The decision to use birth control is a necessary one if you
want to have sex and do not wish to get pregnant. Exactly
which method will work best for you and your partner will
depend on your lifestyle, your willingness to risk pregnancy,
and ability of you and your partner to successfully use the
method. As always, you and your doctor will review the
available methods in light of your medical history and
examination to help you decide how to proceed. To give you
a head start, below is a list of current methods with their
effectiveness, advantages and disadvantages.
Surgical sterilization -- female or male (tubal ligation/vasectomy)
Estimated effectiveness: Over 99 percent
Some risks: Pain, bleeding, infection, other minor postsurgical complications
Protection from sexually transmitted diseases (STDs): None
Convenience: One-time surgical procedure
Availability: Surgery

Injection (Depo-Provera)
Estimated effectiveness: Over 99 percent
Some risks: Irregular bleeding, weight gain, breast tenderness, headaches
Protection from sexually transmitted diseases (STDs): None
Convenience: One injection every three months
Availability: Prescription

Implant (Implanon)
Estimated effectiveness: Over 99 percent
Some risks: Irregular bleeding, weight gain, breast tenderness, headaches,
difficulty in removal
Protection from sexually transmitted diseases (STDs): None
Convenience: Implanted by health-care provider -- minor outpatient surgical
procedure; effective for up to three years.
Availability: Prescription

IUD (Intrauterine device)
Estimated effectiveness: 98 to 99 percent
Some risks: Cramps, bleeding, pelvic inflammatory disease, infertility, perforation
of uterus
Protection from sexually transmitted diseases (STDs): None
Convenience: After insertion by physician, can remain in place for up to one or 10
years, depending on type.
Availability: Prescription

Oral contraceptives -- combined pill
Estimated effectiveness: Over 95 percent
Some risks: Dizziness; nausea; changes in menstruation, mood and weight; rare
side effects: cardiovascular disease, including high blood pressure, blood clots,
heart attack and strokes
Protection from sexually transmitted diseases (STDs): None, except some
protection against pelvic inflammatory disease.
Convenience: Must be taken on daily schedule, regardless of frequency of
intercourse.
Availability: Prescription

Oral contraceptives -- progestin-only "mini pill"
Estimated effectiveness: 95 percent
Some risks: Irregular bleeding, weight gain, breast tenderness, slightly increased
chance of ectopic pregnancy
Protection from sexually transmitted diseases (STDs): None, except some
protection against pelvic inflammatory disease.
Convenience: Must be taken on daily schedule, regardless of frequency of
intercourse.
Availability: Prescription

Male latex condom
Estimated effectiveness: 86 percent (a)
Some risks: Irritation and allergic reactions (less likely with polyurethane)
Protection from sexually transmitted diseases (STDs): Except for abstinence,
latex condoms are the best protection against STDs, including herpes and AIDS.
Convenience: Applied immediately before intercourse; used only once and
discarded.
Availability: Nonprescription

Diaphragm with spermicide
Estimated effectiveness: 80 percent
Some risks: Irritation and allergic reactions, urinary tract infection
Protection from sexually transmitted diseases (STDs): Protects against cervical
infection; spermicide may give some protection against chlamydia and gonorrhea;
otherwise unknown.
Convenience: Inserted before intercourse and left in place at least six hours after;
can be left in place for 24 hours, with additional spermicide for repeated
intercourse.
Availability: Prescription

Cervical cap with spermicide
Estimated effectiveness: 60 to 80 percent (b)
Some risks: Irritation and allergic reactions, abnormal Pap test
Protection from sexually transmitted diseases (STDs): Spermicide may give some
protection against chlamydia and gonorrhea; otherwise unknown.
Convenience: May be difficult to insert; can remain in place for 48 hours without
reapplying spermicide for repeated intercourse.
Availability: Prescription

Female condom
Estimated effectiveness: 79 percent
Some risks: Irritation and allergic reactions
Protection from sexually transmitted diseases (STDs): May give some STD
protection.
Convenience: Applied immediately before intercourse; used only once and
discarded.
Availability: Nonprescription

Spermicides alone
Estimated effectiveness: 74 percent
Some risks: Irritation and allergic reactions
Protection from sexually transmitted diseases (STDs): May give some protection
against chlamydia and gonorrhea; otherwise unknown.
Convenience: Instructions vary; usually applied no more than one hour before
intercourse and left in place at least six to eight hours after.
Availability: Nonprescription

Periodic abstinence
Estimated effectiveness: About 75 percent (varies, based on method)
Some risks: None
Protection from sexually transmitted diseases (STDs): None
Convenience: Requires frequent monitoring of body functions (for example, body
temperature for one method).
Availability: Instructions from health-care provider

Sponge with spermicide
Estimated effectiveness: 60 to 80 percent (b)
Some risks: Irritation and allergic reactions, difficulty in removal
Protection from sexually transmitted diseases (STDs): Spermicide may give some
protection against chlamydia and gonorrhea; otherwise unknown.
Convenience: Inserted before intercourse and protects for 24 hours without
additional spermicide; must be left in place for at least six hours after intercourse;
must be removed within 30 hours of insertion; used only once and discarded.
Availability: Nonprescription