Birth Control

Abstinence is not having sex. It is simple, free, and the only 100% effective way to avoid pregnancy and STIs. It is important to note that this must include vaginal, oral and anal sex to avoid STIs.

Fertility Awareness Method or Natural Family Planning is an effective and safe way to postpone or achieve pregnancy. It is based on the signs of fertility and infertility which occur naturally in a woman’s cycle. There are many apps available that help you interpret specific changes in a woman’s waking body temperature and cervical mucus which indicate fertile times. Two easy to use apps are Natural Cycles, an FDA approved app, which costs about $10, and FEMM is a free app; both use your unique temperature readings to determine when you have ovulated and are most likely to ovulate in your next period, indicating when you are fertile.

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Withdrawal (also known as pulling out) is pulling the penis out of the vagina before ejaculation. It can prevent pregnancy by keeping semen away from the vagina; however, sperm can also be carried in the fluid that is released from the penis prior to ejaculation. Even if semen only gets on the outer genitals (vulva), sperm cells can swim into the vagina and cause pregnancy. It offers no protection against STIs.

The condom is a latex sheath that fits over the penis, or in the case of a female condom, fits in the vaginal opening. The CDC reports that the pregnancy rate for condom usage is 18% for male condom and 21% for female condom usage. Condoms provide some, but not full protection against STIs.

This shallow, bendable cup made of soft silicone is inserted inside the vagina to cover the cervix before having sexual intercourse. The diaphragm acts as a barrier to prevent sperm from joining the egg. It is often used with spermicide (a chemical that kills sperm). It offers no protection against STIs.

This cap is a small cup made from soft silicone shaped like a sailor’s hat. It must be inserted deep inside the vagina to cover the cervix. It acts as a barrier to prevent sperm from joining the egg. It is often used with spermicide (a chemical that kills sperm). It offers no protection against STIs.

The birth control pill works by:

• attempting to block an egg from being released from the ovary which prevents conception.
• thickening cervical mucus making it difficult for sperm to travel up the reproductive tract.
• thinning the lining of the uterus, so that if a baby is conceived, it would be unable to attach in the uterus, and therefore, dies.

It does not offer protection against STIs.  As explained above, the birth control pill can cause an early abortion. If there is break through ovulation and conception occurs, the new life dies because he/she can’t implant itself into the wall of the uterus. Side effects of the pill may include:

• nausea/vomiting
• weight gain
• headache
• depression
• spotting
• high blood pressure
• blood clots

This pill is known as “Plan B”. It may be taken up to 72 hours after sex. It contains a high dose of progesterone and is supposed to prevent ovulation if it has not yet occurred. It offers no protection against STIs. You should not take this pill if you weigh over 165 lbs. Side effects may include:

• nausea/vomiting
• menstrual irregularities
• breast tenderness
• headaches
• abdominal pain and cramping (which can also be a sign of an ectopic pregnancy)
• dizziness

This long-acting synthetic hormone is injected in a woman’s arm or buttocks every three months. It attempts to block an egg from being released; however, ovulation does occur 50-60% of the time. It thickens a woman’s mucus in the cervix making it difficult for sperm to travel up the reproductive tract. It also thins the lining of the uterus so that the fertilized egg cannot attach itself and therefore dies. This does not protect against STIs.  Short-term side effects may include:

• irregular menstrual bleeding–heavy and unpredictable bleeding or no bleeding at all
• depression/anxiety
• weight gain
• blood clots
• headaches
• dizziness
• decreased sex drive
• fatigue
• allergic reaction
• delay in fertility after discontinuance of the drug

Possible long-term side effects include:

• increased risk of breast and uterine cancer
• increased risk of arthritis and osteoporosis

This beige colored patch is worn on the lower abdomen, buttocks, or upper body (but not on the breasts). It does not protect against STIs. The patch releases hormones into the bloodstream and must be changed each week for 3 consecutive weeks. During the 4th week, you do not wear the patch, so you can menstruate. This is not as effective if you weigh over 198 lbs. The patch works by doing the following:

• attempting to block an egg from being released from the ovary which prevents conception.
• thickening cervical mucus making it difficult for sperm to travel up the reproductive tract.
• thinning the lining of the uterus, so that if a baby is conceived, it would be unable to attach in the uterus, and therefore, dies.

Possible Side effects include the following:

• blood clots
• high blood pressure
• stroke
• heart attack
• skin irritation
• breakthrough bleeding
• nausea/vomiting
• headaches
• breast tenderness
• weight gain
• bloating
• yeast infections
• contact lens problems
• depression
• fluid retention

This thin rod is inserted under the skin of the upper arm. The rod contains a synthetic hormone that is released into the body for up to 4 years. It offers no protections from STIs. It works by doing the following:

• attempting to block an egg from being released from the ovary which prevents conception.
• thickening cervical mucus making it difficult for sperm to travel up the reproductive tract.
• thinning the lining of the uterus, so that if a baby is conceived, it would be unable to attach in the uterus, and therefore, dies.

Possible side effects include:

• blood clots
• weight gain
• irregular bleeding
• pain, bruising, or infection at the site of insertion
• headaches
• breast pain
• nausea
• mood swings
• acne
• vaginitis
• back pain
• dizziness
• high blood pressure
• cancerous or non cancerous liver tumors
• ovarian cysts
• scar tissue forming around implant making it difficult to remove
• injury to nerves or blood vessels in arm
• ectopic pregnancy (pregnancy outside of the uterus)
• migration of implant

This is a small plastic device inserted through the cervix and into the uterus by a physician. These IUDs have a slow releasing progesterone.  IUDs can cause an early abortion or a premature delivery. It can also cause infertility secondary to infection.  This does not prevent STIs.  This hormone releasing IUD works by doing the following:

• attempting to block an egg from being released from the ovary which prevents conception.
• thickening cervical mucus making it difficult for sperm to travel up the reproductive tract.
• thinning the lining of the uterus, so that if a baby is conceived, it would be unable to attach in the uterus, and therefore, dies.
• placing a foreign object in the uterus inhibiting implantation should an embryo try to implant

Side effects may include:

• mild to moderate pain when IUD is inserted
• painful sexual intercourse for both men and women
• difficulty in removal of the IUD in some cases requiring surgery
• cramping or backaches after insertion or during periods
• irregular bleeding
• ectopic pregnancy (pregnancy outside of the uterus)
• Pelvic Inflammatory Disease
• embedding of the IUD in the uterus
• perforation of the uterine wall or cervix
• ovarian cysts
• anemia
• headache or migraine
• acne
• depression or altered mood
• nausea
• vaginal infection

This ring releases hormones progestin and estrogen. You place the ring inside your vagina and wear the ring for 3 weeks removing it the fourth week to experience a period. You then insert a new ring. This provides no protection against STIs. It works by doing the following:

• attempting to block an egg from being released from the ovary which prevents conception.
• thickening cervical mucus making it difficult for sperm to travel up the reproductive tract.
• thinning the lining of the uterus, so that if a baby is conceived, it would be unable to attach in the uterus, and therefore, dies.

Side effects of the vaginal ring include:

• nausea
• weight gain
• accidental expulsion of the ring
• headache
• vaginal infection and irritation
• irregular bleeding patterns
• gallbladder disease
• blood clots
• cancerous and non cancerous liver tumors
• stroke
• heart attack
• decreased sex drive

Spermicides are chemicals that kills sperm. They come in foam, gel, cream, vaginal suppositories, and film.  Using spermicides with condoms may compromise the effectiveness of a condom. Spermicides do not prevent STIs. Possible side effects include:

• vaginal or penile irritation, itching, burning, or soreness
• vaginal discharge
• vaginal dryness
• painful urination

This is a small, soft plastic device that works as a barrier method like a diaphragm, but it also releases a spermicide, which is a chemical meant to kill sperm. This is placed deep into the vagina prior to having sex.  The sponge should not be used if you are on your period, have had an abortion, or recently given birth. It may not stay in for more than 30 hours. It does not offer any protection against STIs. Side effects may include:

• Toxic Shock Syndrome
• vaginal or penile irritation, itching, burning, or soreness

These metal coils are inserted through the cervix and uterus and into the Fallopian tubes.  This procedure is done at a physician’s office.  The coils work by allowing an inflammatory response from the body attacking a foreign object causing the tubes to scar which should prohibit sperm from traveling into and throughout the tube. If pregnancy occurs, there is a higher chance that it may be ectopic (outside of the uterus). This procedure must be followed with imaging to make certain the tubes are closed. This is considered permanent and not reversible. If the coils need to be removed, surgery is required. This provides no protection against STIs. Some side effects may include:

• perforation of the uterus and/or tubes
• nickel allergy
• ectopic pregnancy
• migrating coils (coils that leave the tubes and end up somewhere else in the body)

Female sterilization, also known as “getting your tubes tied”, is a surgical procedure that permanently blocks the Fallopian tubes. When the tubes are blocked after a tubal ligation, sperm cannot get to an egg and cause pregnancy. If pregnancy occurs, there is a greater likelihood that it will remain in the tubes and not become implanted in the uterus. It offers no protection against STIs. This should be considered permanent and not reversible; however, there is a chance that the ends of the tubes can reconnect allowing a pregnancy to happen. Possible side effects include:

• ectopic pregnancy

In this male sterilization surgery, the tubes that allow for the sperm to leave the body during ejaculation are cut. The results are not immediate, and it may take some time before a man is considered sterile. This is considered a permanent method of birth control and offers no protection against STIs. Possible side effects include:

• pain and swelling at the site
• chronic pain and swelling of the testis and epididymis
• sperm granulomas found as lumps in the testis
• post vasectomy pain syndrome-chronic long-term pain felt in the testis and lower pelvis