More Ways to Prevent Pregnancy
(But Not STDs)
The Pill
Description: A monthly series of pills—you take one birth control tablet a day. Basically, the Pill has hormones which prevent pregnancy by stopping the release of eggs from your ovaries.
Effectiveness: With typical use, 8 women out of 100 will get pregnant while taking the pill. With perfect use (taking it every day), fewer than 1 out of 100 women will become pregnant. However, it may take a week or two for the Pill to become effective.
Pros: The Pill is good for women who are disciplined (because you have to remember to take it at the same time every day—missing a pill can lead to pregnancy).
Women who use the Pill have more regular periods, less menstrual flow, less cramping, less iron deficiency and anemia, less pelvic inflammatory disease (PID) and less premenstrual tension than women who don’t take it. Also, it generally reduces acne.
Cons: The Pill doesn’t protect against HIV or other STDs. You need a doctor’s prescription to get the Pill. You must take it every day at the same time, even when you aren’t planning to have sex. Women who take it may be at slightly greater risk for some medical conditions like blood clots, heart attack and stroke—ask your doctor about this. Smoking increases your risk for some of these conditions, so doctors recommend that you do not smoke when you are on the pill.
Possible Side Effects: Many women don’t have any side effects, and for those who do, most side effects go away after two or three months. The Pill can cause nausea, vomiting, headaches, mood changes, weight gain or loss, breast tenderness or bleeding between periods.
Price: The pill costs anywhere from $10-$40 a month, depending on what kind you take, whether or not it’s covered by your insurance, and whether you buy it at a drug store or a clinic (clinics are usually cheaper and sometimes offer a reduced rate based on income). You must have a prescription.
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The Patch
Description: The patch is a thin piece of plastic no bigger than a matchbook. Like the Pill, the patch stops your ovaries from producing eggs. The patch is worn on the buttocks, stomach, upper arm or upper torso (but never on the breasts).
Use one patch per week for three weeks in a row. On the fourth week, do NOT wear a patch. Your menstrual period should start. Apply a new patch seven days later to start another month of birth control. For the first seven days of a new patch cycle, you may not be protected from pregnancy. Use backup methods of birth control for seven days.
Effectiveness: You must have the patch firmly attached to your skin—it won’t work if it’s loose or falls off for longer than 24 hours. With typical use, 8 women out of 100 will get pregnant while using the patch. With perfect use, fewer than 1 out of 100 women will become pregnant.
Pros: The patch is convenient and easy to use. It makes your period more regular, lighter and shorter. Like the ring, the patch stops your fertility for only one month at a time.
Cons: The patch does not protect you from HIV and STDs. You must see a doctor to get the patch. If you weigh more than 198 lbs or if you’ve had certain medical conditions, you shouldn’t use the patch. Like the pill, the patch may increase your risk of blood clots, heart attack and stroke, especially if you smoke. You must make sure it does not fall off. For the first three weeks, you must remember to replace the patch with a new one every seven days. Always apply, change and remove the patch on the same day of the week.
Possible Side Effects: Side effects, which should clear up after two or three months, may include bleeding between periods, weight gain or loss, breast tenderness, nausea and mood swings.
Women who experience any of the following symptoms while wearing the patch should call a doctor immediately: severe abdominal (stomach) pains, chest pain or shortness of breath, severe headaches, eye problems (like blurred vision), severe leg or arm pain, or numbness in the arms or legs.
Price: The patches are $30-$40 a month.
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The Ring
Description: A soft and flexible plastic ring that’s inserted into the vagina. You leave it in for three weeks and then take it out for a week. Like the patch and the Pill, the ring (also called the vaginal ring) releases synthetic hormones to prevent pregnancy.
Effectiveness: The ring starts working after seven days of continuous use. Effectiveness is similar to the pill and the patch: with typical use, 8 women out of 100 will get pregnant. With perfect use, fewer than 1 out of 100 women will become pregnant.
Pros: Only one ring is needed for three weeks of use, though you must remember to remove it exactly 21 days after you put it in, and replace it one week after that. Inserting the ring may be awkward at first. However, since the ring is not a barrier method like the diaphragm, incorrect placement is not usually a problem.
Cons: The ring doesn’t protect you from STDs. You need to store the ring at room temperature (no more than 77° F) and away from direct sunlight. It’s possible for the ring to slip out of the vagina. If this happens, you can wash the ring with cold to lukewarm (not hot) water and put it back in. If more than three hours pass without the ring in your vagina, there is a chance you’ll become pregnant if you have sex. The ring must be worn continuously for seven days to regain effectiveness.
As with the patch, if you weigh more than 198 lbs or if you’ve had any of the following medical conditions, you shouldn’t use it: uncontrolled high blood pressure, clots or vein inflammation, heart attack or stroke, vaginal bleeding, an abnormal growth or cancer of the breast or uterus, liver disease, diabetes, or migraine headaches with aura.
Possible Side Effects: Side effects may include mood swings, headache, nausea, vaginal discharge, breast tenderness, weight gain or loss, bleeding between periods, and vaginal irritation.
Women who experience any of the following symptoms while wearing a vaginal ring should call a doctor immediately: severe abdominal (stomach) pains, chest pain or shortness of breath, severe headaches, eye problems (like blurred vision), severe leg or arm pain, or numbness in the arms or legs.
Price: The ring costs $30-$35 a month.
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Depo-Provera
Description: Depo-Provera is a shot that you get injected into your system every 11-13 weeks with a needle. Depo-Provera keeps the ovaries from releasing eggs.
Effectiveness: Fewer than 1 out of 100 women who use Depo-Provera correctly and consistently for a year will get pregnant. Three out of every 100 women will become pregnant with typical use.
Pros: Depo-Provera is convenient in that it prevents pregnancy for 12 weeks at a time; it does not need to be taken daily or used at the time of intercourse. It begins working almost immediately if you take the shot during the first five days of your period. Otherwise, it takes a week to become effective. To be safe, you should use a condom for one week after your first injection. After that, wait 24 hours after each injection before having sex. Depo-Provera can reduce menstrual cramps and anemia and protect against ovarian cysts.
Cons: Depo-Provera doesn’t protect against HIV or other STDs. Depo-Provera must be administered by a doctor every three months. If you don’t like it and want to stop using it, you’ll have to suffer from any side effects you’ve been experiencing for up to three months while waiting for your last injection to wear off. You should not use it continuously for more than two years.
Possible Side Effects: Irregular periods are common. Less common side effects may include increased appetite and weight gain, headache, sore breasts, nausea, nervousness, dizziness, depression, skin rashes or spotty darkening of the skin, hair loss, increased hair on face or body, and increased or decreased sex drive.
Price: The initial visit is $35-$125 and injections are $30-$15.
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Implantable Contraception (Implanon)
Description: Implantable contraception is a small, matchstick-sized flexible plastic tube containing hormones that doctors insert just under the skin of the upper arm. It protects against pregnancy for up to three years.
Effectiveness: Implanon is a very effective method of birth control. With typical use, fewer than 1 out of 100 women using Implanon will get pregnant. The chance of getting pregnant will increase if you wait longer than three years to replace the tube.
Pros: Implanon is simple and convenient. It’s a good choice if you have a hard time remembering to take birth control pills and want long-term protection against pregnancy.
Cons: Implantable contraception does not protect against HIV or other STDs. It’s expensive ($400-$800, although Medicaid may cover the cost). It must be inserted and removed by a health care provider.
Possible Side Effects: You may notice a change in your periods. Other side effects can include: weight gain, headaches, acne, breast tenderness and irritation, infection, and possible scarring where the tubes are inserted.
Price: You need to see a health care provider to get Implanon. The cost of the exam, Implanon, and insertion ranges from $400–$800. Removal costs between $75 and $150. Medicaid and private health insurance may cover Implanon.
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The Diaphragm
Description: A soft silicone or latex cup that you fill with spermicidal cream or jelly. It’s inserted into the vagina to cover the opening of the uterus (which is called the cervix). The diaphragm forms a barrier that prevents sperm from entering the uterus and fertilizing an egg.
Effectiveness: Out of 100 women who use them, 16 will become pregnant during the first year of typical use. With perfect use, six out of 100 will become pregnant.
Pros: There are almost no side effects or health risks. You can insert it up to six hours before intercourse, so you don’t have to worry that putting it in will “ruin the moment.”
The diaphragm is good for someone who’s comfortable with her body, and who feels confident about being able to use it every time she has sex.
Cons: The diaphragm doesn’t protect against HIV and other STDs. You must see a doctor to get one. not good for someone who’s uncomfortable or embarrassed about touching herself or who would find it a hassle to deal with every time she has sex.
You have to use it every time you have sex. You must put it in no more than six hours before having sex and you must leave it in for at least six hours afterward. If you have intercourse more than once while the diaphragm is in, you need to insert more spermicide each time.
You need to wash, rinse and dry it carefully after each use and store it away from light.
It must be checked from time to time for weak spots or tiny holes. The size should be checked every year (your size may change after gaining or losing a lot of weight, giving birth or having an abortion).
The spermicide can be messy. You may feel drippy after use as the spermicide leaves your body.
Possible Side Effects: If left in your body for more than 24 hours, the diaphragm can cause bacterial infections or increase your risk of toxic shock syndrome. It can be difficult to remove if it’s not put in properly.
Price: The diaphragm itself costs $15 or more and is good for an average of two years. But you must also add the cost of spermicidal jelly or cream (from about $8 to $18 a tube, depending on the size, and the tube lasts a while).
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The Cervical Cap
Description: A small silicone cup that you insert deep in the vagina to fit right over your cervix, creating an almost airtight seal. It should be used with a spermicidal cream or jelly.
Effectiveness: With typical use, 14 out of 100 women who use the cap will become pregnant, provided they’ve never been pregnant or given birth. For women who have given birth vaginally, 29 out of 100 will become pregnant.
Pros: The cervical cap may be left in place for up to 48 hours. You can insert it up to 40 hours before intercourse, and you should leave it in for at least six to eight hours afterward.
Like the diaphragm, the cervical cap is good for someone who’s comfortable with her body and feels confident about being able to use it every time she has sex.
The cervical cap requires less spermicide than a diaphragm so it’s less messy and less expensive to use.
Because it’s smaller than the diaphragm, it may be more comfortable. And since you can put it in way ahead of time, many women find it more convenient to use.
The cervical cap has no long-term impact on fertility; if you want to get pregnant, stop using it.
Cons: It does not provide protection against HIV and other STDs. You must see a doctor to get a cervical cap. Not all women can get one that fits properly. Some women find it difficult to put in. It’s not good for someone who’s uncomfortable or embarrassed about touching herself. It’s not as widely available as the diaphragm. It must be used every time you have intercourse. It may become dislodged during intercourse.
Possible Side Effects: An unpleasant odor can result when the cervical cap is worn for more than 48 hours.
Price: About $30-$50 for the cervical cap, plus the cost of spermicide.
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Spermicide
Description: Spermicide is the term used for any sperm-killing chemical. It comes in many forms, including film, inserts (also called suppositories), foam, cream and jelly. Spermicide should be used with another form of contraception, such as condoms.
Effectiveness: With typical use, 29 of 100 women will get pregnant. With perfect use, 15 will become pregnant. Condoms increase effectiveness.
Pros: Application is quick and simple. You can use spermicide 15-30 minutes before you have sex and be ready to go.
Cons: Spermicide provides no protection against HIV or other STDs. It’s only effective for an hour after insertion. If not used properly, spermicidal cream and jelly can be messy.
Possible Side Effects: The most common side effects are burning and itching. If any other symptoms occur, stop using it immediately and call a doctor.
Price: An applicator kit of foam or jelly costs about $8. Refills cost $4-$8. A single application of film or an insert costs about $1, and they’re usually sold in packs of three or more.
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