Comparison of birth control methods

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Effectiveness of contraceptive methods with respect to birth control. Only condoms are useful to prevent sexually transmitted infections. Effectivenessofcontraceptives.png
Effectiveness of contraceptive methods with respect to birth control. Only condoms are useful to prevent sexually transmitted infections.

There are many methods of birth control (or contraception) that vary in requirements, side effects, and effectiveness. As the technology, education, and awareness about contraception has evolved, new contraception methods have been theorized and put in application. Although no method of birth control is ideal for every user, some methods remain more effective, affordable or intrusive than others. Outlined here are the different types of barrier methods, hormonal methods, various methods including spermicides, emergency contraceptives, and surgical methods [1] and a comparison between them.

Contents

While many methods may prevent conception, only male and female condoms are effective in preventing sexually transmitted infections.

Methods

Hormonal methods

The IUD (intrauterine device) is a T-shaped device that is inserted into the uterus by a trained medical professional. There are two different types of IUDs: copper or hormonal. [1] The copper IUD (also known as a copper T intrauterine device) is a non-hormonal option of birth control. It is wrapped in copper which creates a toxic environment for sperm and eggs, thus preventing pregnancy. [2] The failure rate of a copper IUD is approximately 0.8% and can prevent pregnancy for up to 10 years. The hormonal IUD (also known as levonorgestrel intrauterine system or LNg IUD) releases a small amount of the hormone called progestin that can prevent pregnancy for 3–8 years with a failure rate of 0.1-0.4%. [1] IUDs can be removed by a trained medical professional at any time before the expiration date to allow for pregnancy.

Oral contraceptives are another option, these are commonly known as 'the pill'. These must be taken at the same time every day in order to be the most effective. There are two different options, there is a combined pill that contains both of the hormones estrogen and progestin, and a progestin-only pill. The failure rate of each of these oral contraceptives is 7%. [1]

Some choose to get an injection or a shot in order to prevent pregnancy. This is an option where a medical professional will inject the hormone progestin into a woman's arm or buttocks every 3 months to prevent pregnancy. The failure rate is 4%. [1]

Women can also get an implant into their upper arm that releases small amounts of hormones to prevent pregnancy. The implant is a thin rod-shaped device that contains the hormone progestin that is inserted into the upper arm and can prevent pregnancy for up to 3 years. The failure rate for this method is 0.1%. [1]

The patch is another simple option, it is a skin patch containing the hormones progestin and estrogen that is absorbed into the blood stream preventing pregnancy. The patch is typically worn on the lower abdomen and replaced once a week. The failure rate for this is 7%. [1]

The hormonal vaginal contraceptive ring is a ring that contains the hormones progestin and estrogen that a woman inserts into the vagina. It is replaced once a month and has a failure rate of 7%. [1]

Barrier methods

The diaphragm or cervical cap is a small shallow cup-like cap that is inserted into the vagina with spermicide to cover the cervix and block sperm from entering the uterus. It is inserted before sexual intercourse and comes in different sizes. It needs to be fitted by a medical professional. It has a failure rate of 17%. [1]

A contraceptive sponge is another contraceptive method. Like the diaphragm, the contraceptive sponge contains spermicide and is inserted into the vagina and placed over the cervix to prevent sperm from entering the uterus. The sponge must be kept in place 6 hours after sexual intercourse before it can be removed and discarded. The failure rate for women who have had a baby before is 27%; for those who have not had a baby, the failure rate is 14%. [1]

The male condom is typically made of latex (but other materials are available, such as lambskin, if either partner has a latex allergy). The male condom is placed over the male's penis and prevents the sperm from entering the partner's body. It can prevent pregnancy, and STIs such as, but not limited to, HIV if used appropriately. Male condoms can only be used once and are easily accessible at local stores in most countries. The failure rate is 13%. [1]

The female condom is worn by the woman; it is inserted into the vagina and prevents the sperm from entering her body. It can help prevent STIs and can be inserted up to 8 hours before intercourse. The failure rate is 21%. [1]

Other methods

Spermicides come in various forms such as: gels, foams, creams, film, suppositories, or tablets. The spermicides create an environment in which sperm can no longer live. Though typically used in addition to the male condom, diaphragm, or cervical cap, they can also be used by themselves. They are put into the vagina no more than an hour before intercourse and kept inside the vagina for 6–8 hours after intercourse. The failure rate is 21%. [1]

In the fertility awareness-based method a woman who has a predictable and consistent menstrual cycle tracks the days that she is fertile. The typical woman has approximately 9 fertile days a month and either avoids intercourse on those days or uses an alternative birth control method for that period of time. The failure rate is between 2-23%. [1]

Lactational amenorrhea (LAM) is an option for women who have had a baby within the past 6 months and are breastfeeding. This method is only successful if it has been less than 6 months since the birth of the baby, they must be fully breastfeeding their baby, and not having any periods. [1] The method is almost as effective as an oral contraceptive if the 3 conditions are strictly followed. [3]

The 'pull out method' or coitus interruptus is a method where the male will remove his penis from the vagina before ejaculating; this prevents sperm from reaching the egg and can prevent pregnancy. This method has to be done correctly every time and is best if used in addition to other forms of birth control. It has a failure rate of approximately 22%. [4]

Emergency contraceptives

A copper IUD can be used as an emergency contraceptive as long as it is inserted within 5 days after intercourse. [1]

There are two different types of emergency contraceptive pills, one contains levonorgestrel and can prevent pregnancy if taken within 3 days of intercourse. The other contains ulipristal acetate and can prevent pregnancy if taken within 5 days of intercourse. This option can be used if other birth control methods fail. [5]

Use of an emergency contraceptive should occur as soon as possible after unprotected sexual intercourse to reduce the chance of pregnancy.

Surgical methods

Tubal ligation is also known as 'tying tubes'. This is the surgical process where medical professional closes or ties the fallopian tubes in order to prevent sperm from reaching the eggs. This is often done as an outpatient surgical procedure and is effective immediately after it is performed. The failure rate is 0.5%. [1]

A vasectomy is a minor surgical procedure where a doctor will cut the vas deferens and seal the ends to prevent sperm from reaching the penis and ultimately the egg. The method is usually successful after 12 weeks post-procedure or when the sperm count is zero. The failure rate is 0.15%. [1]

User dependence

Different methods require different levels of diligence by users. Methods with little or nothing to do or remember, or that require a clinic visit less than once per year are said to be non-user dependent, forgettable, or top-tier methods. [6] Intrauterine methods, implants, and sterilization fall into this category. [6] For methods that are not user dependent, the actual and perfect-use failure rates are very similar.

Many hormonal methods of birth control, and LAM require a moderate level of thoughtfulness. For many hormonal methods, clinic visits must be made every three months to a year to renew the prescription. The pill must be taken every day, the patch must be reapplied weekly, or the ring must be replaced monthly. Injections are required every 12 weeks. The rules for LAM must be followed every day. Both LAM and hormonal methods provide a reduced level of protection against pregnancy if they are occasionally used incorrectly (rarely going longer than 4–6 hours between breastfeeds, a late pill or injection, or forgetting to replace a patch or ring on time). The actual failure rates for LAM and hormonal methods are somewhat higher than the perfect-use failure rates.[ citation needed ]

Higher levels of user commitment are required for other methods. [7] Barrier methods, coitus interruptus, and spermicides must be used at every act of intercourse. Fertility awareness-based methods may require daily tracking of the menstrual cycle. The actual failure rates for these methods may be much higher than the perfect-use failure rates. [8]

Side effects

Different forms of birth control have different potential side effects. Not all, or even most, users will experience side effects from a method. The less effective the method, the greater the risk of pregnancy, and the side effects associated with pregnancy.

Minimal or no side effects occur with coitus interruptus, fertility awareness-based, and LAM. Some forms of periodic abstinence encourage examination of the cervix; insertion of the fingers into the vagina to perform this examination may cause changes in the vaginal environment. Following the rules for LAM may delay a woman's first post-partum menstruation beyond what would be expected from different breastfeeding practices.[ citation needed ]

Barrier methods have a risk of allergic reactions. Users sensitive to latex may use barriers made of less allergenic materials - polyurethane condoms, or silicone diaphragms, for example. Barrier methods are also often combined with spermicides, which have possible side effects of genital irritation, vaginal infection, and urinary tract infection.[ citation needed ]

Sterilization procedures are generally considered to have a low risk of side effects, though some persons and organizations disagree. [9] [10] Female sterilization is a more significant operation than vasectomy, and has greater risks; in industrialized nations, mortality is 4 per 100,000 tubal ligations, versus 0.1 per 100,000 vasectomies. [11]

After IUD insertion, users may experience irregular periods in the first 3–6 months with Mirena, and sometimes heavier periods and worse menstrual cramps with ParaGard. However, continuation rates are much higher with IUDs compared to non-long-acting methods. [12] A positive characteristic of IUDs is that fertility and the ability to become pregnant returns quickly once the IUD is removed. [13]

Because of their systemic nature, hormonal methods have the largest number of possible side effects. [14] Combined hormonal contraceptives contain estrogen and progestin hormones. [15] They can come in formulations such as pills, vaginal rings, and transdermal patches. [15] Most people who use combined hormonal contraception experience breakthrough bleeding within the first 3 months. [15] Other common side effects include headaches, breast tenderness, and changes in mood. [16] Side effects from hormonal contraceptives typically disappear over time (3-5 months) with consistent use. [16] Less common effects of combined hormonal contraceptives include increasing the risk of deep vein thrombosis to 2-10 per 10,000 women per year and venous thrombotic events (see venous thrombosis) to 7-10 per 10,000 women per year. [15]

Hormonal contraceptives can come in multiple forms including injectables. Depot medroxyprogesterone acetate (DMPA), a progestin-only injectable, has been found to cause amenorrhea (cessation of menstruation); however, the irregular bleeding pattern returns to normal over time. [15] [16] DMPA has also been associated with weight gain. [16] Other side effects more commonly associated with progestin-only products include acne and hirsutism. [16] Compared to combined hormonal contraceptives, progestin-only contraceptives typically produce a more regular bleeding pattern. [15]

Sexually transmitted infection prevention

Male and female condoms provide significant protection against sexually transmitted infections (STIs) when used consistently and correctly. They also provide some protection against cervical cancer. [17] [18] Condoms are often recommended as an adjunct to more effective birth control methods (such as IUD) in situations where STI protection is also desired. [19]

Other barrier methods, such as diaphragms may provide limited protection against infections in the upper genital tract. Other methods provide little or no protection against sexually transmitted infections. [20]

Effectiveness

Cost and cost-effectiveness

Family planning is among the most cost-effective of all health interventions. [21] Costs of contraceptives include method costs (including supplies, office visits, training), cost of method failure (ectopic pregnancy, spontaneous abortion, induced abortion, birth, child care expenses) and cost of side effects. [22] Contraception saves money by reducing unintended pregnancies and reducing transmission of sexually transmitted infections. By comparison, in the US, method related costs vary from nothing to about $1,000 for a year or more for reversible contraception.

During the initial five years, vasectomy is comparable in cost to the IUD. Vasectomy is much less expensive and safer than tubal ligation. Since ecological breastfeeding and fertility awareness are behavioral they cost nothing or a small amount upfront for a thermometer or training. Fertility awareness based methods can be used throughout a woman's reproductive lifetime.[ citation needed ]

Not using contraceptives is the most expensive option. While in that case there are no method related costs, it has the highest failure rate, and thus the highest failure related costs. Even if one only considers medical costs relating to preconception care and birth, any method of contraception saves money compared to using no method.[ citation needed ]

The most effective and the most cost-effective methods are long-acting methods. Unfortunately these methods often have significant up-front costs, and requiring the user to pay a portion of these costs prevents some from using more effective methods. [23] Contraception saves money for the public health system and insurers. [24] [ relevant? ]

Effectiveness calculation

Failure rates may be calculated by either the Pearl Index or a life table method. A "perfect-use" rate is where all rules of the method are rigorously followed, and (if applicable) the method is used for every act of intercourse.

Actual failure rates are higher than perfect-use rates for a variety of reasons:

For instance, someone using oral forms of hormonal birth control might be given incorrect information by a health care provider as to the frequency of intake, or for some reason does not take the pill one or several days, or not go to the pharmacy on time to renew the prescription, or the pharmacy might be unwilling to provide enough pills to cover an extended absence.

Effectiveness comparison

The table below color codes the typical use and perfect use failure rates, where the failure rate is measured as the expected number of pregnancies per year per woman using the method:

Blueunder 1%lower risk
Greenup to 5%
Yellowup to 10%
Orangeup to 20%
Redover 20%higher risk
Greyno datano data available

For example, a failure rate of 20% means that 20 of 100 women become pregnant during the first year of use. Note that the rate may go above 100% if all women, on average, become pregnant within less than a year. In the degenerated case of all women becoming pregnant instantly, the rate would be infinite.

In the user action required column, items that are non-user dependent (require action once per year or less) also have a blue background.

Some methods may be used simultaneously for higher effectiveness rates. For example, using condoms with spermicides the estimated perfect use failure rate would be comparable to the perfect use failure rate of the implant. [6] However, mathematically combining the rates to estimate the effectiveness of combined methods can be inaccurate, as the effectiveness of each method is not necessarily independent. [26]

If a method is known or suspected to have been ineffective, such as a condom breaking, or a method could not be used, as is the case for rape when user action is required for every act of intercourse, emergency contraception (ECP) may be taken 72 to 120 hours after sexual intercourse. Emergency contraception should be taken shortly before or as soon after intercourse as possible, as its efficacy decreases with increasing delay. Although ECP is considered an emergency measure, levonorgestrel ECP taken shortly before sexual intercourse may be used as a primary method for women who have sexual intercourse only a few times a year and want a hormonal method, but do not want to take hormones all the time. [27] The failure rate of repeated or regular use of LNG ECP is similar to the rate for those using a barrier method. [28]

Rate of pregnancy during the first year of use
Birth control methodBrand/common nameTypical-use failure rate (%)Perfect-use failure rate (%)TypeImplementationUser action required
Contraceptive implant Implanon/Nexplanon, [29] Jadelle, [30] the implant0.05
(1 in 2000)
0.05
(1 in 2000)
ProgestogenSubdermal implant 3-5 years
Vasectomy [29] Male sterilization0.15
(1 in 666)
0.1
(1 in 1000)
SterilizationSurgical procedure Once
Combined injectable [31] Lunelle, Cyclofem0.2
(1 in 500)
0.2
(1 in 500)
Estrogen & progestogenInjection Monthly
IUD with progestogen [29] Mirena, Skyla, Liletta0.2
(1 in 500)
0.2
(1 in 500)
Intrauterine & progestogenIntrauterine 3-7 years
Essure (removed from markets) [32] Female sterilization0.26
(1 in 384)
0.26
(1 in 384)
SterilizationSurgical procedure Once
Tubal ligation [29] Tube tying, female sterilization0.5
(1 in 200)
0.5
(1 in 200)
SterilizationSurgical procedure Once
Bilateral salpingectomy [33] Tube removal, "bisalp"0.75 (1 in 133) after 10 years [note 1] 0.75 after 10 yearsSterilizationSurgical procedure Once
IUD with copper [29] Paragard, Copper T, the coil0.8
(1 in 125)
0.6
(1 in 167)
Intrauterine & copperIntrauterine 3 to 12+ years
Forschungsgruppe NFP symptothermal method, teaching sessions + application [29] [34] Sensiplan by Arbeitsgruppe NFP (Malteser Germany gGmbh)1.68
(1 of 60)
0.43
(1 in 233)
BehavioralTeaching sessions, observation, charting and evaluating a combination of fertility symptoms Three teaching sessions + daily application
LAM for 6 months only; not applicable if menstruation resumes [35] [note 2] Ecological breastfeeding2
(1 in 50)
0.5
(1 in 200)
BehavioralBreastfeeding Every few hours
2002 [36] cervical cap and spermicide used by nulliparous (discontinued in 2008) [note 3] [37] [note 4] Lea's Shield 5
(1 in 20)
no dataBarrier & spermicideVaginal insertion Every act of intercourse
MPA shot [38] Depo Provera, the shot4
(1 in 25)
0.2
(1 in 500)
ProgestogenInjection 12 weeks
Testosterone injection for male (unapproved, experimental method) [39] Testosterone Undecanoate6.1
(1 in 16)
1.1
(1 in 91)
TestosteroneIntramuscular Injection Every 4 weeks
1999 cervical cap and spermicide (replaced by second generation in 2003) [40] FemCap 7.6[ failed verification ] (estimated)
(1 in 13)
no dataBarrier & spermicideVaginal insertion Every act of intercourse
Contraceptive patch [38] Ortho Evra, the patch7
(1 in 14)
0.3
(1 in 333)
Estrogen & progestogenTransdermal patch Weekly
Combined oral contraceptive pill [41] The pill7
(1 in 14) [42]
0.3
(1 in 333)
Estrogen & progestogen + placebo [43] Oral medication Daily
Ethinylestradiol/etonogestrel vaginal ring [38] NuvaRing, the ring7
(1 in 14)
0.3
(1 in 333)
Estrogen & progestogenVaginal insertion In place 3 weeks / 1 week break
Progestogen only pill [29] POP, minipill9 [42]
(1 in 11)
0.3
(1 in 333)
Progestogen + placebo [43] Oral medication Daily
Ormeloxifene [44] Saheli, Centron9
(1 in 11)
2
(1 in 50)
SERM Oral medication Weekly
Emergency contraception pillPlan B One-Step®no datano dataLevonorgestrelOral medication Every act of intercourse
Standard Days Method [29] CycleBeads, iCycleBeads12
(1 in 8.3)
5
(1 in 20)
BehavioralCounting days since menstruation Daily
Diaphragm and spermicide [29] 12
(1 in 6)
6
(1 in 12)
Barrier + spermicideVaginal insertion Every act of intercourse
Plastic contraceptive sponge with spermicide used by nulliparous [38] [note 4] Today sponge, the sponge14
(1 in 7)
9
(1 in 11)
Barrier + spermicideVaginal insertion Every act of intercourse
2002 [36] cervical cap and spermicide used by parous (discontinued in 2008) [37] [note 3] [note 5] Lea's Shield 15
(1 in 6)
no dataBarrier & spermicideVaginal insertion Every act of intercourse
1988 cervical cap and spermicide (discontinued in 2005) used by nulliparous [note 4] Prentif 16
(1 in 6.25)
9
(1 in 11)
Barrier & spermicideVaginal insertion Every act of intercourse
External (male) latex condom [38] Condom13
(1 in 7)
2
(1 in 50)
BarrierPlaced on erect penis Every act of intercourse
Internal (female) condom [29] 21
(1 in 4.7)
5
(1 in 20)
BarrierVaginal or anal insertion Every act of intercourse
Coitus interruptus [38] Withdrawal method, pulling out20
(1 in 5) [45]
4
(1 in 25)
BehavioralWithdrawal Every act of intercourse
Symptoms-based fertility awareness ex. symptothermal and calendar-based methods [38] [note 6] [note 7] TwoDay method, Billings ovulation method, Creighton Model 24
(1 in 4)
0.404
(1 in 25250)
BehavioralObservation and charting of basal body temperature, cervical mucus or cervical positionDaily
Calendar-based methods [29] The rhythm method, Knaus-Ogino method, Standard Days methodno data5
(1 in 20)
BehavioralCalendar-based Daily
Plastic contraceptive sponge with spermicide used by parous [38] [note 5] Today sponge, the sponge27
(1 in 3.7)
20
(1 in 4)
Barrier & spermicideVaginal insertion Every act of intercourse
Spermicidal gel, suppository, or film [38] 21
(1 in 5)
16
(1 in 6.25)
SpermicideVaginal insertion Every act of intercourse
1988 cervical cap and spermicide used by parous (discontinued in 2005) [note 5] Prentif 32
(1 in 3)
26
(1 in 4)
Barrier & spermicideVaginal insertion Every act of intercourse
None (unprotected intercourse) [29] 85
(6 in 7)
85
(6 in 7)
BehavioralDiscontinuing birth control N/A
Birth control methodBrand/common nameTypical-use failure rate (%)Perfect-use failure rate (%)TypeImplementationUser action required

Table notes

  1. No data for 1 year failure rates
  2. The pregnancy rate applies until the user reaches six months postpartum, or until menstruation resumes, whichever comes first. If menstruation occurs earlier than six months postpartum, the method is no longer effective. For users for whom menstruation does not occur within the six months: after six months postpartum, the method becomes less effective.
  3. 1 2 In the effectiveness study of Lea's Shield, 84% of participants were parous. The unadjusted pregnancy rate in the six-month study was 8.7% among spermicide users and 12.9% among non-spermicide users. No pregnancies occurred among nulliparous users of the Lea's Shield. Assuming the effectiveness ratio of nulliparous to parous users is the same for the Lea's Shield as for the Prentif cervical cap and the Today contraceptive sponge, the unadjusted six-month pregnancy rate would be 2.2% for spermicide users and 2.9% for those who used the device without spermicide.[ improper synthesis? ]
  4. 1 2 3 Nulliparous refers to those who have not given birth.
  5. 1 2 3 Parous refers to those who have given birth.
  6. No formal studies meet the standards of Contraceptive Technology for determining typical effectiveness. The typical effectiveness listed here is from the CDC's National Survey of Family Growth, which grouped symptoms-based methods together with calendar-based methods. See Fertility awareness#Effectiveness.
  7. The term fertility awareness is sometimes used interchangeably with the term natural family planning (NFP), though NFP usually refers to use of periodic abstinence in accordance with Catholic beliefs.

See also

Related Research Articles

Coitus interruptus, also known as withdrawal, pulling out or the pull-out method, is a method of birth control during penetrative sexual intercourse, whereby the penis is withdrawn from a vagina or anus prior to ejaculation so that the ejaculate (semen) may be directed away in an effort to avoid insemination.

<span class="mw-page-title-main">Condom</span> Device for birth control and STI prevention

A condom is a sheath-shaped barrier device used during sexual intercourse to reduce the probability of pregnancy or a sexually transmitted infection (STI). There are both external (male) and internal (female) condoms.

<span class="mw-page-title-main">Copper IUD</span> Birth control and emergency contraceptive device

A copper intrauterine device (IUD), also known as an intrauterine coil or copper coil or non-hormonal IUD, is a type of intrauterine device which contains copper. It is used for birth control and emergency contraception within five days of unprotected sex. It is one of the most effective forms of birth control with a one-year failure rate around 0.7%. The device is placed in the uterus and lasts up to twelve years. It may be used by women of all ages regardless of whether or not they have had children. Following removal, fertility quickly returns.

<span class="mw-page-title-main">Emergency contraception</span> Birth control measures taken after sexual intercourse

Emergency contraception (EC) is a birth control measure, used after sexual intercourse to prevent pregnancy.

<span class="mw-page-title-main">Combined oral contraceptive pill</span> Birth control method which is taken orally

The combined oral contraceptive pill (COCP), often referred to as the birth control pill or colloquially as "the pill", is a type of birth control that is designed to be taken orally by women. It is the oral form of combined hormonal contraception. The pill contains two important hormones: a progestin and estrogen. When taken correctly, it alters the menstrual cycle to eliminate ovulation and prevent pregnancy.

<span class="mw-page-title-main">Diaphragm (birth control)</span> Cervical barrier type of birth control

The diaphragm is a barrier method of birth control. It is moderately effective, with a one-year failure rate of around 12% with typical use. It is placed over the cervix with spermicide before sex and left in place for at least six hours after sex. Fitting by a healthcare provider is generally required.

Spermicide is a contraceptive substance that destroys sperm, inserted vaginally prior to intercourse to prevent pregnancy. As a contraceptive, spermicide may be used alone. However, the pregnancy rate experienced by couples using only spermicide is higher than that of couples using other methods. Usually, spermicides are combined with contraceptive barrier methods such as diaphragms, condoms, cervical caps, and sponges. Combined methods are believed to result in lower pregnancy rates than either method alone.

<span class="mw-page-title-main">Levonorgestrel</span> Hormonal medication used for birth control

Levonorgestrel is a hormonal medication which is used in a number of birth control methods. It is combined with an estrogen to make combination birth control pills. As an emergency birth control, sold under the brand names Plan B One-Step and Julie, among others, it is useful within 72 hours of unprotected sex. The more time that has passed since sex, the less effective the medication becomes, and it does not work after pregnancy (implantation) has occurred. Levonorgestrel works by preventing ovulation or fertilization from occurring. It decreases the chances of pregnancy by 57–93%. In an intrauterine device (IUD), such as Mirena among others, it is effective for the long-term prevention of pregnancy. A levonorgestrel-releasing implant is also available in some countries.

<span class="mw-page-title-main">Contraceptive patch</span> Transdermal patch applied to prevent pregnancy

A contraceptive patch, also known as "the patch", is a transdermal patch applied to the skin that releases synthetic oestrogen and progestogen hormones to prevent pregnancy. They have been shown to be as effective as the combined oral contraceptive pill with perfect use, and the patch may be more effective in typical use.

Male contraceptives, also known as male birth control, are methods of preventing pregnancy that are used by males or people who produce sperm. The main forms of male contraceptives available today are condoms, vasectomy, and withdrawal, and these methods combined make up less than one-third of global contraceptive use.

<span class="mw-page-title-main">Hormonal intrauterine device</span> Intrauterine device

A hormonal intrauterine device (IUD), also known as an intrauterine system (IUS) with progestogen and sold under the brand name Mirena among others, is an intrauterine device that releases a progestogenic hormonal agent such as levonorgestrel into the uterus. It is used for birth control, heavy menstrual periods, and to prevent excessive build of the lining of the uterus in those on estrogen replacement therapy. It is one of the most effective forms of birth control with a one-year failure rate around 0.2%. The device is placed in the uterus and lasts three to eight years. Fertility often returns quickly following removal.

Progestogen-only pills (POPs), colloquially known as "mini pills", are a type of oral contraceptive that contain synthetic progestogens (progestins) and do not contain estrogens. They are primarily used for the prevention of undesired pregnancy, although additional medical uses also exist.

<span class="mw-page-title-main">Vaginal ring</span>

Vaginal rings are polymeric drug delivery devices designed to provide controlled release of drugs for intravaginal administration over extended periods of time. The ring is inserted into the vagina and provides contraception protection. Vaginal rings come in one size that fits most women.

<span class="mw-page-title-main">Hormonal contraception</span> Birth control methods that act on the endocrine system

Hormonal contraception refers to birth control methods that act on the endocrine system. Almost all methods are composed of steroid hormones, although in India one selective estrogen receptor modulator is marketed as a contraceptive. The original hormonal method—the combined oral contraceptive pill—was first marketed as a contraceptive in 1960. In the ensuing decades, many other delivery methods have been developed, although the oral and injectable methods are by far the most popular. Hormonal contraception is highly effective: when taken on the prescribed schedule, users of steroid hormone methods experience pregnancy rates of less than 1% per year. Perfect-use pregnancy rates for most hormonal contraceptives are usually around the 0.3% rate or less. Currently available methods can only be used by women; the development of a male hormonal contraceptive is an active research area.

Long-acting reversible contraceptives (LARC) are methods of birth control that provide effective contraception for an extended period without requiring user action. They include injections, intrauterine devices (IUDs), and subdermal contraceptive implants. They are the most effective reversible methods of contraception because their efficacy is not reliant on patient compliance. The typical use failure rates of IUDs and implants, less than 1% per year, are about the same as perfect use failure rates.

<span class="mw-page-title-main">Contraceptive implant</span> Implantable medical device used for birth control

A contraceptive implant is an implantable medical device used for the purpose of birth control. The implant may depend on the timed release of hormones to hinder ovulation or sperm development, the ability of copper to act as a natural spermicide within the uterus, or it may work using a non-hormonal, physical blocking mechanism. As with other contraceptives, a contraceptive implant is designed to prevent pregnancy, but it does not protect against sexually transmitted infections.

<span class="mw-page-title-main">Birth control</span> Method of preventing human pregnancy

Birth control, also known as contraception, anticonception, and fertility control, is the use of methods or devices to prevent unintended pregnancy. Birth control has been used since ancient times, but effective and safe methods of birth control only became available in the 20th century. Planning, making available, and using human birth control is called family planning. Some cultures limit or discourage access to birth control because they consider it to be morally, religiously, or politically undesirable.

<span class="mw-page-title-main">Intrauterine device</span> Form of birth control involving a device placed in the uterus

An intrauterine device (IUD), also known as intrauterine contraceptive device or coil, is a small, often T-shaped birth control device that is inserted into the uterus to prevent pregnancy. IUDs are one form of long-acting reversible birth control (LARC). One study found that female family planning providers choose LARC methods more often (41.7%) than the general public (12.1%). Among birth control methods, IUDs, along with other contraceptive implants, result in the greatest satisfaction among users.

Women's reproductive health in the United States refers to the set of physical, mental, and social issues related to the health of women in the United States. It includes the rights of women in the United States to adequate sexual health, available contraception methods, and treatment for sexually transmitted diseases. The prevalence of women's health issues in American culture is inspired by second-wave feminism in the United States. As a result of this movement, women of the United States began to question the largely male-dominated health care system and demanded a right to information on issues regarding their physiology and anatomy. The U.S. government has made significant strides to propose solutions, like creating the Women's Health Initiative through the Office of Research on Women's Health in 1991. However, many issues still exist related to the accessibility of reproductive healthcare as well as the stigma and controversy attached to sexual health, contraception, and sexually transmitted diseases.

There are many types of contraceptive methods available in France. All contraceptives are obtained by medical prescription after a visit to a family planning specialist, a gynecologist or a midwife. An exception to this is emergency contraception, which does not require a prescription and can be obtained directly in a pharmacy.

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