15 ways to prevent pregnancy

By Jayne Leonard   

Reviewed by Holly Ernst, PA-C   

    Barrier methods, Hormonal methods, IUDs and implants Other methods

People who are sexually active and want to avoid pregnancy should be aware of their options when it comes to birth control. There are many types of contraception available to help avoid pregnancy. However, the only completely reliable method for avoiding pregnancy is abstaining from sex.

The Family Planning Association (FPA) in the UK, claim that up to 90 percent of sexually active women will become pregnant in 12 months if they do not use contraception. A person risks becoming pregnant every time they have sex without contraception, including the first time they ever have sex.

Some methods are available without a prescription, but most require one. Each form of birth control has advantages and disadvantages. Read on to learn more about the different types of contraception designed to help people avoid pregnancy.
Barrier methods

Barrier methods prevent sperm from reaching the egg. They include:

1. Male condoms

Condoms can protect against STIs as well as pregnancy. Male and female condoms are the only types of contraception that protect against sexually transmitted infections (STIs). When used correctly, male condoms are more than 80 percent effective against pregnancy, according to the Centers for Disease Control and Prevention (CDC).

To use a male condom correctly:

•     Choose the correct size.
•     Place the condom on the head of the erect penis. If uncircumcised, pull the foreskin back first.
•     Pinch the tip of the condom to remove any air.
•     Unroll the condom down the penis, being careful not to tear it.
•     After intercourse, hold the base of the condom in place before pulling out of the vagina.
•     Remove the condom and dispose of it. Never reuse a condom.

Most male condoms are made of latex, but other types are available for those with a latex allergy. If using a lubricant, check that it is compatible with the kind of condom being used. For example, latex condoms can only be used with water-based lube. Condoms are available over-the-counter (OTC), without a prescription, from supermarkets, drugstores, or online. Latex-free condoms are also available to buy online.

2. Female condoms

Female condoms are also available without a prescription. They can be used instead of a male condom, but should never be used with one. According to the CDC, female condoms are about 79 percent effective for contraception. Many drugstores now sell female condoms, but if local stores do not stock them, they are available online.

3. Diaphragm

A diaphragm is a barrier method of contraception that a person places inside the vagina. It is important to apply spermicide to the diaphragm before each use. When used with spermicide, the CDC estimate that the diaphragm is close to 90 percent effective. A person must insert the diaphragm a few hours before intercourse, leave it in place for 6 hours after sex, and remove it after 24 hours. Diaphragms do not protect against STIs.

4. Cervical cap

A cervical cap (sold as FemCap in the United States) is a soft silicone cup that is placed deep inside the vagina. It covers the cervix to stop sperm from reaching an egg. This effectiveness of the cervical cap varies according to sources, but Planned Parenthood estimate that its effectiveness ranges from about 70 to 85 percent. It does not protect against STIs.

5. Sponge

The contraceptive sponge is a method of birth control that a person can buy without a prescription. Made of polyurethane foam and containing spermicide, the sponge is placed deep inside the vagina to block entry to the uterus. Used alone, the sponge is 76 to 88 percent effective, but using it with a condom further reduces the risk of pregnancy and STIs. Contraceptive sponges are available to buy online.

6. Spermicide

Spermicide is a chemical that inactivates sperm. It is available to buy without a prescription and is used with forms of barrier contraception, such as condoms, but not with the sponge. If used alone, spermicide should be inserted close to the cervix at least 10 minutes before sex. It remains effective for 60 minutes and is approximately 71 percent effective. Spermicide gels can be found at drugstores or purchased online. Talk to a doctor about the most effective ways to use spermicide as a contraceptive.

Hormonal methods

Hormonal forms of birth control prevent conception by stopping ovulation, which is the release of an egg from the ovaries. This type of contraception does not protect against STIs. Most hormonal contraceptives are only available with a prescription from a doctor and, except for emergency contraception, it is not usually available online.

7. Contraceptive pills

There are two types of birth control pills. One stops menstruation, the other does not. Birth control pills are one of the most commonly used methods of contraception in the U.S. There are various brands of pill available, and according to the National Health Service (NHS) in the UK, they are over 99 percent effective if taken as prescribed. However, with typical use, they are approximately 95 percent effective. There are two forms of the pill:

•     The combined pill, which contains estrogen and progestin: These should be taken daily, as per the instructions. The pill pack often contains some pills that are free of hormones. When taking these pills, a person will have a monthly period.
•     The mini-pill, which contains only progestin: A person must take this pill at the same time every day without a break. Someone taking the mini-pill will not necessarily have a scheduled period.

8. Patches

According to the NHS, the contraceptive patch is 99 percent effective when used correctly. With typical use, it is closer to 90 percent effective. A person can place a contraceptive patch on the:

•     back
•     buttocks
•     stomach
•     upper arm

A person must wear each patch for 3 weeks, before removing it for 1 week to allow for a menstrual period. There is a small risk of skin irritation.

9. Injection

The contraceptive shot (Depo-Provera) is usually given by a doctor every 12 weeks. According to the CDC, when used correctly, and assuming that a person gets their shot on time, it is over 90 percent effective at preventing pregnancy. According to Planned Pregnancy, it may take up to 10 months, or sometimes longer, for fertility to return to normal after a person stops getting the contraceptive shot.

10. Vaginal ring

According to the NHS, the birth control ring known as the NuvaRing is over 99 percent effective when used correctly, but is typically less than 95 percent effective due to human error. This small, plastic ring is placed in the vagina for 3 weeks. It releases hormones into the body to prevent pregnancy. The ring must be removed for 7 days to allow for a menstrual period before a inserting a new ring.
Intrauterine devices and implants Intrauterine devices (IUDs) and implants are long-term contraceptive devices. The NHS state that they are over 99 percent effective at preventing pregnancy because there is little room for human error. However, they do not protect against STIs.

11. IUDs

An IUD is a small device that a doctor inserts into the uterus. There are two types of IUDs:

1.     Hormonal: Once fitted, an IUD lasts for at least 5 years before it needs replacing. IUD's do not completely stop ovulation but act as contraception by thickening the cervical mucus to prevent sperm entering the uterus, as well other hormonal changes. Brand names include Mirena, Kyleena, Liletta, and Skyla.
2.     Copper-based: Sold as ParaGard, this hormone-free IUD is covered in copper wire, which destroys sperm trying to enter the uterus. One IUD can prevent pregnancy for approximately 10 years. Adverse reactions include spotting between periods, irregular periods, and menstrual cramps.

12. Implants

Implants are another form of hormonal birth control. A nurse or doctor inserts a matchstick-sized rod into a person's arm to protect against pregnancy. Implants work by releasing the hormone progestin into the body, which prevents ovulation. The CDC estimate that implants are also greater than 99 percent effective for contraception. Implants must be replaced about every 3 years.

Other methods

13. Natural family planning

Natural family planning relies on tracking the menstrual cycle. The natural method of contraception involves tracking the menstrual cycle and avoiding sex when a person is in the fertile phase of the menstrual cycle. An individual's "fertile window" lasts for around 6 to 9 days per month and coincides with ovulation, which is the release of the egg. Several methods are possible for natural family planning. Many people use the following signals to work out whether they are ovulating or are in their fertile window:

•     measuring basal body temperature
•     taking note of the quality and quantity of the cervical mucus
•     logging the start and end times of their cycle details over several months

Each person's fertile window is different, so a person should pay attention to their body's signals. According to the CDC, natural family planning methods are about 76 percent effective when followed accurately.

14. Emergency contraception

In the case of unprotected sex or failed birth control, such as a broken condom or a failure to take the contraceptive pill, it is possible to use emergency contraception to reduce the risk of pregnancy. Emergency contraception should not be used in place of regular birth control methods.

There are two forms of emergency contraception:

1.     Emergency contraceptive pill: People must take a hormonal pill within 3 days of intercourse. The sooner a person takes it, the more effective it is, so a person should take it as soon as possible after having sex. The pill usually contains the chemical levonorgestrel. These pills are available from a doctor or a drugstore.
2.     Copper IUD: The ParaGard IUD can be inserted up to 5 days after sex to prevent pregnancy. According to Planned Pregnancy, it is more than 99.9 percent effective when used in this timeframe.

15. Sterilization

Both women and men can undergo procedures to reduce their fertility permanently. The NHS state that these procedures are typically over 99 percent effective at preventing pregnancy, but they do not protect against STIs.

Men can get a vasectomy, which involves snipping the tubes that carry sperm. It is a minor procedure that does not require hospitalization. A vasectomy reversal is possible in some cases. However, fertility after reversal is not always fully restored.

Women can have a sterilization procedure known as tubal ligation. It involves clamping or sealing the fallopian tubes. The effects are usually permanent. In rare cases, tubes can reconnect and result in pregnancy.

When to take a pregnancy test

A woman can take a pregnancy test if she suspects she is pregnant, especially if her usual method of contraception has failed recently.

Signs of pregnancy include:

•     a missed or late period
•     enlarged or tender breasts
•     fatigue
•     increased urination
•     nausea
•     vomiting

Home pregnancy tests are inexpensive and available in pharmacies, drugstores, and from reputable websites online. It is a good idea to have the results confirmed by a doctor.

Takeaway

There are many contraceptive options to help avoid pregnancy, ranging from barrier methods to hormonal pills, patches, and IUDs. Different methods may work better for different people, and a person may try several options before working out the contraceptive strategies that work for them. Methods of contraception vary in terms of their effectiveness. People who are sexually active should speak with their doctor about the available options, so they can choose the method that is best for them.

Finally, remember that male and female condoms are the only types of contraception that prevent STIs.

Source: MedicalNewsToday