With so many birth control options on the market, unwanted pregnancies should be a thing of the past. But unfortunately, nearly half of all pregnancies in the U.S. each year are unintended. House Call Doctor has the scoop on 13 birth control options available to us today, so you can make an informed decision about your future.
Intrauterine Device (IUD): There are two types of IUDs – a progesterone-releasing 5-year IUD and a non-hormonal 10-year IUD. Other than the diaphragm and cervical cap (which are infrequently used now) and the condom, the 10-year IUD is the only non-hormonal method currently available. The failure rate of the IUD is less than 1%, which makes it one of the most effective options other than sterilization and abstinence. I’ve discussed the IUD in much greater detail in a previous episode, so make sure to check it out if you are interested in learning more. The IUD is more than 99% effective.
Implant: This is a progesterone-only hormone that is released via a small, implantable rod (roughly the size of a match) inserted underneath the skin of the arm and lasts 3 years. The greatest complaints I receive are menstrual irregularities – it can increase bleeding, decrease bleeding, and vary cycle frequencies. How the implant affects your body can be unpredictable and the irregularity may occur for the entire 3 years. However, it is one of the most effective forms of birth control available, equal to the IUD. The failure rate is less than 1%.
Female Sterilization: The tubal ligation is traditionally the most common method of female sterilization. This procedure is performed under general anesthesia and in it, the woman's fallopian tubes are clamped shut. Now there’s also the Essure procedure. This is an in-office female sterilization technique performed under local anesthesia wherein a spring-like device is threaded through the fallopian tubes in order to cause the tubes to form scar tissue. This blocks the egg from reaching the sperm and prevents fertilization. The procedure requires some extensive follow-up, including a post-sterilization procedure called a hysterosalpingogram (HSG) where the doctor injects dye into the uterus and confirms closure of the fallopian tubes. Female sterilization has a less than 1% failure rate.
Male Sterilization (Vasectomy): Likely the simplest, most cost-effective, and generally effective form of birth control. During a vasectomy, the doctor cuts the vas deferens, which is the tube that releases sperm into the male ejaculate. The result is that sperm doesn't ever reach the ejaculate. Newer vasectomy techniques are rather painless, and recovery is within one or two days. It uses only local anesthesia, takes minutes to perform in the doctor's office, and requires minimal follow-up. I interviewed a physician who performs a no-needle, no-scalpel vasectomy technique, so please make sure to check out that episode to learn more about this revolutionary procedure. Male sterilization has a less than 1% failure rate.
Cervical Cap and Diaphragm: These are silicone cups that are inserted to cover the opening to the uterus, so that sperm cannot enter through the cervix. It’s not very often that I find a patient using these methods these days. Both the diaphragm and cervical cap require special fitting for every woman, as they vary in size. They're most effectively used with a spermicide in order to help immobilize sperm so that they don’t swim around these barriers and sneak in. The success rate is 85%.
Natural Family Planning: Women who use this method learn to track their ovulation times (when the egg is released from the ovary) each month and avoid intercourse (or use another form of birth control, such as condoms) during this time period of higher fertility. Ovulation is tracked using various methods – like measuring body temperature and examining the cervical mucus. It requires some charting through time, and is more effective in those who are most disciplined. It has a 75% success rate.
Withdrawal Method: This is often referred to as the “pull out method,” where the male “pulls out” before ejaculation of sperm, and is likely the oldest method of birth control. Oldest yes, but not the most effective, with a roughly 27% failure rate. This is because the male can release small amounts of sperm prior to actual ejaculation.
Emergency Contraception: This is not designed as a chronic method of birth control, but for emergency purposes – like after intercourse without birth control, or if a method malfunctions (for example, if a condom breaks). It's a pill that can be taken up to 5 days after intercourse, but becomes significantly less effective with each passing day. Therefore, it’s important to take emergency contraception as soon as possible after intercourse for best effect.
Make sure you download this free chart that I've created just for you which outlines all the birth control options available to us today.
3 More Quick and Dirty Birth Control Tips
The risk of blood clots in those taking hormonal contraceptives is higher if you're a smoker and those over age of35.
Hormonal contraceptives are contraindicated in patients with a history of breast cancer.
If you're breastfeeding, you can still get pregnant (yes, even if you aren’t menstruating)!
Disclaimer: Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.