Considerations & Limitations
Below is some basic information about the most commonly used methods of birth control. This is intended as an overview, not as medical advice or as an endorsement of any particular method. As described below, all methods of contraception involve risk of pregnancy, STD, and often side-effects. Only abstinence is 100% effective in preventing pregnancy and STDs. If you have technical health questions about birth control drugs or side-effects, consult your physician or pharmacist. Epigee encourages you to consult your pastor, priest, or rabbi for moral questions about reproductive decisions.
| Pregnancy Centers: Don’t rely on family planning clinics or pharmaceutical companies to educate your staff and clients about contraceptives. Did you know that Epigee publishes its own birth control guide, just for pregnancy centers? Click here to learn more… |
For a more comprehensive discussion of birth control, please visit the Epigee Birth Control Guide.
Condoms for Men
Condoms — made of latex, polyurethane, or natural skin — are used by men to prevent pregnancy by acting as a barrier against sperm. Condoms are popular because they are inexpensive, help prevent some STDs, can be found in drug stores and vending machines, and are relatively easy to use. Compared to hormonal methods, condoms pose few health risks.
Among couples with average fertility, condoms have about a 14% failure rate annually, but condoms are far less effective when used by teens. Condoms do not protect against STDs like HPV or herpes. And although condoms will help reduce your risk of contracting diseases like HIV, condoms can break, leak, or slip — even if not visibly — which means you are still at risk if your partner is infected. If you choose condoms, keep in mind that on a per usage basis, 2-6% of condoms break or fall off during intercourse, meaning most users will eventually experience a condom break. The odds are that after using condoms continuously for several years, you will eventually experience a surprise pregnancy.
Barrier Methods for Women
These include the diaphragm, cervical cap, female condom, and contraceptive sponge (not available in the US). These methods are used by women and work by acting as a barrier to sperm. The diaphragm and cervical cap are used with spermicide; contraceptive sponge comes with spermicide already applied. All these are more difficult to use correctly than condoms, as proper placement is essential. Both the cap and diaphragm require a visit to the doctor for fitting. These methods have variable failure rates averaging 21-26% per year, and as high as 40% for women who have had children. Teens are more fertile than older adults, which also increases the failure rate of these methods among this age group. These methods offer only modest protection from STDs. In fact, the spermicide used with these methods has been shown to possibly facilitate HIV infection. These methods are most effective when used by couples who have sex less frequently and are committed to using them properly. Keep in mind that with a 21-26% annual failure rate, the odds are that after using any of these methods continuously for several years, you will eventually experience a surprise pregnancy.
[More about Barrier Methods for Women]
Hormonal Methods
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These include combined oral contraceptives (the Pill), progestin-only pills (the mini-pill or POPs), Depo-Provera or Lunelle (the Shot), Implanon (implants), contraceptive patches, vaginal rings, some types of IUDs, and Emergency Contraceptive Pills (ECP or Morning-After Pills). These methods primarily work by preventing ovulation and thinning the lining of the uterus to prevent implantation should fertilization occur (more about this). Typical failure rates for these methods range from 1-13% per year (1% for Depo-Provera and 13% for the mini-pill).
Oral contraceptives and Depo-Provera are popular methods due to their ease of use. All hormonal methods typically have some unpleasant side-effects, such as weight gain, depression, skin problems, loss in bone density, and loss of sex drive. Some side effects can be quite serious, such as prolonged bleeding, risk of blood clots, and even death, which is why you should always let your health care providers know if you are using any of these methods. Older women who smoke should not use combined oral contraceptives. After discontinuing combined OCs or Depo-Provera, it may take several months to over a year for normal fertility to return. None of these methods offers protection from STDs like the AIDS virus.
Although these are some of the more effective methods of pregnancy prevention, many women do get pregnant despite proper use. Others get pregnant when they forget a pill or take antibiotics (which can compromise the effectiveness of many homonal methods). Keep in mind that with a 1-13% annual failure rate, the odds are that after using many of these methods continuously for several years, you may eventually experience a surprise pregnancy.
[More about Oral Contraceptives and Other Hormonal Methods]
Withdrawal
One popular method for teens is withdrawal (also called the “pull-out” method), which has a failure rate of about 21% for this age group. Effective use of this method requires self-control and practice, which teens are generally lacking, making this a poor choice. This method offers little protection from STDs like the AIDS virus.
[More about Responsible Sexual Choices for Young People]
Natural Methods
These are methods which require no drugs or chemicals; therefore, they are free from side-effects. Most methods work by determining when a woman is fertile and then avoiding sex at that time (periodic abstinence). This may be accomplished through charting the woman’s temperature and/or observing body signals (requires training), or through use of a fertility computer (which can be expensive). These methods have failure rates averaging 17% per year.
Natural methods tend to be most rewarding when both partners are involved, as they require the participation of both during the fertile period. This may be difficult if neither partner has made a long-term commitment to the relationship. Natural methods offer no protection from STDs.
Natural methods are most effective when followed strictly. Keep in mind that with a 17% annual failure rate for typical users, the odds are that after using this method continuously for several years, you will eventually experience a surprise pregnancy.
Abstinence
Abstinence means refraining from any type of sexual activity. Abstinence is the only sure way to avoid pregnancy or sexually transmitted disease. Don’t be fooled: oral sex, anal sex, and other similar activities do not count as abstinence. Some of these can still cause pregnancy and STD, and most eventually lead to “plain old” sexual intercourse.
Teen sexual activity and having multiple sex partners is strongly linked to cervical cancer in women. Considering the risk of pregnancy and death from STDs such as AIDS, refraining from sex is a sensible and popular alternative to sexual activity. Half of all women who begin having sex become pregnant within six months. Deciding to abstain is a positive though difficult choice, with many benefits.
There are many times when abstinence within a marriage is necessary, such as after childbirth or surgery, or during natural family planning. Being able to spend some time not having sex can be a valuable experience for both partners, as it gives couples time to explore other aspects of their relationship.
