Most of us do not want to spend our entire reproductive lives conceiving children. Some of us will try for children at some point, others will choose not to at all. But, if you are having vaginal intercourse, there is a risk of unwanted conception. Thankfully, there are birth control methods that can lower that risk. Some methods lower the risk to below 1%, which can be comforting if you are trying to avoid pregnancy.
Not every type of birth control is right for every person. You should talk to your doctor about what kind of birth control options you have based on your health and lifestyle. Some people are fine on hormonal methods while others cannot tolerate them. Some need or want long-term options and some people even want permanent solutions.
With each type of birth control, there is a “typical use failure rate.” This is how often the birth control fails with typical use. Typical use refers to how strictly most people follow usage guidelines and differs from perfect use. Basically, typical use means there could be some slight user error.
The CDC has plenty of information on contraception and avoiding pregnancy. Here is a rundown of the birth control options that may be available to you:
Oral contraception is probably what you think of first when you hear the term birth control. “The Pill” as it is sometimes called is an oral dose of the hormones progestin and estrogen. Some varieties have a combination of both hormones and others just have progestin. The pill needs to be taken at the same time every day to be most effective. Oral birth control is prescribed by a doctor. Typical use failure rate: 7%
Other Hormonal Methods
There are other hormonal birth control methods that are not taken orally. These include:
- Injections: Progestin shots received every three months from a doctor. Typical use failure rate: 4%
- Patch: The patch is placed on the skin on the buttocks, lower abdomen, or upper body, excluding the breasts. A new patch is applied every week for three weeks. On the fourth week you do not use the patch and have a menstrual period. Prescribed by a doctor. Typical use failure rate: 7%
- Vaginal Contraceptive Ring: This ring is placed in the vagina where it releases hormones. The ring is worn for three weeks and then removed. After the fourth week when you have your period, you put a new ring in. Prescribed by a doctor. Typical use failure rate: 7%
- Implant: A small thin rod containing progestin is inserted under the skin of a woman’s upper arm. The implant works for three years. Requires a prescription and insertion by a doctor. Typical use failure rate: 0.01%
Just as they sound, barrier methods of birth control create a physical barrier that prevents sperm from entering a woman’s uterus. There are several options within this category:
- Diaphragm or Cervical Cap: Both of these methods are placed inside the vagina before intercourse to cover the cervix, which blocks sperm. Should be used with spermicide. You should visit your doctor to obtain a diaphragm to get it fitted. Typical use failure rate: 17%
- Male Condom: Worn by the man to prevent sperm from entering the vagina. Traditionally made of latex but also available in synthetic materials. These varieties also help prevent STDs. Lambskin or those made with natural materials are effective contraceptives but do not protect against STDs. Condoms can only be used once and should only be used with water-based lubricants as oil-based lubricants weaken them causing tearing or breakage. Available at drug stores. Typical use failure rate: 13%
- Female Condom: The female condom is worn inside the woman’s vagina and can be inserted up to eight hours before intercourse. It works similarly to the male condom in that it keeps sperm from entering her body. Also like the male condom, it can help prevent STDs. Available at drug stores. Typical use failure rate: 21%
- Spermicides: These work by killing sperm. You can get them in multiple forms, including gel, foam, cream, tablet, or film and are available at drug stores. The spermicide should be placed in the vagina no more than one hour before intercourse. They are left in the vagina for at least six to eight hours after intercourse. Spermicides can be used in combination with other barrier methods. Typical use failure rate: 21%
- Contraceptive Sponge: A contraceptive sponge is placed in the vagina over the cervix. The sponge contains spermicide and works for up to 24 hours. It is removed and discarded when it has been in the vagina for at least six hours after intercourse. Typical use failure rate: 14% – 27% depending on if the woman has had a baby.
Intrauterine devices (IUD) are good options for women looking for long term birth control that they do not have to think about daily. IUDs last between 3 and 10 years depending on the type. They are T-shaped devices inserted into the uterus to prevent pregnancy. There are two types of IUD:
- Copper: This type of IUD is hormone free and can last up to 10 years. Typical use failure rate: 0.8%
- Levonorgestrel (LNG): This type of IUD releases small amounts of progestin each day to prevent pregnancy. Can last for up to 5 years. Typical use failure rate: 0.1-0.4%
Permanent Birth Control
If you are positive that you do not want to get pregnant and want a permanent method of birth control, there are two options.
- Female Sterilization/Tubal Ligation: Commonly known as “getting your tubes tied.” The fallopian tubes are closed or tied so that sperm and eggs can never meet for fertilization. Surgery can be done as an outpatient procedure at a surgical center or in a hospital. Effective immediately. Typical use failure rate: 0.5%
- Male Sterilization/Vasectomy: This procedure prevents a man’s sperm from making it to the penis by sealing the vas deferens. That means his ejaculate will contain no sperm and therefore cannot fertilize eggs. It is an outpatient procedure. Takes about 12 weeks to become effective and tests should be done to make sure the sperm count has dropped to zero before having unprotected sex. Typical use failure rate: 0.15%
Fertility Awareness Methods
For some people, using any of the above methods are not possible or attractive. Fertility awareness-based methods (FAMs) rely on knowing the female partner’s fertility pattern. They are sometimes called natural birth control methods or the “rhythm method”.
Being familiar with and keeping track of your fertility pattern is easiest if you have a regular menstrual cycle. If you have an irregular cycle, these methods may be more difficult to use and less reliable.
Once you know the fertility pattern, you can determine which days you are able to get pregnant, unable to get pregnant, and the days when you probably wouldn’t get pregnant but it is still possible. If you do not want to get pregnant, you abstain from unprotected vaginal sex on the days conception is possible. This can mean not having vaginal sex at all or using a barrier method during that time. If you do want to get pregnant, then you have unprotected vaginal sex on those days.
There are a few different methods of this kind:
- The Calendar Method means charting your menstrual cycle on a calendar.
- The Cervical Mucus Method involves checking your cervical mucus, or vaginal discharge) daily.
- The Temperature Method requires taking your temperature before you get out of bed each morning.
Combining all three methods is the most effective route.
As you can see, this type of birth control takes a lot of planning and sticking to a schedule. FAMs are not recommended for people not in a committed relationship as they provide no protection against STDs. The failure rate of FAMs varies widely, with the CDC citing a range of between 2-23%.
If you have questions about what kind of birth control is right for you, the experienced providers at Green Valley OB/GYN can help. Call (336) 378-1110 to schedule an appointment and discuss the best option for your current stage of life and future family planning goals.