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Birth Control: Choosing a Method That's Right for You

What kind of birth control is right for me?The type of birth control you choose depends on your needs. Some people only need to prevent pregnancy. Other people may also want to protect themselves or their partners from diseases that can be passed by having sex. Sexually transmitted diseases (STDs) include AIDS, chlamydia, herpes, genital warts, gonorrhea and syphilis. Talk with your family doctor about the pros and cons of each birth control option. How well does birth control work?The box below shows the failure rates (percent of women who get pregnant) for different types of birth control during the first year a couple uses them. These numbers are for couples who use the methods the right way every time they have sex. The failure rates are higher if you don't use the methods the right way every time.

Failure rates for birth control methods when used correctly
0.05%
Hormone implants
0.1%
Vasectomy
0.1-0.5%
The pill
0.1-1.5%
IUD
0.3%
Hormone shots
0.5%
Tubal ligation
0.3%
Male condoms alone*
0.5%
Female condoms alone*
3%
Diaphragm with spermicide
5%
Spermicide alone
6%
Cervical cap with spermicide in women who have never been pregnant
6%
Periodic abstinence
9%
Cervical cap with spermicide in women who have been pregnant
9%
Condoms are more effective when they are used with spermicide.
26%
Source: Contraceptive Technology. 17th revised edition: New York: Ardent Media, Inc., 1998.

Is saying "no" really an option?

Yes. The risk of pregnancy or catching an STD may outweigh the pleasure you get from sex. The only way to make sure you don't get pregnant, get someone pregnant or get an STD is to not have sex at all.

What are barrier methods?

Barrier methods include the diaphragm, the cervical cap and condoms. These methods prevent pregnancy by blocking sperm from getting into the uterus. You have to remember to use them every time you have sex.

What about the diaphragm and the cervical cap?

These are also good options. A woman must visit her doctor to be fitted for a diaphragm or a cervical cap. The diaphragm may increase the risk of urinary tract infections in some women.

Are condoms a good choice?

Yes. Condoms aren't expensive, and they are widely available. Condoms are an especially good choice if you or your partner are having sex with other people or if either of you has had sex with other people in the past.Condoms offer the most protection against STDs. Using a spermicide with condoms can offer better protection against pregnancy, but may not be right for everyone. For example, spermicides containing nonoxynol-9 can cause genital irritation and increase your risk of catching an STD.Female condoms aren't as effective as male condoms, but they may be a good choice if a man won't use a male condom.

What about the pill?

Birth control pills work mostly by preventing ovulation (the release of an egg by the ovaries). Most pills include two hormones, called estrogen and progestin. Birth control pills can cause some side effects such as nausea, headaches, breast swelling, water retention, weight gain and depression. For the pill to work, you have to take it every day. Women who take the pill should not smoke.The pill may reduce cramping and shorten the number of days of bleeding during the menstrual period. The pill may also help premenstrual syndrome (PMS).

What about the patch?

The U.S. Food and Drug Administration (FDA) recently approved a hormonal birth control patch. The patch uses estrogen and progestin to prevent pregnancy. It is applied to 1 of 4 places -- the buttocks, abdomen, upper torso or outer arm. Its side effects are similar to those of the pill.

How do hormone implants and shots work?

Hormone implants (Norplant) and shots (Depo-Provera) work much like the pill, but they only contain the hormone progestin. They may have some side effects, such as headaches and changes in periods, mood and weight. The implants prevent pregnancy for 5 years. (You can have them removed at any time.) The shots prevent pregnancy for 3 months.

What about an IUD?

"IUD" stands for "intrauterine device." It's made of flexible plastic. An IUD is put in a woman's uterus by her doctor. It isn't known exactly how IUDs prevent pregnancy. They seem to stop sperm from reaching the egg or prevent the egg from attaching to the uterus.

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