Birth Control

Birth Control (Contraceptives)

Deciding to have sex is a difficult choice to make, because one must consider the possibility of becoming pregnant. Each method of birth control has its advantages and disadvantages.  Learning about and discussing the various alternatives, then choosing one, is important for both partners.

Abstinence Abstinence means waiting or “abstaining” from sexual activity of any kind.

Effectiveness: When practiced all the time, abstinence is the only 100% effective method of birth control, and offers 100% protection from sexually transmitted infections.

Cost:  There is no cost.

Advantages:  100% protection from both pregnancy and sexually transmitted infections, no side effects, no cost

Disadvantages:  One partner may decide he/she no longer wants to remain abstinent while the other partners wants to continue practicing abstinence.


Condoms

Condoms (also called rubbers) are the only form of temporary birth control available for men.  Condoms are thin latex sheaths that is placed over the penis during intercourse and acts as a barrier to prevent sperm from entering the vagina.

Effectiveness:  The condom is 86% to 97% effective against preventing pregnancy.  The failure rate of condom is usually due to human error, meaning that it was not used correctly and consistently.  Condoms break easily if used with any oil-based lubricant, such as Vaseline or lotion.

Cost: Approximately $0.50 to $2.00 per condom.  Many health departments offer free condoms to anyone who wants them.

Advantages: Available without a prescription, easy to obtain, also protects against most sexually transmitted infections, no harmful side effects.

Disadvantages: May interrupt spontaneity, may reduce sensation.


Oral Contraceptives (The Pill)

Oral contraceptives are the most commonly used reversible method of birth control used by women in the United States.  Oral contraceptives are pills that contain hormones, that when taken orally, prevents ovulation.

Effectiveness: When taken correctly and consistently, the pill is more than 99% effective.  If the pill is not taken correctly and consistently, the effectiveness can drop to 90%-95% or lower.  The most common mistakes that reduce the effectives of birth control pills are skipping or forgetting pills. The pill must be taken at the same time everyday to be effective.

Cost: Approximately $10-$20 per cycle.  Free or reduced cost at many health departments. May be covered by health insurance.

Advantages:  Does not interrupt sexual activity, method is reversible, can reduce menstrual cramps and flow of period, reduces the risk of ovarian and endometrial cancer, can cause decrease in acne.

Disadvantages: Can cause weight change, hormonal side effects, prescription is required, does not protect against sexually transmitted infections.


Injected Contraceptives (Depo-Provera)

Injected contraceptives are hormones that are injected into a woman’s body by a doctor every 12 weeks.  This “shot” prevents pregnancy in one of three ways: by causing the ovaries to stop releasing eggs, by thickening the cervical mucus which stops sperm from reaching the egg, or by preventing the fertilized egg from implanting into the uterus.

Effectiveness: 99% effective against pregnancy.

Cost:  Approximately $35 per injection.  Health departments may have reduced costs.

Advantages: Does not need to be taken daily, doesn’t interrupt sexual activity, prevents pregnancy for twelve weeks.

Disadvantages: Requires prescription, does not protect against sexually transmitted infections, side effects such as weight gain or spotting.


Norplant

Norplant are thin capsules that contain synthetic hormones that are injected into a woman’s upper arm, where it releases small amounts of the hormones into the body for up to five years.  It prevents pregnancy by interfering with ovulation and by thickening the cervical mucus.

Effectiveness:  More than 99% effective against preventing pregnancy.

Cost:  Approximately $650 for five years.

Advantages: Birth control that lasts five years without having to remember to take a pill, or interrupt sexual activity.

Disadvantages: Cost, does not protect against sexually transmitted infections, requires prescription (must be inserted and removed by health professional), hormonal side effects.


Diaphragms or Cervical Caps

Diaphragms and cervical caps are small, round, latex domes that fit over a woman’s cervix, to act as a barrier to prevent sperm from entering the uterus.  Diaphragms and cervical caps must be fitted to each individual, and are inserted into the vagina up to 6 hours before sexual intercourse.

Effectiveness:  Between 80% and 94% effective against pregnancy, less effective for women who have had children.

Cost:  Fitting may cost between $50-$150, diaphragm or cervical cap can cost between $15-$30.

Advantages: May be inserted into vagina 6 hours before intercourse, can last for several years if well cared for.

Disadvantages: Must be re-sized if there is significant weight gain or loss, higher failure rate, may interrupt spontaneity, may cause bladder discomfort, no protection against sexually transmitted infections.


Intrauterine Device (IUD)

The IUD is a small device made of plastic that is inserted into the uterus through the cervix.  IUDs contain either copper or progesterone, which can alter tubal and uterine fluids, thicken cervical mucus, or disrupt ovulatory patterns to prevent pregnancy from occurring. A doctor must insert and remove the IUD. IUDs are recommended only for women who do not want any more children, have at least one child, and are in a mutually monogamous relationship.

Effectiveness:  About 97%-99% effective against pregnancy.

Cost: $250-$500

Advantages: Highly effective, long-term protection against pregnancy,  can work for up to eight years.

Disadvantages: Higher risk of pelvic inflammatory disease, discomfort or cramping, does not protect against sexually transmitted infections, increased chance of infertility.


Vaginal Spermicides

There are several types of vaginal spermicides, including foams, cream, jellies, films, and suppositories.  All of these contain a chemical that kills sperm, to prevent sperm from entering the uterus and causing pregnancy to occur.  All of these vaginal spermicides must be inserted into the vagina before sexual intercourse.

Effectiveness: 74%-95%, depending on whether or not they are used correctly.

Cost: $4-$20 for packs of 12 or more.

Advantages:  A prescription is not needed, they can be bought at a drugstore, no dangerous side effects

Disadvantages: Does not protect against sexually transmitted infections, may cause vaginal irritation.


Sterilization

Sterilization is the most effective method of birth control except abstinence. Sterilization is considered to be a permanent method of birth control, a person should carefully consider their decision to receive this surgery.  Female sterilization can include cutting and closing the fallopian tubes and acts as a roadblock to prevent pregnancy. The woman’s sexual and reproductive healthy systems are not altered chemically or hormonally.  Male sterilization is a minor surgical procedure that involves cutting and closing the duct that carries the sperm, and prevents sperm from entering the semen.

Effectiveness:  About 99% effective.

Cost: Between $350-$2,500

Advantages: Permanent protection against pregnancy, one-time fee.

Disadvantages:  Does not provide protection against sexually transmitted infections, mild side effects, one may reconsider having children after having the surgery.


Withdrawal (Coitus Interruptus)

Withdrawal is the removal of the penis from the vagina before ejaculation occurs.  Although many people use this as their way of preventing pregnancy, this is not a form of birth control.  The penis secretes pre-ejaculatory fluid that can contain sperm and can cause pregnancy to occur, even if the penis is withdrawn before ejaculation.

Effectiveness: 50%-80%

Cost:  There is no cost.

Advantages:  No hormones or devices used.

Disadvantages:  Not very effective in preventing pregnancy, does not protect against sexually transmitted infections, requires a lot of self-control


Outercourse

Outercourse includes all other avenues of sexual contact besides penile-vaginal intercourse, including kissing, mutual masturbation, oral sex, etc.  This effectively provides protection against pregnancy, provided that the man does not ejaculate near the vagina.  This method may still put one at risk for sexually transmitted infections.


Sources:

  1. Crooks, R and Baur, K.  (2002).  Our Sexuality, Eighth Edition.  Wadworth: Australia.
  2. Planned Parenthood Federation of America, www.plannedparenthood.org