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Choosing the Best Type of Contraceptive for You


Aside from abstinence, using a contraceptive is the most effective way to reduce the chance of pregnancy. No method is foolproof, and most have side effects of some type, but by working with your doctor you should be able to find one that works for you.

Mainly used for family planning, contraception can also help regulate menstrual cycles, cramps, ovarian cancer, pelvic inflammatory diseases, infections, and other gynecological problems. Contraception falls into several forms:

  • Hormonal
  • Barriers
  • Intrauterine devices
  • Sterilization
  • Behavioral

The Pill and Other Hormonal Contraceptives

Including pills, patches, rings, and injections, hormonal contraceptives block ovulation or make it more difficult. The birth control pill is credited with being a prime driver of the sexual revolution of the 1960s and beyond. Based on estrogen and progestin in combination, or progestin alone, combination products have a first-year failure rate of only 9% or less. Progestin only pills average a 13% first year failure rate, while Depo-Provera shots of progestin have a 6% failure rate. In some women, estrogen containing hormonal products are linked to blood clots, heart attacks, strokes, and high blood pressure, which makes it important to have annual checkups.

Easy to Obtain Barriers

Ranging from condoms to contraceptive sponges, barrier contraceptives prevent the sperm from entering the uterus to fertilize the egg. Condoms, most often used by men, are available for women too and prevent sperm from entering the body of a sexual partner. They offer the advantage of protecting against disease but have an 18 to 21% first year failure rate, due to incorrect use or failure to use at all. Diaphragms used with spermicide have a 12% failure rate.

One popular form of barrier birth control is the sponge, which contains spermicide. When used correctly, the sponge has a 9 to 11% failure rate as it effectively blocks sperm from entering the vagina and kills any that make it in. Once inserted, the sponge can effectively do its job for multiple acts of intercourse in a 30 hour period.

Intrauterine Devices

Often T-shaped devices containing copper or levonorgestrel, intrauterine devices or IUDs are inserted into the uterus for long-term yet reversible birth control. With failure rates of just .8% for copper models or .2% for hormonal ones, implantable birth control is effective for women of all ages, even those who have not had children, and usually gets high satisfaction rates from users. The side effects vary according to the type of IUD; some increase menstrual bleeding and the intensity of cramps, while others reduce or stop bleeding. Although previous IUD models increase the risk of pelvic inflammatory disease, the major risks from current models include perforation of the uterus (less than .7%) or expulsion (2 to 5%.)

Sterilization for a Permanent Solution

For those who want no children, have completed their family, or who have a medical necessity, sterilization is the ultimate form of nonreversible contraceptive. These come in the forms of vasectomies for men and tubal ligation for women. Two forms of tubal ligation are: 1- laparoscopic tubal ligation, which requires general anesthesia, or 2: ESSURE procedure, which can be done in the office or operating room with no incisions.

For those who regret their decision, attempts to reverse the process vary in success. A hysterectomy performed for medical reasons is an additional method of sterilization.

Behavioral Solutions

Using no birth control has an 85% failure rate on preventing pregnancy; some couples try methods such as withdrawal or fertility awareness to prevent pregnancy. Withdrawal, or coitus interruptus, which means the man pulls the penis out of the vagina before ejaculation, has a 22% first year failure rate due to timing issues. Fertility awareness, which involves determining and avoiding unprotected intercourse on the most fertile days of the month, also has a high failure rate (24%.)

For most of the population, an effective contraceptive is one that is easy to use on a regular basis. For help in determining the best contraceptive method for you, talk to your provider at Rocky Mountain Women’s Health Center.


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