By Sarah Jio
According to statistics, one in two pregnancies in the U.S. is unplanned, which makes birth control, well, a pretty hot topic. We have plenty of options, of course, but which are the best at preventing pregnancy? Below are the most commonly used contraceptive options, with facts on the reliability of each.
It just celebrated its 50th birthday in May, and it's the preferred contraceptive option of many women in America. But is it right for you?
Pros: "One advantage of the Pill and of other hormonal birth control methods, like the Ring and Patch, is that they carry with them a variety of non-contraceptive benefits," says Stern. "The Pill can help regulate irregular periods, make heavy periods lighter and eliminate or minimize period-related and premenstrual symptoms. For women with medical disorders like endometriosis, the Pill can have therapeutic benefits and possibly help preserve future fertility." Bonus: A major British study out this year reported a correlation between taking the Pill and having an increased lifespan.
Cons: "Though many women and many health care providers immediately think of the Pill as the best birth control option, for some women it may not be ideal," says Stern. "For starters, it really should be taken at the same time every single day, which is hard for busy or forgetful women. In my practice, I often advise Pill users to put their Pill pack next to their toothbrush or something else they associate with a daily routine."
How effective? When used as intended, the Pill is very effective at preventing pregnancy, says Rallie McAllister, MD, MPH, a family physician and cofounder of MommyMDGuides.com. "When women use it faithfully according to instructions, fewer than 1 in 100 of these women each year will become pregnant. If women don't always use the Pill as directed, about 8 in 100 of these women each year can expect to become pregnant."
Photo by IAN HOOTON/SPL/Getty Images.
The "Rhythm Method"
According to a new government survey, more young people than ever are relying on the so-called "rhythm method"-a method commonly known as "natural" birth control, in which women learn to read their body's signs and avoid intercourse on their most fertile days of the month.
Pros: It's natural, which means no chemicals or hormones are necessary, and free. Plus, women who subscribe to this method often say they enjoy being in touch with the ebb and flow of their body's natural fertility signs.
Cons: "Women who ovulate or menstruate irregularly will find it difficult to track their cycles and may be at higher risk for rhythm method failure," says Lisa Stern, RN, MSN, a nurse practitioner who works with Planned Parenthood in Los Angeles and blogs at gynfizz.com. Plus, tracking fertility can sometimes feel like a full-time job. "Some versions of fertility awareness just involve a calendar and a calculator, but others require a higher level of user involvement-temperature tracking, checking cervical mucus, etc."
How effective? According to data, perfect usage of the rhythm method results in 1 out of 9 women getting pregnant. But "typical" use leads to about 25 percent of women getting pregnant. "It's important to remember that semen can survive for up to 5 days in the female genital tract," says Stern. "So unprotected intercourse should be avoided both prior to, during and immediately following ovulation."
Photo by Shutterstock.
The Vaginal Ring
The vaginal ring (brand name: NuvaRing) is a flexible ring (think of a thick rubber band) that you insert into your vagina once a month for pregnancy prevention. The ring releases the hormones estrogen and progestin to prevent ovulation.
Pros: "The Ring has all the advantages of the Pill minus the disadvantage of daily dosing," says Stern. "So even those of us who sometimes lock our keys in the car or forget what we need as soon as we enter the supermarket can safely use it. The Ring contains a lower dose of estrogen and progestin than the Pill, so it tends to have fewer systemic side effects (e.g., headaches, breast tenderness) than the Pill."
Cons: "The only downside of the Ring is that a woman has to be comfortable touching her vagina in order to insert it," she adds. "But your doctor or nurse practitioner should also be able to give you some tips if you are uncomfortable or nervous. I've had many patients worry that the Ring will get lost inside their vagina. Not to worry. The vagina is only about 3 inches long, and the opening to the cervix, which lies at the top of the vagina, is way too small for the NuvaRing to slip through. And if you ever have trouble reaching it yourself, your doctor or nurse practitioner can help you take it out very easily."
How effective? Per year, fewer than 1 in 100 women will get pregnant when using the vaginal ring as directed, while about 8 in 100 women will become pregnant if it is used incorrectly. According to Dr. McAllister, there is little information about accuracy rates for the Ring, though the March 2010 journal of Obstetrics & Gynecology found that "contraceptive vaginal ring users were more likely to report perfect use during the 3-month trial period than were oral contraceptive users."
Photo courtesy of NuvaRing.com.
They're cheap, readily available and perhaps the most common form of birth control around, but are they right for you?
Pros: "This is a good option for women who don't want to alter their hormones in any way and for women who want to use contraception only when they're having sex," explains Dr. McAllister. "It's great for women who don't want to take pills daily, and for those who don't want to wear patches on their skin or vaginal rings in their bodies."
Cons: "Some men and women feel that the condom interferes with sensation, and some feel self-conscious or embarrassed by the whole process of putting on a condom before or during sex," says Dr. McAllister. "Some men say they feel pressured to maintain an erection while they're wearing a condom, since it will fall off if they don't." Plus, latex, the most common ingredient used to make condoms, can pose a serious allergy risk for some. "They may experience irritation, rashes or other issues when they're exposed to latex. An estimated 2 percent of people are allergic to latex. If you or your partner have a latex allergy, you can use condoms that are made of another material, such as rubber."
How effective? Condoms tend to be less effective than birth control pills, patches or the Ring, even when used correctly. "Each year, 2 out of 100 women whose partners use condoms will become pregnant if they always use condoms correctly," says Dr. McAllister. However, she adds, "15 out of 100 women whose partners use condoms will become pregnant if they don't always use them correctly." Also, condoms can fall off or be damaged during intercourse, and that can increase the risk of pregnancy. "For many women and their partners, these odds are less than reassuring," she says. "You can increase the effectiveness by using spermicide along with condoms, and by pulling out before ejaculation."
Photo by iStockphoto.
Say what? Female "condoms" are plastic pouches that are inserted into the vagina before intercourse. "If you can insert a tampon, you can insert a female condom," says Dr. McAllister.
Pros: "This is a good option for women who want to be in charge of contraception but who don't want to alter their hormones in any way," says Dr. McAllister. "It's also good for women who are concerned about the risks of STDs."
Cons: The female condom takes some maneuvering to put in place, so "if you feel shy or uncomfortable about inserting a female condom in your partner's presence, this may not be the best option for you," she says. Plus, it may cause irritation of the genitalia in women and men. "I've also had women tell me that the female condom can be a little noisy, and that can be embarrassing for them," she adds. And, they're also a bit pricier than the male version, about $4 per condom.
How effective? Bottom line: Female condoms are less effective than the male condom as well as the Pill, the Patch or the Ring-even when used correctly. "Each year, 5 out of 100 women will become pregnant if they always use female condoms correctly, and 21 out of 100 women who use female condoms will become pregnant if they don't always use them correctly."
Photo courtesy of FemaleHealth.com.
The "Pull-Out" Method
The "pull-out" or "withdrawal" method sounds risky, but does it really work?
Pros: In a committed, monogamous relationship, many couples consider the pull-out method. It's product-, hormone- and medication-free, plus it can make sex feel more natural than with physical contraceptives. "When used religiously, withdrawal can actually be pretty effective," says Stern.
Cons: "If your partner is clumsy or stubborn or excitable, withdrawal isn't going to work well for you," adds Stern. "Not only does the sperm have to land outside the vagina, but it has to land outside the external genitalia as well for withdrawal to be effective."
How effective? Surprisingly, when used properly, this method has a 5 percent failure rate. However, Stern says a more typical failure rate for most couples is about 27 percent-which would be the likely percentage chance you have of getting pregnant if using this method casually. Dr. McAllister explains that "even when a man pulls out in time, pregnancy can still occur." This can be attributed to sperm from a recent ejaculation being carried to the egg via pre-ejaculation fluid or if semen lands onto or around the vulva and is then introduced into the vagina.
Photo by iStockphoto.
If you're a forgetful pill taker, the birth control patch (brand name: Ortho Evra) might be for you. "It's a small, adhesive-backed beige patch that sticks to your skin and releases hormones designed to prevent pregnancy," explains Dr. McAllister.
Pros: It's one of the best options for spontaneous romance. "There's nothing for you or your partner to do right before sex," Dr. McAllister says. Plus, it's low-maintenance. "Simply place a new patch on an area of clean, dry skin once a week for three weeks in a row, followed by a patch-free week. Apply the sticky side of the patch to the skin of your buttocks, stomach, outer upper arm or upper torso, but never on your breasts."
Cons: Women with oily skin, or those who sweat or swim a lot, may find that the patch loses its stickiness and falls off before the end of the week, notes Dr. McAllister. "If you forget and apply lotion or creams to the skin around the patch, that can loosen the adhesive backing as well. I've had patients tell me the patch sometimes starts looking dirty or grungy before the end of the week. Some women also forget to remove and replace their patches."
How effective? "The patch is very effective at preventing pregnancy when used as directed," says Dr. McAllister. "When women use the patch faithfully according to instructions, fewer than 1 in 100 of these women each year will become pregnant. If women don't always use the patch as directed, about 8 in 100 of these women each year can expect to become pregnant."
Photo by iStockphoto.
What pesticides are to insects, spermicides are to sperm. Chemicals in contraceptive creams, gels, films, foams and suppositories stop sperm from moving while also blocking the woman's cervix so that sperm can't reach the egg.
Pros: This is an appealing option for women who don't want to take pills or alter their hormones, says Dr. McAllister. When used with a condom, she says, it can lower your odds of getting pregnant.
Cons: Tick-tock, tick-tock. "For some types, it's recommended that you wait at least 10 minutes after inserting the spermicide before having intercourse," says Dr. McAllister. "And most spermicides remain effective for only 1 hour after insertion. So timing is everything! Also, some spermicides can cause irritation of the penis. Nonoxynol-9, the most commonly used spermicide in the U.S., can be irritating when used several times a day." Irritated tissues may also increase the risk of acquiring STDs and HIV, she adds.
How effective? Used alone, spermicides aren't very effective. "Most women feel it's just too risky to use them without a condom," she says. "If women always use spermicide as directed, 15 out of 100 each year will become pregnant. If women don't always use spermicide as directed, 29 out of 100 each year will become pregnant."
Photo courtesy of Amazon.com.
An IUD is a contraceptive device made of bent plastic or metal that is inserted by a medical professional through the vagina and into the uterus for long-term pregnancy prevention. "Though the IUD got a bad name during the 1970s when many women contracted infections-some fatal-from an IUD called the Dalkon Shield, the IUDs currently on the market are safe," says Stern.
Pros: "The ParaGard or copper IUD is an especially useful birth control option for women who either can't or don't want to use hormones," says Stern. "Though there has been much speculation that the IUD can act as an abortifacient, large anatomical studies have dispelled this myth." The Mirena IUD, which can last for 5 years and contains a small amount of progestin, "is not only the most effective, reversible birth control method presently on the market but can also have therapeutic use for women with heavy or painful periods."
Cons: "One of my patients' major complaints about ParaGard is that it can increase menstrual flow and make menstrual cramps more pronounced," says Stern. "Both of these side effects can be alleviated at least in part by taking ibuprofen consistently, even before the start of the period."
How effective? Very. According to studies of IUDs, pregnancy rates for women using them are fewer than 1 in 100 each year.
Photo by iStockphoto.
Original article appeared on WomansDay.com.
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