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Birth control and family planning

Definition

Your choice of a birth control method depends on a number of factors, including your health, how often you have sex, and whether or not you want children.

Which Form of Birth Control is Right for You?

Which of the following are birth control options for women?

The correct answer is all of the above. Your choice of birth control should depend on several factors, including your health, number of sexual partners, and desire to have children. Talk to your health care provider to select the best form of birth control for you.

How does birth control prevent pregnancy?

The correct answer is all of the above. The goal of all types of birth control is to prevent a fertilized egg from attaching in the uterus. Talk to your doctor and your partner about which type of birth control is best for you.

Which form of birth control offers the most protection against pregnancy?

The correct answer is IUDs. IUDs are 20 times more effective at preventing pregnancy than birth control pills, patches, or rings. Talk to your doctor to find out if this form of contraception is right for you.

Who should NOT use birth control pills?

The correct answer is women who are over age 35 and smoke. Smoking greatly increases your risk of heart disease. Birth control pills can increase this risk even more. If you have endometriosis, PMS, or acne, you may notice fewer symptoms while you’re taking birth control pills. Ask your doctor which pill is right for you.

Certain types of birth control pills can get rid of your period almost entirely.

The correct answer is true. Extended cycle (or continuous use) medicines reduce, or even eliminate, monthly periods. Talk to your doctor about whether this option is right for you.

Which of the following is true about injected contraceptives (Depo-Provera).

The correct answer is all of the above. Depo-Provera does a good job of preventing pregnancy. It also has side effects, including weight gain, menstrual cycle changes, headaches, and bone loss. It could cause infertility for up to 2 years after the last injection. Talk to your doctor about whether Depo-Provera is right for you.

Copper-releasing IUDs can stay in the uterus for up to 10 years.

The correct answer is true. Both copper-releasing (ParaGard) and progestin-releasing (Mirena) IUDs do a good job of preventing pregnancy. ParaGard can remain in the uterus for up to 10 years compared to 5 years for Mirena. Talk to your doctor about whether using an IUD is right for you.

Which natural family planning method works best?

The correct answer is Symptothermal Method. This method combines the calendar, cervical mucus, and temperature methods. Because of the high risk of pregnancy, only couples who can't use or choose not to use other types of birth control should use this method. Talk with your doctor before using this approach to birth control.

You can use a diaphragm safely for 5 years.

The correct answer is false. Some women need to get a different-sized diaphragm after pregnancy, abdominal or pelvic surgery, or weight loss or gain of 10 pounds or more. You should replace your diaphragm every 1 - 2 years.

It's best to use emergency contraception within__ day(s) after having unprotected sex:

The correct answer is 1 day. Emergency contraception works best when you use it within 24 hours of having sex. However, it can prevent pregnancy for up to 3 days after you first had sex. One type may work up to 5 days later, but it's best to take it sooner. Emergency contraception should not be used as a routine form of birth control.

Which sterilization method works the best?

The correct answer is both work equally well. However, vasectomy carries fewer risks and is less expensive than female sterilization. Only you and your partner can decide which method is right for you. Consider your options carefully since it can be difficult to reverse sterilization.

Alternative Names

Contraception; Family planning and contraception; Coitus interruptus

Information

Video: Contraception survey overview

Here are some questions to consider when selecting a birth control method:

  • How well does the method prevent pregnancy? To tell how well a method works, look at the number of pregnancies in 100 women using that method over a period of 1 year.
  • What are your feelings about getting pregnant? Would an unplanned pregnancy create hardship or distress to a woman or her partner? Or would a pregnancy be welcomed if it occurred earlier than planned?
  • How much does a method of birth control cost? Does your insurance plan pay for it?
  • What are the health risks? Talk about these risks with your health care provider before believing what you hear from others.
  • Is your partner willing to accept and use a given method of birth control?
  • Do you want a method that you only need to use when you have sex? Or do you want something that is in place and always working?
  • Is preventing infections spread by sexual contact important? Many methods do not protect you from sexually transmitted infections (STIs). Condoms are the best choice for preventing STIs. They work best when combined with spermicides.
  • Availability: Can the method be used without a prescription, a health care provider visit, or, in the case of minors, parental consent?

BARRIER METHODS OF BIRTH CONTROL

CONDOMS:

The male condom

The male condom

The female condom

The female condom

  • A condom is a thin latex or polyurethane sheath. The male condom is placed around the erect penis. The female condom is placed inside the vagina before intercourse.
  • A condom must be worn at all times during intercourse to prevent pregnancy.
  • Condoms can be bought in most drug and grocery stores. Some family planning clinics offer free condoms. You do not need a prescription to get condoms.

DIAPHRAGM AND CERVICAL CAP:

The diaphragm

The diaphragm

The cervical cap

The cervical cap

  • A diaphragm is a flexible rubber cup that is filled with spermicidal cream or jelly.
  • It is placed into the vagina over the cervix before intercourse, to prevent sperm from reaching the uterus.
  • It should be left in place for 6 to 8 hours after intercourse.
  • Diaphragms must be prescribed by a woman's health care provider. The provider will determine the correct type and size of diaphragm for the woman.
  • About 5 to 20 pregnancies occur over 1 year in 100 women using this method, depending on proper use.
  • A similar, smaller device is called a cervical cap.
  • Risks include irritation and allergic reactions to the diaphragm or spermicide, and increased frequency of urinary tract infection and vaginal yeast infection. In rare cases, toxic shock syndrome may develop in women who leave the diaphragm in too long. A cervical cap may cause an abnormal Pap test.

VAGINAL SPONGE:

  • Vaginal contraceptive sponges are soft, and contain a chemical that kills or "disables "sperm.
  • The sponge is moistened and inserted into the vagina, to cover over the cervix before intercourse.
  • The vaginal sponge can be bought at your pharmacy without a prescription.

HORMONAL METHODS OF BIRTH CONTROL

Some birth control methods use hormones. They will have either both an estrogen and a progestin, or a progestin alone. You need a prescription for most hormonal birth control methods.

  • Both hormones prevent a woman's ovary from releasing an egg during her cycle. They do this by affecting the levels of other hormones the body makes.
  • Progestins help prevent sperm from making their way to the egg by making mucus around a woman's cervix thick and sticky.
Hormone-based contraceptives

Hormone-based contraceptives

Vaginal ring

Vaginal ring

Types of hormonal birth control methods include:

  • Birth control pills: These may contain both estrogen and progestin, or only progestin.
  • Implants: These are small rods implanted beneath the skin. They release a continuous dose of hormone to prevent ovulation.
  • Progestin injections, such as Depo-Provera, that are given into the muscles of the upper arm or buttocks once every 3 months.
  • The skin patch, such as Ortho Evra, is placed on your shoulder, buttocks, or other place on the body. It releases a continuous dose of hormones.
  • The vaginal ring, such as NuvaRing, is a flexible ring about 2 inches wide. It is placed into the vagina. It releases the hormones progestin and estrogen.
  • Emergency (or "morning after") contraception: This medicine can be bought without a prescription at your drugstore.

IUD (INTRAUTERINE DEVICE):

Intrauterine device

Intrauterine device

  • The IUD is a small plastic or copper device placed inside the woman's uterus by her health care provider. Some IUDs release small amounts of progestin. IUDs may be left in place for 5 to 10 years, depending on the device used.
  • IUDs can be placed at almost any time.
  • IUDs are safe and work well. Fewer than 1 out of 100 women per year will get pregnant using an IUD.

PERMANENT METHODS OF BIRTH CONTROL

These methods are best for men, women, and couples who feel certain they do not want to have children in the future. They include vasectomy and tubal ligation. These procedures can sometimes be reversed if a pregnancy is desired at a later time. However, the success rate for reversal is not high.

Before and after vasectomy

Before and after vasectomy

Tubal ligation

Tubal ligation

BIRTH CONTROL METHODS THAT DO NOT WORK VERY WELL

  • Withdrawal of the penis from the vagina before ejaculation can still result in pregnancy. Some semen often escapes before full withdrawal. It can be enough to cause a pregnancy.
  • Douching shortly after sex is not likely to work. The sperm can make their way past the cervix within 90 seconds. Douching is never recommended because it can cause infections in the uterus and tubes.
  • Breastfeeding: Despite the myths, women who are breastfeeding can become pregnant.

Images

The cervical cap
The diaphragm
The female condom
Intrauterine device
Side sectional view of female reproductive system
The male condom
Hormone-based contraceptives
Tubal ligation
Vaginal ring
Barrier methods of birth control - Series
Before and after vasectomy
Tubal ligation - Series
Birth control pill - Series

References

American College of Obstetricians and Gynecologists. Committee opinion no. 539: adolescents and long-acting reversible contraception: implants and intrauterine devices (Reaffirmed 2014). Obstet Gynecol. 2012;120(4):983-988. PMID: 22996129 www.ncbi.nlm.nih.gov/pubmed/22996129.

Centers for Disease Control and Prevention (CDC), Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion. U.S. Selected Practice Recommendations for Contraceptive Use, 2013: adapted from the World Health Organization selected practice recommendations for contraceptive use, 2nd edition. MMWR Recomm Rep. 2013;62(RR-05):1-60. PMID: 23784109 www.ncbi.nlm.nih.gov/pubmed/23784109.

Committee On Adolescence. Emergency contraception. Pediatrics. 2012;130(6):1174-1182. PMID: 23184108 www.ncbi.nlm.nih.gov/pubmed/23184108.

Harper DM, Wilfling LE, Blanner CF. Contraception. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 26.

Jensen JT, Mishell DR. Family planning: contraception, sterilization, and pregnancy termination. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 13.

Lopez LM, Grimes DA, Gallo MF, Stockton LL, Schulz KF. Skin patch and vaginal ring versus combined oral contraceptives for contraception. Cochrane Database Syst Rev. 2013 Apr 30;4:CD003552. PMID: 23633314 www.ncbi.nlm.nih.gov/pubmed/23633314.

Review Date: 
4/5/2016
Reviewed By: 
Irina Burd, MD, PhD, Associate Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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