Contraceptive Choices

Abstinence Choosing not to have sex provides 100 percent protection from HIV, STIs, and pregnancy. For some, this means avoiding vaginal, anal, and oral-genital intercourse altogether.

PROS Choosing not to have sex is free and available to all. Not having sex is extremely effective at preventing both infection and pregnancy. It is the only 100% effective method of preventing sexually transmitted infections (STIs) and unintended pregnancy. Not having sex may encourage people to build relationships in other ways. Not having sex may be the course of action which you feel is right for you and makes you feel good about yourself.

CONS If you've made the choice not to have sex, and change your mind in the heat of the moment, you might not have birth control handy.

Withdrawal What is withdrawal? When the man senses that he is about to ejaculate (come), he pulls his penis out of the vagina or anus. He then ejaculates outside of his partner. Among typical heterosexual couples who initiate use of withdrawal, about 27 percent of women will experience an accidental pregnancy in the first year.

PROS No fluid or much less fluid is deposited in the vagina or anus. This means that there is somewhat less chance of infection spreading from partner to partner. It has no medical complications, no hormones, no supplies, and is free.

CONS It provides poor to no protection against STIs, including HIV, and unplanned pregnancy

Emergency Contraception “Morning After Pill” can prevent pregnancy up to five days (120 hours) after unprotected sex. Emergency Contraception is a stronger dose of the same hormones used in regular birth control pills and is more effective the sooner you take it. Plan B® is the only product specifically approved and marketed in the United States as an emergency contraceptive pill. EC works by delaying ovulation (or the release of an egg from an ovary). It may also prevent the egg from being fertilized. It’s possible, although unproven, that EC may inhibit implantation (that is, prevent a fertilized egg from attaching to the wall of the uterus).

Morning After Pill or Plan B

PROS Emergency Contraception can greatly reduce the chance of getting pregnant. would be made available without a prescription only for women ages 18 and older

CONS may make you nauseous, dizzy, or tired. You may also vomit, develop a headache, and/or have sore breasts. Emergency contraceptive pills cost between $35 and $75

Foams, Creams, and Jellies Foam is placed into the woman's vagina using an applicator and has two effects. It kills or destroys sperm and blocks the man's fluids from entering the cervical canal. Foam stops sperm from getting to the egg. Among typical couples who initiate use of vaginal spermicide, 29 percent will experience an accidental pregnancy in the first year.

Contraceptive Foams, Creams, and Jellies

PROS Foam gives the woman control over use of a contraceptive. It is available over the counter without a visit to a clinician. Foam is safe and has no hormones.

CONS It may not be protective against HIV/AIDS. Foam can be irritating to the vagina Some women do not like placing an applicator up into the vagina The container carrying the foam is large and some may find it embarrassing to carry around.

Condoms Effective condoms are made of latex or polyurethane. Unrolled, condoms look like long, thin balloons. They prevent body fluids from mixing when two people have sex. The condom is put onto the penis before the penis comes into contact with the vagina, mouth, or anus. Latex condoms, when used consistently and correctly during vaginal, oral, or anal intercourse, are highly effective in preventing the sexual transmission of HIV. They are also effective in preventing most sexually transmitted infections (STIs) From family planning clinics, pharmacies or drugstores, supermarkets, and gas stations

Condoms

PROS Condoms are safe and effective at preventing both pregnancy and some infections when used at each act of sex. Using condoms is the best method of preventing infection if two people are going to have sex. No prescription is needed to get condoms.

CONS Condoms do not provide complete protection against genital herpes, syphilis, chancroid, or HPV because the STIs can be transmitted across infected skin surfaces not covered by the condom. Some people are sensitive or allergic to latex

The Pill There are two types of Birth Control Pills: Combined Oral Contraceptive Pills and Progestin-Only Pills. Combined oral contraceptive pills contain two hormones, an estrogen and a progestin. They work by stopping ovulation (release of an egg) and by inhibiting the movement of sperm. Pills are available with a prescription from a clinician, local health department, or family planning clinic.

The Pill

PROS Pills decrease a woman's risk for cancer of the ovaries and cancer of the lining of the uterus (endometrial cancer). Pills also lower a woman's chances of having benign breast masses. Pills significantly decrease a woman's menstrual cramps and pain.

CONS Pills do not protect from HIV/AIDS or other STIs A woman must remember to take the pill at the same time, every day. Nausea and/or spotting are the two problems women may have the first month on pills. Pills can be quite expensive and usually require a prescription Use of pills is associated with a statistically higher risk of developing cervical dysplasia. Pills users with dysplasia who also have HPV (human papillomavirus) have a three- to four-fold higher risk of developing cervical cancer.

Implantable Hormones The contraceptive implant (Implanon) is a single implant inserted into the upper arm. After a woman is given a local anesthetic, insertion takes only a few minutes Implants give off very small amounts of a hormone much like the progesterone a woman's body produces during the last two weeks of each monthly cycle. A woman can get implants from a doctor, nurse practitioner, nurse midwife, health department, or family planning clinic

Implantable Hormones

PROS Implanon is effective for three years Women lose less blood during menstruation. They also have less cramping, headaches, and breast tenderness.

CONS Implants do not protect from HIV/AIDS or other STIs Implants are quite likely to cause irregular periods in some women. You may gain weight, lose hair, develop headaches or note darkening of the skin over your implants. Implants may cause some arm discomfort. Depression and premenstrual symptoms may become worse

Injected Progestin The type of shot most used is called Depo- Provera. It is a shot given every three months. It is a hormone, much like the progesterone a woman produces during the last two weeks of each monthly cycle. Injectables stop the woman's ovaries from releasing an egg and have other contraceptive effects Complete information about this contraceptive is available through a family planning clinic, local health department, or clinician.

Injected Progestin

PROS Women lose less blood during menstruation when they are using injectables and have less menstrual cramps. Privacy is a major advantage. No one has to know a woman is using this method.

CONS Injectables do not protect you from HIV infection or other STIs. Injections can lead to very irregular periods. Some women gain weight. A woman has to return every three months for her injection Injectables may cause bone loss, especially in smokers

Fertility Awareness “Rhythm Method” Fertility awareness is a means of understanding a woman's reproductive cycle by observing and writing down fertility signs. These signs determine whether or not she can become pregnant on a given day A woman is actually fertile during only about a fourth of her cycle. This method is a great way for a woman to learn more about her body, but it is not recommended for teens Some clinicians and some family planning clinics can help you

PROS The method helps a woman know when during her cycle to have sex to become pregnant or to avoid pregnancy, depending on her goal.

CONS This method provides no protection against HIV and other sexually transmitted infections. The method involves daily charting of fertility signs As a contraceptive, this method is unforgiving of improper use. If a woman has sex when this method tells her to abstain, she is very likely to become pregnant

Female Condom Female condoms are made of a thin plastic called polyurethane – NOT latex. The condom is placed into the woman's vagina. It is open at one end and closed at the other. Both ends have a flexible ring used to keep the condom in the vagina. Among typical women use of FC condoms, about 21 percent will experience an accidental pregnancy in the first year Complete information about this contraceptive is available through a clinician or through the package insert. The condom is sold at many drugstores

Female Condom

PROS A woman doesn't need to see a clinician to get it. No prescription or fitting is needed. It can be used by individuals who are allergic or sensitive to latex

CONS It is not available in as many stores as the male condom and may be hard to find. The female condom is about three times more expensive than male condoms This condom is large and some call it unattractive or odd looking

Diaphragm and Cervical Cap A diaphragm is a latex disc a woman places into her vagina The diaphragm blocks a man's semen from entering the cervix (the opening to the womb). A spermicide placed onto the diaphragm kills sperm. A diaphragm and the spermicide keep sperm from getting to the egg. A woman must be fitted in a clinician's office for a diaphragm. Then a woman must be given a prescription for the specific type of diaphragm she will use

Diaphragm and Cervical Cap

PROS Diaphragms are safe; there are no hormones and no side effects from hormones.

CONS A diaphragm does not provide adequate protection from HIV The diaphragm must be fitted by a clinician A diaphragm increases a woman's risk for urinary tract infections If left in too long, it slightly increases a woman's risk for a very serious infection called toxic shock syndrome

Intrauterine Device “IUD” An intrauterine device (IUD) is a small device which is placed into the uterine cavity. Complete information about this contraceptive is available through your clinician or the package insert accompanying the IUD

Intrauterine Device “IUD”

PROS The IUD slowly gives off copper into the uterine cavity. It stops sperm from making their way up through the uterus. The IUD is effective for at least 10 years. Protects against endometrial cancer Very low cost over time. Convenient. Safe. Private

CONS No protection against sexually transmitted infections There may be cramping, pain or spotting after insertion High initial cost of insertion. Must be inserted by a doctor, nurse practitioner, nurse midwife or physician's assistant.