Birth Control Methods

1. Birth Control Methods Information comes from Contraceptive Technology, 18th revised edition, 2004

2. Behavioral Methods • Abstinence • Withdrawal • Fertility Awareness Method

3. Abstinence • How to Get it: Choose not to have intercourse. • % Effective: 100 if used every time • How it Works: No intercourse means sperm cannot reach the egg. • Advantages: No side effects. Free. Can be used at any time and any age. • Disadvantages: Various pressures can make it difficult to practice. Requires a strong commitment and self control. May be more difficult within a serious relationship.

4. Withdrawal(Coitus Interruptus) • How to Get it: Choose to practice it. • % Effective: Depends on man’s ability to withdraw prior to ejaculation. Typical: 73 Perfect: 96 • How it Works: Male removes penis (“pulls out”) from the vagina before ejaculation. Prevents sperm from entering the vagina. • Advantages: Better then using no method at all. • Disadvantages: No STI protection. Male may not be able to “pull out” in time. Sperm that get on the outside of the vagina may still get in to fertilize an egg. Less effective than other methods.

5. MENSTRUATION Lining of uterus sheds 28 1 2 27 3 26 25 4 5 24 New egg matures Lining of uterus begins to thicken Egg travels to uterus; if not fertilized, dissolves Lining of uterus continues to thicken 6 23 7 22 8 21 9 20 10 19 18 11 12 17 13 16 15 14 OVULATION Egg released Menstrual Cycle

6. Fertility Awareness Method • How to Get it: Choose to practice it; learn from provider, class or book. • % Effective: Varies widely depending on which method(s) are used- 40-98%. • How it Works: Predict ovulation by charting menstrual cycle, taking body temperature, checking cervical mucous or a combination. Abstain or use a reliable form of birth control during fertile days. • Advantages: No side effects. Appropriate for couples who cannot or do not want to use other contraceptive methods. • Disadvantages: No STI protection. Takes time and effort. May be difficult to abstain during fertile days.

7. This chart allows women to track multiple factors that indicate fertility including waking body temperature, cervical mucous, and menstrual symptoms. Chart is From “Taking Charge of Your Fertility” by Toni Weschler, MPH

8. Hormonal Methods • Pills • Ortho Evra Patch • NuvaRing • Depo Provera • Implanon • Emergency Contraception

9. Birth Control Pills • How to Get it: Requires a prescription. • % Effective: Typical: 92 Perfect: 99.7 • How it Works: Hormones in the pills, estrogen and progestin (combined) or progestin-only, stop the ovaries from releasing eggs. • Advantages: Shorter, more regular periods. Less cramping. Some pills reduce acne. Decreased risk for ovarian and uterine cancer. • Disadvantages: No STI protection. Must be taken at about the same time every day. Side effects may include nausea, headaches, spotting between periods, breast tenderness, weight gain or loss. Increased risk of blood clots especially for smokers.

10. Ortho Evra Patch • How to Get it: Requires a prescription. • % Effective: Typical: 92 Perfect: 99.7 • How it Works: Hormones similar to those in the pill are release from the patch and absorbed through the skin. The hormones prevent ovulation. • Advantages: Do not have to remember a pill everyday yet receive similar advantages as the pill. • Disadvantages: No STI protection. May experience side effects similar to those of the pill. May cause skin irritation where the patch is worn.

11. NuvaRing • How to Get it: Requires a prescription. • % Effective: Typical: 92 Perfect: 99.7 • How it Works: Hormones similar to those in the pill are released from the ring and absorbed through the vaginal wall. The hormones prevent ovulation. • Advantages: Do not have to remember a pill everyday yet receive similar advantages to the pill. • Disadvantages: No STI protection. May experience side effects similar to those of the pill.

12. Depo Provera • How to Get it: Must visit a doctor or clinic. • % Effective: Typical: 97 Perfect: 99.7 • How it Works: 3 month progestin-only injection prevents ovulation and thickens cervical mucous (harder for sperm to get into uterus). • Advantages: Highly effective. Lasts 12 weeks. Many females stop having periods. • Disadvantages: No STI protection. Tends to cause more side effects than other hormonal methods. Fertility may not return for several months after last injection.

13. Implanon • How to Get it: Inserted and removed by a health care provider. • % Effective: More than 99% • How it Works: Hormonal implant, inserted under the skin on the inside of the arm, slowly releases hormone that prevents ovulation and thickens cervical mucous. • Advantages: Highly effective. Discreet. Lasts 3 years. Do not have to remember anything. • Disadvantages: No STI protection. Irregular bleeding. Insertion and removal may cause pain, swelling, scarring.

14. Emergency Contraceptive Pills(Morning After Pill) • How to Get it: Through medical providers or select pharmacies- no prescription needed. Available OTC for women ages 17 and older. Hotline- 1-888-NOT-2-LATE . • % Effective: If used within 3 days, reduces the risk of pregnancy by at least 75% • How it Works: The hormones in ECPs are similar to those in birth control pills. They prevent ovulation, fertilization and implantation. • Advantages: Can be taken after unprotected intercourse to prevent pregnancy. • Disadvantages: No STI protection. May cause nausea/vomiting. Not as effective as using other hormonal contraception consistently.

15. Barrier Methods • Latex Condoms • Non-Latex Condoms • Female Condom • Spermicides • Foam, Film, Lubricant, Suppository, Sponge • Diaphragm • Use with spermicidal jelly • Dental Dam

16. Latex Condoms • How to Get it: Can buy in grocery/drug stores. Free at Planned Parenthood and Department of Health. • % Effective: Typical use: 85 Perfect use: 98 • How it Works: Prevents sperm from getting inside vagina (physical barrier). • Advantages: STI protection, no hormonal side effects, very inexpensive and accessible. Allows male to take responsibility for birth control. • Disadvantages: Must be used correctly every time. Some have allergies to latex.

17. Non-Latex Condoms • How to Get it: Can buy in grocery/drug stores. • % Effective: Animal Membrane: Some protection against pregnancy. No protection against STIs. Polyurethane: Believed to have similar protection against pregnancy and STIs as latex condoms. • How it Works: Prevents sperm from getting inside vagina (physical barrier). • Advantages: Alternative for those with latex allergies. No hormonal side effects. Allows male to take responsibility for birth control. • Disadvantages: Must be used correctly every time. More expensive than latex condoms.

18. Female Condom(Reality) (Femidom) • How to Get it: Can buy in grocery/drug stores. • % Effective: Typical: 79 Perfect: 95 • How it Works: Prevents sperm from getting inside the uterus by lining the inside of the vagina (physical barrier). • Advantages: Provides some STI protection. No hormonal side effects. • Disadvantages: Must be used correctly every time.

19. Spermicides • How to Get it: Can buy in grocery/drug stores. Free at some clinics. • % Effective: Typical use: 71 Perfect use: 82 • How it Works: Creates a chemical barrier. Kills sperm. • Advantages: Easy to use. Can act as lubrication. Many different forms to choose from. • Disadvantages: No STI protection. Can be messy. Some people are sensitive to it.

20. Diaphragm • How to Get it: Must be fitted by a doctor. • % Effective: Typical: 84 Perfect: 94 • How it Works: Blocks sperm from getting through cervix. Spermicide kills sperm. • Advantages: No hormonal side effects. • Disadvantages: No STI protection. May be difficult for some to use (must be comfortable inserting and removing it.).

21. Dental Dam • How to Get it: Surgical supply stores. • % Effective: Not a form of birth control • How it Works: Used to help protect people from STI’s during vaginal or oral-anal sex. It is placed over the opening to the vagina or anus before having oral sex. • Advantages:May help protect against STI’s. • Disadvantages: Does not prevent pregnancy.

22. Surgical Methods • IUD • Sterilization • Tubal Ligation • Vasectomy • Sterilization Implant

23. Tubal Ligation • How to Get it: Surgery in a hospital or clinic. • % Effective: 99.5 • How it Works: Fallopian tubes are cut and closed so eggs cannot reach the uterus and sperm cannot reach eggs. • Advantages: Permanent. Most insurance will cover surgery. • Disadvantages: No STI protection. Permanent- very difficult and expensive to reverse. Low risk of infection. Some discomfort following procedure.

24. Sterilization Implant (Essure) • How to Get it: Surgery in a hospital or clinic. • % Effective: 99 • How it Works: Tiny spring-like device inserted into the fallopian tubes. Works by causing scar tissue to form around the coil. This blocks the fallopian tubes and stops the egg and sperm from joining. • Advantages:Safer than methods that require an incision. A surgical setting is not needed. Recovery is faster. • Disadvantages: No STI protection. Can take 3 months for the scar tissue to grow. Important to use another form of birth control during this time.

25. Vasectomy • How to Get it: Surgery in a clinic. • % Effective: 99.85 • How it Works: Vas Deferens are cut and closed , so sperm is no longer part of the ejaculate. • Advantages: Permanent. Most insurance will cover surgery. • Disadvantages: No STI protection. Permanent- very difficult and expensive to reverse. Some discomfort during recovery.

26. Intra Uterine Device (IUD) • How to Get it: Must be inserted in a clinic. • % Effective: Typical: 99.2 Perfect: 99.4 • How it Works: Changes the environment inside the uterus, making it inhospitable to sperm. Prevents fertilization; may prevent implantation. • Advantages: Long-term- 5 years for Mirena, 12 years for Paragard. Easily reversible. • Disadvantages: Can cause changes in bleeding patterns (ex: more bleeding/cramping, or no periods).