Oral Contraceptive ("The Pill")

Description

• There are two types of oral contraception – combination pills (which contain both estrogen and progestin) and progestin-only pills (which do not contain estrogen).
• Combination pills prevent the release of an egg from the ovaries (ovulation) and thicken the mucus in the cervix which hinders sperm from meeting an egg.
• Combination pill packs typically contain 21 "active" pills (pills that contain hormones), plus 7 "inactive" pills which are pills that do not contain hormones. The inactive pills serve as reminders to continue taking the pill and when to start the next pack. Pregnancy is still prevented during the fourth week of "inactive" pills.
• With combination pills, depending on when the method is started during the female's cycle, it may take up to 5-7days before protection against pregnancy can be assured. A back-up method should be used during this time.
• Progestin-only pills only thicken the cervical mucus to prevent the sperm from meeting an egg.
• Progestin-only pill packs contain 28 "active" pills (pills that contain hormones). All pills must be taken.
• With progestin-only pills, it will take up to 48 hours before protection against pregnancy can be assured. A back-up method should be sued during this time.
• Both types of pills are effective at preventing pregnancy.
• Menstruation occurs during the fourth week of the pill pack.
• Pills must be taken at the same time every day to be most effective.
• Pill packs may cost $15-$35 each; they may be obtained for free or at reduced cost through the county health department.
• The pill has not been proven to have any effect on the risk of developing breast cancer.
• The pill does not prevent transmission of sexually transmitted infections.

Effectiveness

• If taken correctly and consistently, the pill can be 99% effective.

Advantages

• There are a variety of pills available with varying doses. This means that if a female experiences side effects with one pill, she can try others until side effects are minimized.
• Periods may be more regular, lighter and less painful.
• Studies have shown that women who have used birth control pills are at a lower risk of ovarian, uterine and colon-rectal cancer later in life.
• There are no interruptions in sex play with this method.
• The combination pills may offer protection against the following: acne, cancer of the lining of the uterus, cancer of the ovaries, ectopic pregnancy, excess body hair, iron deficiency anemia experienced due to heavy periods, non-cancerous breast growths, osteoporosis, ovarian cysts, premenstrual symptoms, some menopausal symptoms (vaginal dryness).
• Prolonged use of combination pills (8-10 years) increases protection against ovarian and endometrial cancer with each year of use.
• The pill can be utilized to plan the timing of a woman's period or to cause a woman to delay a period.

Disadvantages

• The female must visit a medical provider and obtain a prescription for the pill.
• The females must remember to take the pill every day and at about the same time of day.
• Certain medications can make the pill less effective including the antibiotic rifampin, oral anti-fungal medications taken for yeast infections, Saint John's Wort, certain anti-seizure medications and certain medications used in the treatment of HIV.
• Vomiting or diarrhea can interfere with the effectiveness of the pill.
• Combination pills may cause depression and/or a decrease in sexual desire.
• Other side effects may be experienced with the pill, including, bleeding between periods, breast tenderness, headache, or nausea. These usually cease after a few months of use.
• Smokers, women over the age of 35, or women with heart conditions may have an increased risk of blood clots in the legs.
• Some women experience slight weight gain (3-5 lbs.) with the use of birth control pills.

Recommended For Teens?

• Since the pill does not protect from sexually transmitted infections, the use of the pill is recommended for teens in addition to use of the condom.
• The pill is not recommended for teens who have irregular or spontaneous intercourse.
• The female must be responsible enough to remember to take the pill every day.

The Patch

Description

• The patch is a thin, beige, plastic adhesive patch that delivers two hormones (estrogen and progesterone) through the skin and into the bloodstream.
• The patch works like the pill in that it prevents the release of an egg from the female's ovaries. The hormones in the patch also thickens the mucus in the cervix, which prevents sperm from reaching the fallopian tubes.
• The patch can be worn on the buttocks, abdomen, upper torso (but not the breasts) or upper outer arm.
• A new patch is applied every week for three weeks. During the fourth week, no patch is applied. During the fourth week, the female will experience her period.
• The patch may not be effective for women who way more than 198 pounds.
• The patch costs $30-$40 per month; they may be obtained for free or at reduced cost through the county health department.
• The patch does not prevent transmission of sexually transmitted infections.

Effectiveness

• The patch is 99% effective.

Advantages

• The patch has many of the same advantages of the pill, but does not require the woman to remember to take a pill daily.
• Periods may be more regular, lighter and less painful.
• There are no interruptions in sex play with this method.
• Since the patch is relatively new, research on additional positive effects, like those experienced with the pill (e.g. protection against acne, certain kinds of cancer, etc.) is not yet available.

Disadvantages

• If the patch falls off or is loose for more than 24 hours, pregnancy could occur.
• If the same patch is worn for more than one week, it is not releasing enough or any hormones and pregnancy could occur.
• Certain medications can make the patch less effective including the antibiotic rifampin, oral anti-fungal medications taken for yeast infections, Saint John's Wort, certain anti-seizure medications and certain medications used in the treatment of HIV.
• In some cases, the skin where the patch is applied can become irritated.
• The patch may cause depression and/or a decrease in sexual desire.
• Other side effects may be experienced with the patch, including, bleeding between periods, breast tenderness, changes in mood, headache, weight gain/loss, or nausea. These usually cease after a few months of use.
• Smokers, women over the age of 35, or women with heart conditions may have an increased risk of blood clots in the legs.
• The patch is not available in all skin tones.

Recommended For Teens?

• Since the patch does not protect from sexually transmitted infections, the use of the patch is recommended for teens in addition to use of the condom.
• The patch is not recommended for teens who have irregular or spontaneous intercourse.
• The female must be responsible enough to remember to change the patch every week.
• Though the patch can be located in a inconspicuous spot, it could be visible to others.

Contraceptive Injections ("The Shot" – Depo-Provera)

Description

• The shot has been used as contraception for over 30 years.
• The shot works by injecting synthetic progesterone into the body every three months. Each shot provides continuous protection against pregnancy for three months.
• The hormone is slowly absorbed by the body over the course of 12 weeks.
• The injection occurs in the buttock or arm.
• Pregnancy is prevented by preventing ovulation, or the release of an egg. Additionally, the cervical mucus may be thickened to prevent the travel of sperm to an egg. Finally, the hormone may reduce the lining of the uterus, resulting in a smaller chance of the implementation of a fertilized egg.
• Each injection costs $30-$75 on top of the fee to visit the clinic; injections may be obtained for free or at reduced cost through the county health department.
• Depo-provera is only recommended to be used for a maximum of two years at one time.
• Contraceptive injections do not prevent transmission of sexually transmitted infections.

Effectiveness

• Contraceptive injections are 99% effective.

Advantages

• There are no interruptions in sex play with this method.
• There is no daily or weekly action to remember to take – the shot is administered only four times per year.
• The injection is private – there is no packaging (pill) or patch that could be potentially embarrassing.
• Most women stop menstruating while using the shot.

Disadvantages

• The female must visit a health care provider for an initial consultation as well as every three months.
• Shots must be administered on time. Shots may be administered up to two weeks early if an appointment cannot be made according to schedule.
• During the first 6 months to year of usage, irregular menstrual bleeding may occur.
• About 70% of women gain 3-7 pounds since depo-provera can increase appetite.
• Other side effects may include: mood changes, tiredness, headache, vaginal dryness, decreased or increased sex drive, and hair loss.
• Because the shot is designed to last three months, if side effects are experienced, it will take approximately that length of time for them to subside.
• It can take 10 months up to an entire year for a woman to become pregnant (if she chooses) after stopping injections.
• Use of the contraceptive injection can result in the loss of bone density (calcium stored in bones) which may result in more brittle bones, especially after menopause. While this bone thinning is temporary, not all calcium may be regained after stopping use of the shot. The longer the shot is used, the greater the bone density loss.

Recommended For Teens?

• The shot is not recommended for teens because the teenage years are a critical time during which females are developing bone density.
• Since the shot does not protect from sexually transmitted infections, the use of the patch is recommended for teens in addition to use of the condom.
• The shot is not recommended for teens who have irregular or spontaneous intercourse.

Vaginal Ring (NuvaRing)

Description

• The vaginal ring is a flexible ring that is about two inches in diameter.
• The ring contains the same hormones as the combination pill – estrogen and progestin.
• The ring is inserted into the vagina and the muscles of the vagina hold it in place. The ring is not detectable to a partner during sexual activity and most women cannot feel it once it is in place.
• The ring releases hormones slowly and steadily over the course of three weeks. At the end of three weeks, the ring is removed for one week. At the end of this week, the female inserts a new ring.
• The woman's period starts the second or third day after the ring is removed and may not be completed before the next ring is inserted.
• The hormones in the vaginal ring work to prevent pregnancy by preventing ovulation, or the release of an egg. Additionally, the cervical mucus may be thickened to prevent the travel of sperm to an egg. Finally, the hormone may reduce the lining of the uterus, resulting in a smaller chance of the implementation of a fertilized egg.
• The ring costs about $30-35 per month; the ring may be obtained for free or at reduced cost through the county health department.
• The vaginal ring does not prevent transmission of sexually transmitted infections.

Effectiveness

• The vaginal ring is 99% effective.

Advantages

• The vaginal ring is easy to use. The ring does not need to be in any particular place in the vagina in order for it to be effective.
• There is no daily or weekly action to remember to take – the ring remains in place for three weeks at a time.
• The ring releases a lower dose of hormones.
• Most women report no side effects.
• Many women experience more regular, shorter and lighter periods while using the ring.
• There are no interruptions in sex play with this method.
• Since the vaginal ring is relatively new, research on additional positive effects, like those experienced with the pill (e.g. protection against acne, certain kinds of cancer, etc.) is not yet available.

Disadvantages

• The female must remember to remove the ring after three weeks, and then insert a new ring after the "ring-free" week.
• If the ring is out of the vagina for more than three hours during the 3-week period, pregnancy may occur and additional contraceptive methods should be used.
• Smokers, women over the age of 35, or women with heart conditions may have an increased risk of blood clots in the legs.
• Certain medications can make the vaginal ring less effective including the antibiotic rifampin, oral anti-fungal medications taken for yeast infections, Saint John's Wort, certain anti-seizure medications and certain medications used in the treatment of HIV.
• Side effects that may be experienced include: bleeding between periods, weight loss or gain, breast tenderness, nausea, mood changes, increased vaginal discharge, vaginal irritation or infection.

Recommended For Teens?

• Since the vaginal ring does not protect from sexually transmitted infections, the use of the patch is recommended for teens in addition to use of the condom.
• The vaginal ring is not recommended for teens who have irregular or spontaneous intercourse.
• The teen must be responsible enough to remember to change the ring according to schedule.

Hormone Releasing IUD (Mirena)

Description

• The hormone releasing IUD is a small, flexible piece of plastic. It is T-shaped.
• The hormone releasing IUD is placed inside the uterus to prevent pregnancy. A small string extends from the IUD out of the cervix for future removal, and for the female to check to make sure the IUD is still in place.
• The hormone released by the Mirena is levonorgestrel. It releases the hormone directly into the lining of the uterus. The levonorgestrel increases the thickness of the cervical mucus which inhibits the travel of sperm.
• The hormone releasing IUD can be left in place for up to 5 years.
• The hormone releasing IUD works by interfering with sperm and egg movement to prevent fertilization. It also thins the lining of the uterus and prevents implantation of an egg if it is fertilized.
• The cost of the exam, insertion and the device itself can range from $175-500; it may be obtained for free or at reduced cost through the county health department.
• The hormone releasing IUD does not protect against sexually transmitted infections.

Effectiveness

• IUD's are 99% effective.

Advantages

• Birth control is always in place. The couple does not have to rely on memory or skill to use this method correctly or consistently.
• There is no interruption during sex.

Disadvantages

• The IUD does not protect against sexually transmitted infections. In fact, if a female with and IUD is exposed to a sexually transmitted infection, it is possible for the string on an IUD that extends out of the cervix to facilitate the transmission of the STI to her uterus and other sex organs. This may result in pelvic inflammatory disease.

Recommended For Teens?

• No. Due to the risks associated with STIs, the IUD is recommended only for women who are in stable, faithful relationships (several years in length). Teens generally are in multiple short-lived relationships. Therefore, their risk of exposure to STIs is increased and therefore, there is an increased risk of pelvic inflammatory disease.

Emergency Contraception (EC)

Description

• Emergency contraception (EC) is a method that can be used to prevent pregnancy after unprotected sex or if the individuals' main form of birth control failed.
• It is recommended that all sexually active females routinely have EC on hand in the event of any unprotected sex or birth control failure.
• Emergency contraception should be taken within five days of unprotected sex. However, it is most effective is taken within 72 hours.
• Plan B contains only the hormone progestin. It works by prevention ovulation and fertilization. In theory, EC could prevent implantation of a fertilized egg, but this has not been scientifically proven.
• Other combination birth control pills may be used in a way that also acts as emergency contraception.
• Emergency contraception does not cause an abortion. It prevents fertilization of the egg in the first place.
• Insertion of an IUD within five days of unprotected sex can also serve as a method of emergency contraception.
• The most common form of EC is Plan B. This consists of two progestin-only pills that may be taken at the same time. (Previously, women were instructed to take these pills 12 hours apart to prevent nausea and vomiting which would reduce the effectiveness of the pills. However, since few women experience these side effects, it is becoming more common to recommend taking both pills at the same time.)
• If combination pills are used, there is a greater chance of nausea and vomiting. Therefore, it is recommended that these pills be taken 12 hours apart. If vomiting does occur with the first dose, it is recommended to take the second does as a suppository in the vagina. The pills will be absorbed by through the vaginal tissue.
• By the end of 2006, Plan B will available without a prescription to both males and females over the age of 18 at any pharmacy.
• Emergency contraception, including Plan B is also available at county health departments, Planned Parenthood, private doctors, college health centers and hospital emergency rooms.
• If a female is unable to obtain Plan B, she may take her own or someone else's birth control pills in a manner which will act as emergency contraception. Depending on the band of birth control pills, this may mean taking any where from two to forty birth control pills over 12 hours. A list of common birth control brands and the recommended dosage is listed on Planned Parenthood's website (www.plannedparenthood.org).
• Emergency contraception should not be used as a primary method of birth control.
• Emergency contraception costs can vary. Plan B can cost from $10-40 per pack. Other forms of EC (e.g. combination pills) can range from $20-70. Emergency contraception is available at reduced or no cost at county health departments.
• Emergency contraception does not protect against sexually transmitted infections.

Effectiveness

• Progestin-only pills (e.g. Plan B) are 83% effective at preventing pregnancy if taken within 72 hours of unprotected sex.
• Combination pills used as EC are 75% effective at preventing pregnancy if taken within 72 hours of unprotected sex.

Advantages

• In the event of unprotected sex or failure of a primary birth control method, EC can reduce the chance of pregnancy.
• It is estimated that EC has reduced the demand for abortions by 43% between 1994 and 2000.

Disadvantages

• Women who take combination pills as EC may experience nausea and/or vomiting. (Anti-nausea medication can be taken to reduce these side effects and therefore, increase effectiveness.)

Breast tenderness, irregular bleeding, dizziness or headaches are other possible side effects.

Recommended For Teens?

• Yes. This method is recommended for teens on an emergency basis, not as an on-going birth control method.

Male Condom

Description

• Male condoms are thin latex (or polyurethane, if allergic to latex) barriers that fit over an erect penis.
• Condoms must be put on before the penis touches the vagina.
• If used correctly, sperm are trapped inside the condom and cannot get into the vagina.
• A new condom should be used each time you have sexual intercourse.
• Use of a spermicide with condoms will increase effectiveness.
• Condoms are the only birth control method which also protects from sexually transmitted diseases.

Effectiveness

• 97-99% effective if used correctly and consistently.

Advantages

• Condoms are free at the Health Department or can be purchased at local pharmacies, groceries and other locations.
• Condoms are inexpensive.
• You don't need a prescription.
• There are lots of styles, sizes, colors, and textures to choose from.

Disadvantages

• May cause a slight interruption before sex. However, application of the condom can be come part of "sex play".
• Sensation may be reduced. However, application of water or silicone-based lubrication to the inside of the condom can increase the sensation experienced by the male.
• If not put on correctly, the condom can break or slip, which can put the partners at risk of pregnancy or infection.
• You must have condoms close at hand to use right before having sex.

Recommended For Teens?

• Yes! Condoms are accessible, easy to use, do not require a prescription, and protect against STIs.

Female Condom

Description

• Female condoms are thin plastic (polyurethane) barriers with flexible rings at each end. They fit into the vagina. One ring fits at the female's cervix while the other ring extends past the vaginal opening and provides protection to the female's labia.
• Condoms must be inserted before the penis touches the vagina. They may be inserted up to 8 hours before sex.
• If used correctly, sperm are trapped inside the condom and cannot get into the vagina.
• A new condom should be used each time you have sexual intercourse.
• Use of a spermicide with condoms will increase effectiveness.
• Condoms are the only birth control method which also protects from sexually transmitted diseases.

Effectiveness

• 95% effective if used correctly and consistently.
• Do not use female condoms with male condoms. This will result in friction which could lead to condom breakage and failure.

Advantages

• Female condoms are free through the M.A.R.S. Program or can be purchased at local pharmacies, groceries and other locations.
• Condoms are inexpensive (about $2/ea).
• You don't need a prescription.
• Female condoms extend past the vaginal opening and cover the labia. This may help prevent transmission of certain STIs which are spread through skin-to-skin contact.

Disadvantages

• May cause a slight interruption before sex. However, application of the condom can be come part of "sex play".
• Sensation may be reduced. However, application of water or silicone-based lubrication to the inside of the condom can increase the sensation experienced by the male.
• If not put on correctly, the condom can break or slip, which can put the partners at risk of pregnancy or infection.
• You must have condoms close at hand to use right before having sex.

Recommended For Teens?

• Yes! Condoms are accessible, easy to use, do not require a prescription, and protect against STIs.

Intrauterine Device (IUD)

Description

• The IUD is a small piece of plastic. It is T-shaped. Portions of the plastic are wrapped in copper.
• The IUD is placed inside the uterus to prevent pregnancy. A small string extends from the IUD out of the cervix for future removal, and for the female to check to make sure the IUD is still in place.
• The IUD can be left in place for up to 10 years.
• The IUD works by interfering with sperm and egg movement to prevent fertilization. It also changes the lining of the uterus and prevents implantation of an egg if it is fertilized.

Effectiveness

• IUD's are 99% effective.

Advantages

• Birth control is always in place. The couple does not have to rely on memory or skill to use this method correctly or consistently.
• There is no interruption during sex.

Disadvantages

• The IUD does not protect against sexually transmitted infections. In fact, if a female with and IUD is exposed to a sexually transmitted infection, it is possible for the string on an IUD that extends out of the cervix to facilitate the transmission of the STI to her uterus and other sex organs. This may result in pelvic inflammatory disease.
• Can cause spotty bleeding, heavier menstrual periods and cramps.

Recommended For Teens?

• No. Due to the risks associated with STIs, the IUD is recommended only for women who are in stable, faithful relationships (several years in length). Teens generally are in multiple short-lived relationships. Therefore, their risk of exposure to STIs is increased and therefore, there is an increased risk of pelvic inflammatory disease.

Spermicides

Description

• Spermicides are chemicals that kill sperm.
• The effectiveness of spermicides is maximized when used with a condom or other barrier method (such as a diaphragm or cervical cap).
• Spermicides are available in foams, jellies, creams and vaginal suppositories.
• Additional spermicide must be applied each time you have intercourse.
• Spermicide should be applied around the edge of a diaphragm or cervical cap to kill any sperm that may manage to get past these devices.
• Spermicides do not prevent transmission of sexually transmitted infections.

Effectiveness

• Spermicides are 74% effective if used alone.
• They are 94% effective when used with another barrier method.

Advantages

• Spermicides are available at most grocery or drug stores.
• Spermicides are inexpensive – kits cost around $4 - $8.

Disadvantages

• You must have spermicides close at hand to use right before sex.
• You must apply more spermicide each time you have sex.
• You must wait ten minutes after spermicide is applied before having intercourse.
• This method can be messy; some people complain about leakage of the spermicidal fluid.
• Using the spermicide nonoxynol-9 many times a day may irritate tissue in the vagina or on the penis. This could increase the risk of transmission of sexually transmitted infections, including HIV.

Recommended For Teens?

• Yes, especially if used with condoms (to prevent STIs).

Diaphragm

Description

• The diaphragm is a small rubber cup that is placed in the vagina. It covers the cervix and therefore prevents sperm from entering the uterus.
• The diaphragm is filled with contraceptive jelly before insertion.
• It must be put in place prior to intercourse. It can be inserted a few hours prior to sex and it must be left in place for eight hours after intercourse. It should not remain in the vagina longer than 24 hours.
• A partner should not be able to feel the diaphragm if it fits well.
• The diaphragm must be fitted to the size of the female's cervix by a health care provider.
• Spermicide must be applied to the diaphragm each time you have sex.
• The diaphragm is reusable after it is washed thoroughly.
• Diaphragms cost $15 - $75; they may be obtained for free or reduced cost through the county health department.
• Diaphragms do not prevent transmission of sexually transmitted infections.

Effectiveness

• Diaphragms are 94% effective.

Advantages

• Unlike hormonal methods, no chemicals are absorbed into the female's body.
• The device can be inserted six to eight hours before sex, so interruption during sex can be avoided.
• Neither partner can feel the diaphragm once it is in place.

Disadvantages

• You must have the diaphragm available ahead of or at the time of sex.
• The diaphragm must be inserted correctly to be effective.
• Some people may be allergic to the spermicide applied inside the diaphragm.
• Diaphragms must be obtained from a health provider.
• The female must feel comfortable touching her genitalia in order to insert the diaphragm properly.
• The device may be pushed out of place by some sexual positions, penis sizes, and thrusting techniques and angles.
• If the device causes irritation in the vagina, this could facilitate the transmission of an STI.

Recommended For Teens?

• This method is not typically used by teens. However, some teen women may prefer to use this method if they have sex infrequently and do not wish to have on-going side affects associated with hormonal methods.

Cervical Cap

Description

• The cervical cap is like the diaphragm, but is smaller. It uses suction to fit over the cervix and blocks sperm from entering the uterus.
• The cervical cap is filled with contraceptive jelly before insertion. The rim of the cap must be coated with contraceptive jelly as well.
• It must be put in place prior to intercourse. It can be inserted a few hours prior to sex and it must be left in place for eight hours after intercourse. It should not remain in the vagina longer than 48 hours.
• The cervical cap must be fitted to the size of the female's cervix by a health care provider.
• The cervical cap is reusable after it is washed thoroughly.
• Cervical caps cost $15 - $75; they may be obtained for free or reduced cost through the county health department.
• Cervical caps do not prevent transmission of sexually transmitted infections.

Effectiveness

• The cervical cap is 91% effective in women who have never had a child.
• It is 84% effective in women who have had a child.

Advantages

• Unlike hormonal methods, no chemicals are absorbed into the female's body.
• The device can be inserted six to eight hours before sex, so interruption during sex can be avoided.
• The cervical cap provides continuous protection for up to 48 hours.
• Neither partner can feel the cervical cap once it is in place.

Disadvantages

• You must have the cervical cap available ahead of or at the time of sex.
• The cervical cap must be inserted correctly to be effective.
• Some people may be allergic to the spermicide applied inside the cervical cap.
• Diaphragms must be obtained from a health provider.
• The female must feel comfortable touching her genitalia in order to insert the cervical cap properly.
• The device may be pushed out of place by some sexual positions, penis sizes, and thrusting techniques and angles.
• If the device causes irritation in the vagina, this could facilitate the transmission of an STI.

Recommended For Teens?

• This method is not typically used by teens. However, some teen women may prefer to use this method if they have sex infrequently and do not wish to have on-going side affects associated with hormonal methods.

Surgical Sterilization

Description

• Surgical sterilization can be performed in both males and females.
• This is a permanent form of birth control. (In some cases, attempts to reverse the procedure may be effective.)
• In females, the two fallopian tubes are blocked so an egg cannot pass through them to be fertilized by sperm. The tubes may be blocked by incisions and are then tied off. Another form of sterilization involves placing metal coils into the tubes to encourage tissue growth that will ultimately block the path between sperm and eggs. This is called a "tubal ligation"
• A female still releases eggs, however they dissolve and are absorbed by the body. A woman still has a period.
• In males, the vasa deferentia (the tubes through which sperm travel from the testes to the glands where they mix with seman) are blocked. The tubes are tied off, cauterized or cut. After three months, ejaculate will no longer contain sperm. This is called a "vasectomy".
• A male still produces sperm, however they dissolve and are absorbed by the body.
• Surgical sterilization does not prevent the transmission of sexually transmitted infections.

Effectiveness

• Surgical sterilization is over 99% effective.

Advantages

• The procedure is highly effective and permanent, resulting in peace of mind that no pregnancy will occur.
• There is no interruption during sex play.

Disadvantages

• This is a medical procedure that must be conducted by a physician.
• This method is permanent. Reversal procedures are costly and have low success rates.

Recommended For Teens?

• No, developmentally, teens are typically unable to know for sure if they want to have children in the future. This method is irreversible.

Abstinence

Description

• Abstinence means not having sexual intercourse or any genital contact that could result in pregnancy.

Effectiveness

• Abstinence is the only 100% way to avoid a pregnancy.

Advantages

• There are no health risks with abstinence.
• Anyone can choose to be abstinent at any point in time, even if he or she has already been sexually active.
• No prescription is required.
• Free!

Disadvantages

• If you change your mind and decide to have sexual intercourse, you must be prepared and have another birth control method handy.
• Some sexually transmitted infections can be spread by oral-genital or skin-to-skin contact even if you don't have sexual intercourse.

Recommended For Teens?

• This method is recommended for young people because there are no adverse health effects; young people may not be emotionally prepared for sex.

Outercourse

Description

• Individuals may have different definitions of outercourse: 1) sex play without vaginal intercourse (oral and anal sex not excluded); 2) sex play without any penetration (vaginal, oral or anal).
• Examples of outercourse include: kissing, masturbation, erotic massage, body-to-body rubbing (frottage), fantasy play, sex toys, and oral and anal sex play.
• Outercourse, if conducted properly, can eliminate the possibility of sperm entering the vagina.
• There is still the risk of transmission of sexually transmitted infections.

Effectiveness

• Outercourse is nearly 100% effective.
• Pregnancy is possible if during sex play pre-ejaculate or semen is allowed to enter the vagina.

Advantages

• There are no hormones involved with this method and no medical side effects.
• Outercourse can be used when no other birth control methods are available.
• Can result in better exploration of each other's bodies and possibly lead to better orgasm.
• Can result in increasing trust and comfort between partners.
• Outercourse as a birth control method does not interrupt sex play; no additional materials/prescription are required.

Disadvantages

• Couples may let outercourse lead to intercourse without making a conscious decision to do so.
• There is a chance for sperm to come into contact with the vagina during sex play.
• Outercourse does not prevent the transmission of sexually transmitted diseases if there is the exchange of bodily fluids or skin-to-skin contact.

Recommended For Teens?

• Yes. Outercourse is a good way for teens who wish to be sexually active to learn about their own bodies and those of the opposite sex.
• Many women do not achieve orgasm with vaginal stimulation. Outercourse also gives males the opportunity to learn how to bring a female to orgasm by stimulating the clitoris.
• Outercourse can take the pressure off of sexual performance.
• Teens who use outercourse as a method need to be prepared to protect themselves from sexually transmitted infections.
• They should have a backup birth control method available in the event outercourse transitions to intercourse.

Natural Family Planning

Description

• With natural family planning, a woman tracks her menstruation cycle so she knows when she is ovulating (releasing an egg).
• Once released, an egg lives one day. Since sperm can live up to one week, sex is avoided at least five days before ovulation and a minimum of two days after ovulation.
• The woman charts her menstrual cycle by using one or a combination of the following methods:
  1. Temperature: Every day a woman's temperature must be taken before getting out of bed. On the day of ovulation, her temperature rises approximately 0.4 – 0.8 degrees Fahrenheit.
  2. Cervical mucus: The female must track changes in her cervical mucus throughout her cycle. During the most fertile times of the month (with the greatest risk of pregnancy), a woman's cervical mucus will change from being cloudy and tacky (yellow or white) to being clear and slippery (like raw egg whites) and stretching between the fingers.
  3. Calendar: The female track her menstrual cycle on a calendar. This method is only useful if the length of her cycle varies little each month.
• The fertility-awareness method is most effective when all three of the above methods are used together to predict ovulation. Use of all three methods is called the "symptothermal method".
• This method costs very little – only $10-12 for a thermometer.
• The fertility-awareness method does not protect against sexually transmitted infections.

Effectiveness

• This method is 80% effective with typical use.

Advantages

• No hormones are introduced into the body with this method.
• No prescription is required, though consultation with a health care provider is recommended to gain in-depth education about this method.
• This method may be in line with some individual's religious beliefs.

Disadvantages

• The day of ovulation can vary from month to month, therefore the woman must take measures to carefully estimate the exact time of ovulation each month.
• Careful and diligent recording of symptoms is required.
• The female must be comfortable touching herself in order to get a sample of her cervical mucus.
• Many factors may alter the female's body temperature, consistency of cervical mucus and length of menstrual cycle including: stress, illness, disturbed sleep, alcohol, smoking, recent use of hormonal methods, vaginitis, use of contraceptive foams/jellies/fims/suppositories, presence of a sexually transmitted infection, etc.
• Couples must be prepared to abstain or use a back-up method of birth control during the fertile time of the female's cycle.

Recommended For Teens?

• No. The menstrual cycle of teens is typically too irregular to be a reliable predictor of ovulation.
• This method requires reliable tracking and recording of information which may be difficult for a teen to follow through on.

Withdrawal

Description

• The male removes his penis from the female's vagina before he ejaculates.
• Once ejaculation has occurred outside of the vagina, the couple must be careful to prevent semen from coming in contact with the vagina.
• This method required a high level of awareness and self-control during intercourse.
• There is no financial cost associated with withdrawal.
• Withdrawal does not protect against sexually transmitted infections.

Effectiveness

• Withdrawal is 73% effective with typical use.

Advantages

• Withdrawal can be used by anyone.
• No prescription or medical devices are required.
• There are no hormonal or medical side effects.
• Withdrawal can be used if no other birth control method is available.

Disadvantages

• The male must be very aware of his state of arousal in order to pull out of the vagina before ejaculation.
• Sperm may be found in pre-ejaculate which may cause pregnancy.

Recommended For Teens?

• No. This method is not recommended for sexually inexperienced males since they may not have enough awareness to know when they are going to ejaculate.
• Teens are likely to experience premature ejaculation which increases the risk of pregnancy.
• The risk of pregnancy with this method is high.