Birth control, also called contraception, is a way to prevent or dramatically reduce the chance of getting pregnant. The type of birth control you choose depends on your needs. Different methods of birth control have varying characteristics. Condoms, for example, are the only methods that provide significant protection from sexually transmitted diseases.
Types of contraception available:
- Barrier methods - condoms, diaphragm, spermicides
- Birth control pills - contain estrogen and progesterone and block ovulation or may contain progesterone only and make it hard for fertilization occur.
- Vaginal ring - called Nuvaring is placed in the vagina for 3 - 4 weeks and secretes estrogen and progesterone absorbed through the vagina into the body to block ovulation like the pill.
- Injections - Depo-Provera is a progesterone shot given every 3 month
- Implant - Implanon is a progesterone only implant that is placed under the skin and lasts for 3 years.
- Intrauterine device (IUD) - an apparatus placed inside the uterus in the office that blocks fertilization. There are 2 types: Mirena which secrets progesterone and lasts for up to 5 years and Paragard which is non-hormonal and lasts up to 10 years. Both IUDs can be easily removed in the office when desired.
- Permanent sterilization - Bilateral tubal ligation is a procedure done in the operating room and involves destroying a portion of each fallopian tube to prevent pregnancy. Adiana and Essure are procedures that can be done in the office that rely on small implants placed in the fallopian tube hysteroscopically to cause tissue to grow into and block the tube. Read more about permanent sterilization here.
Misconceptions about pregnancy prevention:
Modern misconceptions and urban legends have given rise to a great deal of false claims:
- The suggestion that douching with any substance immediately following intercourse works as a contraceptive is untrue. While it may seem like a sensible idea to try and wash the ejaculate out of the vagina, it is not likely to be effective. Due to the nature of fluids and the structure of the female reproductive tract, douching most likely actually spreads semen further towards the uterus. Some slight spermicidal effect may occur if the douche solution is particularly acidic, but overall it is not scientifically observed to be reliably effective method.
- It is untrue that a female cannot become pregnant as a result of the first time she engages in sexual intercourse.
- While women are usually less fertile for the first few days of menstruation, it is a myth that a woman absolutely cannot get pregnant if she has sex during her period.
- Having sex in a hot tub does not prevent pregnancy, but may contribute to vaginal infections.
- Although some sex positions may encourage pregnancy, no sexual positions prevent pregnancy. Having sex while standing up or with a woman on top will not keep the sperm from entering the uterus. The force of ejaculation, the contractions of the uterus caused by prostaglandins in the semen, as well as ability of sperm to swim, overrides gravity.
- Urinating after sex does not prevent pregnancy and is not a form of birth control, although it is often advised anyway to help prevent urinary tract infections.
- Toothpaste cannot be used as an effective contraceptive
Effectiveness is measured by how many women become pregnant using a particular birth control method in the first year of use. Thus, if 100 women use a method that has a 12 percent first-year failure rate, then sometime during the first year of use, 12 of the women should become pregnant.
The most effective methods in typical use are those that do not depend upon regular user action. Surgical sterilization, Depo-Provera, implants, and intrauterine devices (IUDs) all have first-year failure rates of less than one percent for perfect use. Sterilization, implants, and IUDs also have typical failure rates under one percent. The typical failure rate of Depo-Provera is disagreed upon, with figures ranging from less than one percent up to three percent.
Other methods may be highly effective if used consistently and correctly, but can have typical use first-year failure rates that are considerably higher due to incorrect or ineffective usage by the user. Hormonal contraceptive pills, patches or rings, fertility awareness methods, and the lactational amenorrhea method (LAM), if used strictly, have first-year (or for LAM, first-6-month) failure rates of hormonal contraceptive pills (and by extrapolation, patches or rings) were as high as five percent per year. Fertility awareness methods as a while have typical use first-year failure rates as high as 25 percent per year; however, as stated above, perfect use of these methods reduces the first-year failure rate to less than 1%.
Condoms and cervical barriers such as the diaphragm have similar typical use first-year failure rates (14 and 20 percent, respectively), but perfect usage of the condom is more effective (three percent first-year failure vs. six percent) and condoms have the additional feature of helping to prevent the spread of sexually transmitted diseases such as the HIV virus. The withdrawal method, if used consistently and correctly, has a first-year failure rate of four percent. Due to the difficulty of consistently using withdrawal correctly, it has a typical use first-year failure rate of 19 percent, and is not recommended by some medical professionals.
Talk to your doctor about your individual situation to determine the best contraceptive option(s) for you and your partner.