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Male and female condoms are the only form of contraception that can protect you from pregnancy and most STDs.
If you and your partner aren't planning on having a baby, you need to use a form of birth control. Here's a roundup of the options available to you–you may even be surprised!
If you're not thinking about diapers, strollers and toys, you and your partner should be using contraception (known as birth control).
Unfortunately, it seems many of us are confused when it comes to birth control methods. Condoms, cervical caps, pills, patches… Which should you use? Where can you get them? What are the health risks?
To avoid an unwanted pregnancy, contraception should have an important role in your sex life. It can also protect you from sexually transmitted diseases (STDs). We have some good advice to help you choose a birth control method that is right for you.
Why should I use contraception?
If you don't want to become pregnant, you and your partner need to use contraception. Birth control methods may:
Kill sperm
Prevent sperm from reaching the egg
Keep eggs from being released each month
Change the endometrium (lining of the uterus)
In other words, they prevent you from becoming pregnant! You may also need protection from STDs, including chlamydia, gonorrhea and genital warts (see our article on STDs). In this case, you will probably want to use a particular form of contraception–the condom.
Where can I get contraception?
Remember
Beware the phrase "safe sex." Even with perfect use, contraception cannot give you complete protection against pregnancy and STDs. It makes sex safer, not safe!
This depends on the type of contraception you require. Many types need to be prescribed by a nurse or doctor–for example, birth control pills. You may also need to be measured for a diaphragm or cervical cap, or be fitted with an intrauterine device (IUD). Other forms of contraception, such as condoms and spermicides, are available without prescription, and can be found in drugstores, supermarkets, even vending machines.
What are the options?
Barrier methods
Barrier methods–chemical or physical–prevent sperm from reaching and fertilizing the egg. They include:
Spermicides These chemicals are used to kill sperm. Spermicides are placed inside your vagina, near to the cervix (the entrance to your uterus). They include tablets, cream, foam, film and jelly.
Condoms Male and female condoms are the only form of contraception that can protect you from pregnancy and most STDs. The male condom, or "rubber," is more popular, but both are widely available.
Cervical cap This is a small, thin dome, made of rubber or plastic, which is placed over your cervix. Cervical caps, which are prescribed by a nurse or doctor, should be used with a spermicide.
Diaphragm A small rubber dome, the diaphragm is similar to the cervical cap and, again, needs to be used with a spermicide.
Lea's Shield This is similar to a cervical cap or diaphragm. A dome-shaped silicone device, the Lea's Shield is placed inside your vagina and used with spermicide.
Hormone methods
Hormonal birth control makes your body think it is pregnant and prevents you from releasing an egg each month (ovulation). In very rare cases, hormone treatments can increase your risk of heart attack and stroke. You shouldn't use them if you re over 35 years old and you smoke. Some hormonal contraceptives have health benefits in addition to preventing pregnancy.
Emergency contraception
If you have sex without using birth control, or the birth control doesn t work (for example, the condom breaks), you can use emergency contraception. With this method, certain doses of combination birth control pills need to be taken as soon as possible, up to 72 hours after having unprotected sex. This helps reduce your chances of becoming pregnant. However, it shouldn t be used as a regular birth control method–only in emergencies! An IUD also can be used for emergency contraception.
Birth control pills Many women use birth control pills. Most are "combined pills," which contain two hormones–estrogen and progestin–although you can also get progestin-only pills. You have to take one pill, at the same time each day for either 21, 28, or 84 days.Then, for seven days, you don't take pills or you take a pill that doesn't contain hormones. During this time, you have bleeding similar to a menstrual period. With some types of pills, eventually you will not get periods.
Injections Hormone injections are given every 3 months. They're useful if–like many women–you can't remember to take your birth control pills!
Implants A contraceptive implant is a single rod that is inserted under the skin of the upper arm. It protects against pregnancy for 3 years. The implant works similar to other hormonal methods of birth control.
Skin patch This is a small, adhesive patch worn on the arm, chest, buttocks or upper back. You change it once a week, for a total of three weeks. During the fourth week, you don't wear the patch–this is when you have bleeding similar to a menstrual period.
Vaginal ring This flexible, plastic ring, which is placed in the vagina and releases estrogen and progestin, is worn for 21 days and removed for seven days. As with birth control pills and the skin patch, this is when you have bleeding similar to a menstrual period. Afterward, you need to insert a new vaginal ring.
Long-term or permanent methods
If you and your partner have decided to wait to have children or not to have children, you may want to consider long-term or permanent methods.
Intrauterine device (IUD) This is a small, plastic, T-shaped device, which is inserted into the uterus. There are two types–hormonal and copper that both prevent the sperm reaching and fertilizing the egg. The hormonal IUD must be replaced every 5 years. The copper IUD can remain in your body for as long as 10 years. IUDs also cause changes in the uterus–for example, thinning the endometrium, which helps prevent pregnancy.
Male and female sterilization This should only be considered if you and your partner don't want to have a baby–not now nor any time in the future–because it's a permanent birth control method. The procedure in a woman, called tubal sterilization, involves closing the fallopian tubes by tying, clipping, cutting or blocking them. Male sterilization–known as a vasectomy–closes up the vas deferens, a small tube that carries sperm to the man's penis.
Natural family planning and withdrawal
You and your partner may not want to use contraception because of personal and religious beliefs. If so, natural family planning can help you to avoid unwanted pregnancies (see our article on natural family planning).
You can also use the withdrawal method, or "pulling out," in other words, your partner takes his penis out of you before he ejaculates in an attempt to keep sperm out of the vagina. However, be warned that sperm can be present in fluid produced by the penis even before ejaculation. Also, your partner may not be able to withdraw completely, or in time.
How do I choose?
It's a good idea to see your doctor, nurse or family planning counselor to help you decide on a birth control method. You might be asked about your general health, and your blood pressure will be checked (especially if you want to use hormone treatments).
Remember, it's important to mention your individual situation and preferences–for example, how often you have sex, whether you want to have children in the future, and your need to protect against STDs.
Finally…
There are many forms of contraception, each with pros and cons. However, with careful consideration and advice from your doctor, nurse or family planning counselor, you should be able to find the right one for you.
A guide to… Birth control methods
Birth control method
Pregnancy rates (%)*
Protection against STDs?
Pros
Cons
Recommended for
Spermicides
29
Some
Available over-the-counter
Must be used with another birth control method
Side effects include allergic reaction to spermicides; vaginitis; urinary tract infections (UTI)
Women who are using a cervical cap, diaphragm or Lea's Shield
Condoms
15 (male condom)
21 (female condom)
Yes (male)
Some (female)
Effective protection against pregnancy and and STDs
Available over-the-counter
Affordable
Side effects include allergic reaction to latex condoms
Women who need protection against pregnancy and STDs
Diaphragm
16
Some
Re-usable, therfore cheap and convenient
Side effects include allergic reaction to latex or spermicide; toxic shock syndrome (TSS); UTI
Women who need a long-acting birth control method
(for example, those in long-term relationships)
Cervical cap
20 (40 for women who already had a baby)
Some (with spermicide use)
Re-usable
Side effects include allergic reaction to latex or spermicide; UTI; TSS
Women who need a long-acting birth control method
Lea's Shield
15
Some (with spermicide use)
Re-usable
Side effects include abnormal uterine bleeding or spotting; vaginitis; UTI
Women who need a long-acting birth control method
Combination birth control pills
8
No
Can help to prevent certain types of cancer
Menstrual periods become regular, lighter and shorter
Also reduce menstrual cramps
Some pills can help to treat acne
Side effects include headache, breast tenderness, nausea, irregular bleeding, missed periods, cardiovascular problems
Women who need a long-acting birth control method
Progestin-only birth control pills
8
No
Can be used by women older than 35, and smokers
Useful for breastfeeding, as it doesn't affect milk production
Side effects include irregular bleeding, headache, breast tenderness, nausea dizziness, acne, weight gain, anxiety, depression
Women who need a long-acting birth control method
Injection
3
No
Very convenient
Effective for 3 years
Side effects include irregular bleeding, headache, dizziness, acne, weight gain, anxiety, depression, slowing of bone growth, delay in return to fertility
Women who need a long-acting birth control method
Skin patch
8
No
Can be applied at home, without visiting your doctor or nurse
May have similar health benefits to birth control pills
Side effects include allergic reaction on skin, abdominal pain, breast tenderness, menstrual cramps, nausea, cardiovascular problems
Women who need a long-acting birth control method
Vaginal ring
8
No
May have similar health benefits to birth control pills
Side effects include headache, nausea, vaginal discharge, weight gain, cardiovascular problems
Women who need a long-acting birth control method
Intrauterine device (IUD)
0.8 (copper)
2 (hormonal)
No
Very convenient, and can be worn for 5-10 years
Side effects include irregular, heavy or painful bleeding, vaginal discharge
Women who don't want to have a baby in th enext 5-10 years
Male sterilization
0.15
No
A permanent birth control method
May be post-surgery complications
Attempts to reverse sterilization require major surgery and aren't covered by medical insurance.
Also, they might not be successful
Those who don't want to have children
Female sterilization
0.5
No
A permanent birth control method
May be post-surgery complications
May be problems reversing sterilization
Those who don't want to have children
Natural family planning
25
No
Useful for those who can't use other forms of contraception
Not very effective
Women with personal and religious beliefs about the use of contraception
Withdrawal ("pulling out")
27
No
Useful for those who can't use other forms of contraception
Not very effective
Women with personal and religious beliefs about the use of contraception
* These rates are for typical use. This means that the method either was not always used correctly or not used with every act of intercourse, or was used correctly but failed anyway.
A number of birth control methods are available for women, but is there a natural alternative? We examine the natural family planning method and ask if it can prevent unwanted pregnancies.
Sexually transmitted diseases are bad news! They can cause serious health and fertility problems and, every year, there are millions of new cases. It's important to know the facts–every woman should know how to protect herself and her partner.
