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Expert Guide to Birth Control

Expert Guide to Birth Control


9 minute read

Medical advances and technology that helps us advance medicine are cool. But when a new form of birth control comes over every other day, it can get a little overwhelming when you're trying to find out what you want. We always recommend speaking with your doctor before starting or stopping a new contraceptive routine but we've complied (what we think is) a pretty solid guide to birth control. 

Guide to Birth Control | What birth control is best | Condom Depot Learning Center

Pill (Estrogen & Progestin) DOES NOT PROTECT AGAINST STDS
  • Price – $20-$50 per 28-day cycle.
  • How it’s Used – Daily birth control pill for 3 weeks, then an inactive pill for 1 week, producing withdrawal bleeding.
  • How it Works – Prevents ovulation and thickens cervical mucus to prevent sperm from passing.
  • Advantages – Long-term use reduces lifetime risk of ovarian and endometrial cancers. Typically eases menstrual symptoms such as cramps.
  • Disadvantages – Can cause nausea, breast tenderness, spotting, moodiness, and headaches. Estrogen raises blood-clot risk slightly for healthy users, and significantly for smokers or those with high blood pressure.
  • Failure Rate * – Less than 1% if used perfectly; 8% in typical use.
Three-Month Pill (Seasonale) DOES NOT PROTECT AGAINST STDS
  • Price – $115 for 3 months
  • How it’s Used – Daily birth control pill for 12 weeks, then inactive pill for 1 week, producing withdrawal bleeding.
  • How it Works – Same as pill.
  • Advantages – Same as for pill. Suppresses periods for 3 months at a time.
  • Disadvantages – Side effects same as for pill. Irregular bleeding can occur during the first cycles.
  • Failure Rate * – Less than 1% if used perfectly. Method is too new for typical use statistics.
Patch (Ortho Evra) DOES NOT PROTECT AGAINST STDS
  • Price – $40 per 28-day cycle
  • How it’s Used – Patch put on buttocks, abdomen, upper torso, or arm weekly for 3 weeks, then left off for 1 week, producing withdrawal bleeding.
  • How it Works – Same as birth control pill, except that hormones do not pass through digestive system.
  • Advantages – Same as the birth control pill. No need to take a daily pill.
  • Disadvantages – Side effects same as for the birth control pill. Can detach from or irritate skin. Less effective in women weighing more than 200 pounds.
  • Failure Rate * – Less than 1% if used perfectly. Method is too new for typical use statistics.
Ring (NuvaRing) DOES NOT PROTECT AGAINST STDS
  • Price – $38 per 28-day cycle
  • How it’s Used – Hormone-impregnated polymer birth control ring worn in vagina for 3 weeks, then removed for 1 week, producing withdrawal bleeding.
  • How it Works – Same as birth control pill, except that hormones do not pass through digestive system.
  • Advantages – Same as for birth control pill. No need to take a daily pill. Can remove for up to 3 hours without compromising effectiveness.
  • Disadvantages – Side effects same as for birth control pill. May cause vaginal irritation or discharge. If dislodged or removed for more than 3 hours, must use backup contraception for 7 days.
  • Failure Rate * – Less than 1% if used perfectly. Method is too new for typical use statistics.
Mini-Pill (Progestin Only) DOES NOT PROTECT AGAINST STDS
  • Price – $30-$50 per 28-day cycle
  • How it’s Used – Daily birth control pill.
  • How it Works – Thickens cervical mucus to block sperm.
  • Advantages – Can be used when health prevents use of birth control pills with estrogen.
  • Disadvantages – Possible irregular bleeding. May raise cholesterol levels. Must take birth control pill at same time each day.
  • Failure Rate * – Less than 1% if used perfectly; 8% in typical use.
Injection (Depo-Provera) DOES NOT PROTECT AGAINST STDS
  • Price – $57 per injection plus cost of office visit.
  • How it’s Used – A progestin injection every 3 months, usually at the doctor’s office.
  • How it Works – Same as mini birth control pill.
  • Advantages – Frequently suppresses periods completely.
  • Disadvantages – Can cause weight gain. Should not be used for more than 2 years because of bone thinning risk. May take 1 year or more to regain fertility after stopping use.
  • Failure Rate * – Less than 1% if used according to schedule; 3 in typical use.
Male Condom
  • Price – $0.25-$1 per use.
  • How it’s Used – Put over erect penis prior to or during foreplay.
  • How it Works – Sheath prevents sperm from entering vagina and uterus.
  • Advantages – Very effective in preventing sexually transmitted disease.
  • Disadvantages – Interrupts foreplay. May interfere with sensation. May break or slip off during use.
  • Failure Rate * – 2% if used perfectly; 12% if used typically.
Female Condom
  • Price – $3 per use.
  • How it’s Used – Insert into vagina prior to or during foreplay.
  • How it Works – Sheath covers vagina and cervix, prevents sperm from entering uterus.
  • Advantages – No hormonal side effects. Helps prevent sexually transmitted disease.
  • Disadvantages – Interrupts sexual foreplay. Large and awkward to use.
  • Failure Rate * – 5% if used perfectly; 21% if used typically.
Copper Intrauterine Device (ParaGard) DOES NOT PROTECT AGAINST STDS

2023 update:  There is a class action lawsuit against ParaGard and its manufacturer. Based on personal experience, we DO NOT recommend this brand. 

  • Price – $250 to $300 every 10 years plus cost of office visit.
  • How it’s Used – T-shaped copper device inserted into uterus at doctor’s office. Can leave in place for up to 10 years.
  • How it Works – Believed to inhibit passage of sperm and maturation of eggs.
  • Advantages – Fertility returns soon after removal. No hormonal side effects.
  • Disadvantages – Can occasionally fall out. May increase menstrual cramps and bleeding. Rarely, can perforate uterus.
  • Failure Rate * – Less than 1%.
Progestin Intrauterine System (Mirena) DOES NOT PROTECT AGAINST STDS
  • Price – $300 to $400 every 5 years plus cost of office visit.
  • How it’s Used – T-shaped plastic device, with progestin, inserted into uterus at doctor’s office. Can leave in place for 5 years.
  • How it Works – Same as mini birth control pill.
  • Advantages – Fertility returns soon after removal. May lessen menstrual cramps and bleedings, or stop periods.
  • Disadvantages – Can occasionally fall out. Rarely, can perforate uterus. Irregular spotting for first 3 to 6 months.
  • Failure Rate * – Less than 1%.
Diaphragm DOES NOT PROTECT AGAINST STDS
  • Price – $30 to $40, plus cost of fitting and spermicide
  • How it’s Used – Rubber dome placed over cervix before intercourse and left in place for 6 to 24 hours. Used with spermicide.
  • How it Works – Prevents sperm from passing from vagina into uterus.
  • Advantages – Can be inserted prior to foreplay. No hormonal side effects. Does not interfere with normal menstrual cycle.
  • Disadvantages – Must plan ahead for use. Must remember to have on hand if away from home.
  • Failure Rate * – 6% if used perfectly; 16% if used typically.
Cervical Cap DOES NOT PROTECT AGAINST STDS
  • Price – $100-$200, plus cost of fitting and spermicide.
  • How it’s Used – Silicon or latex rigid covering placed over cervix before sex and left in place for 8 to 48 hours. Used with spermicide.
  • How it Works – Prevents sperm from passing from vagina into uterus.
  • Advantages – Can be inserted prior to foreplay. No hormonal side effects. Does not interfere with normal menstrual cycle.
  • Disadvantages – Must plan ahead for use. Must remember to have on hand if away from home.
  • Failure Rate * – For women who have not delivered vaginally, 9% in perfect use, 16% in typical use. For others who have, 26% in perfect use and 32% in typical use.
Surgical Sterilization DOES NOT PROTECT AGAINST STDS
  • Price – $2,500 to $4,000.
  • How it’s Used – Fallopian tubes cut, blocked, or tied off in laparoscopic surgery.
  • How it Works – Prevents sperm from reaching eggs.
  • Advantages – Does not affect hormones or menstrual cycle.
  • Disadvantages – Irreversible. Inappropriate for women who may wish to have more children.
  • Failure Rate * – Less than 1%.
Transcervical Sterilization (Essure) DOES NOT PROTECT AGAINST STDS
  • Price – $2,000 to $3,000.
  • How it’s Used – Coils inserted into fallopian tubes using instrument passed through the cervix.
  • How it Works – After three months, scar tissue forms that blocks tubes, preventing passage of eggs.
  • Advantages – Does not affect hormones or menstrual cycle.
  • Disadvantages – Irreversible. Inappropriate for women who may wish to have more children.
  • Failure Rate * – Less than 1%.
Spermicides DOES NOT PROTECT AGAINST STDS
  • Price – $1 to $1.50 per use.
  • How it’s Used – Jelly, suppository, foam, or cream inserted into vagina no more than 1 hour before intercourse.
  • How it Works – Chemicals block cervix and kill sperm.
  • Advantages – Can buy without a prescription at drugstores and some supermarkets.
  • Disadvantages – Can leak. High failure rate if not used carefully. Those with nonoxynol-9 may irritate penis or vagina and may raise risk of sexually transmitted disease.
  • Failure Rate * – 15% if used perfectly; 29% if used typically.
Periodic Abstinence
  • Price – No cost.
  • How it’s Used – Abstention from intercourse during fertile days of the menstrual cycle.
  • How it Works – Fertile period determined by examining menstrual cycle, cervical mucus, and/or resting body temperature.
  • Advantages – Only acceptable method in some religions. No physical or hormonal side effects.
  • Disadvantages – High failure rate if used incorrectly, or if woman has irregular cycle.
  • Failure Rate * – 1-9% if used perfectly; 25% if used typically.
Vasectomy DOES NOT PROTECT AGAINST STDS
  • Price – $250 to $1,000.
  • How it’s Used – Sperm tubes tied or sealed in outpatient surgery via incision in the scrotum.
  • How it Works – Sperm blocked from mingling with ejaculate so cannot cause pregnancy.
  • Advantages – Does not affect sexual performance. Does not require action by woman.
  • Disadvantages – Irreversible. Not appropriate for men who may wish to father more children.
  • Failure Rate * – Less than 1%.

* Pregnancies per 100 users per year

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