Resources - Contraception

The prevention of unwanted pregnancy is an important issue. Four types of birth control are available: hormonal, barrier, natural, and surgical. Most of these are reversible, but not all. Below is a brief description of several contraceptives available, along with information about their effectiveness in preventing pregnancy and STI's (Sexually Transmitted Infections).

	Hormonal Methods Birth Control Pill The Mini-Pill The Patch Depo-Provera Nuva Ring
	Barrier Methods Male Condom Female Condom IUDs Sponge Diaphragm Cervical caps and Lea’s Shield
	Natural Methods Rhythm Method
	Surgical Methods Sterilization
	Further Information

Hormonal Methods

Birth Control Pill
The Birth Control Pill is an estrogen and progestin pill taken daily to block the release of eggs from the ovaries.
Effectiveness: 99.9%, when used correctly.
Advantages: May reduce premenstrual symptoms, acne and risk of pelvic inflammatory disease (PID), ovarian cancer, and benign ovarian cysts.
Drawbacks: Must be taken daily; May increase risk of heart disease, high blood pressure, blood clots, and artery blockage, especially for smokers; Does not protect against STD's or HIV.

The Mini-pill
The Mini-pill is an oral contraceptive alternative, similar to the Birth Control Pill, for women who can’t take estrogen, contains only progestin. It works in the same way the combination pill does to prevent pregnancy. It’s also good for women who are breastfeeding, women who are over 35 and women who smoke.
Effectiveness: 97%
Drawbacks: Must be taken every day, even during menstruation.

The Patch (Ortho Evra)
This is a patch that is worn on the upper outer arm, upper torso, abdomen, or buttocks and releases progestin and estrogen; prevents the ovary from releasing an egg to be fertilized; thickens the cervical mucous, making it difficult for the sperm to enter the uterus.
Effectiveness: 99% when used correctly.
Advantages: Discreet form of birth control; Needs to be changed only once a week.
Drawbacks: Releases about 60% more estrogen than birth control pills, increasing the risk of blood clots and other serious side effects; May be less effective for women who weigh more than 198 pounds; Does not protect against STD's or HIV.

Depo-Provera
Depo-Provera is time-released synthetic progesterone that is injected into the buttocks or arm every three months to stop the ovaries from releasing eggs; thickens cervical mucous.
Effectiveness: 97-99.7%.
Advantages: Discreet form of birth control; Injections needed infrequently; Can be used by nursing women and women who cannot take estrogen.
Drawbacks: Using Depo-Provera for more than two years can trigger bone calcium loss, which may not return after usage stops; Can cause irregular or heavy menstrual bleeding; Can result in absence of periods after one year; Triggers weight gain (about 5 pounds on average); Does not protect against STD's or HIV.

Nuva Ring
Nuva Ring is a soft, flexible ring worn inside the vagina for three weeks each month. It releases a combination of estrogen and progestin that is continuously absorbed into the bloodstream.
Effectiveness: 99% when used correctly.
Advantages: Discreet; Can be worn during sex; Regulates menstrual period; Creates lighter menstrual flow.
Drawbacks: Increased vaginal discharge; May cause irritation; Requires a prescription; Ring must be self-inserted and removed, and replaced monthly; Does not protect against STD's or HIV.

Barrier Methods

Male Condom
The Male Condom is a thin sheath of latex or polyurethane fitted over an erect penis to prevent ejaculated semen from entering the vagina.
Effectiveness: 88%; 85-98% with spermicide.
Advantages: Inexpensive; Non-prescription; One of the only contraceptives that reduces the risk of STD's.
Drawbacks: Some people are allergic to latex; Reduces sensations for some people during sex.

Female Condom
The Female Condom is a sheath made of polyurethane that lines the vagina to prevent sperm from entering the cervix.
Effectiveness: 85-98%.
Advantages: Non-prescription; Reduces the risk of STD's; Can be inserted up to 8 hours before sex.
Drawbacks: Sheath may move; Can be noisy and uncomfortable; Outer ring is visible.

Intrauterine Devices (IUDs)
The IUD is a“T-shaped” device inserted into the uterus by a doctor to prevent sperm from fertilizing an egg. There are two types: Paragard (or Copper T), which contains copper and can be left in the uterus for 10 years, and Mirena, which releases a progestin-like hormone continuously for up to five years.
Effectiveness: Paragard/Copper T, 99% in first year, though effectiveness dwindles over time; Mirena: 99.9%.
Advantages: Long-lasting; Mirena may reduce risk of PID; Can be used while breastfeeding; Cost-effective over time; Reduces risk of ectopic pregnancy.
Drawbacks: May cause menstrual discomfort (especially true of Copper-T); Risk of accidental expulsion; Slight risk of perforating uterine wall during insertion; Neither device protects against STD's or HIV.

Sponge
The Sponge is a solid polyurethane foam that contains spermicide.
Effectiveness: 84-91% for women who haven’t had children, 68-80% for those who have.
Advantages: Non-prescription; Inexpensive; Doesn't contain hormones; Often undetected by partner.
Drawbacks: Difficult to insert and remove; Must be left in 6 hours after sex; May cause vaginal irritation or dryness during sex; Does not protect against STD's or HIV.

Diaphragm
The Diaphragm is a soft, shallow rubber dome that fits over the cervix, blocking sperm from fertilizing an egg. It must be used with a spermicide every time.
Effectiveness: 86-94% when used properly with a spermicide.
Advantages: Inexpensive; Effective immediately; Can be inserted hours ahead of time; Few side effects.
Drawbacks: Must be fitted by a doctor; Must remain in place 6 to 8 hours after sex; Difficult to insert; May cause allergic reactions; Increases risk of urinary tract infection; Does not protect against STD's or HIV.

Cervical caps and Lea’s Shield
Cervical caps fit over the cervix and are used with spermicide. Lea’s Shield is a rubber disk that covers the cervix and is 85% effective.
Effectiveness: 84-91% for women who have not had children, 68-74% for those who have.
Drawbacks: Both must remain inserted for 8 hours after intercourse, require a prescription and do not protect against STD's or HIV.

Natural Method

Rhythm Method
The Rhythm Method involves abstaining from sex or using a barrier method on the days of the menstrual cycle when a woman is ovulating.
Effectiveness: Up to 92%, depending on how meticulously it is practiced, how regular the woman’s menstrual cycle is and what type of barrier method is used during ovulation.
Advantages: No hormones; No side effects.
Drawbacks: Requires that women keep track of their cycle, often by testing basal body temperatures and changes in cervical mucous, which makes it inconvenient; Does not protect against STD's or HIV.

Surgical Method

Sterilization
Sterilization in females involves blocking the Fallopian tubes, preventing the sperm from getting to the egg. In males it involves cutting the Vas deferens to prevent sperm from traveling to the penis.
Effectiveness: 99.9%.
Advantages: Permanent; Few to no side effects; For females it allows sexual spontaneity and is cost-effective in the long run; For males it is a low-risk procedure with no effect on erectile function.
Drawbacks: Permanent; For females it requires an abdominal incision; For males there is a small risk of infection; Does not protect against STD's or HIV.

Extracts taken from Battaglia, E., Contraceptives 101, LifeScript Staff Writer, Friday, February 23, 2007.

Further Information
Click on the links below for further information about Contraceptives and relevant support services available.

Better Health Channel
Family Planning Victoria - Sex Life