Robin Black, WHCNP Women's Health Care Specialist
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Your Birth Control Choices

Condom External

Method: Condom External

Effectiveness:
87%
How to use
  • Use a new condom each time you have sex
  • Use a polyurethane condom if allergic to latex
Things to know
  • Can use for oral, vaginal, and anal sex
  • Protects against HIV and other sexually transmitted infections (STIs)
Condom Internal

Method: Condom Internal

Effectiveness:
79%
How to use
  • Use a new condom each time you have sex
  • Use extra lube as needed
Things to know
  • Can use for oral, anal and vaginal sex
  • May increase vaginal/anal pleasure
  • Good for people with latex allergy
  • Protects against HIV and other sexually transmitted infections (STIs)
Diaphragm

Method: Diaphragm

Caya® and Milex®
Effectiveness:
83%
How to use
  • Put in vagina each time you have sex
  • Use with spermicide each time
Things to know
  • Can last several years
  • Spermicide may raise the risk of getting HIV
  • Raises risk of bladder infection
Emergency Contraception (EC) Pills

Method: Emergency Contraception (EC) Pills

Plan B®, Next Choice®, ella® and others
Effectiveness:
58-94%
How to use
  • Works best the sooner you take EC pills after unprotected sex
  • You can take EC up to 5 days after unprotected sex
Things to know
  • May cause spotting
  • Your next monthly bleeding may come early or late
  • Ulipristal acetate EC works better than progestin EC if your body mass index (BMI) is over 26.
  • ella EC works better than progestin EC 3–5 days after sex
Fertility Awareness

Method: Fertility Awareness

Natural Family Planning
Effectiveness:
85%
How to use
  • Predict fertile days by: taking temperature daily, checking vaginal mucus, and/or keeping a record of your monthly bleeding
Things to know
  • Can help with avoiding or trying to become pregnant
  • Use another birth control method on fertile days
  • Does not work well if your monthly bleeding is irregular
Implant

Method: Implant

Nexplanon®
Effectiveness:
>99%
How to use
  • A clinician places it under the skin of the upper arm
  • It must be removed by a clinician
Things to know
  • Lasts up to 5 years
  • May cause irregular spotting or no monthly bleeding at all
  • Cramps often improve
IUD - Copper

Method: IUD - Copper

ParaGard®
Effectiveness:
>99%
How to use
  • Must be placed in uterus by a clinician
  • Usually removed by a clinician
Things to know
  • Lasts up to 12 years
  • May cause cramps and heavy monthly bleeding
  • Can be used as emergency contraception up to 5 days after unprotected sex
IUD - Hormonal

Method: IUD - Hormonal

Liletta®, Mirena®, Skyla®, and others
Effectiveness:
>99%
How to use
  • Must be placed in uterus by a clinician
  • Usually removed by a clinician
Things to know
  • Lasts 3 to 8 years, depending on which IUD you get
  • May improve cramps
  • May cause lighter monthly bleeding, spotting, or no monthly bleeding at all
  • Uses levonorgestrel, a progestin
  • Some types can be used as emergency contraception up to 5 days after unprotected sex
The Patch

Method: The Patch

Ortho Evra®
Effectiveness:
93%
How to use
  • Apply a new patch once a week for three weeks
  • No patch in week 4
Things to know
  • Can irritate skin under the patch
  • Can make monthly bleeding more regular and less painful
  • May cause spotting the first few months
The Pill

Method: The Pill

Effectiveness:
93%
How to use
  • Take the pill daily
Things to know
  • Can improve acne and premenstrual syndrome (PMS) symptoms
  • May cause nausea, weight gain, headaches, change in sex drive
  • Can make monthly bleeding more regular and less painful
  • May cause spotting the first few months
Progestin-Only Pills

Method: Progestin-Only Pills

Effectiveness:
93%
How to use
  • Take the pill daily
Things to know
  • May cause changes in hair, skin, or sex drive
  • Can make monthly bleeding more regular and less painful
  • May cause spotting the first few months
The Ring

Method: The Ring

ANNOVERA® and Nuvaring®
Effectiveness:
93%
How to use
  • Insert a small ring into the vagina
  • Monthly Ring: Change ring each month
  • Yearly Ring: Change ring each year
Things to know
  • There are 2 types: a monthly ring and a yearly ring
  • Can make monthly bleeding more regular and less painful
  • May cause spotting the first few months
  • Can increase vaginal discharge
The Shot

Method: The Shot

Depo-Provera®
Effectiveness:
96%
How to use
  • Get a shot every 3 months (13 weeks)
  • Give yourself the shot or get it in a medical office
Things to know
  • May cause changes in mood, weight, hair, skin, or sex drive
  • Side effects may last up to 6 months after you stop the shots
  • Often decreases monthly bleeding
  • May cause spotting or no monthly bleeding
Sterilization: Tubal Methods

Method: Sterilization: Tubal Methods

“tubes tied”
Effectiveness:
>98%
How to use
  • This method closes the fallopian tubes
  • A clinician reaches the tubes through your belly
Things to know
  • This method is permanent
  • Reversal is difficult
  • Risks include infection, bleeding, pain, and reactions to anesthesia
Sterilization: Vasectomy

Method: Sterilization: Vasectomy

Effectiveness:
>99%
How to use
  • A clinician blocks or cuts the tubes that carry sperm
  • Can be done in the clinician’s office
Things to know
  • This method is permanent
  • It is more effective, safer, and cheaper than tubal procedures
  • Reversal is difficult
  • Risks include infection, pain, and bleeding
  • It may take a few months to work
Vaginal Acidifying Gel

Method: Vaginal Acidifying Gel

Phexxi®
Effectiveness:
86%
How to use
  • Insert gel in vagina each time you have sex
Things to know
  • Can be put in as part of sex play/foreplay
  • Does not have any hormones
  • Requires a prescription
  • May irritate vagina, penis
  • Should not be used with urinary tract infection
Vaginal Spermicide

Method: Vaginal Spermicide

cream, gel, sponge, foam, inserts, film
Effectiveness:
79%
How to use
  • Insert spermicide each time you have sex
Things to know
  • Comes in many forms: cream, gel, sponge, foam, inserts, film
  • May raise the risk of getting HIV
  • May irritate vagina, penis
  • Can buy at many stores without a prescription

Method: Withdrawal

Pull-out
Effectiveness:
80%
How to use
  • Pull penis out of vagina before ejaculation (coming)
Things to know
  • Costs nothing
  • Less pleasure for some
  • Does not work if penis is not pulled out in time
  • Must interrupt sex

*Typical Use

If you are looking for protection from STIs and HIV, both the internal and external condom are great options!

www.reproductiveaccess.org

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Source: Reproductive Health Access Project patient education handout. This page reproduces patient education material for convenience; Robin Black, WHCNP is not the original author.