Birth control options for women

Birth Control Options

Birth control options for women include:

• Hormonal contraceptives, such as birth control pills
• Intrauterine devices (IUDs)
• Barrier devices, such as condoms, diaphragm, and the cervical cap
• Fertility awareness methods
• Sterilization

Ortho Evra Warning

• The FDA has updated the label for the birth control skin patch Ortho Evra to include results of recent studies warning of increased risks for blood clots for women who use this product.
• Recent epidemiology studies have reported that women who use the birth control patch have a higher risk for developing venous thromboembolism (blood clots in the veins) than women who use birth control pills. Venous thromboembolism is a condition that can lead to pulmonary embolism, the blockage of an artery in the lungs.
• Ortho Evra is a combination hormonal product that contains the progesterone norelgestromin and the estrogen hormone estradiol. Compared to birth control pills, the patch exposes women to higher levels of estrogen, which increases the risk for blood clots. Women who are older than age 40 or who smoke cigarettes should discuss with their doctors whether the birth control patch is a safe choice.

Nonoxynol-9 Warning

• The FDA has ordered manufacturers of stand-alone contraceptive products containing the spermicide nonoxynol-9 to include a warning that this chemical does not provide protection against sexually transmitted disease, including HIV (the virus that causes AIDS).
• Contraceptive products that use nonoxynol-9 include gels, foams, films, and inserts that are used as the sole means of contraception.
• The FDA also warns that nonoxynol-9 can irritate the vagina and rectum, which may increase the risk of contracting HIV from an infected partner.

Contraceptives are devices or methods for preventing pregnancy, either by preventing the fertilization of the female egg by the male sperm or by preventing implantation of the fertilized egg.

Contraceptive Options

Choosing the appropriate contraceptive is a personal decision that varies from individual to individual. Contraceptive options include:

• Hormonal contraceptives (oral contraceptives, skin patch, vaginal ring, implant, injection)
• Intrauterine devices (IUDs), which contain either a hormone or copper
• Barrier devices with or without spermicides (diaphragm, cervical cap, sponge, condom)
• Fertility awareness methods (temperature, cervical mucus, calendar, symptothermal)
• Female sterilization (tubal ligation, Essure)
• Vasectomy [For more information, see In-Depth Report #37: Vasectomy and vasectomy reversal .]

The condom is the only birth control method that provides protection against sexually transmitted diseases (STDs).

Determining Effectiveness

Contraceptive effectiveness is characterized by "typical use" and "perfect use":

• Typical use refers to real-life conditions, in which mistakes (such as forgetting to take a birth control pill at the right time) sometimes happen.
• Perfect use refers to contraceptives that are used correctly each time intercourse occurs.

The most effective standard female contraceptives are surgical sterilization, intrauterine devices (IUDs), and the implant. They all have an estimated failure rate of 1% or less during the first year of normal (typical) use. Vasectomy (male surgical sterilization) is the only male contraceptive that is equally effective. By comparison, the estimated failure rate of the male latex condom is 17% with typical use and 2% with perfect use. To put these rates into perspective, a sexually active woman of reproductive age who does not use contraception faces an 85% likelihood of becoming pregnant in the course of a year.