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Birth Control for Women

Birth Control for Women

Birth Control

There are lots of things to thing about when choosing the most appropriate method to prevent pregnancy (contraceptive method). This includes how safe and effective it is, and how easy it is to get and use (i.e., access and cost). It is important when choosing a method, that the choice is based on the individual’s preference, and needs, and they have enough information to make their own decision. Contraceptive counseling is a key contributor to the successful use of methods chosen.

In choosing a method of contraception, protection from the risk for HIV and other Sexually Transmitted Infections (STIs) also should be taken into consideration. Hormonal contraceptives and intrauterine devices (IUDs) are highly effective at preventing pregnancy, but do not protect against STIs or HIV. Consistent and correct use of the male latex condom reduces the risk for HIV infection and other STIs, including chlamydial infection, gonococcal infection, and trichomoniasis.

Use of contraceptive methods are affected by human error and are therefore categorized into perfect and typical use.

Perfect use refers to how effective a method is if used correctly every time.

Typical use refers to how effective a method is for those who may not always use it consistently or correctly.

Listed below is information on reversible methods of contraception in order of most effective to least effective:

Abstinence

  • Abstinence, not having sex, protects you and your partner from pregnancy and sexually transmitted infections (STIs), including HIV.
  • You can choose to be abstinent at any time in your life.
  • Used continuously, abstinence is 100% effective.  

Implant

  • The implant is a thin plastic rod that releases a hormone, called progestin, to prevent pregnancy. It works for three years.
  • A doctor or nurse practitioner inserts the implant under the skin on the inside of your arm. It can be inserted at a family planning clinic or doctor's office.
  • Implants are 99% effective, meaning that 1 or less women in 100 will become pregnant using the implant.

Intrauterine Device (IUD)

  • An IUD is inserted into your uterus to prevent pregnancy. Insertion is done at a family planning clinic or doctor's office.
  • You can choose a non-hormonal IUD that lasts up to 12 years or you can choose one with a hormone, called progestin, that lasts three to five years.
  • If you decide you want to become pregnant, you can have your IUD removed at a family planning clinic or doctor's office.
  • IUDs are 99% effective, meaning 1 or less women in 100 will become pregnant using an IUD.

The "Shot"

  • You get the birth control shot every three months at a family planning clinic or doctor's office. The shot contains a hormone, called progestin, to prevent pregnancy.
  • The shot is 99% effective with perfect use, meaning you get your shot on time every three months.
  • With typical use, the shot is 94% effective, meaning 6 out of 100 women will get pregnant with the shot.

Birth Control Pills

  • Birth control pills contain hormones that prevent you from becoming pregnant. Combined hormonal pills have both estrogen and progestin in them. Mini pills have only progestin in them.
  • You take one birth control pill every day. Pills are small and easy to take. Missing a pill increases your chance of pregnancy. The mini pill must be taken at the same time every day.
  • If taken perfectly, meaning every day, birth control pills are 99% effective. For the mini pill, perfect use is every day at the same time.
  • With typical use, birth control pills are 92% effective, meaning 8 out of 100 women get pregnant on the pill.     

Vaginal Ring

  • The vaginal ring is a small soft plastic ring that releases estrogen and progestin to prevent pregnancy. You place a new ring in your vagina every month. Your partner will not feel the ring.
  • If used perfectly, meaning keeping the ring in place and changing it on time, the ring is 99% effective.
  • With typical use, the ring is 91% effective, meaning 9 out of 100 women will get pregnant with the vaginal ring.
  • A new vaginal ring was approved for use in the United States in 2018. The new ring is made of silicone and releases estrogen and progestin to prevent pregnancy. It can be used for one year.

Birth Control Patch

  • The contraceptive patch is a thin, stick-on square that is placed on your body.
  • The contraceptive patch releases estrogen and progestin to prevent pregnancy. A new patch is used once a week for three weeks and the fourth week is patch-free.
  • The patch is 99% effective with perfect use, meaning it is kept in place and changed on time.
  • With typical use, the patch is 91% effective, meaning 9 out of 100 women will get pregnant with the contraceptive patch.

Diaphragm

  • The diaphragm is a flexible silicone cup that you insert introto your vagina before you have sex. It must be inserted each time you have sex and lasts up to two hours.
  • The traditional diaphragm is fitted to your size by a doctor or nurse practitioner. The newer design diaphragm comes in one size and fits most women. It is designed to be easy to insert and remove. It is prescribed by your doctor or nurse practitioner.
  • The diaphragm must stay in place for 6 hours after you have sex and can stay in place up to 24 hours. Spermicide is used with the diaphragm to make it an effective method.
  • The diaphragm is 94% effective when used correctly every time you have sex.
  • With typical use, the diaphragm is 88% effective, meaning 12 out of 100 women will get pregnant with the diaphragm.

Female Condom

  • The female condom, also called internal condom, is a soft, loose-fitting thin plastic pouch that goes inside of a woman's vagina.
  • You put it in place before sex each time. A new condom must be used each time you have sex.
  • Female condoms also protect against STIs and HIV.
  • You can get female condoms at drug stores or family planning clinics. They are made of plastic so people with latex allergies can use them.
  • Female condoms are 95% effective when used correctly every time you have sex.
  • With typical use, the female condom is 79% effective, meaning 21 out of 100 women will get pregnant with the female condom.

Fertility Awareness-Based Methods

  • Fertility awareness-based methods involve learning to tell when you are fertile (can get pregnant) and when you should avoid sex (or using another method) to prevent getting pregnant.
  • There are several methods for learning when you are fertile, including tracking your menstrual cycle and learning to recognize changes in your body and signs of fertility. Your doctor or family planning provider can give you information to use these methods.
  • Overall effectiveness in preventing pregnancy depends on how well a women tracks her body's cycle changes and avoids sex during risky times.
  • Fertility awareness for preventing pregnancy is typically only 77% effective, meaning 23 out of 100 women will become pregnant.
  • Many couples use fertility awareness methods when they want to become pregnant.

Spermicides

  • Spermicides are chemicals that kill sperm. They come in several forms: foam, gel, film, or suppositories.
  • You can get spermicides at a drug store or family planning clinic. They are very effective when used with a male condom, also called external condom. They are also used with a diaphragm or cervical cap to make them more effective.
  • If used correctly every time you have sex, spermicides are considered 82% effective.
  • Typical use is only 72% effective, meaning that 28 out of 100 women using spermicides as their method will become pregnant.

Emergency Contraception

If a condom breaks or your method fails, you may still prevent pregnancy with emergency contraception.

Emergency Contraceptive Pills

  • Emergency contraceptive pills (EC) can be taken after unprotected sex to prevent pregnancy.
  • EC should be taken as soon as possible, but can be taken up to five days after unprotected sex.
  • EC is not an abortion pill. It will not stop or harm an already established pregnancy.
  • You can get EC pills over the counter at a drugstore or family planning clinic at a reduced cost.
  • EC pill effectiveness varies by brand and the number of days after unprotected sex.
    • Levonogestrel EC pills are up to 89% effective when taken within 72 hours (three days) after unprotected sex. These pills reduce the risk of pregnancy up to 120 hours (five days) after unprotected sex, but are less effective as time passes.
    • The prescription EC pill containing Ulipristal acetate lowers the risk of pregnancy by 85% up to 120 hours (five days) after unprotected sex. It stays as effective for five days after unprotected sex.
    • The Copper IUD can also be used as emergency contraception if placed within five days of having unprotected sex. It can then be continued as a very effective form of birth control.

Permanent Contraception

If you know you do not want children or do not want any more children, you might consider sterilization. A family planning provider can give you information and answer questions about sterilization procedures and can schedule or refer you for the procedure.

Sterilization

  • There are two types of female sterilization procedures. Tubal ligation is a surgical procedure that prevents an egg from passing through the fallopian tubes where it could meet sperm. A thin metal coil implant is inserted into the fallopian tubes to create a blockage and prevent an egg from passing through the tubes. As of 2019, the implant will no longer be available in the United States, however, women currently using the device may continue using it.
  • Sterilization is a permanent birth control method and should be chosen only if you are sure you do not want a future pregnancy.
  • Sterilization does not change a woman's sex drive, her ability to have sex, or orgasm.
  • Sterilization procedures are over 99% effective.
  • Sterilization procedures are available only to clients who are over 21 years of age.

 

(Reference list)

Centers for Disease Control and Prevention (2022) Available at:

Contraception | Reproductive Health | CDC (Accessed: 30 June 2022)