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There is a wide variety of options available today. Some options are listed below.
Abstinence- Not having sex is a fool-proof method. However, if you are reading this it probably does not apply to you!
Withdrawal or rhythm method- Withdrawal method is when a man pulls out before ejaculation. Rhythm method is sometimes called natural family planning and involves avoiding sex around the time of ovulation. These methods are not very effective for most couples and are associated with high failure rate.
Birth control pill (oral contraceptive) see below
Condoms (male and female)- Condoms are always recommended to be used in addition to another method of birth control in order to help prevent the transmission of sexually transmitted diseases. By itself, it is not highly effective.
Spermicidal (foam, jelly, film, lube, etc)- This can be used in conjunction with condoms which makes this combination much more effective. However, by itself spermicidal agents are not highly effective.
Diaphragm- This is a cup you put inside the vagina before intercourse that helps to block the sperm from reaching the cervix. You must see the doctor who will determine the appropriate size for you and provide you with a prescription. It must always be used with a spermicidal agent.
IUD (intrauterine device) see below
Injection every 3 months (DMPA) see below
Implant (Nexplanon) see below
Sterilization (tubal ligation or vasectomy) see below
Oral contraceptives, or birth control pills, are estrogen and progestin hormone pills that prevent pregnancy by inhibiting ovulation, modifying the uterine lining, and making cervical mucus thick and impenetrable to sperm. Most pills have a combination of both estrogen and progestin but there are progestin only pills (minipill) that can be used in women who cannot take estrogen for various reasons. In the past, minipill was used in breastfeeding women as it was thought that combination pill interfered with milk production but this has been disproven. However, combination pills should not be started until about 6 weeks after delivery. Some early possible side effects include nausea, headache, and breakthrough bleeding. However, these side effects almost always disappear with time. Also, it may cause some mood changes in few women in the first months. It should be noted that birth control pills have many beneficial effects besides preventing pregnancy. These include regulation of menstrual cycle, decreased menstrual flow, decreased cramping, decreased acne, and decreased uterine and ovarian cancers. The pill should be taken once a day around the same time.
An IUD, or an intrauterine device, is a small flexible plastic device that is placed in the uterine cavity by a physician. It prevents pregnancy primarily by inducing changes in the uterine cavity that kills the sperm. It is an office procedure which only takes a few minutes of time. There are two types of IUDs available in the United States. One has copper coil wrapped around the rod (Paragard). It is good for 10 years of use. It may make your periods little heavier than before. The other type contains small amount of progestin hormone (Liletta, Mirena, etc) and it makes your period very light or nonexistent. It is currently good for 5 years but may be approved for longer use in the near future. This birth control method is as effective as sterilization.
DMPA (depo-medroxyprogesterone acetate) is a progestin hormone injection that is administered every 3 months. It is a highly effective method in pregnancy prevention. In most cases, your periods will stop completely. There are some women who will experience weight gain or depressive symptoms with this method.
This is a small, soft, flexible plastic rod that is implanted just under the skin in the upper arm. It contains progestin hormone that is slowly released over a 3 year period at which time it must be replaced. It takes only few minutes to have this inserted in a doctor’s office under local anesthetic. This method is also highly effective. Some women using this method have no periods while others have regular periods and still others anything in between.
Sterilization refers to a permanent and generally irreversible method of birth control. For women, this is usually called tubal ligation which is a minor surgical procedure performed through a small incision below the bellybutton. Both fallopian tubes are tied or cauterized so there is blockage of the tube, thus preventing fertilization of the egg by sperm. This procedure generally only takes few minutes to perform as an outpatient. Most women can return to normal activities the next day. For men, sterilization procedure is called vasectomy which is typically done at a doctor’s office under local anesthesia. Since we are women’s health specialists, we do not offer vasectomy services but will be happy to provide a referral.
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