Birth Control

Birth Control Methods

There are many methods of birth control. Learn about the different kinds of birth
control to help you choose the best one for you. When making your choice, also
consider that only a condom will help protect you from sexually transmitted
diseases (STDs). To protect yourself and your partner against STDs, use a
condom (along with your chosen birth control method) every time you have sex.

Hormonal methods

Hormonal methods are very reliable means of birth control. Hormonal methods
use two basic formulas:

• Combination hormonal methods contain both estrogen and progestin

(synthetic progesterone). Combination methods include pills ("the Pill"),
skin patches, and rings.
• Progestin-only hormonal methods include pills, also called "mini-pills";
injections (Depo-Provera); and implants (Implanon). If you cannot take
estrogen, a progestin-only method may be an option for you. See
information about the progestin-only Mirena intrauterine device (IUD)
below under IUDs.

Combination and progestin-only methods are prescribed for women for different
reasons. Compare the recommendations for and against combination and
progestin-only hormonal birth control pills, patches, implants, and rings. Each
type of method has its pros and cons.

• Combination pills may reduce acne, pain during ovulation, and

premenstrual symptoms. Both types of pill reduce heavy bleeding and
cramping. Unlike the combination pill, the progestin-only pill can be
taken by almost all women, including those who are breast-feeding,
although it must be taken at the same time each day to be effective.
(Combination pills are also taken daily but without as much attention to
the time of day.) When you first start taking either type of birth control
pill, it is necessary to use a backup birth control method for the first
week.
• Patches or vaginal rings are similar to combination pills, but they don't
require taking a daily pill. The patch is changed weekly, and the ring is
changed monthly (with 1 week off after 3 weeks of use).
• Some birth control pills reduce severe mood and physical symptoms that
some women get before they start their monthly periods. These
symptoms are called premenstrual dysphoric disorder (PMDD). There
are birth control pills that are helpful for women who have migraines
with their periods. There are also birth control pills for women who want
fewer periods or who want to stop having periods.
• The progestin-only (Depo-Provera) shot does not require taking a daily
pill. Instead, you see your health professional once every 3 months for
the injection.
• The progestin-only hormone implant (Implanon) releases hormones that
prevent pregnancy for about 3 years. It must be inserted and removed by
a trained health professional. The actual implant is about the size of a
matchstick and is inserted under the skin on the inside of the upper arm.
Intrauterine device (IUD)

An intrauterine device (IUD) is a small device that is placed in the uterus to

prevent pregnancy. There are two main types of IUDs: copper IUDs (such as
Paragard) and hormonal IUDs (such as Mirena). Once an IUD is in place, it can
provide birth control for 5 to 10 years, depending on the type. Unlike IUDs that
were used in the 1970s, present-day IUDs are small, safe, and highly effective.

If a sexually transmitted disease is present at the time the IUD is inserted, the
infection can be carried into the uterus. This can lead to pelvic inflammatory
disease (PID), which can lead to infertility.4

The hormonal IUD (Mirena) typically reduces menstrual flow and cramping
over time. On the other hand, the copper IUD can cause longer and heavier
periods. However, the progestin IUD can have other side effects, including
spotting, mood swings, and breast tenderness. These side effects occur less
frequently than with other progestin-only methods.

Barrier methods

Barrier methods (including the diaphragm; cervical cap; Lea's Shield; male
condom; female condom; and spermicidal foam, sponge, gel, suppository, or
film) prevent sperm from entering the uterus and reaching the egg. Typically,
barrier methods are not highly effective, but they generally have fewer side
effects than hormonal methods or IUDs. Spermicides and condoms should be
used together or along with another method to increase their effectiveness.
Barrier methods can interrupt lovemaking because they must be used every time
you have sex.

Condoms (male or female) should always be used if you are at risk of getting or
spreading a sexually transmitted disease, such as genital herpes, chlamydia, or
HIV.

Fertility awareness (periodic abstinence or natural family planning)

Fertility awareness requires that a couple chart the time during a woman's
menstrual cycle when she is most likely to become pregnant and avoid
intercourse or use a barrier method during that time. Fertility awareness is not a
good choice if you need a highly effective form of birth control.

Breast-feeding may work as a form of birth control in the first 6 months after
giving birth if you follow specific guidelines. For this method to work, you must
breast-feed your baby every time. You can't use formula or other supplements.
This is called the lactational amenorrhea method (LAM). Although LAM has
been shown to be 98.5% effective when these conditions are met, many doctors
recommend that you use another birth control method.5
Permanent birth control (sterilization)

Sterilization is a surgical procedure done for men or women who decide that
they do not want to have any (or more) children. Sterilization is one of the most
effective forms of birth control. Sterilization is intended to be permanent, and
although you can try to reverse it with another surgery, reversal is not always
successful.

• Tubal ligation or implants. Tubal ligation is a surgical procedure where

the fallopian tubes, which carry the eggs from the ovaries to the uterus,
are tied, cut, or blocked. A new nonsurgical sterilization technique uses a
small metal coil, or tubal implant, inserted up into each fallopian tube.
Over time, scar tissue grows around each tubal implant, permanently
blocking the tubes. Most women are able to return home within a couple
of hours after either procedure. You must use another form of birth
control for 3 months after receiving tubal implants. At 3 months, you
will need to have an X-ray taken to make sure that your tubes are closed.
• Vasectomy. In this minor surgery, the vas deferens, the tubes that carry
sperm from the testicles to the seminal fluid (semen), are cut and blocked
so that the semen no longer contains sperm,This does not interfere with a
man's ability to have an erection or enjoy sex. Men must have a sperm
count check after having a vasectomy before relying on this for birth
control.

Female sterilization is more complicated, has higher risks of problems after

surgery, and is more expensive than male sterilization.

Contraception following pregnancy

Birth control is an important consideration after you have had a child. Your
ability to become pregnant again may return within 3 to 6 weeks after childbirth.
Think about what type of birth control you will be using, and make a plan during
your pregnancy. Start using birth control as soon as possible after childbirth.
Most methods of birth control can be started soon after childbirth, although
some may not be recommended if you are breast-feeding.
 INTRODODUCTION

Birth control, sometimes synonymous with

contraception, is a regimen of one or more actions,
devices, or medicationfollowed in order to deliberately
prevent or reduce the likelihood of pregnancy or
childbirth."Contraception" may refer specifically to
mechanisms that are intended to reduce the likelihood of
a sperm cell fertilizing the egg. Birth control is
commonly used as part of family planning.

The history of birth control began with the discovery of

the connection between coitus and pregnancy. The oldest
forms of birth control included coitus interruptus,
pessaries, and the ingestion of herbs that were believed
to be contraceptive or abortifacient. The earliest record
of birth control use is an ancient Egyptian set of
instructions on creating a contraceptive pessary.

Different methods of birth control have varying

characteristics. Condoms, for example, are the only
methods that provide significant protection from
sexually transmitted diseases. Cultural and religious
attitudes on birth control vary significantly.