Birth control, sometimes synonymous with contraception, is a regimen of
one or more actions, devices, or medications followed in order to
deliberately prevent or reduce the likelihood of pregnancy or
childbirth. Contraception may refer specifically to mechanisms which are
intended to reduce the likelihood of the fertilisation of an ovum by a
spermatozoon.
The history of birth control began with the discovery of the connection
between coitus and pregnancy. The oldest forms of birth control included
coitus interruptus, pessaries, and the ingestion of herbs that were
believed to be contraceptive or abortifacient. The earliest record of
birth control use is instructions on creating a contraceptive pessary
from Ancient Egypt.
Different methods of birth control have varying characteristics.
Condoms, for example, are the only method that provides significant
protection from sexually transmitted diseases.
Because of the sexual and ethical nature of the subject, cultural and
religions attitudes on birth control vary significantly.
Different birth control methods
There are many methods of birth control that a woman can use. Talk with
your health care provider to help you figure out what method is best for
you. You can always try one method and if you do not like it, you can
try another one.
Keep in mind that most birth control does NOT protect you from HIV or
other sexually transmitted diseases (STDs) like gonorrhea, herpes, and
chlamydia . Other than not having sex, the best protection against STDs
and HIV is the male latex condom. The female condom may give some STD
protection. Other birth control methods that involve using a spermicide
(a cream or jelly that kills sperm) also may give some protection
against chlamydia and gonorrhea.
Don't forget that all of the methods we talk about below work best if
used correctly. Be sure you know the correct way to use them. Talk with
your health care provider and don't feel embarrassed about talking with
her or him again if you forget or don't understand.
Know that learning how to use some birth control methods can take time
and practice. Sometimes health care providers do not explain how to use
a method because they may think you already know how. For example, some
people do not know that you can put on a male condom "inside out." Also,
not everyone knows that you need to leave a "reservoir" or space at the
tip of the condom for the sperm and fluid when a man ejaculates, or has
an orgasm.
The more you know about the correct way to use birth control, the more
control you will have over deciding if and when you want to become
pregnant.
Here is a list of birth control methods with estimates of effectiveness,
or how well they work in preventing pregnancy when used correctly, for
each method:
Abstinence -This means not having sexual intercourse at any time. It is
the only sure way to prevent pregnancy. This method is 100% effective at
preventing pregnancy.
Periodic Abstinence or Fertility Awareness - A woman who has a regular
menstrual cycle has about nine or more fertile days, or days when she is
able to get pregnant, each month. Periodic abstinence means you do not
have sex on the days that you may be fertile. Fertility awareness means
that you can be abstinent or have sex but you use a "barrier" method of
birth control to keep sperm from getting to the egg. Barrier methods
include condoms, diaphragms, or cervical caps, used together with
spermicides, which kill sperm. These methods are 75 to 99% effective at
preventing pregnancy.
Keep in mind that to practice these methods, you need to learn about
your menstrual cycle (or how often you get your period). You keep a
written record of when you get your period, what it is like (heavy or
light blood flow), and how you feel (sore breasts, cramps). You also
check your cervical mucus and take your basal body temperature daily,
and record these in a chart. This is how you learn to predict, or tell,
which days you are fertile or "unsafe." You can ask your health care
provider for more information on how to record and understand this
information.
The Condom - Condoms are called barrier methods of birth control because
they put up a block, or barrier, which keeps the sperm from reaching the
egg. Only latex or polyurethane (because some people are allergic to
latex) condoms are proven to help protect against STDs, including HIV.
"Natural" or "lambskin" condoms made from animal products also are
available. But lambskin condoms are not recommended for STD prevention
because they have tiny pores that may allow for the passage of viruses
like HIV, hepatitis B and herpes. Male condoms are 86 to 98% effective
at preventing pregnancy. Condoms can only be used once. You can buy them
at a drug store. Condoms come lubricated (which can make sexual
intercourse more comfortable and pleasurable) and non-lubricated (which
can also be used for oral sex). It is best to use lubrication with
non-lubricated condoms if you use them for vaginal or anal sex. You can
use KY jelly or water-based lubricants, which you can buy at a drug
store. Oil-based lubricants like massage oils, baby oil, lotions, or
petroleum jelly will weaken the condom, causing it to tear or break.
Always keep condoms in a cool, dry place. If you keep them in a hot
place (like a billfold, wallet, or glove compartment), the latex breaks
down, causing the condom to tear or break.
Oral Contraceptives - Also called "the pill," it contains the hormones
estrogen and progestin . A pill is taken daily to block the release of
eggs from the ovaries. It also lightens the flow of your period and
protects against pelvic inflammatory disease (PID), ovarian cancer , and
endometrial cancer. It does not protect against STDs or HIV. The pill
may add to your risk of heart disease, including high blood pressure,
blood clots, and blockage of the arteries. If you are over age 35 and
smoke, or have a history of blood clots or breast or endometrial cancer
, your health care provider may advise you not to take the pill. The
pill is 95 to 99.9% effective at preventing pregnancy if used correctly.
You will need a prescription and visits with your health care provider
to make sure you are not having problems.
The Mini-Pill - Unlike the pill, the mini-pill only has one hormone,
progestin, instead of both estrogen and progestin. Taken daily, the
mini-pill reduces and thickens cervical mucus to prevent sperm from
reaching the egg. It also prevents a fertilized egg from implanting in
the uterus (womb). The mini-pill also can decrease the flow of your
period and protect against PID and ovarian and endometrial cancer.
Mothers who breastfeed can use it because it will not affect their milk
supply. The mini-pill is a good option for women who can't take estrogen
or for women who have a risk of blood clots. The mini-pill does not
protect against STDs or HIV. Mini-pills are 95 to 99.9% effective at
preventing pregnancy if used correctly. You will need a prescription and
visits with your health care provider to make sure you are not having
problems.
Copper T IUD (Intrauterine Device) - An IUD is a small device that is
shaped in the form of a "T." Your health care provider places it inside
the uterus. The arms of the Copper T IUD contain some copper, which
stops fertilization by preventing sperm from making their way up through
the uterus into the fallopian tubes. If fertilization does occur, the
IUD would prevent the fertilized egg from implanting in the lining of
the uterus. The Copper T IUD can stay in your uterus for up to 10 years.
It does not protect against STDs or HIV. This IUD is 99% effective at
preventing pregnancy. Requires visits with your health care provider to
have it inserted and to make sure you are not having any problems. Not
all health care providers insert IUDs.
Progestasert IUD (Intrauterine Device) -This IUD is a small plastic T-
shaped device that is placed inside the uterus by a health care
provider. It contains the hormone progesterone, the same hormone
produced by a woman's ovaries during the monthly menstrual cycle. The
progesterone causes the cervical mucus to thicken so sperm cannot reach
the egg, and so that a fertilized egg cannot successfully implant into
the lining of the uterus. The Progestasert IUD can stay in your uterus
for one year. This IUD is 98% effective at preventing pregnancy.
Requires visits with your health care provider to have it inserted and
to make sure you are not having any problems. Not all health care
providers insert IUDs.
Intrauterine System or IUS (Mirena) - The IUS is a small T-shaped device
like the IUD and is placed inside the uterus by a health care provider.
It releases a small amount of a hormone each day to keep you from
getting pregnant. The IUS stays in your uterus for up to five years. It
does not protect against STDs or HIV. The IUS is 99% effective. The Food
and Drug Administration approved this method in December 2000. Requires
visits with your health care provider to make sure you are not having
any problems. Not all health care providers insert the IUS.
The Female Condom - Worn by the woman, this barrier method keeps sperm
from getting into her body. It is made of polyurethane, is packaged with
a lubricant, and may protect against STDs, including HIV. It can be
inserted up to 8 hours prior to sexual intercourse. Female condoms are
79 to 95% effective at preventing pregnancy. There is only one kind of
female condom and its brand name is Reality. Purchase at a drug store.
Implant (Norplant and Norplant 2) - This product was taken off the
market in July 2002. If you are using the Norplant system, you should
contact your health care provider about what your contraceptive options
will be after the five year expiration date of your Norplant system.
Norplant consists of small stick-like devices, or "rods," that are
placed under the skin. The rods release a very low, steady level of a
steroid that prevents pregnancy for up to five years. However, the rods
can be taken out at any time and you then can become pregnant. This
method is 99.9% effective at preventing pregnancy. It does not protect
against STDs or HIV. Requires visits with your health care provider to
make sure you are not having any problems.
Depo-Provera - With this method women get injections, or shots, of the
hormone progestin in the buttocks or arm every three months. It does not
protect against STDs or HIV. It is 99.7% effective at preventing
pregnancy. Requires visits with your health care provider to make sure
you are not having any problems. Prolonged use of the drug may result in
significant loss of bone density. This bone loss is greater the longer
the drug is used. Women should only use Depo-Provera Contraceptive
Injection as a long-term birth control method (longer than two years) if
other birth control methods are inadequate.
Diaphragm or Cervical Cap - These are barrier methods of birth control,
where the sperm are blocked from reaching the egg. The diaphragm is
shaped like a shallow latex cup. The cervical cap is a thimble-shaped
latex cup. Both come in different sizes and you need a health care
provider to "fit" you for one. Before sexual intercourse, you use them
with spermicide (to block or kill sperm) and place them up inside your
vagina to cover your cervix (the opening to your womb). You can buy
spermicide gel or foam at a drug store. Spermicide will also help
protect you from the STDs gonorrhea and chlamydia if they have
nonoxynol-9 in them. Some women can be sensitive to nonoxynol-9 and need
to use spermicides that do not contain it. The diaphragm is 80 to 94%
effective at preventing pregnancy. The cervical cap is 80 to 90%
effective at preventing pregnancy for women who have not had a child,
and 60 to 80% for women who have had a child. Requires a visit with your
health care provider for proper fitting.
The Patch (Ortho Evra) -This is a skin patch worn on the lower abdomen,
buttocks, or upper body. It releases the hormones progestin and estrogen
into the bloodstream. You put on a new patch once a week for three
weeks, then do not wear a patch during the fourth week in order to have
a menstrual period. The patch is 99% effective at preventing pregnancy,
but appears to be less effective in women who weigh more than 198
pounds. It does not protect against STDs or HIV. The Food and Drug
Administration approved this method in 2001. You will need to visit your
health care provider for a prescription and to make sure you are not
having problems.
The Hormonal Vaginal Contraceptive Ring (NuvaRing) - The NuvaRing is a
ring that releases the hormones progestin and estrogen. You squeeze the
ring between your thumb and index finger and insert it into your vagina.
You wear the ring for three weeks, take it out for the week that you
have your period, and then put in a new ring. The ring is 98 to 99%
effective at preventing pregnancy. The Food and Drug Administration
approved this method in 2001. You will need to visit your health care
provider for a prescription and to make sure you are not having
problems.
Surgical Sterilization (Tubal Ligation or Vasectomy) - These surgical
methods are meant for people who want a permanent method of birth
control. In other words, they never want to have a child or they do not
want more children. Tubal ligation or "tying tubes" is done on the woman
to stop eggs from going down to her uterus where they can be fertilized.
The man has a vasectomy to keep sperm from going to his penis, so his
ejaculate never has any sperm in it. They are 99 to 99.5% effective at
preventing pregnancy.
Nonsurgical Sterilization (Essure Permanent Birth Control System) - This
is the first non-surgical method of sterilizing women and was approved
by the Food and Drug Administration in November 2002. A thin tube is
used to thread a tiny spring-like device through the vagina and uterus
into each fallopian tube. Flexible coils temporarily anchor it inside
the fallopian tube. A Dacron-like mesh material embedded in the coils
irritates the fallopian tubes' lining to cause scar tissue to grow and
eventually permanently plug the tubes. It can take about three months
for the scar tissue to grow, so it is important to use another form of
birth control during this time. Then you will have to return to your
health care provider for a test to see if scar tissue has fully blocked
your tubes. In studies of more than 600 women, followed for a year,
there so far have been no pregnancies in those whose Essure devices were
implanted successfully.
Emergency Contraception - This is NOT a regular method of birth control
and should never be used as one. Emergency contraception, or emergency
birth control, is used to keep a woman from getting pregnant when she
has had unprotected vaginal intercourse. "Unprotected" can mean that no
method of birth control was used. It can also mean that a birth control
method was used but did not work - like a condom breaking. Or, a woman
may have forgotten to take her birth control pills, or may have been
abused or forced to have sex when she did not want to. Emergency
contraception consists of taking two doses of hormonal pills taken 12
hours apart and started within three days after having unprotected sex.
These are sometimes wrongly called the "morning after pill." The pills
are 75 to 89% effective at preventing pregnancy. Another type of
emergency contraception is having the Copper T IUD put into your uterus
within seven days of unprotected sex. This method is 99.9% effective at
preventing pregnancy. Neither method of emergency contraception protects
against STDs or HIV. You will need to visit your health care provider
for either a prescription for the pills or for the insertion of the IUD,
and to make sure you are not having problems.
Ortho Evra
Ortho Evra is the first birth control patch approved by the U.S. Food
and Drug Administration (FDA). Ortho Evra is an easy-to-use, safe and
effective new birth control option for women. Ortho Evra is the first
weekly form of birth control that's as effective as the Pill. Ortho Evra
is more than 99 percent effective when used correctly. Because the Ortho
Evra patch is small, thin and smooth, you can easily wear it under your
clothes.
Ortho Tri-Cyclen
Ortho Tri-Cyclen is an estrogen and progestin combination used to
prevent pregnancy. Ortho Tri-Cyclen may also be used to regulate the
menstrual cycle, treat symptoms of menopause, or treat other conditions
as determined by your doctor.
Yasmin
Yasmin is a combination medication is used to prevent pregnancy. Yasmin
does not protect you or your partner against sexually transmitted
diseases (e.g., HIV, gonorrhea).
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