Comparison of birth control methods
Encyclopedia
Different types of birth control
methods have large differences in effectiveness, actions required of users, and side effects.
s, and coitus interruptus
must be used at every act of intercourse. The male condom may not be applied until the man achieves an erection. Barriers such as diaphragm
s, caps, the contraceptive sponge
, and female condom
s may be placed several hours before intercourse begins (note that when using the female condom the penis must be guided into place when initiating intercourse). The female condom should be removed before arising. The other female barrier methods must be left in place for several hours after sex. Spermicides, depending on the form, may be applied several minutes to an hour before intercourse begins.
Fertility awareness-based methods require that users recognize fertility signs and abstain from intercourse or use other methods during their fertile time.
The lactational amenorrhea method
(LAM) requires breast feeding at least every four to six hours.
Oral contraceptives require some action every day. Other hormonal methods require less frequent action - weekly for the patch, twice a month for vaginal ring, monthly for combined injectable contraceptive, and every twelve weeks for the injection Depo-Provera.
Implants, such as Implanon
, provide effective birth control for three years without any user action between insertion and removal of the implant. Insertion and removal of the Implant involves a minor surgical procedure.
Intrauterine methods require clinic visits for removal and replacement (if desired) only once every few years (5-10, depending on the device).
Sterilization is a one-time, permanent procedure - after the success of surgery is verified, no action is usually required of users.
Many hormonal methods of birth control, and LAM require a moderate level of thoughtfulness. For many hormonal methods, clinic visits must be made every three months to a year to renew the prescription. The pill must be taken every day, the patch must be reapplied weekly, or the ring must be replaced monthly. Injections are required every 12 weeks. The rules for LAM must be followed every day. Both LAM and hormonal methods provide a reduced level of protection against pregnancy if they are occasionally used incorrectly (rarely going longer than 4–6 hours between breastfeeds, a late pill or injection, or forgetting to replace a patch or ring on time). The actual failure rates for LAM and hormonal methods are somewhat higher than the perfect-use failure rates.
Higher levels of user commitment are required for other methods. Barrier methods, coitus interruptus, and spermicides must be used at every act of intercourse. Fertility awareness-based methods may require daily tracking of the menstrual cycle. The actual failure rates for these methods may be much higher than the perfect-use failure rates.
The less effective the method, the greater the risk of the side-effects associated with pregnancy.
Minimal or no other side effects are possible with coitus interruptus, fertility awareness-based, and LAM. Following the rules for LAM may delay a woman's first post-partum menstruation beyond what would be expected from different breastfeeding practices.
Barrier methods have a risk of allergic reaction. Users sensitive to latex may use barriers made of less allergenic materials - polyurethane condoms, or silicone diaphragms, for example. Barrier methods are also often combined with spermicides, which have possible side effects of genital irritation, vaginal infection, and urinary tract infection.
Sterilization procedures are generally considered to have low risk of side effects, though some persons and organizations disagree.
After IUD insertion, menstrual periods may be heavier, more painful, or both - especially for the first few months after they are inserted. However, some IUDs are designed to cause periods to become lighter or to cease completely.
Because of their systemic nature, hormonal methods have the largest number of possible side effects.
or a life table method
. A "perfect-use" rate is where any rules of the method are rigorously followed, and (if applicable) the method is used at every act of intercourse.
Actual failure rates are higher than perfect-use rates for a variety of reasons:
For instance, someone using oral forms of hormonal birth control might be given incorrect information by a health care provider as to the frequency of intake, or for some reason not take the pill one or several days, or not go to the pharmacy on time to renew the prescription, or the pharmacy might be unwilling to provide enough pills to cover an extended absence.
In the User action required column, items that are non-user dependent (require action once per year or less) also have a blue background.
Some methods may be used simultaneously for higher effectiveness rates. However, mathematically combining the rates to estimate the effectiveness of combined methods can be inaccurate, as the effectiveness of each method is not necessarily independent, except in the perfect case.
If a method is known or suspected to have been ineffective, such as a condom breaking, emergency contraception
may be taken up to 120 hours after sexual intercourse
. Emergency contraception should be taken shortly before or as soon after intercourse as possible, as its efficacy decreases with increasing delay.
Birth control
Birth control is an umbrella term for several techniques and methods used to prevent fertilization or to interrupt pregnancy at various stages. Birth control techniques and methods include contraception , contragestion and abortion...
methods have large differences in effectiveness, actions required of users, and side effects.
Ease of use
Different methods require different actions of users. Barrier methods, spermicideSpermicide
Spermicide is a contraceptive substance that eradicates sperm, inserted vaginally prior to intercourse to prevent pregnancy. As a contraceptive, spermicide may be used alone. However, the pregnancy rate experienced by couples using only spermicide is higher than that of couples using other methods...
s, and coitus interruptus
Coitus interruptus
Coitus interruptus, also known as the rejected sexual intercourse, withdrawal or pull-out method, is a method of birth-control in which a man, during intercourse withdraws his penis from a woman's vagina prior to ejaculation...
must be used at every act of intercourse. The male condom may not be applied until the man achieves an erection. Barriers such as diaphragm
Diaphragm
-Optics and photography:* Diaphragm , a stop in the light path of a lens, having an aperture that regulates the amount of light that passes* Diaphragm shutter, a type of leaf shutter consisting of a number of thin blades in a camera-Acoustics:...
s, caps, the contraceptive sponge
Contraceptive sponge
The contraceptive sponge combines barrier and spermicidal methods to prevent conception. Three brands are marketed: Pharmatex, Protectaid and Today. Pharmatex is marketed in France and the province of Quebec; Protectaid in the rest of Canada and Europe; and Today in the United States.Sponges work...
, and female condom
Female condom
A female condom is a device that is used during sexual intercourse as a barrier contraceptive and to reduce the risk of sexually transmitted infections and unintended pregnancy...
s may be placed several hours before intercourse begins (note that when using the female condom the penis must be guided into place when initiating intercourse). The female condom should be removed before arising. The other female barrier methods must be left in place for several hours after sex. Spermicides, depending on the form, may be applied several minutes to an hour before intercourse begins.
Fertility awareness-based methods require that users recognize fertility signs and abstain from intercourse or use other methods during their fertile time.
The lactational amenorrhea method
Lactational Amenorrhea Method
The lactational amenorrhea method is a method of avoiding pregnancies which is based on the natural postnatal infertility that occurs when a woman is amenorrheic and fully breastfeeding...
(LAM) requires breast feeding at least every four to six hours.
Oral contraceptives require some action every day. Other hormonal methods require less frequent action - weekly for the patch, twice a month for vaginal ring, monthly for combined injectable contraceptive, and every twelve weeks for the injection Depo-Provera.
Implants, such as Implanon
Implanon
Implanon, made by Organon International, is a single-rod long acting reversible hormonal contraceptive subdermal implant that is inserted just under the skin of a woman's upper arm. The 4 cm by 2 mm Implanon rod contains 68 milligrams of etonogestrel which is released over a three year...
, provide effective birth control for three years without any user action between insertion and removal of the implant. Insertion and removal of the Implant involves a minor surgical procedure.
Intrauterine methods require clinic visits for removal and replacement (if desired) only once every few years (5-10, depending on the device).
Sterilization is a one-time, permanent procedure - after the success of surgery is verified, no action is usually required of users.
User dependence
Different methods require different levels of diligence by users. Methods that require a clinic visit less than once per year are said to be non-user dependent. Intrauterine methods, implants and sterilization fall into this category. For methods that are not user dependent, the actual and perfect-use failure rates are very similar.Many hormonal methods of birth control, and LAM require a moderate level of thoughtfulness. For many hormonal methods, clinic visits must be made every three months to a year to renew the prescription. The pill must be taken every day, the patch must be reapplied weekly, or the ring must be replaced monthly. Injections are required every 12 weeks. The rules for LAM must be followed every day. Both LAM and hormonal methods provide a reduced level of protection against pregnancy if they are occasionally used incorrectly (rarely going longer than 4–6 hours between breastfeeds, a late pill or injection, or forgetting to replace a patch or ring on time). The actual failure rates for LAM and hormonal methods are somewhat higher than the perfect-use failure rates.
Higher levels of user commitment are required for other methods. Barrier methods, coitus interruptus, and spermicides must be used at every act of intercourse. Fertility awareness-based methods may require daily tracking of the menstrual cycle. The actual failure rates for these methods may be much higher than the perfect-use failure rates.
Side effects
Different forms of birth control have different potential side effects. Not all, or even most, users will experience side effects from a method.The less effective the method, the greater the risk of the side-effects associated with pregnancy.
Minimal or no other side effects are possible with coitus interruptus, fertility awareness-based, and LAM. Following the rules for LAM may delay a woman's first post-partum menstruation beyond what would be expected from different breastfeeding practices.
Barrier methods have a risk of allergic reaction. Users sensitive to latex may use barriers made of less allergenic materials - polyurethane condoms, or silicone diaphragms, for example. Barrier methods are also often combined with spermicides, which have possible side effects of genital irritation, vaginal infection, and urinary tract infection.
Sterilization procedures are generally considered to have low risk of side effects, though some persons and organizations disagree.
After IUD insertion, menstrual periods may be heavier, more painful, or both - especially for the first few months after they are inserted. However, some IUDs are designed to cause periods to become lighter or to cease completely.
Because of their systemic nature, hormonal methods have the largest number of possible side effects.
Effectiveness calculation
Failure rates may be calculated by either the pearl indexPearl Index
The Pearl Index, also called the Pearl rate, is the most common technique used in clinical trials for reporting the effectiveness of a birth control method.-Calculation and usage:...
or a life table method
Decrement table
Decrement tables, also called life table methods, are used to calculate the probability of certain events.-Birth control:Life table methods are often used to study birth control effectiveness...
. A "perfect-use" rate is where any rules of the method are rigorously followed, and (if applicable) the method is used at every act of intercourse.
Actual failure rates are higher than perfect-use rates for a variety of reasons:
- mistakes on the part of those providing instructions on how to use the method
- mistakes on the part of the method's users
- conscious user non-compliance with method.
- insurance providers sometimes impede access to medications (e.g. require prescription refills on a monthly basis)
For instance, someone using oral forms of hormonal birth control might be given incorrect information by a health care provider as to the frequency of intake, or for some reason not take the pill one or several days, or not go to the pharmacy on time to renew the prescription, or the pharmacy might be unwilling to provide enough pills to cover an extended absence.
Effectiveness of various methods
The table below color codes the typical-use and perfect-use failure rates, where the failure rate is measured as the expected number of pregnancies per year per 100 women using the method:| Blue | under 1% | lower risk |
| Green | up to 5% | |
| Yellow | up to 10% | |
| Orange | up to 20% | |
| Red | over 20% | higher risk |
| Grey | no data | no data available |
In the User action required column, items that are non-user dependent (require action once per year or less) also have a blue background.
Some methods may be used simultaneously for higher effectiveness rates. However, mathematically combining the rates to estimate the effectiveness of combined methods can be inaccurate, as the effectiveness of each method is not necessarily independent, except in the perfect case.
If a method is known or suspected to have been ineffective, such as a condom breaking, emergency contraception
Emergency contraception
Emergency contraception , or emergency postcoital contraception, refers to birth control measures that, if taken after sexual intercourse, may prevent pregnancy.Forms of EC include:...
may be taken up to 120 hours after sexual intercourse
Sexual intercourse
Sexual intercourse, also known as copulation or coitus, commonly refers to the act in which a male's penis enters a female's vagina for the purposes of sexual pleasure or reproduction. The entities may be of opposite sexes, or they may be hermaphroditic, as is the case with snails...
. Emergency contraception should be taken shortly before or as soon after intercourse as possible, as its efficacy decreases with increasing delay.
Comparison table
This table lists the chance of pregnancy during the first year of use.| Birth control method | Implanon Implanon Implanon, made by Organon International, is a single-rod long acting reversible hormonal contraceptive subdermal implant that is inserted just under the skin of a woman's upper arm. The 4 cm by 2 mm Implanon rod contains 68 milligrams of etonogestrel which is released over a three year... | "the implant" | Progestogen | Subdermal implant | |||
|---|---|---|---|---|---|---|---|
| Jadelle (lower-dose) | "the implant" | Progestogen | Subdermal implant | ||||
| Vasectomy Vasectomy Vasectomy is a surgical procedure for male sterilization and/or permanent birth control. During the procedure, the vasa deferentia of a man are severed, and then tied/sealed in a manner such to prevent sperm from entering into the seminal stream... |
"male sterilization" | Sterilization | Surgical procedure | ||||
| Combined injectable Combined injectable contraceptive Combined injectable contraceptive monthly injection of progesterone and estradiol taken to inhibit fertility. Brand names include Cyclofem, Novafem, Mesigyna, Lunelle and Cyclo-Provera.... |
Lunelle, Cyclofem | Estrogen + progestogen | Injection | ||||
| Essure Essure Essure is a permanent transcervical sterilization procedure for women developed by Conceptus Inc. It was approved for use in the United States on November 4, 2002.... |
"female sterilization" | Sterilization | Surgical procedure | ||||
| IUD with progestogen | Mirena | Intrauterine & progestogen | Intrauterine | ||||
| Tubal ligation Tubal ligation Tubal ligation or tubectomy is a surgical procedure for sterilization in which a woman's fallopian tubes are clamped and blocked, or severed and sealed, either method of which prevents eggs from reaching the uterus for fertilization... |
"female sterilization" | Sterilization | Surgical procedure | ||||
| IUD with copper | Paragard Paragard The ParaGard T-380A is an IUD with copper, manufactured and marketed in the United States by Duramed Pharmaceuticals. It is the only copper-containing intrauterine device approved for use in the U.S.... , Copper T |
Intrauterine & copper | Intrauterine | ||||
| LAM Lactational Amenorrhea Method The lactational amenorrhea method is a method of avoiding pregnancies which is based on the natural postnatal infertility that occurs when a woman is amenorrheic and fully breastfeeding... for 6 months only; not applicable if menstruation resumesThe pregnancy rate applies until the user reaches six months postpartum, or until menstruation resumes, whichever comes first. If menstruation occurs earlier than six months postpartum, the method is no longer effective. For users for whom menstruation does not occur within the six months: after six months postpartum, the method becomes less effective. |
"ecological breastfeeding" | Behavioral | Breastfeeding | ||||
| Depo Provera Depo Provera Depo-Provera is a branded progestogen-only contraceptive, depot medroxyprogesterone acetate long acting reversible hormonal contraceptive birth control drug that is injected every 3 months... |
"the shot" | Progestogen | Injection | ||||
| Lea's Shield and spermicide Spermicide Spermicide is a contraceptive substance that eradicates sperm, inserted vaginally prior to intercourse to prevent pregnancy. As a contraceptive, spermicide may be used alone. However, the pregnancy rate experienced by couples using only spermicide is higher than that of couples using other methods... used by nulliparous |
Barrier + spermicide | Vaginal insertion | |||||
| FemCap FemCap FemCap is a cervical barrier contraceptive. As of February 2009, FemCap is the only brand of cervical cap available in the United States.FemCap is made of silicone, its shape is similar to a sailor's hat. FemCap has had two designs; the newer design added a loop, molded into the silicone, to... and spermicide |
cervical cap Cervical cap The cervical cap is a form of barrier contraception. A cervical cap fits over the cervix and blocks sperm from entering the uterus through the external orifice of the uterus, called the os.-Terminology:... |
(estimated) | no data | Barrier & spermicide | Vaginal insertion | ||
| Combined oral contraceptive pill | "the Pill" | Estrogen & progestogen | Oral medication | ||||
| Contraceptive patch Contraceptive patch A contraceptive patch is a transdermal patch applied to the skin that releases synthetic estrogen and progestin hormones to prevent pregnancy. They have been shown to be as effective as the combined oral contraceptive pill with perfect use, and the patch may be more effective in typical use.The... |
Ortho Evra, "the patch" | Estrogen & progestogen | Transdermal patch | ||||
| NuvaRing NuvaRing NuvaRing is the trade name for a combined hormonal contraceptive vaginal ring manufactured by Merck that is available by prescription... |
"the ring" | Estrogen & progestogen | Vaginal insertion | ||||
| Progestogen only pill | "POP", "minipill" | Progestogen | Oral medication | ||||
| Ormeloxifene |
"Saheli", "Centron" | SERM Selective estrogen receptor modulator Selective Estrogen Receptor Modulators are a class of compounds that act on the estrogen receptor. A characteristic that distinguishes these substances from pure receptor agonists and antagonists is that their action is different in various tissues, thereby granting the possibility to selectively... |
Oral medication | ||||
| Male latex Latex Latex is the stable dispersion of polymer microparticles in an aqueous medium. Latexes may be natural or synthetic.Latex as found in nature is a milky fluid found in 10% of all flowering plants . It is a complex emulsion consisting of proteins, alkaloids, starches, sugars, oils, tannins, resins,... condom Condom A condom is a barrier device most commonly used during sexual intercourse to reduce the probability of pregnancy and spreading sexually transmitted diseases . It is put on a man's erect penis and physically blocks ejaculated semen from entering the body of a sexual partner... |
Condom | Barrier | Placed on erect penis | ||||
| Lea's Shield and spermicide Spermicide Spermicide is a contraceptive substance that eradicates sperm, inserted vaginally prior to intercourse to prevent pregnancy. As a contraceptive, spermicide may be used alone. However, the pregnancy rate experienced by couples using only spermicide is higher than that of couples using other methods... used by parous |
Barrier + spermicide | Vaginal insertion | |||||
| Diaphragm Diaphragm (contraceptive) The diaphragm is a cervical barrier type of birth control. It is a soft latex or silicone dome with a spring molded into the rim. The spring creates a seal against the walls of the vagina.-Use:... and spermicide Spermicide Spermicide is a contraceptive substance that eradicates sperm, inserted vaginally prior to intercourse to prevent pregnancy. As a contraceptive, spermicide may be used alone. However, the pregnancy rate experienced by couples using only spermicide is higher than that of couples using other methods... |
Barrier & spermicide | Vaginal insertion | |||||
| Prentif cervical cap Cervical cap The cervical cap is a form of barrier contraception. A cervical cap fits over the cervix and blocks sperm from entering the uterus through the external orifice of the uterus, called the os.-Terminology:... and spermicide Spermicide Spermicide is a contraceptive substance that eradicates sperm, inserted vaginally prior to intercourse to prevent pregnancy. As a contraceptive, spermicide may be used alone. However, the pregnancy rate experienced by couples using only spermicide is higher than that of couples using other methods... used by nulliparous |
Barrier + spermicide | Vaginal insertion | |||||
| Today contraceptive sponge Contraceptive sponge The contraceptive sponge combines barrier and spermicidal methods to prevent conception. Three brands are marketed: Pharmatex, Protectaid and Today. Pharmatex is marketed in France and the province of Quebec; Protectaid in the rest of Canada and Europe; and Today in the United States.Sponges work... used by nulliparous |
"the sponge" | Barrier & spermicide | Vaginal insertion | ||||
| Female condom Female condom A female condom is a device that is used during sexual intercourse as a barrier contraceptive and to reduce the risk of sexually transmitted infections and unintended pregnancy... |
Barrier | Vaginal insertion | |||||
| Symptoms-based fertility awareness Fertility awareness Fertility awareness refers to a set of practices used to determine the fertile and infertile phases of a woman's menstrual cycle. Fertility awareness methods may be used to avoid pregnancy, to achieve pregnancy, or as a way to monitor gynecological health.... No formal studies meet the standards of Contraceptive Technology for determining typical effectiveness. The typical effectiveness listed here is from the CDC Centers for Disease Control and Prevention The Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta... 's National Survey of Family Growth, which grouped symptoms-based methods together with calendar-based methods. See Fertility awareness#Effectiveness.The term "fertility awareness Fertility awareness Fertility awareness refers to a set of practices used to determine the fertile and infertile phases of a woman's menstrual cycle. Fertility awareness methods may be used to avoid pregnancy, to achieve pregnancy, or as a way to monitor gynecological health.... " is sometimes used interchangeably with the term "natural family planning Natural family planning Natural family planning is a term referring to the family planning methods approved by the Roman Catholic Church. In accordance with the Church's requirements for sexual behavior in keeping with its philosophy of the dignity of the human person, NFP excludes the use of other methods of birth... " (NFP), though NFP usually refers to use of periodic abstinence in accordance with Catholic Catholic The word catholic comes from the Greek phrase , meaning "on the whole," "according to the whole" or "in general", and is a combination of the Greek words meaning "about" and meaning "whole"... beliefs. |
basal body temperature Basal body temperature Basal body temperature is the lowest temperature attained by the body during rest . It is generally measured immediately after awakening and before any physical activity has been undertaken, although the temperature measured at that time is somewhat higher than the true basal body temperature... , cervical mucus |
Behavioral | Observation and charting | ||||
| Standard Days Method, CycleBeads & iCycleBeads | Behavioral | Calendar-based | |||||
| Knaus-Ogino method | "the rhythm method" | Behavioral | Calendar-based | ||||
| Coitus interruptus Coitus interruptus Coitus interruptus, also known as the rejected sexual intercourse, withdrawal or pull-out method, is a method of birth-control in which a man, during intercourse withdraws his penis from a woman's vagina prior to ejaculation... |
"withdrawal method", "pulling out" | Behavioral | Withdrawal | ||||
| Spermicidal Spermicide Spermicide is a contraceptive substance that eradicates sperm, inserted vaginally prior to intercourse to prevent pregnancy. As a contraceptive, spermicide may be used alone. However, the pregnancy rate experienced by couples using only spermicide is higher than that of couples using other methods... gel, foam, suppository, or film |
Spermicide | Vaginal insertion | |||||
| Today contraceptive sponge Contraceptive sponge The contraceptive sponge combines barrier and spermicidal methods to prevent conception. Three brands are marketed: Pharmatex, Protectaid and Today. Pharmatex is marketed in France and the province of Quebec; Protectaid in the rest of Canada and Europe; and Today in the United States.Sponges work... used by parous |
"the sponge" | Barrier & spermicide | Vaginal insertion | ||||
| Prentif cervical cap Cervical cap The cervical cap is a form of barrier contraception. A cervical cap fits over the cervix and blocks sperm from entering the uterus through the external orifice of the uterus, called the os.-Terminology:... and spermicide Spermicide Spermicide is a contraceptive substance that eradicates sperm, inserted vaginally prior to intercourse to prevent pregnancy. As a contraceptive, spermicide may be used alone. However, the pregnancy rate experienced by couples using only spermicide is higher than that of couples using other methods... used by parous |
Barrier + spermicide | Vaginal insertion | |||||
| None (unprotected intercourse) | |||||||
| Birth control method | The source of this article is wikipedia, the free encyclopedia. The text of this article is licensed under the GFDL.
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