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Contraception

Reversible Contraception

Non-reversible Contraception

Birth Control Pills

Tubal Ligation

Vaginal Hormonal Ring

Vasectomy

Patch (OrthoEvra)

 

Depo-Provera Injection

Intra-Uterine Device (IUD)

Cervical Cap

Diaphragm

Sponge

Male Condom

Female Condom

Spermicide

Birth Control Pills

Pros:

  • Very effective against pregnancy if used correctly

  • Make menstrual periods more regular and lighter

  • Decrease menstrual cramps and acne

  • Makes you less likely to get ovarian and uterine cancer, pelvic inflammatory disease, ovarian cysts, and anemia

  • Doesn't interrupt lovemaking

Cons:

  • Doesn't protect against STDs

  • Cost between $15-$50 per month if not covered by insurance

  • Need to remember to take every day at the same time

  • Can't be used by women with certain medical problems or by women taking certain medications

  • Can cause side effects such as nausea, increased appetite, headaches, irregular bleeding, high blood pressure in those predisposed,  and, very rarely, blood clots, heart attacks, and strokes

  • Need a prescription

  • Need to use a barrier method if a pill is missed or using certain medications

Vaginal Hormonal Ring (NuvaRing)

Pros:

  • Benefits similar to the oral contraceptives

  • Some patients may have less side effects because of the lower blood levels of hormones

  • Lessens some symptoms of menstruation, such as cramping and heavy flow

  • Less likely to forget to use; once a month dosing

  • Doesn’t interrupt sexual activity

Cons:

  • May cause side effects, such as nausea, breast tenderness, bloating, depression, or increased vaginal discharge

  • May pose the risk of rare but serious complications, such as blood clots, heart attacks, and strokes

  • Offer no protection against STDs, including HIV

  • May be felt during sex, but can be removed for short period of time without changing efficacy

Patch (OrthoEvra)

Pros:

  • As effective as the “Pill”

  • Benefits similar to the pill and vaginal ring

  • Convenience of weekly application of the transdermal or “thru the skin” patch

  • Discrete and easy to use weekly; don’t have to worry about “missing pills”

  • Doesn’t interrupt sexual activity

Cons:

  • Side effects similar to the pill and vaginal ring

  • Increased exposure to estrogen by 60% compared to the birth control pill (35 mcg) which increases the risk of blood clots, heart attacks, and strokes in those susceptible

  • No protection against STDs

Depo-Provera Injection

Pros:

  • Each injection provides 3 months of protection against pregnancy

  • Very effective against pregnancy

  • Many women stop getting their menstrual period while getting injections. (This is not a medical problem and menstrual periods usually return 6-18 months after you stop taking injections)

  • Helps protect against uterine cancer

Cons:

  • Doesn't protect against STDs

  • Need to see your health care provider every 3 months for an injection

  • Costs $30-$75 every 3 months for 1 injection

  • May have side effects such as weight gain, tiredness, delay in return of fertility in some, and possibly a decrease in bone density

  • Menstrual irregularities, such as spotting and bleeding between periods, are common. 

Intra-Uterine Device (IUD)

Pros:
  • Very effective against pregnancy; patient satisfaction with IUD’s is among the highest of any reversible method. 

  • Long –term reversible birth control:  Copper IUD (ParaGard) lasts 10 years.  Low dose hormonal IUD (Mirena) lasts 5 years.  They can be removed at any time.

  • Provide protection against pregnancy as long as in place in your uterus- protects as soon as inserted (so don't need to remember to use contraception if you have sexual intercourse)

  • Convenient- doesn't need daily attention;  just need to check to make sure in place at least once a month at time of menstrual period

  • Comfortable- you and your partner cannot feel the IUD; sometimes your partner may feel the string

  • The levonorgestrel IUD (Mirena) lessens menstrual flow and can be used to treat heavy periods

Cons:

  • Doesn't protect against STDs

  • Needs to be inserted by a health care provider

  • Should not be used by women who might get a sexually transmitted disease. It is best for women who have already had children and are in a steady relationship with one partner.

  • Can fall out or can rarely puncture the uterus

  • The copper IUD can have side effects such as menstrual cramping, longer and/or heavier menstrual periods, and spotting between menstrual periods

  • Slightly higher risk for infection in the few weeks after insertion

  • Expensive for some people because the cost of the device and insertion is often “up-front” rather than paid monthly like oral contraceptive pills, but is comparable or less costly over time used

Cervical Cap

Pros:

  • Can insert several hours before sexual intercourse

  • Can leave in place 24-48 hours, will give protected sex for up to 48 hours

  • Use less spermicide with the cap than with the diaphragm- no need to apply more spermicide with each act of intercourse

Cons:

  • Doesn’t protect against sexually transmitted diseases

  • Cost $25-$50, plus the cost of spermicidal gel

  • Need to be fitted by a health care provider and need a prescription

  • Limited sizes available

  • Can’t take out until 6-8 hours after intercourse

  • Can be difficult to insert and may get moved out of place

  • Some women may be allergic to material of cap or to spermicide

  • Need to get a new one every so often if becomes cracked, tears, or following a delivery

  • Can’t be used by women with a history of abnormal Pap tests

Diaphragm

Pros:

  • Can be put in place right before intercourse or 2-3 hours before intercourse

  • Don't need to take out between acts of sexual intercourse (protects against pregnancy for about 6 hours, but need to reapply spermicide

Cons:

  • Doesn't protect against sexually transmitted diseases

  • Need to get fitted by a health care provider and need a prescription

  • Can't take out until 6 hours after intercourse

  • Cost $25-$45, plus the cost of spermicidal gel

  • May get moved out of place during sexual intercourse

  • Some women may be allergic to the diaphragm or to the spermicide

  • Need to get a new one every so often (replace every 2 years or if torn or cracked, often need to be refitted with 10 pound weight gain or loss and after pregnancy)

  • Can be messy

  • Need to reapply spermicide with each act of sexual intercourse

  • Can cause an increase in urinary tract infections

  • Rarely associated with Toxic shock syndrome

Sponge

Pros:

  • Can insert right before or several hours before sexual intercourse and will provide protection against pregnancy for a total of 24 hours

  • Don't need a prescription

Cons:

  • Doesn't protect against sexually transmitted diseases and may increase the risk of HIV infection with multiple daily acts of sexual intercourse

  • Can't take out until 6 hours after sexual intercourse

  • Cannot be used by women that are allergic to nonoxynol-9 (in the spermicides)

Male Condom

Pros:

  • Lowers risk of STDs

  • Effective against pregnancy

  • Contraception that provides the most protection against sexually transmitted diseases (latex condoms are best)

  • Don't cost much (50 cent s each), can buy at almost any drug store (don't need a prescription)

  • "Last longer" when using a condom

  • Allow men to have an active part in preventing pregnancy

Cons:

  • Have to use a new one every time you have sexual intercourse (can only be used once)

  • May disrupt/interrupt lovemaking

  • Can break during use

  • Women may be allergic to latex

Female Condom

Pros:

  • Provide protection against STDs (new product, so not clear how much protection given) and pregnancy

  • Can be inserted well before intercourse

  • Male does not need to withdraw right after ejaculation, as he does with a male condom

  • Cheap- each costs about $2.50

Cons:

  • May move, be noisy, or uncomfortable

  • Can only use for one act of sexual intercourse

Spermicide

Pros:

  • Don't cost much, available at many drug stores, don't need a prescription

Cons:

  • Doesn't protect against sexually transmitted diseases (STDs) and may increase the risk of HIV infection in women who have sex multiple times daily because of irritation from the spermicide

  • Effectiveness usually lasts only one hour (need to reapply each time have sexual intercourse)

  • Some women and men may be allergic to spermicides

  • May interrupt lovemaking (some forms need to be inserted at 10-20 minutes before intercourse)

  • Has a lower effectiveness against pregnancy than many other types of contraception- should use with another form of contraception to increase effectiveness

  • May change bacteria living in vagina and increase urinary tract infections

Non-reversible Contraception

Tubal Ligation

Pros:

  • Very effective against pregnancy

  • One time decision that will provide protection against pregnancy forever

Cons:

  • Need to have minor surgery (done usually laparoscopically or hysteroscopically); please see “Procedures” section of website

  • Permanent (although it is possible to undo sterilization with major surgery, it is not always successful)

  • Only should be used by women who are absolutely sure that they do not want any or any more children

  • Expensive- ranges from $1000-$2500- but cost for contraception spread over rest of life

  • No protection against STDs

Vasectomy

Pros:

  • Very effective against pregnancy

  • Office procedure, usually less expensive than tubal ligation

Cons:

    • Although permanent, it can be reversible, but is less so over time

    • Only should be used in those who do not desire any more children

    • No protection against STDs