Contraception: Pros and Cons of Different Contraceptive Methods

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contraceptives

Here’s a list of the many available types of contraception, and the pros and cons of using each.

Birth Control Pills
Minimum Effectiveness: 95%
Pros Cons
  • Very effective against pregnancy if used correctly
  • Makes menstrual periods more regular and lighter
  • Decreases menstrual cramps and acne
  • Makes you less likely to get ovarian and uterine cancer, pelvic inflammatory disease, ovarian cysts, and anemia
  • Doesn’t interrupt lovemaking
  • Doesn’t protect against STIs
  • Cost or co-pays between $15-$50 per month
  • Need to remember to take every day at the same time
  • Can’t be used by women with certain medical problems or by women taking certain medications
  • Can occasionally cause side effects such as nausea, increased appetite, headaches, and, very rarely, blood clots
  • Need a prescription
  • Should use condoms to lower the risk of STIs
Vaginal Hormonal Ring (Nuva-Ring)
Minimum Effectiveness: 98%
Pros Cons
  • Very effective against pregnancy if used correctly
  • Makes menstrual periods more regular and lighter
  • Decreases menstrual cramps and acne
  • Makes you less likely to get ovarian and uterine cancer, pelvic inflammatory disease, ovarian cysts, and anemia
  • Doesn’t interrupt lovemaking
  • Doesn’t protect against STIs
  • Should use condoms to lower the risk of STIs
  • Can’t be used by women with certain medical problems or by women taking certain medications
  • Can occasionally cause side effects such as nausea, increased appetite, headaches
  • Higher risk of blood clots
  • Need a prescription
Hormone Patch (Ortho-Evra)
91-99% effective in preventing pregnancy
Pros Cons
  • Very effective against pregnancy if used correctly
  • Makes menstrual periods more regular and lighter
  • Decreases menstrual cramps and acne
  • Makes you less likely to get ovarian and uterine cancer, pelvic inflammatory disease, ovarian cysts, and anemia
  • Doesn’t interrupt lovemaking
  • Doesn’t protect against STIs
  • Should use condoms to lower the risk of STIs
  • Can’t be used by women with certain medical problems or by women taking certain medications
  • Can occasionally cause side effects such as nausea, increased appetite, headaches
  • Higher risk of blood clots
  • Need a prescription
Depo-Provera Hormonal Injection
Minimum effectiveness: 99%
Pros Cons
  • Each injection provides 3 months of protection against pregnancy
  • Very effective against pregnancy if used correctly
  • Many women stop getting their menstrual period while getting injections. (This is not a medical problem and menstrual periods usually return 6-18 months after you stop taking injections)
  • Helps protect against uterine cancer
  • Doesn’t interrupt lovemaking
  • Doesn’t protect against STIs
  • Need to see your health care provider every 3 months for an injection
  • Costs $30-$75 every 3 months for 1 injection
  • May have side effects such as weight gain, tiredness, and possibly a decrease in bone density
  • Many women have very irregular menstrual bleeding or spotting for the first 3 to 6 months and sometimes longer
Male Condom
Minimum effectiveness: 86%
Pros Cons
  • Lowers risk of STIs
  • Effective against pregnancy
  • Contraception that provides the most protection against sexually transmitted infections (latex condoms are best)
  • Don’t cost much (50 cents each), can buy at almost any drug store (don’t need a prescription)
  • “Last longer” when using a condom
  • Allow men to have an active part in preventing pregnancy
  • Have to use a new one every time you have sexual intercourse (can only be used once)
  • May disrupt/interrupt lovemaking
  • Can break
  • Women may be allergic to latex
Female Condom
Minimum effectiveness: 79%
Pros Cons
  • Provide protection against STIs (new product, so not clear how much protection given) and pregnancy
  • Can be inserted well before intercourse
  • Male does not need to withdraw right after ejaculation, as he does with a male condom
  • May move, be noisy, or uncomfortable
  • Can only use for one act of sexual intercourse
  • Cost about $2.50 each
Hormonal Implants
Minimum effectiveness: 99%
Pros Cons
  • Long-term method of birth control (protects against pregnancy from 24 hours to 3 years (or even 5 years) after insertion- can remove whenever you want to or can wait until time for a change of implant
  • Very effective against pregnancy
  • May cause light or no menstrual periods
  • Doesn’t protect against STIs
  • Requires minor surgery and insertion of the tiny rod(s) underneath the skin
  • Requires minor surgery to remove capsules
  • Can cause side effects such as irregular menstrual periods, depression, nervousness, hair loss, and weight gain
  • Could have infection at area where capsules implanted
  • Can’t be used by women with certain medical conditions and by women who use certain medications
Intra-Uterine Device (IUD)
Minimum effectiveness: 99%
Pros Cons
  • Very effective against pregnancy
  • Provide protection against pregnancy as long as in place in your uterus- protects as soon as inserted (so don’t need to remember to use contraception if you have sexual intercourse)
  • Doesn’t need daily attention- just need to check to make sure in place at least once a month at time of menstrual period
  • Comfortable- you and your partner cannot feel the IUD, although you partner may feel the string
  • The levonorgestrel IUD (Mirena) lessens menstrual flow and can be used to treat heavy periods
  • Can be removed at any time
  • Doesn’t protect against STIs
  • Needs to be inserted by a health care provider
  • Should not be used by women who have a high risk of getting a sexually transmitted infection. It’s best for women who have already had children and are in a steady relationship with one partner.
  • Can fall out or can rarely puncture the uterus
  • The copper IUD can have side effects such as menstrual cramping, longer and/or heavier menstrual periods, and spotting between menstrual periods
  • Slightly higher risk for infection in the few weeks after insertion
Contraceptive Sponge
Minimum effectiveness: 87%
Pros Cons
  • Can insert right before or several hours before sexual intercourse and will provide protection against pregnancy for a total of 24 hours
  • Don’t need a prescription
  • Doesn’t protect against STIs and may increase the risk of HIV infection with multiple daily acts of sexual intercourse
  • Can’t take out until 6 hours after sexual intercourse
  • Can’t be used by women who are allergic to nonoxynol-9 (in the spermicides)
  • Can cause increased urinary tract infections
Cervical Cap
Minimum effectiveness: 80%
Pros Cons
  • Can insert several hours before sexual intercourse
  • Can leave in place 24-48 hours, will give protected sex for up to 48 hours
  • Use less spermicide with the cap than with the diaphragm, no need to apply more spermicide with each act of intercourse
  • Doesn’t protect against STIs
  • Cost $30-$50, plus the cost of spermicidal gel
  • Need to be fitted by a health care provider and need a prescription
  • Limited sizes available
  • Can’t take out until 6-8 hours after intercourse
  • May get moved out of place
  • Some women may be allergic to material of cap or to spermicide
  • Need to get a new one every so often
  • Can’t be used by women with a history of abnormal Pap tests
  • Can cause increased urinary tract infections
Spermicide
Minimum effectiveness: 74%
Pros Cons
  • Doesn’t cost much, available at many drug stores, don’t need a prescription
  • Doesn’t protect against STIs and may increase the risk of HIV infection in women who have sex multiple times daily because of irritation from the spermicide
  • Effectiveness usually lasts only one hour (need to reapply each time have sexual intercourse)
  • Some women and men may be allergic to spermicides
  • May interrupt lovemaking (some forms need to be inserted at 10-20 minutes before intercourse)
  • Has a lower effectiveness against pregnancy than many other types of contraception- should use with another form of contraception to increase effectiveness
  • May change bacteria living in vagina and increase urinary tract infections
Diaphragm
Minimum effectiveness: 80%
Pros Cons
  • Can be put in place right before intercourse or 2-3 hours before intercourse
  • Don’t need to take out between acts of sexual intercourse (protects against pregnancy for about 6 hours, but need to reapply spermicide)
  • Doesn’t protect against STIs
  • Need to get fitted by a health care provider and need a prescription
  • Can’t take out until 6 hours after intercourse
  • Cost $25-$45, plus the cost of spermicidal gel
  • May get moved out of place during sexual intercourse
  • Some women may be allergic to the diaphragm or to the spermicide
  • Need to get a new one every so often (need to re-fitted after a 10 pound weight gain or loss and after pregnancy)
  • Can be messy
  • Need to reapply spermicide with each act of sexual intercourse
  • Can cause an increase in urinary tract infections
Lactational Amenorrhea Method (LAM)
Minimum effectiveness: 99%
Pros Cons
  • Natural
  • Costs nothing
  • No side effects
  • Effective against pregnancy during the first 6 months after childbirth in women who have not had their menstrual period after childbirth and are feeding their babies only breast milk
  • Only can be used by women who have given birth in last 6 months, fully breast feeding, and have not had menstrual period after childbirth
  • Doesn’t protect against STIs
  • Only effective until menstrual period returns
  • Costs $30-$75 every 3 months for 1 injection
  • May need to use a lubricant with sexual intercourse because of vaginal dryness
Fertility Awareness Based Methods
Minimum effectiveness: 76%
Pros Cons
  • Natural
  • Approved by many religions
  • Woman gets to know her body and menstrual cycles
  • Can be helpful for partners who are very careful and don’t have sex during ovulation period and several days before and after
  • Doesn’t protect against STIs
  • Need to figure out when ovulating for each month, since different from one month to the next and young women often have irregular periods
  • Requires a lot of work- need careful instruction and the woman needs to figure out when ovulating
  • Can’t have sexual intercourse for at least a week each month (during ovulation and several days before and after) Teens and women with irregular periods should not use- failure rate is high
Tubal Ligation (Female Sterilization)
Minimum effectiveness: 99%
Pros Cons
  • Very effective against pregnancy
  • One time decision that will provide protection against pregnancy forever
  • Need to have minor surgery
  • Permanent (although it is possible to undo sterilization with major surgery, it’s not always successful)
  • Only should be used by women who are absolutely sure that they do not want any or any more children
  • Expensive- ranges from $1000-$2500- but cost for contraception spread over rest of life
  • No protection against STIs
Withdrawal
Minimum effectiveness: 72%
Pros Cons
  • Natural, so no side effects
  • Doesn’t cost anything
  • Allows men to be an active part of preventing pregnancy
  • Doesn’t protect against STIs
  • Not very effective method of contraception
  • Difficult for male to always predict ejaculation
  • May decrease sexual pleasure of woman since need to always be thinking about what is happening during sexual intercourse
  • No control by women- need to rely completely on men to prevent pregnancy