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Birth Control

Choosing a birth control method can be overwhelming. There are many things to consider regarding your own personal lifestyle, health status and future plans before choosing a particular method. You should assess whether you are emotionally ready to have sex, whether you will want children in the future, which type of contraception is the most convenient for you, your willingness to follow a birth control method fully, whether you smoke, and whether or not you want your partner to take part in your birth control practices. Knowing the effectiveness of each type of birth control should also contribute to your decision. Consider talking to your healthcare provider about the different options available.

Below are some of the more common types of contraception, each divided into categories.

Barrier Methods

Condoms: a sheath (usually latex) that fits over an erect penis before sex to prevent entry of semen into the vagina. Use of this method is 85 percent effective in preventing pregnancy and can be more effective if used with a spermicide. Condoms also provide protection against many sexually transmitted diseases (STDs) including HIV. They are available at drugstores without a prescription. Side effects most commonly experienced with condom use are latex allergy or skin irritation. Common causes of failure include condom breakage, improper use or the use of an expired condom.

Spermicide: a cream, jelly or foam meant to immobilize or kill sperm so it cannot enter the uterus to join with an egg in the fallopian tube. It is inserted deep inside the vagina before intercourse to create a barrier to prevent entry. The chemical nonoxynol-9 is the active ingredient and can be obtained without a prescription. Spermicide alone can have a failure rate of 3—29 percent, as an adequate barrier may not form over the cervix to prevent sperm entry. However, if used with a condom, effectiveness can be increased. Use of spermicide does not protect against STDs.

Cervical cap: a rubber, hat-like cup that fits over the cervix to prevent entry of sperm into the uterus. Use of this method is about 86 percent effective. This type of contraceptive does not provide protection against STDs including HIV. A doctor’s prescription is needed for a cervical cap. Side effects include vaginal irritation due to concurrent spermicide use, urinary tract infections, and although rare, toxic shock syndrome.

Diaphragm: a reusable rubber cup that is inserted into the vagina. When used with a spermicide, the effectiveness of this method is 84 percent. This method may provide protection against HIV/STDs, however, clinical trials are still underway. Usually, your doctor will assess the size and type of diaphragm best suited for you. Vaginal irritation may also occur with this type of contraception.

Hormonal Methods

Birth control pill: an oral contraceptive that is composed of a combination of estrogen and progestin. It is designed to prevent ovulation. When directions are followed and pills are taken daily, the effectiveness rate is 99 percent. Using the birth control pill does not offer any protection against STDs including HIV. Side effects include nausea, bloating, breast tenderness and mood instability. Your doctor will need your thorough medical history before prescribing the pill. Use of this method is not recommended for those aged 35 and older with a history of cardiovascular disease, breast, uterine or liver cancer or those with a history of blood clots or who smoke.

What about those new pills that reduce the frequency/length of periods? Currently there are birth control pills approved by the FDA that reduce the frequency and length of menstrual periods. They are similar to traditional oral contraceptives, with the main difference being the dosing schedule. Instead of the conventional 28-day regimen (21 days of active pills followed by seven days of inactive pills to initiate a period), there is a 91-day regimen (12 weeks of active hormone followed by seven days of inactive pills to bring on a period). In short, it is safe for a woman to have as few as four periods within a year instead of one each month. The risks and side effects associated with this type of pill are similar to other oral contraceptives. This method may alleviate problems with those who normally experience heavy, painful bleeding. Other advantages include a decrease in migraines associated with menses, endometriosis and acne. With this being said, there may be more unplanned bleeding or spotting between periods as compared to the traditional 28-day regimen pill. Also, users should be cautious of a possible pregnancy if a scheduled period is missed.

Birth control patch: a small skin patch that is applied to the area of the buttocks, upper body or lower abdomen. The release of estrogen and progestin goes from the skin into the bloodstream. One patch is applied weekly for three consecutive weeks, and no patch is applied during the fourth week to allow for menstruation. The effectiveness of the patch is similar to the pill (99.7 percent), however less effective for those weighing over 198 pounds. Side effects are similar to the pill, and this method does not protect against STDs/HIV.

Injection: Depo-provera is an injectable contraceptive that has high doses of progestin. It is given once every three months in the upper arms or buttocks within the first five days of your period—otherwise it is necessary to use backup protection for two weeks. This method is 97 percent effective at preventing pregnancy. This method does not protect against STDs/HIV. Side effects include weight gain, breast tenderness and bone loss with prolonged use (over 2 years). There is no risk of blood clots or cardiovascular disease as there is no estrogen exposure with this method.

Intrauterine Device (IUD): a T-shaped device that is surgically implanted within the uterus to impair sperm motility and implantation. This device can be kept in place for up to 10 years. Effectiveness is 99 percent.

  • Copper IUD- releases copper, which alters cervical mucus to inactivate sperm.
  • Hormonal IUD- releases progestin, which inhibits sperm motility and makes the uterine environment unsuitable for implantation.

Side effects include abnormal vaginal bleeding, perforation of the uterus, infection and spontaneous expulsion.

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