Birth Control Comparison Chart

Birth Control Comparison Chart

The following methods are in order from most effective to least.

“Percent Effectiveness” is based on typical-use effectiveness statistics from the American Sexual Health Association 2013.

-To further reduce the risk of sexually transmitted infection (STI) transmission, all methods can be used with a male or female latex, polyurethane or polyisoprene condom. However, a male and female condom should not be used together. When two condoms are used together, material friction may lead to the condoms ripping or tearing.

 

Birth Control Method

Advantages (+)

Disadvantages (-)

 

 

 

Abstinence

 

Effectiveness: 100%

 

STI Protection: Dependent on which behaviors a person chooses to engage in. Oral, anal and vaginal sex all carry risks for STI transmission.

 

Hormones:

None

 

Advantages (+)

-No cost.

-No side effects.

-Most effective method of STI prevention if oral, anal and vaginal sex are all abstained from. To prevent STI transmission, latex condoms and dental dams should be used every time the user decides to engage in oral, anal and vaginal sex, even if penetration does not occur.

-Can still get sexual pleasure through masturbation.

-Can focus on alternate activities with your partner.

 

 

 

Disadvantages (-)

-Requires discipline and self-control. 

-May be unprepared for protection against pregnancy or infection if user decides to forego abstinence.

-Pregnancy can occur from non-coital activities, like dry humping while unclothed. Any activity that allows semen to come into contact with the vaginal opening carries a risk of pregnancy.

 

 

 

 

 

IUD (Hormonal)

 

Popular Brands:

Mirena, Skyla

 

Effectiveness: 99.9%

 

STI Protection: None

 

Hormones:

Progestin

 

 

 

Advantages (+)

-Mirena lasts up to 5 years, Skyla up to 3 years. Can be removed at any time during that period.

-Most inexpensive long-term method of contraception.

-Ability to become pregnant returns quickly upon removal.

-Remains in place; allows sexual spontaneity.

-Only requires monthly thread checks.

-May reduce cramps and lighten or completely eliminate menstrual period. On average, menstrual flow is reduced by 90%.

-Can be used while breastfeeding.

-Can help prevent endometrial cancer.

-Gives females control over their own pregnancy prevention.

 

Disadvantages (-)

-Relatively high upfront cost but no long-term costs.

-There may be cramping or backaches for a few days following insertion.

-Can cause irregular periods for the first 3-6 months.

-There is a slight chance that the IUD may slip out of the uterus, usually within the first few months following insertion.

-Can increase the risk of ectopic pregnancy.

 

 

 

 

 

 

IUD (Nonhormonal)

 

Popular Brands: ParaGuard

 

Effectiveness: 99.2%

 

STI Protection: None

 

Hormones:

None

 

 

 

Advantages (+)

-Lasts up to 10 years. Can be removed at any time during that period.

-Most inexpensive long-term method of contraception.

-Ability to become pregnant returns quickly upon removal.

-Remains in place; allows sexual spontaneity.

-Only requires monthly thread checks.

-Can be used while breastfeeding.

-Can help prevent endometrial cancer.

-Very effective form of emergency contraception if inserted within 5 days after unprotected sex.

-Gives females control over their own pregnancy prevention.

 

Disadvantages (-)

-Relatively high upfront cost but no long-term costs.

-There may be cramping or backaches for a few days following insertion.

-There is a slight chance that the IUD may slip out of the uterus, usually within the first few months following insertion.

-Can increase the risk of ectopic pregnancy.

-May increase menstrual cramps or bleeding during the first 6 months following insertion. Pain relievers can reduce cramps and bleeding.

-Can cause a 50 to 75% increase in menstrual flow, increasing a female’s risk for anemia.

 

 

The Implant

 

Popular Brands: Implanon, Nexplanon

 

Effectiveness: 99.9%

 

STI Protection: None

 

Hormones:

Progestin

 

 

 

 

Advantages (+)

-Provides protection from pregnancy for up to 3 years.

-Inserted and removed by a healthcare professional so leaves little room for error.

-Remains in place; allows sexual spontaneity.

-Easily reversible. Most females can return to fertility within 3 months of removing the implant.

-It is safer than the pill for females who are older than 35, smoke, have high blood pressure, are overweight or have a history of blood clots.

-Does not have the estrogenic side effects of combination pills (including nausea and vomiting, abdominal pain, back pain and decreased vaginal lubrication.)

-Most females will experience shorter and lighter menstrual periods within the first year of use.

-Gives females control over their own pregnancy prevention.

 

Disadvantages (-)

-Relatively high upfront cost.

-Bump on the skin may be felt or visible.

-Irregular bleeding is common during the first 6-12 months of use. Some females will experience longer and heavier periods or increased spotting between periods.

-Less common side effects include breast tenderness, irregular bleeding, discoloring of the skin over the implant, pain or infection at the insertion side, a change in sexual desire and an increase in appetite that may lead to weight gain.

-May not be reliable for females that weigh over 200 pounds.

 

 

 

 

The Shot

 

Popular Brands:

Depo-Provera

 

Effectiveness: 99.7%

 

STI Protection: None

 

Hormones:

Progestin

 

 

Advantages (+)

-A single injection lasts up to 12 weeks.

-Injections are administered by medical professionals so there is little room for error.

-Protection begins immediately following first injection.

-Can be used while breastfeeding.

-Over 50% of females will stop their menstrual periods after a year of use.

-Gives females control over their own pregnancy prevention.

 

 

 

 

Disadvantages (-)

-Requires repeated medical visits.

-Many females experience irregular menstrual cycles during the first year of use.

-Less common side effects can include a change in sexual desire, depression, acne, hair loss and an increase in appetite that may lead to weight gain.

-If negative side effects occur, they may remain for three months after the last injection until the hormones wear off.

-Not immediately reversible; can take 6-10 months to return to full fertility following the last shot.

-May cause temporary bone thinning. Body density should increase once the female stops Depo-Provera, but it is important to make sure to get adequate calcium from diet or supplements. Due to this loss of bone density, the FDA encourages users to take the shot for no more than two years.

Sterilization

 

Includes: Vasectomy (males) or Tubal Ligation (females)

 

 

Effectiveness: 99.5%

 

STI Protection: None

 

Hormones:

None

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Advantages (+)

Male Sterilization (vasectomy):

-Highly effective and permanent form of contraception.

-No effects on sexual desire or performance.

-Ease of surgery. The surgery is performed under general anesthesia and only takes about 30 minutes and the patient can usually return home within the next hour.

-Sexual activity can resume about a week after surgery.

- Male sterilization is not immediately effective following surgery; residual sperm may remain in the vas deferens for 3 months after the surgery is performed, which means additional contraception should be used during those 3 months.

-Has no noticeable effect on the volume of ejaculate since sperm is such a small component of semen.

-Can be reversed, though reversal procedures can be expensive and high risk.

 

Female Sterilization (tubal ligation):

-Is immediately effective following surgery.

-Highly effective and permanent form of contraception.

-No effects on sexual desire or performance.

-Ease of surgery. The surgery is performed under general anesthesia and only takes about 30 minutes and the patient can usually return home within a few hours. Can be performed on patients within 24 hours after childbirth or on outpatients.

-Associated with a decrease in the risk of ovarian and endometrial cancer.

-Can be reversed, though reversal procedures can be expensive and high risk.

 

Disadvantages (-)

Both:

-High initial cost.

-Since they are surgical procedures there is risk of infections at the site of incision. Also, they must be performed under anesthetics.

-Reversal procedures can be expensive and high risk.

 

Male Sterilization (vasectomy):

-Long-term vasectomy complications can include chronic testicular aches that intensify with ejaculation.

-Vasovasostomy surgery (vasectomy reversal) has only a 50% chance of success.

 

Female Sterilization (tubal ligation):

-The surgery for tubal ligation is riskier and more expensive than a vasectomy. Also has a longer recovery period.

-If tubal ligation fails, there is an increased risk for ectopic pregnancy.

-Pregnancy following Tubal Ligation reversal surgery has a 40-80% success rate, dependent on factors including a female’s age, amount of scar tissue and type of ligation procedure performed.

 

 

 

 

 

 

The Combination Pill

 

Popular Brands: Seasonale, Seasonique, Jolessa, Loestrin, Lybrel, Quasense, Yaz

 

Effectiveness: 92-97%

 

STI Protection: None

 

Hormones:

Estrogen and progestin

Advantages (+)

-Does not interfere with sexual spontaneity.

-Has no effect on penile or vaginal sensation.

-Easily reversible. Most females can return to fertility within 3 months of stopping the pill.

-Can reduce menstrual cramps and bleeding.

-If used for 10 years, it reduces the risk of ovarian and endometrial cancer by 80%.

-Can also reduce the risk or prevalence of iron-deficiency anemia, endometriosis, ovarian cysts, acne and hirsutism (excessive facial and body hair).

-Gives females control over their own pregnancy prevention.

 

Disadvantages (-)

-Must be taken daily at the same time.

-May cause adverse side effects, including nausea and vomiting, breast tenderness, irregular bleeding, abdominal pain, back pain, decreased vaginal lubrication, and an increase in appetite that may lead to weight gain. Most side effects will disappear within 3 months.

-Can increase the risk of blood clots.

-Should not be used during breast-feeding because the hormones can reach the baby through the milk.

-After stopping the pill, a female may have irregular or absent periods for the first 2 months.

 

 

The Progestin-Only Pill

(the mini-pill)

 

Popular Brands: Cerazette, Ovrette, Ortho-Micronor, Errin, Camilla, Jolivette

 

Effectiveness: 92-97%

 

STI Protection: None

 

Hormones:

Progestin

 

 

 

Advantages (+)

-Convenient and does not interfere with sexual spontaneity.

-Has no effect on penile or vaginal sensation.

-Easily reversible. Most females can return to fertility within 3 months of stopping the pill.

-It is safer than the combination pill for females who are older than 35, smoke, have high blood pressure, are overweight or have a history of blood clots.

-Does not have the estrogenic side effects of combination pills.

-Most females will experience shorter and lighter menstrual periods within the first year of use.

-Gives females control over their own pregnancy prevention.

-Gives females control over their own pregnancy prevention.

 

Disadvantages (-)

-Effects last only 24 hours, so the female using this method must be very careful not to miss a dose, or even delay a dose by more than a few hours.

-May cause adverse side effects, including breast tenderness, irregular bleeding and an increase in appetite that may lead to weight gain. Most side effects will disappear within 3 months.

-Can cause menstrual irregularity during the first 3 months.

 

 

 

 

 

 

 

The Patch

 

Popular Brands:

Ortho Evra

 

Effectiveness: 92%

 

STI Protection: None

 

Hormones:

Estrogen and progestin

 

 

 

 

Advantages (+)

-Easy to use and replace.

-Small and easily hidden.

-External visibility can serve as a visual reminder for females to apply a new patch.

-It can be used continuously to eliminate monthly periods.

-Convenient and does not interfere with sexual spontaneity.

-Has no effect on penile or vaginal sensation.

-Many females users experience shorter, lighter periods.

-Can reduce the risk or prevalence of iron-deficiency anemia, endometriosis, ovarian cysts, acne and hirsutism (excessive facial and body hair).

-Gives females control over their own pregnancy prevention.

 

 

Disadvantages (-)

-Must be replaced weekly.

-Can cause skin irritations.

-Externally visible (but can be hidden).

-Can become loose or fall off.

-Females using the patch are exposed to about 60 percent more estrogen compared to most combination pills. This increased exposure can put females at a greater risk to blood clots and more severe adverse side effects. The patch should not be used by females over the age of 35 who smoke or who weigh more than 200 pounds. The patch may also put females at a greater risk for heart attacks compared to the combination pill.

-Adverse side effects may include nausea and vomiting, breast tenderness, irregular bleeding, abdominal pain, back pain, decreased vaginal lubrication, and an increase in appetite that may lead to weight gain. Most side effects will disappear within 3 months.

-Should not be used during breast-feeding because the hormones can reach the baby through the milk.

Vaginal Ring

 

Popular Brands:

NuvaRing

 

Effectiveness: 92%

 

STI Protection: None

 

Hormones:

Estrogen and progestin

 

 

 

 

 

 

Advantages (+)

-Can remain in place for up to three weeks. Low maintenance method.

-Hormones are absorbed directly from the vagina, so the ring releases a lower dosage of estrogen into the bloodstream compared to the combination pill or the patch. This can put females on the ring at a lower risk of blood clots, vaginal spotting and cancer.

-It can be used continuously to eliminate monthly periods.

- Convenient and does not interfere with sexual spontaneity.

-Has no effect on penile or vaginal sensation.

-Easily reversible. Most females can return to fertility within 3 months of stopping the patch.

-Can reduce menstrual cramps and bleeding.

-Can reduce the risk or prevalence of iron-deficiency anemia, endometriosis, ovarian cysts, acne and hirsutism (excessive facial and body hair).

-Gives females control over their own pregnancy prevention.

 

Disadvantages (-)

-The ring may slip out, but should be rinsed in lukewarm or cool water and placed back into the vagina within three hours.

-May cause adverse side effects including nausea and vomiting, breast tenderness, irregular bleeding, abdominal pain, back pain, decreased vaginal lubrication, and an increase in appetite that may lead to weight gain. Most side effects will disappear within 3 months.

-Can also cause long-term increase in vaginal discharge, irritation or infection.

-Can increase the risk of blood clots.

-Should not be used during breast-feeding because the hormones can reach the baby through the milk.

 

 

 

 

 

 

Emergency Contraceptive Pills (ECPs)

(also known as “the morning-after pill”)

 

Popular Brands: Plan B One-Step, i-pill, My Way, Next Choice One Dose, Levonorgestrel Tablets, Ella,

 

Effectiveness: 89%

 

STI Protection: None

 

Hormones:

Estrogen and progestin

Advantages (+)

-Can reduce risk of pregnancy if used within the first 5 days following unprotected intercourse. –It is most effective the sooner it is used after unprotected sex or contraceptive failure.

-If pregnancy has already been established, the pill(s) will in no way harm or affect the existing fetus; emergency contraception is simply a method of prevention.

 

 

 

 

 

 

 

 

Disadvantages (-)

-Should not be used as a permanent or reliable method of birth control.

-Can cause nausea, vomiting and irregular bleeding. If vomiting occurs within two hours of taking the pill, the pill will not be effective and it must be taken again.

-Can cause a heavier or lighter period or make it earlier or later than usual.

-Frequent use can cause irregularity in the menstrual cycle.

-Can be relatively expensive or difficult to access (some countries and states have minimum age requirements and require proof of identification. In the US, Plan-B One Step is available to males and females without age restrictions.

 

 

Diaphragm with Spermicide

 

Popular Brands:

Koro-flex, Koromex, Ortho-Diaphragm

 

Effectiveness: 88%

 

STI Protection: None

 

Hormones:

None

 

 

 

 

Advantages (+)

-It can be inserted up to 6 hours prior to intercourse (but spermicide must be reapplied within 2 hours before intercourse).

-Can remain in place for repeated acts of coitus (penile-vaginal sex).

-Does not affect penile or vaginal sensation during coitus.

-Reusable and relatively inexpensive.

-Can last up to two years.

-Can be used while breastfeeding.

-Does not affect hormones.

-Immediately effective upon insertion and immediately reversible upon removal.

-Long-term use is associated with a lowered risk of cervical cancer because it offers some protection against HPV.

-Gives females control over their own pregnancy prevention.

 

Disadvantages (-)

-Requires initial professional fitting.

-May be difficult to insert or remove. Requires insertion prior to every act of intercourse (compared to the hormone-releasing vaginal ring, which can remain in place for up to three weeks).

-Spermicide must be reapplied before each sex act or if two hours have passed since insertion.

-The spermicide may cause irritation, which could increase the risk of STI transmission.

-Can possibly get dislodged during intercourse.

-Can increase urinary tract infection (UTI) prevalence.

-May increase the risk of toxic shock syndrome (TSS) in some women if left in for over 24 hours

 

 

 

 

Male Condom

 

Popular Brands:

Crown, Durek, Lifestyles, Trojan

 

Effectiveness: 84%

 

STI Protection: Yes

 

*Lambskin condoms are porous and therefore do not protect against STIs

 

Hormones:

None

 

 

 

 

Advantages (+)

-Offers significant protection against STIs.

-Allows males to share responsibility in pregnancy prevention and STI protection.

-Male condoms are widely available at local drugstores and family planning clinics. They are inexpensive and can be purchased without a prescription.

-Are lightweight and disposable.

-Variety of colors, textures, and flavors.

-Polyurethane, polyisoprene, and lambskin condoms can be used if one is allergic to latex. Lambskin condoms are porous and therefore do not protect against STIs.

-Immediately effective upon insertion and immediately reversible upon removal.

-Reliable when properly used.

-Can be used in combination with any method, except the female condom. (When two condoms are used together, friction between the condoms can cause ripping or tearing).

-Can be used with water-based lubricants to reduce friction and increase sensation.

 

Disadvantages (-)

-Can decrease sexual spontaneity.

-Can decrease penile sensitivity.

-Cannot be put on until the male has an erection.

-It requires the male to maintain an erection as long as the condom is in use. So, he must withdraw promptly after ejaculation.

-May rip during use, especially if expired or put on incorrectly.

-Should not be used with oil-based lubricants like petroleum jelly, baby oil, Vaseline or vegetable oil. These will increase the chance of the condom ripping or tearing.

 

 

 

 

 

 

 

 

Cervical Cap with Spermicide

 

Popular Brands:

FemCap

 

Effectiveness: 60-80%

 

STI Protection: None

 

Hormones:

None

 

 

 

Advantages (+)

-Smaller version of the diaphragm that requires less spermicide.

-Can be inserted up to two hours prior to intercourse.

-Can remain in place for repeated acts of coitus (penile-vagina sexl).

-Does not affect penile or vaginal sensation during coitus.

-Reusable and relatively inexpensive.

-Can last up to two years.

-Can be used while breastfeeding.

-Does not affect hormones.

-Is immediately effective upon insertion and reversible upon removal.

 

 

Disadvantages (-)

-Requires initial professional fitting.

-Must be used with each act of intercourse.

-May be difficult to insert or remove.

-Spermicide must be reapplied before each sex act or if two hours have passed since insertion.

-The spermicide may cause irritation, which could increase the risk of STI transmission.

-Can possibly get dislodged during intercourse.

-Can increase urinary tract infection (UTI) prevalence.

-May increase the risk of toxic shock syndrome (TSS) in some women if left in for over 24 hours.

-Can be more difficult to insert than the diaphragm. Can also be more easily dislodged from the cervix.

-Less effective for females who have given birth.

 

Contraceptive Sponge

 

Popular Brands:

Today Sponge

 

Effectiveness: 60-80%

 

STI Protection: None

 

Hormones:

None

Advantages (+)

-Small, lightweight and relatively inexpensive. Is available at most local drugstores and family planning clinics. The sponge does not require a prescription or fitting.

-Can be inserted hours before sex so does not interrupt spontaneity.

-Is effective for 24 hours without requiring removal or reinsertion.

-Can be used during breastfeeding.

-Can be purchased at most drugstores; does not require a fitting by a healthcare provider.

 

 

Disadvantages (-)

-May be difficult to insert or remove.

-Requires spermicide, which can cause vaginal irritation or numbing.

-Can increase the risk of toxic shock syndrome if used during a female’s period.

-Less effective for females who have given birth.

 

 

 

 

 

Female Condom

 

Popular Brands:

Care, Dominique, Femy, Myfemy, Protectiv, Reality

 

Effectiveness: 79%

 

STI Protection: Yes

 

Hormones:

None

Advantages (+)

-Offers significant protection against STIs.

-Can be used for vaginal and anal intercourse.

-Can be used with oil-based and water-based lubricants.

-Remains in place whether or not the male has an erection.

-Can be inserted up to 8 hours ahead of time so that it does not interrupt sexual spontaneity.

-The ring may stimulate the clitoris during vaginal intercourse.

-Can be used in combination with any method except the male condom. (When two condoms are used together friction between the condoms can make them more likely to rip or tear).

Disadvantages (-)

-May cause vaginal, penile, or anal irritation.

-Can slip into the vagina or anus during intercourse.

-Can decrease penile and/or vaginal sensitivity.

-Can generate distracting noises during intercourse.

 

 

 

 

 

 

 

Withdrawal (also known as “pulling out”)

 

Effectiveness: 78%

 

STI Protection: None

 

Hormones:

None

Advantages (+)

-No cost and requires no prior planning. Allows for sexual spontaneity.

-Can be supplemented by another contraceptive method for extra protection.

-Allows males to share responsibility in pregnancy prevention.

-No hormonal side effects.

 

Disadvantages (-)

-Requires a high amount of self-control and trust between partners.

-Should not be used for men who ejaculate prematurely or have difficulty telling when they are about to ejaculate.

-Sperm can be present in pre-ejaculatory fluid, or “pre-cum.”

 

 

Fertility Awareness

 

Includes: Standard Days, Calendar Rhythm, Cervical Mucus and Basal Body Temperature Methods

 

Effectiveness: 76%

 

STI Protection: None

 

Hormones:

None

Advantages (+)

-Little cost- only requires purchase of a digital thermometer and calendar.

-Completely and immediately reversible.

-No hormonal side effects.

-Viable method for individuals who do not believe in artificial hormones or interfering with the body’s natural mechanisms (possibly backed by moral or religious rhetoric).

 

 

 

 

Disadvantages (-)

-Considerably less reliable than other methods due to user error and cycle irregularity.

-Requires females to keep track of their cycles for at least 3 months prior to using the method.

-Requires a minimum of 6 days abstention from vaginal intercourse during each cycle.

-Should not be used for females who have irregular periods or who are not completely dedicated to tracking their fertility.

-Should not be used following the use of hormonal contraception since the hormones will affect the female’s cycle.

 

Vaginal Spermicide

 

Effectiveness: 74%

 

STI Protection: None

 

Hormones:

None

Advantages (+)

-Low cost.

-Readily available without a prescription.

-Can provide lubrication in addition to pregnancy prevention.

-Immediately reversible.

 

 

Disadvantages (-)

-Can be messy.

-The unpleasant taste may make oral sex less enjoyable.

-Can cause genital irritation. Irritation is most common with frequent use (once a day or more often).

-Genital irritation can increase the likelihood of STI transmission.

 

 

 

 

References

1. Birth Control Method Comparison Chart (n.d.): n. pag. American Sexual Health Association. 2013. Web. 7 Nov. 2013. <http://www.ashasexualhealth.org/pdfs/ContraceptiveOptions.pdf>.

2. "Birth Control Methods - Birth Control Options." Planned Parenthood. N.p., 2013. Web. 7 Nov. 2013. <http://www.plannedparenthood.org/learn/birth-control>.

3. LeVay, Simon, Janice I. Baldwin, and John D. Baldwin. "Contraception and Abortion." Discovering Human Sexuality. Sunderland, MA: Sinauer Associates, 2009. Print.

 

Last Updated 9 November 2013.

 

 

 

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