What’s the Right Birth
Control For You?
There are a few questions you should ask yourself before
choosing on a birth control method.
Things like—is there protection against STDs? What is the convenience or cost? While abstinence is the only 100% effective
method—there are others that are nearly close in regards to effectiveness. The following options will discuss birth
control options. It is best to review
them and ask your doctor for advice on the right one for you.
Fertility Awareness
Also known as Natural Family Planning Fertility Awareness,
this is when you avoid sex when you are the most fertile. One way to do this is to watch for changes in
the cervical mucus as well as your body temperature. You may need to get help from a health care
professional. The pros to this method is
there are no drugs, devices and it’s inexpensive. The cons are it limits spontaneous sex. 25% of those who choose this method end up
pregnant.
Spermicide
A spermicide contains a chemical that kills the sperm. It comes in a foam, jelly, cream or film and
is placed inside the vagina before sexual intercourse. Some types are placed in the vagina 30
minutes before sexual intercourse. If
used frequently, it may cause tissue irritation and increased risk against
infections or STDs. Spermicides are
mostly used with other birth control methods.
The pros to spermicide are it’s easy to use and cheap—about $1 per use. The cons are an increase risk with STDs. 29% of users get pregnant with this method.
Male Condom
This is a latex condom is a classic barrier method. It prevents the male sperm from entering the
woman’s body which protects against pregnancy and most STDs. Those who use this method, 15% get
pregnant. The pros to using a male
condom are that they are widely available, protects against most STDs and cheap
to use—about $1 each. The cons—if used
effectively every time, can protect against pregnancy and STDs. This method can’t be reused.
Female Condom
This is a thin, plastic pouch that lines the vagina and is put
inside up to 8 hours before sex. People
who use this can grasp the flexible, plastic ring at the closed end and guide
it inside the vagina. However, it is not
as effective as a male condom. The pros
are is it is also widely available and gives some protection against STDs and
conducts body heat better than the male condom.
The cons are that it can be a little noisy and 21% of users end up
pregnant. It is not reusable and should
not be used in conjunction with the male condom to avoid breakage.
Diaphragm
This is a rubber dome that is placed over the cervix before
having sex. A spermicide is generally
used with this method. Effectiveness
compares to the male condom in that 16% of those who use this get pregnant,
even if it isn’t used correctly every time.
The pros are that it is inexpensive (about $15-$75 per device and lasts
about 2 years). The cons are that it
must be fitted by your doctor and there is no STD protection. Diapragms can’t be used during your menstrual
cycle because of the risk of toxic shock syndrome.
Cervical Cap
This is similar to the diaphragm but smaller. It fits in place over the cervix which blocks
sperm from entering the uterus. It is
also used with a spermicide. There is a
15% failure rate for women who have never had children and 30% for those who
have. The pros are that it stays inside
for 48 hours, it is cheap to use. The
cons are that it too must be fitted by your doctor and also has not STD
protection. It too, can’t be used during
your menstrual cycle.
Birth Control Sponge
This is a sponge that is made of foam and contains
spermicide. It is sold as the Today
Sponge. It is placed against the cervix
up to 24 hours before you have sex. It
is just as effective as the cervical cap where the failure rate for women who haven’t
had children is 16%; those who have—32%.
The pros to using the birth control sponge is you don’t need a
prescription and is effective immediately.
The cons: it is hard to insert
correctly and has no STD protection. It
also can’t be used during your period.
Birth Control Pill
The most common form of birth control, the pill uses the
hormones estrogen and progestin to prevent ovulation. If taken on schedule, it is highly
effective. 8% of users get pregnant,
even if they miss a dose. Like hormonal
contraceptives, it requires a prescription.
The pros are more regular, lighter periods, or no periods, depending on
the type of pill used, and there is usually less cramping. The cons are the cost: about $15-50 per month, and there is no STD
protection. The pill can cause side
effects like breast tenderness, spotting, serious blood clots, elevated blood
pressure. Some women shouldn’t use birth
control pills—it is best to check with your doctor first.
Birth Control Patch
This may be right for you if you have difficulty remembering
to take the birth control pill. Referred
to as the Ortho Evra patch, it is worn on the skin and changed once a week for
three weeks; the fourth week is patch-free.
It releases the same hormones as the birth control pill and can be just
as effective. The pros are it gives you
more regular, lighter periods, have less cramping, and there is no daily pill
to remember. The cons are the cost at
about $15-$50 per month, and may cause skin irritation or side effects that are
similar to the birth control pill. It
also doesn’t protect against STDs.
Vaginal Ring
Sold as the NuvaRing, it is a soft, plastic ring that is
worn inside the vagina. It too, releases
the same hormones as the pill and patch and is also just as effective. But unlike the patch, it only needs replaced
once a month. The pros are lighter, more
regular periods and is replace once a month.
The cons: it costs $30-$50 per
month and has the same side effects as the pill and patch. It also doesn’t protect against STDs.
Birth Control Shot
Called Depo Provera, it is a hormonal injection that
protects against pregnancy for three months.
A typical couple who uses it can be more effective than the pill with
just 3% of users who get pregnant in a year.
The pros are it is injected 4 times a year and is highly effective. The cons are the cost—about $240 per year and
can cause spotting and other side effects.
It also doesn’t protect against STDs.
Birth Control Implant
Sold as Nexplanon, it is a matchstick-sized rod that is
placed under the skin of the upper arm.
It too releases the same hormone in the birth control shot. The implant protects against pregnancy for up
to 3 years with a failure rate of less than 1%.
The pros are it lasts 3 years and is highly effective. The cons are it is more expensive--$400-$800
for the exam, implant and insertion—and can cause side effects like irregular
bleeding. It doesn’t protect against
STDs.
IUD
Referred to as an intrauterine device, it is a T-shaped
piece of plastic that is inserted inside the uterus by a doctor. The Copper IUD,or ParaGard, works for as long
as 10 years. Mirena, a hormonal IUD, is
replaced every 5 years and can lighten periods and ease cramps. Liletta/Skyla is also a hormonal IUD that
prevents for up to 3 years. Both types
make it more difficult for sperm to fertilize the egg. Fewer than 8 in 1000 women get pregnant with
this method. The pros are that it is
long-lasting and low-maintenance. The
cons: it may cause irregular, heavier
periods with ParaGard, and is more expensive with upfront costs, and it can
slip out as well as cause side effects.
Tubal Ligation
If you’re sure you’ve had all the children you want, this
procedure is a more permanent method to birth control. The traditional method was for a woman to
have her tubes tied. The surgeon closes
off the fallopian tubes which prevent the eggs from completing their journey
out of the ovaries—called the Banding method.
The pros are it is permanent and almost 100% effective. The cons are it requires surgery and may or
may not be reversible. It too doesn’t
protect against STDs.
Tubal Implants
A newer procedure it blocks the fallopian tubes without
requiring surgery. They are small
implants of metal or silicone that are placed inside each tube. Scar tissue will eventually grow around the
implants and blocks the tubes. Once an
x-ray shows that the tubes are blocked, no birth control is needed. The pros are it is permanent, but doesn’t
require surgery and is also almost 100% effective. The cons are it takes a few months to become
effective and can raise the risk of pelvic infections. It is irreversible and expensive.
Vasectomy
Along with condoms, this is the only birth control method
available for men. It surgically closes
the vas deferens—the tubes that carry the sperm from the testes through the
reproductive system. It prevents the
release of sperm, but doesn’t interfere with ejaculation. The pros are that it is cheaper than a tubal
ligation and is also almost 100% effective.
The cons are it does require surgery and is not effective immediately
and may not be irreversible.
Emergency Contraception
This works after you’ve had sex to avoid pregnancy. It is usually used if no birth control was
used or a woman suspects her usual method failed. Plan B-Step 1 is a generic version that is
called Next Choice and contains a high dose of the hormone in birth control
pills. It must be used within 72 hours
of having sex. Ella uses a non-hormonal
drug and requires a doctor’s prescription.
It can be taken up to 5 days after having sex.
Options for Older
Women
Age and lifestyle are important factors when it comes to
choosing a birth control method. If
you’re over the age of 35, smoke, are obese—birth control pills, patch or ring
may not be suitable for you. You should
consult with your doctor for safer alternatives. If you’re heading into menopause, the birth
control shot can give an added benefit and relieve the symptoms of
periomenopause.
Withdrawal
6 to 10 women confirm that their partner uses this “pulling
out” method—it is a centuries-old method that only requires the man to withdraw
his penis from the vagina before he ejaculates.
Research reports that if done correctly every single time—4% of users
get pregnant in a year. If typically
used, 18% get pregnant. The pros are
that it is free and you don’t need devices or hormones. The cons are it can be hard to do correctly
and there is no protection against STDs.
Least Effective
Methods
If not using any form of birth control method, 85% of
sexually active couples get pregnant in a year.
The least effective birth control methods reduce the number
considerably. Just how many get pregnant
within a year are: no birth control—85%;
spermicide—29%; fertility awareness—25%; female condom—21%; withdrawal—18%.
More Effective Methods
Barrier methods like condoms and diaphragms are moderately
more effective with typical patterns of use and the hormonal contraceptives are
better to track for effectiveness. There
are several choices where couples like the lower odds of getting pregnant. Two are reversible with IUDs and hormonal
implants. The only birth control method
that is 100% effective is ABSTINENCE.
The following is a guide for effectiveness: implant, IUD, vasectomy and tubal method—99%;
birth control shot—97%; birth control pill/vaginal ring—92-95%; condom,
diaphragm, cervical cap and sponge—84-89%.
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