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 are only 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 (STDs).
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 ¼-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% effective if used correctly. With
careful use, they are even more effective.
You should know: Latex condoms provide protection from STDs by preventing the
infected area from coming into contact with the partner. Use only water-based
lubricants, such as K-Y Jelly® or Astroglide®. Oil-based lubricants (Vaseline®)
can cause condoms to leak or break. If a condom breaks, you are increased risk
of getting pregnant. You should see your health care provider and consider
emergency contraception.
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% effective if used
correctly.
You should know: Female condoms provide some protection against STDs, 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 1
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% to 80% effective. Spermicides have a
high failure rate because they often are used incorrectly. Used correctly and
together, spermicides and condoms are about 97% effective.
You should know: Do not douche for at least 8 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 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% effective.
You should know: Contraceptive foam may not protect against some 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% to
91% 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 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% to 94% effective.
You should know: Vaginal contraceptive film is effective for 1 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 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 2 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% to 94% effective if used correctly.
You should know: Do not remove the diaphragm for at least 8 hours after
intercourse. Using a diaphragm and spermicide may not protect against some 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% to 94% effective if used
correctly.
You should know: Do not remove the cervical cap for at least 8 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 2 hours before sex. Using a
cervical cap and spermicide may not protect against some 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 5 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% 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 have spotting or stop bleeding all
together. IUDs are a good alternative for patients who cannot take the birth
control pill for various reasons. IUDs should not be used if you have a recent
history of pelvic infections or are at risk for infections. In the rare chance
pregnancy occurs while having an IUD, there is greater risk of ectopic pregnancy
(pregnancy outside the uterus) Discuss these side effects with your health care
provider. IUDs are placed while you are on your period to ensure you are not
pregnant and make the placement easier. IUDs do not protect against STDs,
including HIV (the virus that causes AIDS). The male condom provides the best
protection from most STDs.
The Birth Control 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 1 month
and up to 1 year of protection depending on the type prescribed.
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 others allow the women to have period every 3 months or not at
all. You need to discuss which pill 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% 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 such as mood symptoms, breast tenderness/pain, nausea, headaches
and irregular menses. 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
and are in good health. Some pills are supplemented with folic acid (which is
required for all women in their child bearing years) or iron (for patients with
anemia). The Pill does not protect against 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% effective. Typically the mini pill is less effective than the
combination Pill described above.
You should know: Mini pills tend to make periods short and less frequent. Some
women go several months with no bleeding at all. The mini pill is a good
alternative for women who are breast feeding or who cannot take estrogen in the
traditional Pill. Mini pills do not protect against 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 every 3 months.
How effective is it? Depo-Provera is 99% effective.
You should know: Depo-Provera has side effects similar to Implanon® 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 STDs, including HIV (the virus that causes AIDS). The male condom
provides the best protection from most STDs.
Implanted Hormone – Implanon®
What is it? Implanon is a single rod of hormone (4 cm long by 2 mm thick)
that is placed directly under the skin of the upper arm by a physician which
delivers a hormone, a progesterone, over a 3-year period. Implanon is similar to
Norplant®, which is no longer available.
How can I get it? Implanon is placed by a physician who is certified in this
procedure.
How effective is it? Implanon is greater than 99% effective. Its
effectiveness is comparable to female sterilization.
You should know: The side effects of Implanon are similar to those of the
birth control pill or Depo-Provera. Specific side effects include swelling
and/or pain at time of placement, breakage or internal scarring of tissue around
the Implanon. The Implanon is only effective for 3 years and can be removed at
any time before if desired.
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% effective, if used correctly. It
is slightly less effective (92%) 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. Some women
can experience an allergic reaction to the adhesive. Some studies have shown
that the patch delivers higher levels of the hormone estrogen and that women may
be at greater risk for blood clots. You should discuss these risks and side
effects with your health care provider. The patch does not protect against 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% to 99% 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
similar to birth control pills, 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 STDs, including HIV (the virus that causes AIDS). The
male condom provides the best protection from most STDs.
Female Sterilization - tubal ligation (surgical) or Essure® (nonsurgical)
What is it? Tubal ligation is surgery to "tie the tubes" (fallopian tubes) of
a woman. This 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 called 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 an 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% effective.
Depending on the technique your doctor uses, tubal ligation has about 3 to 17
failures in 1,000 procedures.
You should know: Sterilization is not reversible. Sterilization does not
protect against 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 is usually 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%
effective. Although vasectomy has a failure rate of less than 1%, failure, while
rare, is possible.
You should know: Sterilization does not protect against STDs, including HIV
(the virus that causes AIDS). The male condom provides the best protection from
most STDs.
Ryhthm
What is it? A woman practices rhythm, or natural family planning, by learning
to recognize the days she is fertile, and then 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% 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 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®, Ella, Next Choice
or referred to as the "morning after pill" -- is a form of birth control that
may be used by women within 120 hours (5 days) of having unprotected sex. It is
more effective when taken soon after unprotected intercourse. 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% effective when take within 72 hours
of unprotected intercourse.
You should know: Plan B is generally 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. It is an important decision with
serious emotional and physical consequences.
© Copyright 1995-2011 The Cleveland Clinic Foundation. All rights reserved.
Can't find the health information you’re looking for?
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: 3/15/2011...#11427
