Birth Control

What is the best method of birth control (or contraception)?

All women and men should have control over if and when they become parents. Making decisions about birth control, or contraception, is not easy - there are many things to think about. Learning about birth control methods you or your partner can use to prevent pregnancy and talking with your health care provider are two good ways to get started.

There is no "best" method of birth control. Each method has its own pros and cons. Some methods work better than others do at preventing pregnancy. Researchers are always working to develop or improve birth control methods.

The birth control method you choose should take into account:

your overall health;

how often you have sex;

the number of sexual partners you have;

if you want to have children;

how well each method works (or is effective) in preventing pregnancy;

any potential side effects; and

your comfort level with using the method.

Bear in mind that NO method of birth control prevents pregnancy all of the time. Birth control methods can fail. But you can greatly increase a method's success rate by using it correctly all of the time. The only way to be sure you never get pregnant is to not have sex (abstinence).

What are the different birth control methods that I can use?

There are many methods of birth control that a woman can use. Talk with your health care provider to help you figure out what method is best for you. You can always try one method and if you do not like it, you can try another one.

Keep in mind that most birth control does NOT protect you from HIV or other sexually transmitted diseases (STDs) like gonorrhea, herpes, and chlamydia. Other than not having sex, the best protection against STDs and HIV is the male latex condom. The female condom may give some STD protection. Other birth control methods that involve using a spermicide (a cream or jelly that kills sperm) also may give some protection against chlamydia and gonorrhea.

Don't forget that all of the methods we talk about below work best if used correctly. Be sure you know the correct way to use them. Talk with your health care provider and don't feel embarrassed about talking with her or him again if you forget or don't understand.

Know that learning how to use some birth control methods can take time and practice. Sometimes health care providers do not explain how to use a method because they may think you already know how. For example, some people do not know that you can put on a male condom "inside out." Also, not everyone knows that you need to leave a "reservoir" or space at the tip of the condom for the sperm and fluid when a man ejaculates, or has an orgasm.

The more you know about the correct way to use birth control, the more control you will have over deciding if and when you want to become pregnant.

Here is a list of birth control methods with estimates of effectiveness, or how well they work in preventing pregnancy when used correctly, for each method:

Continuous Abstinence -This means not having sexual intercourse at any time. It is the only sure way to prevent pregnancy. This method is 100% effective at preventing pregnancy.

Periodic Abstinence or Fertility Awareness Methods - A woman who has a regular menstrual cycle has about nine or more fertile days, or days when she is able to get pregnant, each month. Periodic abstinence means you do not have sex on the days that you may be fertile. Fertility awareness means that you can be abstinent or have sex but you use a "barrier" method of birth control to keep sperm from getting to the egg. Barrier methods include condoms, diaphragms, or cervical caps, used together with spermicides, which kill sperm. These methods are 75 to 99% effective at preventing pregnancy.

Keep in mind that to practice these methods, you need to learn about your menstrual cycle (or how often you get your period). You keep a written record of when you get your period, what it is like (heavy or light blood flow), and how you feel (sore breasts, cramps). You also check your cervical mucus and take your basal body temperature daily, and record these in a chart. This is how you learn to predict, or tell, which days you are fertile or "unsafe." You can ask your health care provider for more information on how to record and understand this information.

The Male Condom - Condoms are called barrier methods of birth control because they put up a block, or barrier, which keeps the sperm from reaching the egg. Only latex or polyurethane (because some people are allergic to latex) condoms are proven to help protect against STDs, including HIV. "Natural" or "lambskin" condoms made from animal products also are available. But lambskin condoms are not recommended for STD prevention because they have tiny pores that may allow for the passage of viruses like HIV, hepatitis B and herpes. Male condoms are 86 to 98% effective at preventing pregnancy. Condoms can only be used once. You can buy them at a drug store. Condoms come lubricated (which can make sexual intercourse more comfortable and pleasurable) and non-lubricated (which can also be used for oral sex). It is best to use lubrication with non-lubricated condoms if you use them for vaginal or anal sex. You can use KY jelly or water-based lubricants, which you can buy at a drug store. Oil-based lubricants like massage oils, baby oil, lotions, or petroleum jelly will weaken the condom, causing it to tear or break. Always keep condoms in a cool, dry place. If you keep them in a hot place (like a billfold, wallet, or glove compartment), the latex breaks down, causing the condom to tear or break.

Oral Contraceptives - Also called "the pill," it contains the hormones estrogen and progestin. A pill is taken daily to block the release of eggs from the ovaries. It also lightens the flow of your period and protects against pelvic inflammatory disease (PID), ovarian cancer, and endometrial cancer. It does not protect against STDs or HIV. The pill may add to your risk of heart disease, including high blood pressure, blood clots, and blockage of the arteries. If you are over age 35 and smoke, or have a history of blood clots or breast or endometrial cancer, your health care provider may advise