Contraception Pros and Cons

Fecundity: probability of pregnancy during a single menstrual cycle is 25%.

- Significantly decreases in a woman’s early 30s

- Younger women – 30%
- Age mid 30’s – 10%
- Age >40 – 1-5%

Hormonal Implants

Success Rate with Typical Use: 99%

Pros Cons

Long-term method of birth control (protects against pregnancy for 3 Doesn’t protect against STIs
years after insertion–it can be removed by a health care provider when you Requires minor surgery and
want to or you can wait for 3 years when it’s time for a change of implant) insertion of the tiny rod(s) underneath the
Very effective against pregnancy skin
May cause light or no menstrual periods Requires minor surgery to remove
device
Can cause side effects such as
irregular menstrual periods, depression,
nervousness, hair loss, and weight gain
Could get infection at area where
capsule is implanted
Can’t be used by women with
certain medical conditions and by women
who use certain medications
Intra-Uterine Device (IUD)

Success Rate with Typical Use: 99%

Pros Cons

Very effective against pregnancy Doesn’t protect against STIs and shouldn’t
Provide protection against pregnancy as long as in place be selected if high risk of STI
in your uterus- protects as soon as inserted (so don’t need to Needs to be inserted by a health care
remember to use contraception if you have sexual intercourse) provider
Doesn’t need daily attention- just need to check to make Can fall out or can rarely puncture the uterus
sure in place at least once a month at time of menstrual period The copper IUD can have side effects such
Comfortable- you and your partner cannot feel the IUD, as menstrual cramping, longer and/or heavier
although you partner may feel the string menstrual periods, and spotting between menstrual
The levonorgestrel IUD (Mirena, Skyla) lessens menstrual periods
flow and can be used to treat heavy periods Slightly higher risk for infection in the first 20
Can be removed at any time and you can get pregnant days after insertion
right after removal

Tubal Ligation (Female Sterilization)

Success Rate with Typical Use: 99%

Pros Cons

Very effective against pregnancy Need to have minor surgery

 One time decision that will provide Permanent (although it is possible to undo sterilization with
protection against pregnancy forever 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

Depo-Provera Hormonal Injection (injection of progesterone)

Success Rate with Typical Use: 94%

Pros Cons

Each injection provides 3 months of protection against Doesn’t protect against STIs
pregnancy Need to see your health care provider
Very effective against pregnancy if used correctly every 3 months for an injection
Many women stop getting their menstrual period while getting Depending on your insurance, your
injections. (This is not a medical problem and menstrual periods usually birth control may be free or there may be a co-
return 6-18 months after you stop taking injections) pay
Helps protect against uterine cancer May have side effects such as weight
Doesn’t interrupt sexual activity 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

Combined oral contraceptive pill (COCP)

Success Rate with Typical Use: 91%

Pros Cons

Very effective against pregnancy if used correctly Doesn’t protect against STIs
Makes menstrual periods more regular and Depending on your insurance, your birth control may
lighter be free or there may be a co-pay.
Decreases menstrual cramps and acne Need to remember to take every day at the same time
Makes you less likely to get ovarian and uterine Can’t be used by women with certain medical
cancer, pelvic inflammatory disease, ovarian cysts, and problems or by women taking certain medications
anemia Can occasionally cause side effects such as nausea,
Doesn’t interrupt sexual activity increased appetite, headaches, and, very rarely, blood clots
Need a prescription
Still need condoms to lower the risk of STIs

COCP side effects

Oestrogenic

- Headache, nausea, breast-tenderness, chloasma

Progestogenic:

- Acne, lowered libido and mood changes, bloating

(weight gain)
Hormone Patch (Ortho-Evra) (Xulane)

Success Rate with Typical Use: 91%

Pros Cons

Very effective against pregnancy if used Doesn’t protect against STIs

correctly Still need condoms to lower the risk of STIs
Makes menstrual periods more regular and Can’t be used by women with certain medical problems
lighter or by women taking certain medications
Decreases menstrual cramps and acne Can occasionally cause side effects such as nausea,
Makes you less likely to get ovarian and uterine increased appetite, headaches, and irregular bleeding in the
cancer, pelvic inflammatory disease, ovarian cysts, and first few cycles
anemia Increased risk of blood clots
Doesn’t interrupt sexual activity Need a prescription

Vaginal Hormonal Ring (Nuva-Ring)

Success Rate with Typical Use: 91%

Pros Cons

Very effective against pregnancy if used correctly Doesn’t protect against STIs
Makes menstrual periods more regular and lighter Still need condoms to lower the risk of STIs
Decreases menstrual cramps and acne Can’t be used by women with certain medical
 Makes you less likely to get ovarian and uterine cancer, problems or by women taking certain medications
pelvic inflammatory disease, ovarian cysts, and anemia Can occasionally cause side effects such as
Doesn’t interrupt sexual activity nausea, increased appetite, headaches
Increased risk of blood clots
Need a prescription

Diaphragm

Success Rate with Typical Use: 88%

Pros Cons

Can be put in place right before intercourse or 2-3 hours before Doesn’t protect against STIs
intercourse Need to get fitted by a health care
Don’t need to take out between acts of sexual intercourse (protects provider and need a prescription
against pregnancy for about 6 hours, but need to reapply spermicide) May be difficult to find
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 be 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

Cervical Cap

Success Rate with Typical Use: 86%

Pros Cons

Can insert several hours before sexual intercourse Doesn’t protect against STIs
Can leave in place 24-48 hours, will give protected sex for up to 48 Cost $30-$50, plus the cost of
hours spermicidal gel
Use less spermicide with the cap than with the diaphragm, no need Need to be fitted by a health care
to apply more spermicide with each act of intercourse 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
Can’t be used by women with a
history of abnormal Pap tests
Can cause increased urinary tract
infections

Male Condom
Success Rate with Typical Use: 82%

Pros Cons

Lowers risk of STIs Have to use a new one every time you have
Contraception that provides the most protection against sexual intercourse (can only be used once)
sexually transmitted infections (latex condoms are best) May disrupt/interrupt sexual activity as it
Don’t cost much (50 cents each), can buy at almost any needs to be put on just before penetration
drug store (don’t need a prescription) Can break
Men feel they can “last longer” when using a condom Women may be allergic to latex
Allow men to have an active part in preventing pregnancy

Female Condom

Success Rate with Typical Use: 79%

Pros Cons

Provide protection against STIs (new product, so not clear how much May move, be noisy, or
protection given) and pregnancy uncomfortable
Can be inserted well before intercourse so less interruption of sexual Can only use for one act of
activity sexual intercourse
Male does not need to withdraw right after ejaculation, as he does with a Cost about $2.50 each
male condom

Withdrawal
Success Rate with Typical Use: 78%

Pros Cons

Natural, so no side effects Doesn’t protect against STIs

Doesn’t cost anything Not very effective method of contraception
Allows men to be an active Difficult for male to always predict ejaculation
part of preventing pregnancy 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

Contraceptive Sponge

Success Rate with Typical Use: 76-88%

Pros Cons

Can insert right before or several hours before Doesn’t protect against STIs and may increase the risk
sexual intercourse and will provide protection against of HIV infection in women who have sex multiple times daily
pregnancy for a total of 24 hours because of irritation from the spermicide
Don’t need a prescription 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)
Increases urinary tract infections
Lactational Amenorrhea Method (LAM)

Success Rate with Typical Use (only applies if you meet all conditions): 98%

Pros Cons

Nat Only effective in women who have given birth in last 6 months, who have not had a menstrual
ural period after childbirth and are feeding their babies only breast milk
Cost Doesn’t protect against STIs
s nothing Only effective until menstrual period returns
No May need to use a lubricant with sexual intercourse because of vaginal dryness
side effects

Fertility Awareness Based Methods

Success Rate with Typical Use: 76%

Pros Cons

Natural Doesn’t protect against STIs

Approved by many religions Need to figure out when ovulating for each month, since this
Woman gets to know her body and can differ from one month to the next and young women often have
menstrual cycles irregular periods

Can be helpful for partners who are very Requires a lot of work- need careful instruction and the woman
careful and don’t have sex during ovulation needs to figure out when ovulating
period and several days before and after 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

Spermicide

Success Rate with Typical Use: 72%

Pros Cons

Doesn’t cost much, available at Doesn’t protect against STIs and may increase the risk of HIV infection
many drug stores, don’t need a in women who have sex multiple times daily because of irritation from the
prescription 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 sexual activity (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
Increases urinary tract infections