Compare Effectiveness for Pregnancy Prevention
(Percentages based on the number of pregnancies per 100 women during one year of use *)

Click on a method for more information

* Source:   Contraceptive Technologies, 1994,
updated from J. Trussell, R.A. Hatcher, F.H. Stewart,
and K. Kost "Contraceptive Failures in the United States:
An Update, "Studies in Family Planning 21 [1], 1990.

Condom

How it works
Covers penis and stops sperm from going into vagina
Some condom brands have lubrication on them which destroys sperm

How it's used
Rolled on erect penis to the base before penis gets near vagina or other body opening
Room is left at tip of condom to collect sperm.
Condom is held on penis when it's pulled out of vagina to keep sperm from going into vagina.
Each condom is used only once.
Avoid use of oil-based lubricants such as petroleum jelly, baby oil and hand lotion.
Use a latex condom.

Concerns
Must be used correctly every time.

Vaginal Spermicides (foam, jelly, cream, suppositories, film)

How it works
Destroys sperm when they go into vagina

How it's used
Inserted into vagina no more than 20 minutes before sexual intercourse
Reapply before each act of intercourse.

Benefits
No major health concerns
No exam needed
Can be bought in a store without prescription

Concerns
Sometimes a man or woman is allergic to a certain brand (can change brands).

Depo Provera (the shot)

How it works
Releases a hormone that interferes with eggs leaving the ovaries
Gradually releases a hormone that thickens cervical mucus which hinders movement of sperm into uterus
Causes changes in the lining of the uterus that interfere with ability of fertilized egg to implant in the uterus

How it's used
Exam needed to check blood pressure, breasts, pelvis
An injection which prevents pregnancy for three months is given in the buttock or upper arm.
Clinic visit is required at the end of three months for another injection.

Benefits
Doesn't interrupt sex
Relatively long-lasting and highly effective
Easily reversed by not having another injection

Concerns
May cause irregular periods, including prolonged menstrual bleeding, spotting between periods, very little bleeding or no bleeding at all. If heavy bleeding occurs, call the clinic.
Minor side effects may include weight gain, mood changes, tender breasts, acne, mild hair loss.
Medical risks include increased risk of blood clots or stroke for women with certain risk factors and medical conditions.
Call the clinic or doctor immediately if you have chest or abdominal pain, severe leg pain, blurred vision, bad headaches, numbness, or pain, pus or bleeding at the injection site.

Norplant (an implant)

How it works
Gradually releases a hormone that thickens cervical mucus which hinders movement of sperm into uterus
Interferes with ovulation
Causes changes in the lining of the uterus that interfere with ability of fertilized egg to implant in the uterus

How it's used
Six match-sized capsules are inserted under the skin of the upper arm in a fan-like pattern.
Once the capsules are inserted, the contraceptive benefits last for up to five years.
Clinic visit required for insertion and removal

Benefits
Doesn't interrupt sex
Long-lasting and highly effective
No need to worry about birth control again for five years
Effect is easily reversed by removing the implants
The implant site is comfortable and barely visible.
Becomes effective within 24 hours after insertion

Concerns

The implants may be slightly visible.
Most women have no major problems with Norplant, but minor side effects can occur. If you experience any of the following problems, contact your clinician: severe lower abdominal pain, heavy vaginal bleeding, arm pain, pus or bleeding at the insertion site, expulsion of an implant, delayed periods after a long interval of regular periods, migraine headaches, repeated very painful headaches, or blurred vision.
May cause irregular periods. Changes in bleeding patterns can include: prolonged menstrual bleeding, spotting between periods, very little bleeding or no bleeding at all. Irregular bleeding is normal; however, if heavy bleeding occurs, call your clinician.

Birth Control Pills

How it works
Hormones in pills stop eggs from leaving the ovaries.
Causes changes in cervical mucus which hinder movement of sperm into uterus

How it's used
Exam needed to check blood pressure, breasts, pelvis
One pill is taken at the same time each day.
Pills must be taken regularly.

Benefits
Easy to use
Doesn't interrupt sex
May decrease menstrual cramps
Decreases risk of certain kinds of cancer
Provides some protection against tubal infection called PID (pelvic inflammatory disease)

Concerns
Minor side effects may include nausea, bloated feeling, light or missed periods, spotting between periods, weight gain or loss, tender breasts, mood changes. If these happen, don't stop the pill, do call your clinician.
Medical risks include increased risk of blood clots, heart attack and stroke in women with certain risk factors and medical conditions. Call your clinician right away for severe leg pain, chest or abdominal pain, blurred vision, bad headaches, numbness, shortness of breath.

Diaphragm/Cervical Cap

How it works
Covers opening to uterus
Holds contraceptive cream or jelly which destroys sperm

How it's used
Exam needed to measure correct size
Cervical cap or diaphragm with cream or jelly is inserted into vagina before sexual intercourse.
Left in place at least 6 hours after intercourse, but not longer than 24 hours

Benefits
No major health concerns
Diaphragm or cervical cap can be reused many times if properly cared for.

Concerns
Sometimes a man or woman is allergic to a brand of cream or jelly (can change brands).
May lead to increased risk of urinary tract infection (bladder infection)
May increase risk of toxic shock if used during period.

Female Condom

How it works
Inner ring covers opening to uterus (cervix), an outer ring covers the outside of the vagina, stopping sperm from entering.

How it's used
Prior to intercourse, closed end is inserted into vagina past the pubic bone, leaving the open outside ring outside of vagina.
Each condom is used only once.
Do not use together with male condom - they will stick together and tear.

Concerns
Effectiveness rate not yet established
Lubricate adequately
Must be used correctly every time

Natural Family Planning and Fertility Awareness Method

How it Works
Women learn to recognize their fertile time (when they can get pregnant) and infertile time (when they can't get pregnant) by:
checking temperature and cervical mucus daily
keeping a record of their periods

How it's used
Special classes needed to learn the method
Natural Family Planning users do not have intercourse during fertile time if pregnancy is not desired.

Benefits
No major health concerns
Also helpful in planning pregnancy
Allowed by most religious groups

Concerns
Must check temperature and mucus every day
Difficult for women with irregular cycles
Needs partner's cooperation to abstain during fertile periods

Permanent Methods (Sterilization)

How it works
Sexual pleasure is not decreased.
Women have tubal ligation, an operation which separates and blocks the tubes between the ovaries and uterus so that sperm cannot reach eggs.
Men have a vasectomy, an operation which separates the tubes between the testes and penis so they can still ejaculate (come) though there is no sperm in their semen (fluid).

How it's used
Requires surgery

Benefits
It's permanent. No need to worry about birth control
Doesn't interrupt sex

Concerns
Rarely reversible
Some pain shortly after operation
Slight chance of minor infection after surgery
A small percentage of sterilized people later change their mind and regret not being able to have children.

IUD (Intrauterine Device)

How it works
Thought to keep fertilized egg from attaching to uterus or to interfere with conception

How it's used
Exam needed to check uterus and insert IUD
You check IUD string monthly to make sure it's in place.
Should be replaced in 1 to 10 years, depending on type

Benefits
Effective immediately
Always available
Long lasting and highly effective
Doesn't interrupt sex
Easily reversed

Concerns
Some women have more bleeding or cramping with periods.
May slip out of place
May increase risk of infection called PID (pelvic inflammatory disease) which can lead to infertility (risk is highest in women who have multiple sex partners)
Medical risks sometimes include infection or puncture of uterus. Problems if user becomes pregnant. Call your clinician right away for: very heavy periods, bleeding between periods, severe cramping, lost string, IUD felt at cervical opening with fingertip, abdominal or pelvic pain, fever, chills.

Abstinence (Not Having Sexual Intercourse)

How it works
Prevents sperm from fertilizing egg since sexual intercourse does not take place

How it's used
Sexual intercourse is avoided. Some people choose to express their sexual feelings in other ways, and at times choose not to have any sexual contact.

Benefits
No major health concerns
No exam needed
Always available
Protects against STDs (Sexually Transmitted Diseases)

Concerns
Pregnancy and passage of STDs still may occur if couple's genitals touch.

Withdrawal

How it works
The man pulls his penis out of the vagina before he ejaculates (comes) to keep sperm from joining egg

Benefits
There are no practical benefits to this method. Withdrawal is extremely unreliable as a method of birth control -- See Concerns

Concerns
Not effective against sexually transmitted infections
Some men lack the experience and self-control to pull out in time.
Some men have been known to say they will pull out, and then they get so excited and carried away that they don’t.
Some men cannot tell when they are going to ejaculate.
Some men ejaculate very quickly, before they realize it.
Before ejaculation, almost all penises leak fluid that can cause pregnancy.