Birth Control Options

The table below summarizes various birth control methods. Discuss these options with your doctor to determine what’s best for you, depending on your age, health, and sexual habits.

No longer is birth control simply a matter of planning or preventing a pregnancy. Protection from AIDS and sexually transmitted diseases (STD’s) should also be considered. Using more than one method may be needed to prevent both pregnancy and diseases that are transmitted sexually.

Ideal Use – is the percentage of pregnancies that occur among couples who use the method correctly for every time they have sexual intercourse.

Average Use – combines figures for ideal use with pregnancies that occur among couples who do not use the birth control method(s) correctly or every time when they have sexual intercourse.


MethodFailure Rate……%*InformationAdvantagesDisadvantages

Cervical Cap

Covers the cervix; prevents sperm from reaching egg.

Ideal use……6%

Average use……18%

Works by creating a barrier that prevents sperm from reaching the cervix. Needs a prescription and proper fitting by a doctor.Can be kept in place up to 3 days. No dangerous side effects.Limited number of sizes available. Potential problems with insertion. Slight risk of infection when left in place for several weeks. May cause an abnormal Pap smear. Not to be used by those with a history of abnormal Pap smears. Should not be used during menstrual period.
Condom (Female)

Ideal Use……5%

Average Use……25%

Shaped like a male condom, but larger. Is placed inside the vagina like a lining. Made of polyurethane which is thinner and stronger than latex. Has 2 rings; One around the outer rim which covers the labia and the base of the penis and one inside that fits over the cervix like a diaphragm.Effective protection against STD’s and AIDS (especially when used with a male condom.) Available over-the-counter.Can take time and patience to use correctly. Can twist if not inserted properly. Costs more than male condoms. May reduce sexual spontaneity and sensation.
Condom (Male)

Ideal Use……2%

Average Use……16%

Thin pliable sheath worn over erect penis; prevents sperm from entering vagina. Latex ones are more durable than ones made of animal membranes.Easy to get. Easy to use. Latex brands are most effective. They protect against gonorrhea, syphilis and AIDS (especially when used with a spermicide containing Nonoxynol 9)May reduce sexual spontaneity and sensation. Slight risk of breakage. Easily damaged with improper storage. Deteriorate when exposed to ultraviolet light, heat or moisture. Not good choice if allergic to latex or spermicides.

Ideal use……0.3%

Average use……0.04%

A female prescription contraceptive given by injection every 3 months. A synthetic version of the female hormone progesterone. Blocks ovulation.Highly effective in preventing pregnancy. May reduce risk of endometrial cancer.Provides no protection for STD’s or AIDS. May cause side effects, irregular periods, weight gain, fatigue and headaches. Once stop-ped, it can take 4-18 months for a woman to become fertile again.

Ideal Use……6%

Average Use……18%

Thin, soft, rubber cap that covers the cervix; prevents sperm from reaching and fertilizing egg. (Up to 6 hours after insertion) Needs doctor’s prescription.Not disposable. Can be used over and over again. No dangerous side effects. Helps protect against some STD’s when used with spermicides.Requires proper fitting. Should be checked for leaks and size may need to be changed with weight increase or decrease. May dislodge during intercourse. May reduce sexual spontaneity. May increase chance of getting bladder infections. Should not be used during menstrual period.
Spermicides (Foams, Jellies, Creams, Suppositories)

Ideal Use……3%

Average Use……30%

Spermicides inserted into the vagina; kill sperm before entering the uterus.Available over-the-counter. More reliable when used with barrier methods (condoms, diaphragms). Protects against some STD’s. No dangerous side effects.May cause irritation. Must be applied no longer than 10 minutes before intercourse. May reduce sexual spontaneity and sensation.
Intrauterine Device (IUD)

Ideal Use……0.8%

Average Use……4%

Small copper device inserted into uterus; prevents pregnancy by interfering with sperm transport and fertilization. Needs a doctor’s prescription. Inserted by a doctor. There are at present only two IUDs available in the U.S.: Copper T-380A and used up to 10 years. Progestasert can be used for up to one year. Remains in place at all times.Does not prevent STD’s or AIDS. May cause heavy menstrual flow. May become dislodged. Risk of infection and perforation of the uterus. Not recommended for those who have a history of pelvic inflammatory disease.
Natural Family Planning (Fertility Awareness, Periodic abstinence)

Ideal Use……1-9%

Average Use……19-35%

Requires monitoring of body temperature and observation of cervical mucus to determine when ovulation occurs. A woman is most fertile 2 days before and through the 2 days after ovulation. Safe days start the day after the three days of elevated temperature and last until menstruation begins.Does not require use of hormones, or other things that are placed inside the body. Is completely reversible. Method to use when planning a pregnancy because it helps a woman know when she ovulates.Sexual intercourse must be limited to “safe days”. Consult your health care provider for an explanation of “safe days”. This method takes training, time, and a need to keep records of measurements, to be effective. Does not protect against STD’s.

Ideal Use……0.04%

Average Use……0.05%

Six thin capsules (the size of match sticks) are placed under the skin of a woman’s upper arm. Releases a hormone that keeps a woman from making hormones needed for ovulation. Needs a doctor’s prescription, insertion and removal. Make sure doctor is well trained in inserting
and removing implants.
One time insertion effective for up to six years. Can be removed at any time. Fertility returns soon after removal of implants.Does not prevent STD’s or AIDS. May cause irregular menstrual bleeding during the first 6 months after implants are put in. More expensive than birth control pills. Some women may need more than one simple surgery (with only local anethesia) to remove implants.
Pill (Oral Contraceptives)

Ideal Use……0.1%

Average Use……6%

Hormones, in pill form; prevent the release of eggs. (Ovulation) Needs a doctor’s prescription.May reduce a woman’s chance for: uterine and ovarian cancers, pelvic inflammatory disease (PID). Promotes regular periods, lighter menstrual flow.Does not prevent
STD’s or AIDS. Must be taken as prescribed. Not recommended for women who smoke or have heart disease. May increase the risk of blood clots and stroke.
Sterilization (Female): Tubal Ligation, (Having “tubes tied”)Failure Rate……0.003%Surgery to burn, cut or tie off the fallopian tubes. This prevents eggs from being fertilized. Failures are usually due to pregnancy prior to surgery, surgical error or regrowth of the fallopian tubes.Permanent form of birth control.Should be used only when no more children are desired. Usually requires general anesthesia. Does not prevent STD’s or AIDS. Costs more than a vasectomy.
Sterilization (Male): Vasectomy

Ideal Use……0.1%

Average Use……0.2%

The tubes through which the sperm travels from the testes (vas diferans) are cut. Can be done with a surgical cut or a puncture tool. (Newer method)Done as out-patient with local anesthesia. Less costly than tubal ligation.Does not take effect right away. Sperm can still be present for 20 ejaculations. Vasectomies can be reversed with surgery, but this is not always successful. Does not prevent STD’s or AIDS.

[Note: In addition, another way to prevent pregnancy is total abstinence from sexual encounters. Using no method of birth control has about 90% chance of pregnancy in one year.]

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Written by American Institute for Preventive Medicine

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