The Pill

The pill is the first contraceptive that most women think of when considering birth control. Today the pill is available as combined oral contraceptives (COC) which contain both estrogen and progestin, or in progestin only pills (POP) which contain only progestin.

POPs work by reducing and thickening the cervical mucus to prevent sperm from reaching the egg, and by keeping the uterine lining from thickening to prevent implantation of a fertilized egg. Because these pills contain no estrogen the risk of blood clots is not present as with the combined oral contraceptives.

This type of birth control pill is a good option for women who cannot take estrogen because they are breast feeding or because of headaches or high blood pressure problems associated with estrogen. The progestin only pill may cause menstrual changes, weight gain, and breast tenderness.

Injectable Progestins

Pregnancy can be prevented up to three months by injection of Depo-Provera. Depo-Provera prevents pregnancy by inhibiting ovulation, changing the cervical mucus to prevent sperm from reaching an egg, and by changing the uterine lining so that a fertilized egg will be unable to implant. This method is extremely effective since all that's required of a woman is to return to her health care provider for a shot every three months. Benefits and side effects of Depo-Provera are similar to those of progestin only pills.

Intrauterine Devices (IUD)

The IUD has experienced some bad publicity in the past when the Dalkon Shield was associated with a high incidence of pelvic infections, infertility, and some deaths. However, today's IUDs have one of the lowest failure rates of any contraceptive method. An IUD is a T-shaped device that is inserted into the uterus by a health care professional. The IUD is an appropriate choice for those in long term monogamous relationships who are not at high risk for sexually transmitted diseases or infections.

The Ring

NuvaRing is a comfortable, flexible ring about 2" in diameter. You insert it into your vagina just once a month - the exact position isn't even important. Once inside, NuvaRing releases a low level of hormones to prevent pregnancy. You leave the ring in place for 3 weeks, then remove it for a "week off. Have your period and reinsert another ring one week later. NuvaRing is 99% effective at preventing pregnancy - the same as the pill.

Diaphragm

The diaphragm is available by prescription and is sized by a health care professional to ensure a proper fit. The diaphragm works by covering the cervix with a dome-shaped rubber disk with a flexible rim to prevent sperm from entering the uterus. A spermicidal is applied to the diaphragm before insertion to kill sperm. The diaphragm may be left in place for 6 hours, however for repeated sexual intercourse or intercourse after 6 hours spermicide should be inserted into the vagina while the diaphragm is still in place. Diaphragms should never be left in for more than 24 hours due to risk of toxic shock syndrome (TSS).

Vaginal Spermicides

Vaginal spermicides are available over the counter in the form of cream, jelly, foam, film, vaginal suppository or tablets. These products contain a sperm killing chemical. There is debate about the effectiveness of using vaginal spermicides alone but it is thought that they have a failure rate of approximately 21% per year. Women who choose this method of contraceptive should be sure to follow the package directions exactly as each product is different. Allow the spermicide to remain in the vagina for 6-8 hours following intercourse and do not douche or rinse the vagina during this time to ensure that all sperm are killed.

Natural Family Planning

Being aware of your fertility is another way of reducing your chances of getting pregnant. Natural family planning is the only method accepted by some religions and it requires extreme attention and a highly motivated couple for it to be successful. It works by not having sexual intercourse on the days when you are most likely to ovulate. These methods estimate a woman's fertility based upon changes in the cervical mucus or changes in body temperature.

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