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Back on Birth Control?
...
a look at the methods


Is your man “sponge worthy”? Or is he a condom kind of guy? What about “the pill” or “the patch”? With so many methods of birth control out there, how is a girl (or guy) to choose?

Natural Methods

Continuous Breast Feeding

Description: Breastfeeding on demand for six months postpartum. Your baby must consume only breast milk as her food.

Effectiveness: Up to 98% effective ONLY IF a woman has not had a period since delivery, baby suckles at least six times a day on both breasts, and mom wakes baby for nighttime breastfeeding. It is best to use a backup method with breast feeding.

Advantages: No medical or hormonal side effects. No supplies needed.

Disadvantages: Can be unreliable. Only effective for six months.

Withdrawal Method

Description: Man withdraws penis before ejaculation.

Effectiveness: 73-96% effective. Pregnancy is possible if sperm is spilled onto vulva or if penis is not withdrawn in time.

Advantages: No medical or hormonal side effects. No supplies needed.

Disadvantages: Can be unreliable. Requires experience for man.

Fertility Awareness-Based Methods (FAMs)

Description: Sometimes referred to as the “Rhythm Method”. Woman charts her menstrual cycle, temperature patterns, and/or tracks cervical mucus consistency to determine the time period in which she normally ovulates. Sex is avoided or a barrier method (condom or diaphragm) is used during that time period.

Effectiveness: 75% effective. You should not use this method is you have irregular periods, irregular body temperature patterns, or an uncommitted or uncooperative partner.

Advantages: No medical or hormonal side effects. Calendars, thermometers, and charts are easy to get and cheap.

Disadvantages: These methods require months of training and charting to determine your conceptual timeline. Illness or even lack of sleep can cause inaccurate readings. Vaginal infections and the use of douches can interfere with cervical mucus.

Sterilization

Description: Tubal sterilization – permanently blocks tubes so the egg cannot meet with sperm. Vasectomy – permanently blocks tubes in testes so sperm is not ejaculated.

Effectiveness: 99.5% - 99.9%

Advantages: Permanent. No lasting side effects. No effects on sexual pleasure.

Disadvantages: Risks of minor surgery. Healing time with some pain. Permanent – you can no longer have natural children and it is often irreversible.

Cost: Tubal sterilization: $2,000 - $6,000. Vasectomy: $240 - $520

Hormonal Methods

Depo-Provera ® Shots

Description: The shot is injected into your buttocks or arm every 12 weeks. The hormone that is injected is similar to the progesterone made by your ovaries. It begins its work two days later in which it should stop the ovaries from releasing an egg. It also may thicken the cervical mucus, which prevents the sperm from joining your egg.

Effectiveness: 97% - 99% effective

Advantages: Once injected, no thought required for twelve weeks. Can be used while breastfeeding. Helps prevent cancer of the uterus lining. The longer you take “the shot”, the more likely you will stop having a period while on it.

Disadvantages: Irregular or absent periods, longer or heavier menstrual flow. Some physical side effects such as weight gain, depression, skin and hair changes, breast tenderness, change in sex drive. If you do get pregnant on “the shot”, you have an increased chance of an ectopic pregnancy, although very minimal.

Cost: $30 - $75 for the injection plus the cost of the visit

Progestin-Only Pills (POP)s

Description: A monthly pack of pills taken daily containing a synthetic form of the progesterone hormone.

Effectiveness: 92% - 99% effective

Advantages: Like “the pill”, these require no regular doctor visits. You can breastfeed while taking this pill. Ability to become pregnant when you stop is immediate. Decreases menstrual cramps. Nothing needs to be done before sex.

Disadvantages: Irregular or absent periods. Headache, nausea, dizziness, sore breasts, should be taken at the same time every day.

Cost: $20 - $35 per pack plus cost of initial doctor visit.

The IUD (Intrauterine Device)

Description: A plastic device inserted into the uterus by a doctor that prevents fertilization of an egg. The ParaGard ® (copper T 380A) can be left in place for 12 years. Mirena ® is effective for five years.

Effectiveness: One of the most effective reversible birth control methods. 99% - 99.5% effective

Advantages: Like “the pill”, these require no regular doctor visits. You can breastfeed while using this method. Ability to become pregnant when you stop use of the device is immediate. Decreases menstrual cramps. Nothing needs to be done before sex.

Disadvantages: Cramping may be greater during the time after the initial insertion. Periods may be heavier and last longer with ParaGard ®

Costs: $175 - $400 for insertion plus cost of initial doctor visit.

The Pill – Combined Oral Contraceptives

Description: A monthly pack of pills taken daily containing a synthetic form of the progesterone and estrogen hormones. These hormones thicken the cervical mucus and suppress ovulation.

Effectiveness: 92% - 99.5% effective

Advantages: Requires no regular doctor visits. Ability to become pregnant when you stop is immediate. Decreases menstrual cramps. More regular, lighter flow periods. Nothing needs to be done before sex. Health benefits such as decreased risk for pelvic inflammatory disease, ectopic pregnancies, osteoporosis, ovarian and uterine cancer, and ovarian growths or cysts. Less acne, less anemia. Decreases PMS symptoms. Less vaginal dryness.

Disadvantages: Temporary within the first few months: irregular bleeding, weight gain or loss, nausea, tender breasts, and/or changes in mood. The pill must be taken at the same time every day. The pill should not be taken by smokers or by those with certain medical conditions such as heart disease, diabetes, high blood pressure, high cholesterol, and blood clotting risks. The pill increases your chances of developing blood clots and/or liver damage. These risks are minimal for healthy non-smokers under the age of 35. Talk to your doctor for more information.

Cost: $20 - $35 per pack plus cost of initial doctor visit. Ask for a generic version to decrease cost.

The Ring – NuvaRing ®

Description: A small, flexible ring that is inserted into the vagina for three weeks and then taken out in the fourth week. It releases synthetic progesterone and estrogen hormones. These hormones thicken the cervical mucus and suppress ovulation.

Effectiveness: 99% effective if used correctly. Do not expose the package to direct sunlight or very high or very low temperatures. If it slips out of the vagina, it must be replaced within 3 hours. It must stay in the vagina 3 weeks in a row, but not longer than 3 weeks at a time.

Advantages: Requires no regular doctor visits. Does not require daily maintenance. Does not require a fitting. Protects against pregnancy for one month. Ability to become pregnant when you stop is immediate. Decreases menstrual cramps. More regular, lighter flow periods. Nothing needs to be done before sex. Health benefits such as decreased risk for pelvic inflammatory disease, ectopic pregnancies, osteoporosis, ovarian and uterine cancer, and ovarian growths or cysts. Decreases PMS symptoms. Less vaginal dryness.

Disadvantages: Increased vaginal discharge. Can cause vaginal irritation or infection. No barrier method backup method can be used. Temporary within the first few months: irregular bleeding, weight gain or loss, nausea, tender breasts, and/or changes in mood. The ring should not be used by smokers or by those with certain medical conditions such as heart disease, diabetes, high blood pressure, high cholesterol, and blood clotting risks.

Cost: $20 - $35 per package plus cost of initial doctor visit.

The Patch – Ortho Evra ®

Description: A thin, plastic beige-colored patch worn on the skin of the buttocks, stomach, upper outer arm or torso once a week for 3 out of 4 weeks. The patch releases synthetic progesterone and estrogen hormones. These hormones thicken the cervical mucus and suppress ovulation.

Effectiveness: 99.5% effective if used correctly. For maximum effectiveness, the patch should be changed on the same day of the week for three weeks in a row. Pregnancy can result if the patch becomes loose or falls off for more than 24 hours, or if the same patch is left on the skin for more than one week.

Advantages: Require no regular doctor visits. Does not require daily maintenance. Protects against pregnancy for one month. Ability to become pregnant when you stop is immediate. Decreases menstrual cramps. More regular, lighter flow periods. Nothing needs to be done before sex. Health benefits such as decreased risk for pelvic inflammatory disease, ectopic pregnancies, osteoporosis, ovarian and uterine cancer, and ovarian growths or cysts. Decreases PMS symptoms. Less vaginal dryness.

Disadvantages: Possible skin reaction where the patch is placed. Temporary within the first few months: irregular bleeding, weight gain or loss, nausea, tender breasts, and/or changes in mood. The patch should not be worn by smokers or by those with certain medical conditions such as heart disease, diabetes, high blood pressure, high cholesterol, and blood clotting risks. Please keep in mind that the Patch has recently been suspected of having a three times greater risk of stroke and blood clots than the Pill. Talk to your doctor for more information.

Cost: $20 - $35 per patch plus cost of initial doctor visit.

Prescription Barrier Methods

Diaphragm/Cervical Cap

Description: A diaphragm is a dome-shaped cup that is fitted to the shape of your cervix.

A cervical cap is a thimble-shaped cup similar to the diaphragm, but smaller. You should not use these methods until 6-8 weeks after childbirth.

Effectiveness: The Diaphragm: 84% - 94% effective.

Cervical Cap: 84% - 91% effective for women who have never given birth. 68% - 76% effective if you have given birth.

Advantages: Can be inserted hours ahead of sex. Portable, can be carried in your pocket or your purse. Can’t be felt by partner or by you. No effect on hormones. Can use while breastfeeding.

Disadvantages: May be difficult for some women to insert. Need to insert every time you have sex for maximum effectiveness. May require refittings. Some sexual positions or penis sizes may push the barriers out of place. Bladder infections may result. Women who are allergic to latex or spermicide cannot use these methods. Cannot use this method during menstruation. Need to use spermicide in addition to the barrier to achieve maximum effectiveness. (Can be messy)

Cost: $15 - $75 for barrier. $8 - $17 for spermicide.

Non-Prescription Barrier Methods

Condom/Female Condom/Spermicide

Description: A condom is a sheath of latex or plastic placed on the penis right before sex. A female condom is a plastic pouch with rings on each end that is placed deep in the vagina like a diaphragm with one ring covering the cervix and the other end open on the outside of the vagina. Spermicide should ideally be used with both of these for maximum effectiveness.

Effectiveness: Condom: 85% - 98% effective. 98% effective with perfect use.

Female Condom: 79% - 95% effective. 95% effective with perfect use.

Advantages: Portable, can be carried in your pocket or your purse. No effect on woman’s hormones. Can use while breastfeeding. No side effects, unless you are allergic to latex. Can be used with other methods. Men can use a condom, sharing the responsibility with you. Helps men with premature ejaculation. Female condom may stimulate the clitoris. Protects against STDs.

Disadvantages: Condoms can break if they are not used properly. Must be careful that sperm is not spilled during withdrawal. Some report diminished sexual pleasure. Can be messy.

Cost: $.50 per condom. $2.50 per female condom.

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