BIRTH CONTROL METHODS

 What is the best method of birth control (or contraception)?

 What are the different types of birth control?

 Can all types of birth control prevent sexually transmitted infections (STIs)?

 How well do different kinds of birth control work? Do they have side effects?

 Where can I get birth control? Do I need to see a doctor?

 Are there any foams or gels I can use to keep from getting pregnant?

 How effective is withdrawal as a birth control method?

 Everyone I know is on the pill. Is it safe?

 Will birth control pills protect me from sexually transmitted infections (STIs),
including HIV/AIDS?

 I've heard my girlfriends talking about dental dams — what are they?

 More information on birth control methods

What is the best method of birth control (or contraception)?

There is no "best" method of birth control. Each method has its pros and cons.

All women and men can have control over when, and if, they become parents. Making
choices about birth control, or contraception, isn't easy. There are many things to think
about. To get started, learn about birth control methods you or your partner can use to
prevent pregnancy. You can also talk with your doctor about the choices.

Before choosing a birth control method, think about:

 Your overall health

 How often you have sex

 The number of sex partners you have

 If you want to have children someday

 How well each method works to prevent pregnancy

 Possible side effects

 Your comfort level with using the method

Keep in mind, even the most effective birth control methods can fail. But your chances of
getting pregnant are lowest if the method you choose always is used correctly and every
time you have sex.
What are the different types of birth control?

You can choose from many methods of birth control. They are grouped by how they work:

Types of birth control

 Continuous abstinence

 Natural family planning/rhythm method

 Barrier methods

 Contraceptive sponge

 Diaphragm, cervical cap, and cervical shield

 Female condom

 Male condom

 Hormonal methods

 Oral contraceptives — combined pill ("The pill")

 Oral contraceptives — progestin-only pill ("Mini-pill")

 The patch

 Shot/injection

 Implantable devices

 Intrauterine devices

 Permanent birth control methods

 Sterilization implant

 Surgical sterilization

 Emergency contraception

Detailed information on each type is provided in the following charts. Talk with your doctor
if you have questions about any of the choices.
 Continuous abstinence

This means not having sex (vaginal, anal, or oral) at any time. It is the only sure way to prevent
pregnancy and protect against sexually transmitted infections (STIs), including HIV.

Barrier methods — Put up a block, or barrier, to keep sperm from reaching the egg

Contraceptive sponge

This barrier method is a soft, disk-shaped device with a loop for taking it out. It is made out of
polyurethane (pah-lee-YUR-uh-thayn) foam and contains the spermicide (SPUR-muh-syd)
nonoxynol-9. Spermicide kills sperm.

Before having sex, you wet the sponge and place it, loop side down, inside your vagina to cover
the cervix. The sponge is effective for more than one act of intercourse for up to 24 hours. It
needs to be left in for at least 6 hours after having sex to prevent pregnancy. It must then be
taken out within 30 hours after it is inserted.

Only one kind of contraceptive sponge is sold in the United States. It is called the Today
Sponge. Women who are sensitive to the spermicide nonoxynol-9 should not use the sponge.

Diaphragm, cervical cap, and cervical shield

These barrier methods block the sperm from entering the cervix (the opening to your womb) and
reaching the egg.

 The diaphragm is a shallow latex cup.

 The cervical cap is a thimble-shaped latex cup. It often is called by itsBRAND NAME ,
FemCap.
 The cervical shield is a silicone cup that has a one-way valve that creates suction and helps
it fit against the cervix. It often is called by its brand name, Lea's Shield.
The diaphragm and cervical cap come in different sizes, and you need a doctor to "fit" you for
one. The cervical shield comes in one size, and you will not need a fitting.

Before having sex, add spermicide (to block or kill sperm) to the devices. Then place them
inside your vagina to cover your cervix. You can buy spermicide gel or foam at a drug store.

All three of these barrier methods must be left in place for 6 to 8 hours after having sex to
prevent pregnancy. The diaphragm should be taken out within 24 hours. The cap and shield
should be taken out within 48 hours.

Female condom
This condom is worn by the woman inside her vagina. It keeps sperm from getting into her
body. It is made of thin, flexible, manmade rubber and is packaged with a lubricant. It can be
inserted up to 8 hours before having sex. Use a new condom each time you have intercourse.
And don't use it and a male condom at the same time.

Male condom

Male condoms are a thin sheath placed over an erect penis to keep sperm from entering a
woman's body. Condoms can be made of latex, polyurethane, or "natural/lambskin". The natural
kind do not protect against STIs. Condoms work best when used with a vaginal spermicide,
which kills the sperm. And you need to use a new condom with each sex act.

Condoms are either:

 Lubricated, which can make sexual intercourse more comfortable

 Non-lubricated, which can also be used for oral sex. It is best to add lubrication to non-
lubricated condoms if you use them for vaginal or anal sex. You can use a water-based
lubricant, such as K-Y jelly. You can buy them at the drug store. Oil-based lubricants like
massage oils, baby oil, lotions, or petroleum jelly will weaken the condom, causing it to tear
or break.
Keep condoms in a cool, dry place. If you keep them in a hot place (like a wallet or glove
compartment), the latex breaks down. Then the condom can tear or break.

Hormonal methods — Prevent pregnancy by interfering with ovulation, fertilization, and/or

implantation of the fertilized egg

Oral contraceptives — combined pill ("The pill")

The pill contains the hormones estrogen and progestin. It is taken daily to keep the ovaries
from releasing an egg. The pill also causes changes in the lining of the uterus and the cervical
mucus to keep the sperm from joining the egg.

Some women prefer the "extended cycle" pills. These have 12 weeks of pills that contain
hormones (active) and 1 week of pills that don't contain hormones (inactive). While taking
extended cycle pills, women only have their period three to four times a year.

Many types of oral contraceptives are available. Talk with your doctor about which is best for
you.

Your doctor may advise you not to take the pill if you:

 Are older than 35 and smoke

 Have a history of blood clots
 Have a history of breast, liver, or endometrial cancer
Antibiotics may reduce how well the pill works in some women. Talk to your doctor about a
backup method of birth control if you need to take antibiotics.

Women should wait three weeks after giving birth to begin using birth control that contains
both estrogen and progestin. These methods increase the risk of dangerous blood clots that
could form after giving birth. Women who delivered by cesarean section or have other risk
factors for blood clots, such as obesity, history of blood clots, smoking, or preeclampsia,
should wait six weeks.

The patch

Also called by its brand name, Ortho Evra, this skin patch is worn on the lower abdomen,
buttocks, outer arm, or upper body. It releases the hormones progestin and estrogen into the
bloodstream to stop the ovaries from releasing eggs in most women. It also thickens the
cervical mucus, which keeps the sperm from joining with the egg. You put on a new patch once
a week for 3 weeks. You don't use a patch the fourth week in order to have a period.

Women should wait three weeks after giving birth to begin using birth control that contains
both estrogen and progestin. These methods increase the risk of dangerous blood clots that
could form after giving birth. Women who delivered by cesarean section or have other risk
factors for blood clots, such as obesity, history of blood clots, smoking, or preeclampsia,
should wait six weeks.

Shot/injection

The birth control shot often is called by its brand name Depo-Provera. With this method you
get injections, or shots, of the hormone progestin in the buttocks or arm every 3 months. A new
type is injected under the skin. The birth control shot stops the ovaries from releasing an egg in
most women. It also causes changes in the cervix that keep the sperm from joining with the
egg.

The shot should not be used more than 2 years in a row because it can cause a temporary loss
of bone density. The loss increases the longer this method is used. The bone does start to grow
after this method is stopped. But it may increase the risk of fracture and osteoporosis if used for
a long time.

Vaginal ring

This is a thin, flexible ring that releases the hormones progestin and estrogen. It works by
stopping the ovaries from releasing eggs. It also thickens the cervical mucus, which keeps the
sperm from joining the egg.

It is commonly called NuvaRing, its brand name. You squeeze the ring between your thumb
and index finger and insert it into your vagina. You wear the ring for 3 weeks, take it out for
the week that you have your period, and then put in a new ring.

Women should wait three weeks after giving birth to begin using birth control that contains
 both estrogen and progestin. These methods increase the risk of dangerous blood clots that
could form after giving birth. Women who delivered by cesarean section or have other risk
factors for blood clots, such as obesity, history of blood clots, smoking, or preeclampsia,
should wait six weeks.

Implantable devices — Devices that are inserted into the body and left in place for a few years.

Implantable rod

This is a matchstick-size, flexible rod that is put under the skin of the upper arm. It is often called
by itsBRAND NAME , Implanon. The rod releases a progestin, which causes changes in the
lining of the uterus and the cervical mucus to keep the sperm from joining an egg. Less often, it
stops the ovaries from releasing eggs. It is effective for up to 3 years.

Intrauterine devices or IUDs

An IUD is a small device shaped like a "T" that goes in your uterus. There are two types:

 Copper IUD — The copper IUD goes by the brand name ParaGard. It releases a small
amount of copper into the uterus, which prevents the sperm from reaching and fertilizing the
egg. If fertilization does occur, the IUD keeps the fertilized egg from implanting in the lining
of the uterus. A doctor needs to put in your copper IUD. It can stay in your uterus for 5 to 10
years.

 Hormonal IUD — The hormonal IUD goes by the brand name Mirena. It is sometimes
called an intrauterine system, or IUS. It releases progestin into the uterus, which keeps the
ovaries from releasing an egg and causes the cervical mucus to thicken so sperm can't reach
the egg. It also affects the ability of a fertilized egg to successfully implant in the uterus. A
doctor needs to put in a hormonal IUD. It can stay in your uterus for up to 5 years.

Permanent birth control methods — For people who are sure they never want to have a child or
they do not want more children

Sterilization implant (essure)

Essure is the first non-surgical method of sterilizing women. A thin tube is used to thread a tiny
spring-like device through the vagina and uterus into each fallopian tube. The device works by
causing scar tissue to form around the coil. This blocks the fallopian tubes and stops the egg and
sperm from joining.

It can take about 3 months for the scar tissue to grow, so it's important to use another form of
birth control during this time. Then you will have to return to your doctor for a test to see if scar
tissue has fully blocked your tubes.

Surgical sterilization
 Birth control
Emergency contraception — Usedmethods, failure rates,
if a woman's and sidemethod
primary effects of birth control fails. It
should not be used as a regular method of birth control.

Method Failure rate (the Some side effects and risks

Emergency contraception (Plan B One-Step
number of or Next Choice. It is also called the "morning
after pill.") pregnancies expected
per 100 women)
Emergency contraception keeps a woman from getting pregnant when she has had unprotected
Sterilization
vaginal surgery
intercourse. Less
"Unprotected" than
can 1 that no method
mean  ofPain
birth control was used. It can also
for that
mean womena birth control methodpregnancy
was used but it was used incorrectly, or did not work (like a
 Bleeding
condom breaking). Or, a woman may have forgotten to take her birth control pills. She also may
have been abused or forced to have sex. These are just some of the reasons women
Complications may need
from surgery
emergency contraception.
 Ectopic (tubal) pregnancy
Emergency contraception can be taken as a single pill treatment or in two doses. A single dose
treatment worksimplant
Sterilization as well as two doses and does
Less than 1 not have more side effects. It works by stopping
 Pain
thefor
ovaries
women from releasing an egg or keeping
pregnancy the sperm from joining with the egg. For the best
chances  Ectopic (tubal)
for it to work, take the pill as soon as possible after unprotected sex. pregnancy
It should be taken
(Essure)
within 72 hours after having unprotected sex.
Sterilization surgery Less than 1  Pain
A single-pill dose or two-pill dose of emergency contraception is available over-the-counter
for men pregnancy
(OTC) for women ages 17 and older.  Bleeding

 Complications from surgery

Implantable rod Less than 1  Acne

(Implanon) pregnancy
 Weight gain
Might not work  Ovarian cysts
as well for
women who are  Mood changes
overweight or  Depression
obese.
 Hair loss
 Headache
 Upset stomach
 Dizziness
 Sore breasts
 Changes in period
 Lower interest in sex

Intrauterine device Less than 1  Cramps

(ParaGard, Mirena) pregnancy
 Bleeding between periods
 Pelvic inflammatory disease
 Infertility
 Tear or hole in the uterus

Shot/injection Less than 1  Bleeding between periods

(Depo-Provera) pregnancy
 Weight gain
 Sore breasts
 Headaches
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Can all types of birth control prevent sexually transmitted infections

(STIs)?

No. The male latex condom is the only birth control method proven to help protect you
from STIs, including HIV. Research is being done to find out how effective the female
condom is at preventing STIs and HIV. For more information, see Will birth control pills
protect me from sexually transmitted infections (STIs), including HIV/AIDS?

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How well do different kinds of birth control work? Do they have side
effects?

All birth control methods work the best if used correctly and every time you have sex. Be
sure you know the right way to use them. Sometimes doctors don't explain how to use a
method because they assume you already know. Talk with your doctor if you have
questions. They are used to talking about birth control. So don't feel embarrassed about
talking to him or her.

Some birth control methods can take time and practice to learn. For example, some people
don't know you can put on a male condom "inside out." Also, not everyone knows you
need to leave a little space at the tip of the condom for the sperm and fluid when a man
ejaculates, or has an orgasm.

Here is a list of some birth control methods with their failure rates and possible side
effects.

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Where can I get birth control? Do I need to see a doctor?

Where you get birth control depends on what method you choose.

You can buy these forms over the counter:

 Male condoms

 Female condoms

 Sponges

 Spermicides

 Emergency contraception pills (girls younger than 17 need a prescription)

You need a prescription for these forms:

 Oral contraceptives: the pill, the mini-pill

 Skin patch

 Vaginal ring

 Diaphragm (your doctor needs to fit one to your shape)

 Cervical cap

 Cervical shield

 Shot/injection (you get the shot at your doctor's office)

 IUD (inserted by a doctor)

 Implantable rod (inserted by a doctor)

You will need surgery or a medical procedure for:

 Sterilization, female and male

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Are there any foams or gels I can use to keep from getting
pregnant?

You can buy spermicides over the counter. They work by killing sperm. They come in many
forms:

 Foam

 Gel

 Cream

 Film

 Suppository

 Tablet

Spermicides are put in the vagina no more than 1 hour before having sex. If you use a film,
suppository, or tablet, wait at least 15 minutes before having sex so the spermicide can
dissolve. Do not douche or rinse out your vagina for at least 6 to 8 hours after having sex.
You will need to use more spermicide each time you have sex.

Spermicides work best if used along with a barrier method, such as a condom, diaphragm,
or cervical cap. Some spermicides are made just for use with the diaphragm and cervical
cap. Check the package to make sure you are buying what you need.
All spermicides contain sperm-killing chemicals. Some contain nonoxynol-9, which may
raise your risk of HIV if you use it a lot. It irritates the tissue in the vagina and anus, so it
can cause the HIV virus to enter the body more freely. Some women are sensitive to
nonoxynol-9 and need to use spermicides without it. Medications for vaginal yeast
infections may lower the effectiveness of spermicides. Also, spermicides do not protect
against sexually transmitted infections.

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How effective is withdrawal as a birth control method?

Not very! Withdrawal is when a man takes his penis out of a woman's vagina (or "pulls
out") before he ejaculates, or has an orgasm. This stops the sperm from going to the egg.
"Pulling out" can be hard for a man to do. It takes a lot of self-control.

Even if you use withdrawal, sperm can be released before the man pulls out. When a
man's penis first becomes erect, pre-ejaculate fluid may be on the tip of the penis. This
fluid has sperm in it. So you could still get pregnant.

Withdrawal does not protect you from STIs or HIV.

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Everyone I know is on the pill. Is it safe?

Today's pills have lower doses of hormones than ever before. This has greatly lowered the
risk of side effects. But there are still pros and cons with taking birth control pills. Pros
include having:

 More regular and lighter periods

 Fewer menstrual cramps

 A lower risk of ovarian and endometrial cancers, pelvic inflammatory disease (PID),
noncancerous ovarian cysts, and iron deficiency anemia

Cons include a higher chance, for some women, of:

 Heart disease, high blood pressure, and blood clots

 Nausea, headaches, sore breasts, and weight gain

 Irregular bleeding

 Depression

Many of these side effects go away after taking the pill for a few months. Women who
smoke, are older than 35, or have a history of blood clots or breast or endometrial cancer
are more at risk of bad side effects and may not be able to take the pill. Talk with your
doctor about whether the pill is right for you.

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Will birth control pills protect me from sexually transmitted

infections (STIs), including HIV/AIDS?

No, they won't protect you. Birth control pills and most other birth control methods
will not protect you from STIs, including HIV (the virus that causes AIDS). They only protect
against pregnancy.

The male latex condom is the best birth control method that also can protect you from
STIs, including HIV. If you are allergic to latex, polyurethane condoms are a good
alternative. If your partner can't or won't use a male condom, female condoms also create
a barrier that can help protect you from STIs.

It is important to only use latex or polyurethane condoms to protect you from STIs.
"Natural" or "lambskin" condoms have tiny pores that may allow for the passage of viruses
like HIV, hepatitis B, and herpes. If you use non-lubricated male condoms for vaginal or
anal sex, you can add lubrication with water-based lubricants (like K-Y jelly) that you can
buy at a drug store. Never use oil-based products, such as massage oils, baby oil, lotions,
or petroleum jelly, to lubricate a male condom. These will weaken the condom, causing it
to tear or break. Use a new condom with each sex act.

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I've heard my girlfriends talking about dental dams — what are they?

The dental dam is a square piece of rubber that is used by dentists during oral surgery and
other procedures. It is not a method of birth control. But it can be used to help protect
people from STIs, including HIV, during oral-vaginal or oral-anal sex. It is placed over the
opening to the vagina or the anus before having oral sex. You can buy dental dams at
surgical supply stores.

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More information on birth control methods

For more information about birth control methods, call womenshealth.gov at 800-994-9662
(TDD: 888-220-5446) or contact the following organizations:

 American College of Obstetricians and Gynecologists

Phone: 800-762-2264 x 349 (for publications requests only)
  Food and Drug Administration
Phone: 888-463-6332

 Planned Parenthood Federation of America

Phone: 800-230-7526

 Population Council
Phone: 212-339-0500

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Content last updated: July 16, 2012.

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