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• Highlights
• Introduction
• Oral Contraception
• Implant Contraception
• Injected Contraception
• Intrauterine Devices (IUDs)
• Spermicidal and Barrier Contraception
• Natural Family Planning Methods
• Emergency Contraception
• Female Sterilization
• Resources
• References

Birth control options for women

Description

An in-depth report on the birth control options available to women.

Alternative Names

Contraception

Introduction

Contraceptives are devices or methods for preventing pregnancy, either by preventing the fertilization of the female egg by the male sperm or by preventing implantation of the fertilized egg. Contraceptives are not modern inventions. The first prescription for a contraceptive device described a tampon barrier device and was written on papyrus in 1550 BC.

Contraceptive Options

Choosing the appropriate contraceptive varies from individual to individual. Contraceptive options include:

• Hormonal contraceptives (oral contraceptives, skin patch, vaginal ring, implant, injection)
• Intrauterine devices (IUDs), which contain either a hormone or copper
• Barrier devices with or without spermicides (diaphragm, cervical cap, sponge, condom)
• Natural family planning methods (basal body temperature, cervical mucus, symptothermal)
• Female sterilization (tubal ligation, Essure)

Determining Effectiveness

Contraceptive effectiveness is characterized by "typical use" and "perfect use":

• Typical use refers to real-life conditions, in which mistakes (such as forgetting to take a birth control pill at the right time) sometimes happen
• Perfect use refers to contraceptives that are used correctly each time intercourse occurs

Research has shown that the four most effective standard female contraceptives are surgical sterilization, the IUD, implants, and injections. They all have an estimated failure rate of less than 1% during the first year of normal (typical) use. Vasectomy (male surgical sterilization) is the only male contraceptive that is equally effective. By comparison, the estimated failure rate of the male latex condom used without spermicide is 14% with typical use and 3% with perfect use. To put these rates into perspective, a sexually active woman of reproductive age who does not use contraception faces an 85% likelihood of becoming pregnant in the course of a year.

Access to Contraceptives

Birth control is a controversial subject. In recent years, there has been a growing movement in the United States to restrict a woman's access to contraceptives. In addition to the political battles over non-prescription access to emergency contraception (Plan B), 18 states (as of 2006) are considering legislation that would allow pharmacists to refuse to dispense medications due to moral or religious objections. There have been hundreds of reports of pharmacists refusing to fill birth control prescriptions. In response to this trend, several members of Congress introduced in April 2005 the Access to Legal Pharmaceuticals Act, which would override any state legislation. The bill would require that pharmacies fill birth control prescriptions and would protect women’s legal right to purchase such products.

• Review Date: 10/22/2006
• Reviewed By: Harvey Simon, M.D., Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital.

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