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I've divided this list
into two headings - Barrier Methods
(Contraception) which prevent sperm from reaching the egg and Hormonal
Methods (Birth Control) which do not prevent sperm from
reaching the egg. In other words, they can allow conception (fertilization)
to take place but do not allow implantation to occur or they interfere with
implantation once it has occured.
Barrier methods are
generally available without a prescription with the exception of the
diaphragm and cervical cap. Hormonal methods required a
prescription with no exceptions. If you do opt for a hormonal method it
is extremely important that you are honest with your doctor about your
lifestyle and habits. Hormonal methods do have a wide range of possible
side effects and problems which you need to be aware of. Most people can
use them without adverse affect but you always want to be honest with
your doctor so that you can evaluate your possible risks. (For example -
if you're on the pill do not smoke as this increases your chances
of forming blood clots which can sometimes cause serious complications
and even death in very, very rare cases. Why risk it?) The best source of information is
from your health care provider - don't hesitate to call your doctor and
get information!
If you're
looking ahead to the future, check out what may be up
and coming in birth control.
Condom
Average Failure Rate: 14%
What it is:
A sheath, commonly made of latex, which is unrolled onto the erect penis
(prior to any contact with the vagina) to prevent semen from entering
the vagina.
Benefits: Latex condoms help prevent some
STDs. (Keywords here are "help" and "some".) It
doesn't offer blanket protection from syphilis, genital warts, crab
lice, and
several other STDs because they can be transmissible outside of what a
condom will cover. In fact, recent studies show that condoms have a 15%
failure rate when it comes to HIV alone.
This is vitally important and could save your life: If you've decided to
become sexually active, use a condom. It does lower the risk
substantially. Just don't use it thinking it's a magic umbrella that will shield you from
all the possible negative consequences because it won't. It is not
perfect. If you're looking for perfect, you need abstinence. It is much
better than nothing, however, if you have decided to have sex outside of
a mutually monogamous relationship and are at risk for STDs or if you
and your partner are simply not ready to have a baby. Use a condom every
single time and use
it correctly to get the maximum benefit. This will lower your
failure rate dramatically! Also, consider pairing it with another type
of contraception for added protection.
Tips/Problems: Use
a condom with a reservoir at the end as these are less likely to leak or
burst. The condom should be put on before any contact occurs between the
penis and vagina and before oral sex to prevent STDs. Prelubricated condoms are less likely to tear and ones lubricated with a
spermicide offer more protection when it comes to pregnancy prevention,
but not when it comes to STDs. Only use these with a water soluble
lubricant such as KY Jelly. Don't use anything like petroleum jelly
which is oil based. Only use a condom one time and then throw
it out. Generally speaking, you are risking an STD every time you have
sex with or without protection, but proper use can minimize your risk
drastically. More of interest on condoms.
Cost:
25-50 cents a piece
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Cervical
Cap
Average Failure rate: 20% w/o prior pregnancy
40% w/ prior pregnancy
What it is:
A small rubber cap
shaped like a thimble that fits over the cervix.
Benefits:
It can stay in place
up to 24 hours. There is no association with Toxic Shock Syndrome.
Tips/Problems:
It is not as
effective after pregnancy or for women who have an unusually shaped
cervix. It can also be harder to place and remove than a diaphragm as
it's much smaller. More information on the Cervical
Cap.
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Diaphragm
Average Failure rate: 20%
What it is: It is a dome shaped device that fits over the cervix like a
tiny umbrella without a stick preventing the sperm from reaching the
egg. It can be inserted up to 2 hours before and must be left in 6-8
hours after an act of intercourse.
Benefits: Using a diaphragm allows both partners to
experience the full range of physical sensations during intercourse.
Tips/Problems: The diaphragm is only available by
prescription and you must be refitted after giving birth (even if it's a
C-section) and every time you gain or lose 15 pounds. Also, Toxic Shock
Syndrome has occurred when the diaphragm is left in for over 24 hours.
To avoid TSS, never leave it in over 24 hours and don't use it if you're
menstruating. If you notice any of the symptoms of TSS (fever of 100
degrees or higher, diarrhea, vomiting, sunburn-like rash) call your
doctor immediately.
Cost:
$13-$25 for the diaphragm itself, less than $10 for the spermicide.
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What it is:
The
female condom is a sheath made of polyurethane that fits along the walls
of the vagina with the outer edges covering the external genitalia.
Benefits: Polyurethane is about 40% stronger than the
latex used in male condoms. It also transmits heat more effectively and
can be used with an oil-based lubricant.
Tips/Problems: Users say that it can be awkward and
messy as well as cause irritation to the vagina or penis. Like male
condoms, this method
doesn't offer blanket protection from some STDs like HPV (genital
warts), syphilis and others but consistent and proper use will reduce
your risk.
Cost:
$3 a piece.
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Sponge
Average Failure rate: 20% w/o prior
pregnancy
40% w/ prior pregnancy
This
product is currently off the market in the U.S. The Today Sponge is still waiting
for FDA approval to return. There is also an option called the
Protectaid Sponge available in Canada. You can check out BabyTech
for more information.
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Spermicide
(Jelly/Cream/Film/Foam)
Average Failure Rate: 20-26%
What it is:
Spermicides
are chemicals which kill the sperm before they can reach the egg. The
most common ingredient is Nonoxonyl-9 and spermicides come in foam,
cream, a thin film or jelly.
Benefits: Spermicides add lubrication which is helpful
to new mothers whose vaginal tissue can be temporarily drier than usual.
Tips/Problems: Watch for a rash or itching as these are
signs of an allergic reaction. If they occur, discontinue use. Spermicide
does not kill AIDS or other STDs, it only kills sperm. In
fact condoms lubricated with Nonoxonyl-9 show have an increased risk
of HIV transmission.
Cost:
Less than $10 a tube
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What it is: There
are several different methods and combination of methods under the
Fertility Awareness or Natural Family Planning contraception. The basics
involve charting the woman's body temperature, cervical mucus, and other
signs of ovulation. It takes dedication from both partners for it to be
successful.
Benefits: There's
no cost, although you may want to invest in a class or book to help you
learn all you need to know for this method to be effective.
Tips/Problems:
Requires organized record-keeping, planning, and abstinence during fertile
periods.
Cost: Free!
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The Pill
Average Failure Rate: 3 - 8%
 What
it is: Think the pill only
prevents conception? Think
again. The pill contains estrogen and progesterone which are
hormones naturally found in a woman's body. By artificially altering the
levels of these hormones the pill can prevent ovulation, thicken the
cervical mucus and prevent implantation.
Benefits: Fairly
easy to use.
Tips/Problems:
As noted before,
with the pill comes certain risks, especially for smokers. These are
uncommon but very real problems associated with taking the pill. They
include abnormal blood clotting and heart attacks, cancer, and
gallbladder disease. Side effects include headaches, acne, weight gain,
vaginal infections, and depression.
This just in:
Painful
Sex Linked to The Pill
Cost:
$25-$35 a month.
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The Mini-Pill
Average Failure Rate: 1 - 13%
What it is: Progestin-Only Oral
Contraceptives, like Ortho-Micronor. You take one pill a day on a twenty-eight cycle. The
mini-pill only contains progesterone.
Benefits: Many doctors feel that the mini-pill is acceptable for
nursing mothers since it does not contain estrogen. This is also safer for
women over 35 (compared to the pill) and is better for women who suffer
from migraines or hypertension (also compared to the pill).
Side Effects/Risks: Similar to those of the combination pill,
although irregular bleeding is more common. According to some sources
this method does not stop ovulation in 67 - 81% of women.
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What it is: Depo-Provera is a
progesterone solution that is injected with a needle. It provides birth
control for three months although infertility can last up to a year.
Benefits: It provides birth-control for three months.
Side Effects/Risks: Irregular vaginal bleeding,
bloating, headaches, mood swings, nervousness, fatigue and weight gain.
Also, if you decide that you don't like Depo-Provera or if something
goes wrong, you are stuck with it for three months after your last
injection.
Cost: $48
- $58 an injection
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IUD
Average Failure Rate: 1 - 5%
What it is:
I an only going to
cover the basics here. There are several varieties made of things
ranging from plastic to copper. In general, an IUD is a small plastic
device that is inserted through the cervix into the uterus where it
remains until it is removed (generally speaking). It works by preventing the
fertilized egg form implanting in the uterus. It is effective from one
to ten years depending on the type.
Most women experience cramping when the IUD is inserted as well as
cramping and spotting for up to a week afterward. A thin, nylon tail
protrudes from the cervix allowing the woman to check it's position
after each menstrual period.
Benefits: Provides effective birth control for several years.
Side Effects/Risks:
The IUD carries with it a number of serious health risks which have
caused many manufacturers to stop distribution. In some very rare
instances an IUD perforates the uterine wall or cervix or even migrates
into the abdominal cavity, requiring surgical removal. This risk, while
slight, may be
higher in mothers who are nursing.
If the uterus does not adapt to insertion, it may expel the IUD. It may
also move upward causing an ectopic (or tubal) pregnancy.
IUDs are also associated with a higher risk of pelvic inflammatory
disease. Because of this, the IUD should never be used by women with
multiple sex partners (that includes serial monogamy). Also, because of the risks to fertility, doctors
do not usually recommend the IUD to women who have not had children.
Cost:
Around $500 counting both insertion and removal.
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Norplant
Average Failure Rate: 1 - 5%
 What it is:
Norplant (the brand name for this type of birth control) is made up of
six sticks each about the size of a matchstick. They are usually
inserted in the inside of the woman's upper arm in a surgical procedure
that takes about 15 minutes. Once in place, the capsules slowly release
progesterone.
Benefits: It can last up to five years.
Tips/Problems: Norplant is currently no
longer available. A possible replacement is Implanon which is similar
and currently awaiting FDA approval. Removal is often more difficult than
insertion. Some women have experienced severe pain and unacceptable
scarring after removal. Irregular vaginal bleeding is also common and
you may also experience bloating, mood swings, nervousness, fatigue and
weight gain. Something to remember is that the birth control
effectiveness tends to wear off
more quickly in overweight women.
Cost:
$500-$700
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Average failure rate: 1%
What it is:
Ortho-Evra is the first birth control patch. It
works by delivering a continuous level of hormones through the skin and
into the bloodstream. Each patch lasts about one week. You wear a patch
for three weeks and then go patch free for one week. You can wear the
patch in any one of four areas - the upper torso, buttocks, abdomen or
upper arm. It should stay on even while bathing or swimming.
Benefits:
You don't have to take a pill every day at the
same time or get a shot.
Tips/Problems:
It is obtainable only with a prescription. It does
not prevent HIV or any other STD. If you smoke or have a heart condition
you are advised to not use the patch because of an increased risk of heart
attack and stroke. There are other side effects like headaches, abdominal
pain, and upper respiratory infections.
Cost: $25-$35
a month.
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The
Morning After Pill
Thought to be 85% effective
Emergency Contraceptive
Pills (ECP), or The Morning-After "Pill," are actually a large
dose of ordinary oral contraceptives taken after intercourse has
occurred. Recently the FDA has begun promoting oral contraceptives for
emergency use when a woman has had unprotected intercourse within the
previous 72 hours.
ECPs work in the same
way as other hormonal methods, by suppressing ovulation, making the
uterus inhospitable to the newly conceived human being, and interfering
with the movement of the ovum. So it can both prevent conception and
prevent implantation. For women who have had unprotected
intercourse and do not wish to use ECPs, it is suggested that
immediately following unprotected intercourse a spermicidal agent be
applied to reduce the probability of conception. (That option does
not provide the same level of protection.)
Cost:
$30-$40
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Lunelle
Average failure rate: 1%
What it
is: An injection
which contains estrogen and progestin, it is as effective as sterilization
but as reversible as the pill. One injection lasts 30 days.
Benefits:
Very effective.
Tips/Problems:
Lunelle offers no
protection against HIV or any other STD and can have side effects like
weight gain, acne, and breast tenderness. You also have to go to the
doctor's once a month to get the shot.
Cost:
$35-$40 an injection.
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NuvaRing
Average failure rate: 2%
What it
is: A flexible,
transparent, 2 inch ring that is inserted into the vagina once a month to
provide a continuous flow of hormones to prevent pregnancy.
Benefits:
Easy to use.
Tips/Problems:
NuvaRing does not protect against HIV or other STDs. It may cause
headaches, dizziness, weight gain, and breakthrough bleeding in some
users. Some may consider the purchase and insertion of a new ring every
month inconvenient. (This product is slated to be available June of 2002.)
Cost:
$35-$45 a month.
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