercourse. The
diaphragm is then inserted into the vagina. More spermicide should be
inserted into the vagina each time you have sex without removing the
diaphragm.
How can I get it? — You must visit your health care
provider and get a pelvic exam so that you can be fitted for a diaphragm
that is right for you.
How effective is it? — A diaphragm is 82 percent to
94 percent effective if used correctly.
You should know — Do not remove the diaphragm for at
least eight hours after intercourse. Using a diaphragm and spermicide
may not protect against some sexually transmitted diseases (STDs),
including HIV (the virus that causes AIDS). The male condom provides the
best protection from most STDs. If you gain or lose 10 to 15 pounds, you
may have to be refitted for a new diaphragm.
Cervical cap
What is it? — The cervical cap is a thimble-shaped
cup made out of plastic or soft rubber that fits snugly over the cervix.
How is it used? — It is used the same way as a
diaphragm. The woman coats the cup with spermicide, and inserts the cap
into her vagina and up to her cervix before sex. The cap blocks the
cervix, and the spermicide paralyzes the sperm. More spermicide must be
inserted into the vagina each time you have sex. (Do not remove the cap
each time you have sex.)
How can I get it? — You must visit your health care
provider and get a pelvic exam so that you can be fitted for a cervical cap.
How effective is it? — The cervical cap is 82
percent to 94 percent effective if used correctly.
You should know — Do not remove the cervical cap for
at least eight hours after intercourse. The cap can be kept in place for
up to 48 hours, but spermicide must be applied inside the vagina no more
than two hours before sex. Using a cervical cap and spermicide may not
protect against some sexually transmitted diseases (STDs), including HIV
(the virus that causes AIDS). The male condom provides the best
protection from most STDs.
IUD
What is it? — An IUD, or intrauterine device, is a
small, plastic, flexible, T-shaped device that is placed into the uterus
(womb). There are several types of IUDs. One type, ParaGard T380A, can
be kept in place for 10 years. (It contains copper, which is slowly
released into the uterine cavity. The copper stops the sperm from making
it through the vagina and uterus to reach the egg, thus preventing
fertilization.) Mirena® is an IUD
that contains a hormone and is kept in place for five years. IUDs, such
as Mirena, release the hormone progesterone, which causes the cervical
mucus to become thicker so the sperm cannot reach the egg. The hormone
also changes the lining of the uterus, so implantation of a fertilized
egg cannot occur.
How is it used? — Once the IUD has been inserted,
the woman does not need to take any further steps to prevent pregnancy.
How is it available? — You must get a pelvic exam
and set of cultures. The IUD is placed into the uterus through the
cervix by a trained health care provider.
How effective is it? — The IUD is 99 percent effective.
You should know — IUDs rarely cause serious side
effects when used in a monogamous relationship (having only one sex
partner). Side effects are different for the different IUDs. In some
cases copper IUDs can cause more painful and heavy periods and
backaches. Mirena, because of the hormone, lightens periods and some
women will stop bleeding all together. IUDs should not be used if you
have a recent history of pelvic infections or are at risk for
infections. Discuss these side effects with your health care provider.
IUDs are placed while you are on your period to insure you are not
pregnant and make the placement easier. IUDs do not protect against
sexually transmitted diseases (STDs), including HIV (the virus that
causes AIDS). The male condom provides the best protection from most
STDs.
The pill
What is it? — The Pill is a medication that women
take to prevent pregnancy. The Pill comes in the form of a pill pack
that contains enough pills for one month of protection.
How is it used? — A pill is taken at the same time
every day. There are several different types of pills some are designed
to allow the women to have a period every month and other have a period
every 3 months or not at all. You need to discuss which pills is best
for you with your health care provider Follow your health care
provider's instructions for how to take the pill.
How can I get it? — The Pill must be ordered for you
by your health care provider. It is obtained by prescription.
How effective is it? — The Pill is 99 percent
effective, if taken correctly. Typically it is about 93% effective.
You should know — Occasionally you need to use an
additional form of birth control for the first month you are on the
pill. Certain medications, especially antibiotics, cause the Pill to
lose effectiveness. You should use back-up birth control while taking
these medications. The Pill can cause minor and/or serious side effects.
You should discuss these side effects with your health care provider.
The Pill is not recommended for women who are over 35 years of age and
smoke, but it can be used until menopause if you don't smoke cigarettes.
The Pill does not protect against sexually transmitted diseases (STDs),
including HIV (the virus that causes AIDS). The male condom provides the
best protection from most STDs.
Mini pills
What is it? — These are pills that contain only one hormone (progestin).
How do they work? — Mini pills work by thickening
the cervical mucus so the sperm cannot reach the egg. The hormone in the
pills also changes the lining of the uterus, so implantation of a
fertilized egg cannot occur. In some cases, mini pills stop ovulation
(the release of an egg). A pill is taken every day.
How is it available? — The Pill must be ordered for
you by your health care provider. It is obtained by prescription.
How effective is it? — If the pills are used
consistently and correctly, they are about 95 percent effective.
You should know — Mini pills tend to make periods
short and scant. Some women go several months with no bleeding at all.
Mini pills do not protect against sexually transmitted diseases (STDs),
including HIV (the virus that causes AIDS). The male condom provides the
best protection from most STDs.
Depo-Provera
What is it? — Depo-Provera® is a form of the hormone progestin.
How is it used? — It is given as an injection into
the woman's buttocks or arm. Each injection provides protection against
pregnancy for 12 weeks.
How is it available? — Depo-Provera must be ordered and given by a health care provider.
How effective is it? — Depo-Provera is 99 percent effective.
You should know — Depo-Provera has side effects similar to Norplant® and the Pill. Fifty percent of women who use Depo-Provera for more than a year stop getting their periods while on the medication. Depo-Provera does not protect against sexually transmitted diseases (STDs), including HIV (the
virus that causes AIDS). The male condom provides the best protection from most STDs.
Ortho Evra® – "the patch"
What is it? — Ortho Evra is a patch that prevents
pregnancy by delivering continuous levels of the hormones estrogen and
progesterone transdermally (through the skin) and into the bloodstream.
The hormones in the patch prevent the release of an egg by the ovaries.
They also increase mucus production in the cervix, making it more
difficult for sperm to enter.
How is it used? — Ortho Evra is a 1¾-inch square
patch with hormones embedded in its adhesive layer. It is worn on the
lower abdomen, buttocks, upper arm or upper torso (excluding the
breasts). The hormones are slowly released when the patch is applied to
the skin. One patch is worn continuously for 1 week and is replaced with
a new patch on the same day of the week (patch change day) for a total
of 3 weeks. No patch is worn during the fourth week (patch-free week),
when the menstrual period occurs. Although the patch is designed to
remain in place during bathing, showering and swimming, you should not
apply lotion or oil on or near the patch site.
How can I get it? — Your health care provider must order the patch, which is obtained by prescription. You apply the patch yourself.
How effective is it? — The patch is about 99 percent effective, if used correctly.
It is slightly less effective (92 percent) in women weighing more than 198 pounds.
You should know — You should use an additional form
of birth control the first 7 days after your first patch is applied.
Certain medications—such as antibiotics, anti-seizure medications and
migraine medications—can cause the hormones in Ortho Evra to be less
effective at preventing pregnancy. You should use a back-up birth
control method while taking these medications. The patch can cause side
effects, including mood swings, irregular bleeding, headaches, nausea,
menstrual cramps, breast pain/tenderness and an allergic reaction to the
adhesive. In addition, women taking hormones are at greater risk for
blood clots, heart attack and stroke. Smoking increases the risk of
developing these conditions. You should discuss these risks and side
effects with your health care provider. The patch does not protect
against sexually transmitted diseases (STDs), including HIV (the virus
that causes AIDS). The male condom provides the best protection from
most STDs.
Vaginal ring (NuvaRing®)
What is it? — A vaginal ring is a small, flexible,
donut-shaped device that slowly releases the hormones estrogen and
progesterone into the bloodstream to prevent pregnancy. The hormones in
the vaginal ring prevent the release of an egg by the ovaries. They also
increase mucus production in the cervix, making it more difficult for
sperm to enter.
How is it used? — A vaginal ring is inserted high
into the vagina. It stays in place for 3 weeks in a row. It is removed
for a 1-week break—when the menstrual period occurs—before a new ring is
inserted.
How can I get it? — Your health care provider must
order the vaginal ring, which is obtained by prescription. Your provider
will teach you how to insert and remove the ring, which you can do
yourself. (It is inserted and removed much like a tampon.)
How effective is it? — The vaginal ring is 98
percent to 99 percent effective, if used correctly. Because it is not a
barrier method of contraception, the ring cannot be incorrectly
inserted. It is effective as long as it stays in the vagina. If the ring
is removed for more than 3 hours, an additional form of birth control
should be used.
You should know — You should use an additional form
of birth control the first 7 days after inserting the first vaginal
ring. Certain medications—such as antibiotics, anti-seizure medications,
migraine medications and herbal remedies containing St. John’s Wort—can
cause the hormones in the vaginal ring to be less effective at
preventing pregnancy. You should use a back-up birth control method
while taking these medications. The vaginal ring can cause side effects,
including irregular bleeding, breast tenderness, weight gain, headaches,
and vaginal discharge and irritation. In addition, women taking hormones
are at greater risk for blood clots, heart attack and stroke. Smoking
increases the risk of developing these conditions. You should discuss
these risks and side effects with your health care provider. The vaginal
ring does not protect against sexually transmitted diseases (STDs),
including HIV (the virus that causes AIDS). The male condom provides the
best protection from most STDs.
Rhythm
What is it? — A woman practices rhythm, or natural
family planning, by learning to recognize the days she is fertile, and
abstaining from sex before and during those days.
How is it done? — Methods include keeping track of changes in body temperature and vaginal discharge (fluid from the vagina.)
How is it learned? — Your health care provider can describe how to practice natural family planning.
How effective is it? — The rhythm method is 53 percent effective.
You should know — Natural family planning also can
be used to help a woman get pregnant by pinpointing her most fertile
times. It also has no side effects and is inexpensive. The rhythm method
does not work for all couples. Women who have regular menstrual cycles
and who are very careful about when they have sex usually find it to be
effective. Women who have irregular cycles and who are not so careful
often end up becoming pregnant. Rhythm does not protect against sexually
transmitted diseases (STDs), including HIV (the virus that causes AIDS).
The male condom provides the best protection from most STDs.
Female sterilization – tubal ligation
What is it? — Tubal ligation is surgery to "tie the
tubes" (fallopian tubes) of a woman, which causes permanent sterility by
preventing transport of the egg (ovum) to the uterus. This also blocks
the passage of sperm up the tube to the ovulating ovary where
fertilization normally occurs.
How is it done? — Tubal ligation is done in a
hospital or outpatient surgical clinic while the patient is
anesthetized. One or two small incisions (cuts) are made in the abdomen
at the navel, and a device similar to a small telescope on a flexible
tube (called a laparoscope) is inserted. Using instruments that are
inserted through the laparoscope, the fallopian tubes are burned or
sealed shut. The skin incision is then stitched closed. The patient is
able to return home within a few hours after the procedure. Tubal
ligation can be performed immediately after childbirth through a small
incision near the navel or during a Cesarean section.
Female sterilization can now also be done without an
incision in the belly. The procedure is call Essure. The doctor puts a
camera in your uterus through the vagina and inserts coils in the
openings of the fallopian tubes. The body scars around the coils and
blocks the tubes. It takes about 3 months for the tubes to be blocked,
so you must use an alternative method of contraception during that time.
It is recommended that you get and x-ray dye study after the 3 months to
prove the tubes are blocked.
How is it available? — Tubal ligation must be performed by a health care provider.
How effective is it? — Except in rare cases, this procedure is 100 percent effective. Depending on the technique your doctor uses, tubal ligation has about 3-17 failures in 1000 procedures.
You should know — Sterilization does not protect
against sexually transmitted diseases (STDs), including HIV (the virus
that causes AIDS). The male condom provides the best protection from
most STDs.
Male sterilization – vasectomy
What is it? — A vasectomy is a simple, permanent
sterilization procedure for men. The operation, usually done in a
physician's office, requires cutting and sealing the vas deferens, the
tubes in the male reproductive system that carry sperm. A vasectomy
prevents the transport of sperm out of the testes. This surgery does not
affect the man's ability to achieve orgasm or ejaculate (potency). There
will still be a fluid ejaculate, but there will be no sperm in this
fluid.
How is it done? — Vasectomy usually is done in the
surgeon's office while the patient is awake but pain-free (using local
anesthesia). A small incision is made in the upper part of the scrotum,
under the penis. The tubes (vas deferens) are tied off and cut apart.
The skin incision is stitched closed. The patient is able to return home
immediately.
How is it available? — Vasectomy must be performed by a health care provider.
How effective is it? — Except in rare cases, this
procedure is nearly100 percent effective. Although vasectomy has a
failure rate of less than 1 percent, failure, while rare, is possible.
You should know — Sterilization does not protect
against sexually transmitted diseases (STDs), including HIV (the virus
that causes AIDS). The male condom provides the best protection from most STDs.
Emergency contraception
What is it? — Emergency contraception—also called
Plan B® or the "morning after pill"—is a form of birth control that may be used by women within 72 hours of having unprotected sex. The most commonly used emergency contraception consists of two doses of hormone pills taken in one day 12 hours apart.
How does it work? — The 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.
How is it available? — Plan B can be purchased at a
pharmacy without a prescription if you are over 16. For those under 16 a
health care provider must order the medication.
How effective is it? — Plan B is about 90 percent effective when take within 72 hours of unprotected intercourse.
You should know — Plan B generally is reserved for
emergency situations and is not a regular method of birth control.
Emergencies include being raped, having a condom break or slip off
during sex, missing two or more birth control pills during a monthly
cycle and having unplanned sex.
Abstinence
Of course, the best way to avoid getting pregnant is to not have sex (abstinence). You may not be ready to have sex. Don't let someone pressure you into having sex if you don't feel ready.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 9/12/2008...#11427