Contraception (Birth Control)

Contraception, also known as birth control, is the prevention of pregnancy through various methods and behaviors.

Today there are many birth control options available. Some require daily actions to prevent pregnancy, like taking a pill. Others, like implantable devices, provide protection for years without any action needed. Still others are used just before having sex.

Which birth control method is right for you?

Talk to your OB/GYN about the best options for you based on your overall health, age, lifestyle, and plans for pregnancy in the future. Ask about the effectiveness, risks, and possible side effects of each method. 

Hormonal Methods

Hormonal birth control methods use the hormones estrogen and/or progestin to prevent pregnancy. If you are on other medications, talk to your healthcare provider about possible interactions with these hormonal methods.

• The pill (oral contraceptives). The most common form of birth control is “the pill,” a prescription tablet that contains both estrogen and progestin. These hormones prevent ovulation. The pill is taken daily, preferably around the same time to avoid forgetting a dose. 
• The minipill (progestin only pill, or POP). The minipill contains only the progestin hormone. It must be taken once a day at the same time every day, within a 3-hour window. 
• Depo or Depo-Provera shot. In this method, the hormone progestin is injected into your arm or buttocks to prevent ovulation. A new shot is required every 3 months.
• Skin patch. The birth control patch contains estrogen and progestin which are passed through the skin and into your bloodstream. The patch is worn for 3 weeks at a time, followed by 1 week without a patch.
• Vaginal ring. A vaginal ring is a small, flexible, plastic ring a woman inserts into her upper vagina. It prevents pregnancy by releasing estrogen and progestin. The ring stays in the vagina for 21 days and is then removed. Depending on the type of ring used, a new ring is placed again immediately or after 7 days. 
• Arm implant. This thin, matchstick-size rod is placed under the skin in a woman’s upper arm by a healthcare provider. The rod releases progestin into the body to prevent pregnancy. It can prevent pregnancy for up to 3 years, at which time it is removed by your provider and replaced, if desired. 
• Intrauterine devices (IUD). IUDs are small, plastic T-shaped devices placed in the uterus by a healthcare provider to prevent pregnancy. There are two types of IUDs – hormonal and copper. Hormonal IUDs prevent pregnancy by releasing progestin into the body. Copper IUDs have copper wrapped around the T-shaped device, which is toxic to the sperm and eggs, preventing pregnancy. IUDs last anywhere from 3 to 10 years depending on type, but can be removed by your provider whenever you choose.

Barrier Methods

Barrier methods of birth control prevent pregnancy by blocking the sperm from reaching an egg. Some barrier methods must be prescribed by your healthcare provider while others are available without a prescription. Barrier birth control methods must be used each time you have sex.

• Condom (male). A male condom is a thin sleeve typically made of latex or polyurethane and is placed over the erect penis prior to intercourse. Using spermicide (placed inside the woman’s vagina) in addition to a condom increases protection against pregnancy. Male condoms (those made of latex and plastic) are the only form of birth control that also protect against HIV and other sexually transmitted infections (STIs).
• Condom (female). A female or “internal” condom is a thin plastic or rubber pouch that is inserted in the vagina to stop sperm from reaching an egg. Both male and female condoms can tear or leak. Male and female condoms should not be used together, as it can increase the risk of tearing.
• Diaphragm. A diaphragm is a small, dome-shaped silicone device that a woman places inside her vagina before sex to cover the cervix, preventing sperm from entering the uterus. Spermicide, a chemical that is toxic to sperm, is applied to the diaphragm to prevent pregnancy. Diaphragms are available by prescription only. 
• Cervical cap. Similar to a diaphragm, a cervical cap is a smaller silicone cup that is placed high in the vagina over the cervix to prevent sperm from entering the uterus. Cervical caps require a prescription and sizing by your healthcare provider. Spermicide should be used at the same time for maximum effectiveness. 
• Sponge. The sponge is a soft round foam device inserted into the vagina before sex to cover the cervix, blocking sperm from entering the uterus. The sponge contains spermicide that makes sperm inactive. It does not require a prescription.

Note: Women should wait 6 weeks after giving birth before using barrier birth control methods such as the diaphragm, cervical cap, and sponge. This allows the uterus and cervix to return to their normal size. These methods will be less effective during those 6 weeks.

Spermicide

Spermicides are over-the-counter chemical products that prevent pregnancy by keeping sperm from reaching an egg. Spermicides are inserted into the upper vagina before sex. They are available in a variety of forms, including foams, creams, and suppositories. Spermicides are typically effective for only one hour. They are most effective when used together with another method of birth control.

Behavioral Methods

Behavioral birth control methods are actions taken or decisions made by you and your partner to prevent pregnancy. They avoid the side effects and risks of other forms of birth control but they are typically less effective.

• Abstinence. Abstinence means you choose not to have sexual intercourse or genital contact. 
• Withdrawal (pulling out). This method requires the man to withdraw his penis from the woman’s vagina before he ejaculates. It is a less effective birth control method than others, as sperm can be released prior to the man pulling out. 
• Natural family planning or “rhythm” method. In this approach, intercourse is avoided on days when a woman is ovulating. Birth control is used only during ovulation, when the woman is most likely to get pregnant. Several at-home tools as well as phone apps are available today to monitor ovulation.

Sterilization

Sterilization is birth control that permanently prevents pregnancy from occurring. For women, the sterilization procedure is known as a tubal ligation, and requires abdominal surgery. This is commonly referred to as “having your tubes tied”; however, typically the fallopian tubes are removed completely from the body (salpingectomy), which makes it permanent. Note if a woman requires a hysterectomy (removal of the uterus) for medical reasons, it will also result in sterilization. For men, the sterilization procedure is a vasectomy, a procedure that prevents sperm from reaching the semen.

Emergency Contraception

Emergency Contraception is a type of contraception used as soon as possible after having unprotected sex. It should only be used in an emergency.

There are two primary forms of emergency contraception:

• A pill, which must be taken within 5 days of unprotected sex. Some emergency contraception pills are available over the counter. Others are available only by prescription. Prescription pills are more effective, and pills should be taken as soon as possible after the event. If you need emergency birth control, please call your doctor’s office as soon as possible.
• A copper IUD inserted in the woman’s uterus by a healthcare provider within 5 days of unprotected intercourse.