Abstinence
Abstinence is the only 100% reliable form of birth control.

Rhythm
70% effective. This means avoiding sexual intercourse at ovulation time. In order for this method to be effective, a woman must have predictable menstrual cycles, and the couple must exercise consistent restraint. The rhythm method is appropriate for those in a committed relationship who wish to have children together.

Barrier Methods of Birth Control

Condoms
97% effective

• Inexpensive and easy to obtain
• Protective against sexually transmitted disease transmission. Note: Parts of the body that touch one another, and are not covered by a condom, are not protected from STD transmission.
• Condom use is recommended for all persons engaging in oral or genital sexual relations, even if another form of birth control is being used.

Diaphragm
94% effective

• The diaphragm is not a true "barrier" because it does not block sperm from reaching the cervix. The diaphragm works by keeping the cervix submerged in spermicide, so sperm are destroyed before entering the cervix. Using a diaphragm without spermicide is not effective.
• Obtaining a diaphragm involves a visit to your gynecologist for proper sizing. Diaphragms are inexpensive and can be used repeatedly. They last for a long time.

Spermicidal Agents
94% effective

• Easy to obtain without a prescription
• Inexpensive

Hormonal Methods of Birth Control
99% effective

Oral Contraceptive Pills
OCP's are the most popular reversible form of birth control available today. The dosages of OCP's have decreased over the years, and are available in low but effective dosages associated with minimal side effects.

OCP's Have Many Benefits:

• Cycle regulation
• Reduction in bleeding. The heaviness and duration of menses are reduced
• Reduction in menstrual pain. 80% of women using OCP's will have no menstrual cramping
• Reduction in PMS symptoms
• Reduction in menstrual migraines and other symptoms when taken in such a way to reduce the number of periods per year
• Reduction in ovarian and uterine cancers
• Reduction in benign ovarian cysts
• No increased risk of breast cancer
• No increased risk of weight gain

OCP's Are Not Recommended For:

• Women who have a predisposition to forming blood clots
• Women over 35 years of age who smoke
• Women with a personal history of certain types of cancer

OCP's must be taken daily. Because they contain very low doses of hormones, if taken even a few hours late, it is common to experience spotting or bleeding. Many women experience irregular spotting/bleeding during the first 2 to 3 cycles of OCP's as they adjust to low hormone levels.

Extended Regimen OCP's
An OCP is available which results in only four periods/year. There are many advantages to this regimen. By reducing menstrual cycles from twelve to four each year, there is a parallel reduction in the number of episodes of uncomfortable menstrual-related symptoms. This is entirely safe, and does not result in more severe symptoms when menses do occur. Women who try this extended cycle regimen are typically pleased, and do not wish to return to a 12 cycle/year regimen.

Hormonal Contraceptive Patch
The patch utilizes the same hormones as the OCP, however the patch delivers the medication through the skin. The patch has the same benefits as the OCP, but does not require daily administration. Instead, it is worn for seven days at a time and then changed.

Contraceptive Vaginal Ring
The ring also contains the same hormones as OCP's, but in an even lower dose. It has the same benefits as OCP's. The ring is placed in the vagina and the hormones are slowly absorbed. It is worn for 21 days at a time.

Injectable Hormones

Depoprovera
Depoprovera contains only progesterone and is given by injection every three months. For approximately the first six months of use, bleeding patterns become very irregular, though not typically heavy. After approximately six months, most women stop having periods. This is a safe and temporary condition, and when Depoprovera injections are stopped, menses will return to the woman's typical pattern.

Benefits of Depoprovera

• When menses do not occur, the associated menstrual symptoms do not occur
• Safe for women who cannot take estrogen

Side Effects of Depoprovera

• Irregular bleeding
• Weight gain at an average rate of 4 pounds per year of use

Non-hormonal, Long-term Forms of Birth Control

Intrauterine Device
99% effective
An IUD is a small "T" shaped device that is inserted into the uterus in the office. The IUD can be removed at any time to restore fertility. There are currently two IUD's available for use in the U.S.

• Progestasert IUD
  Effective as birth control for five years from the time of insertion. Coated with progesterone, and typically results in menses that are lighter than before the IUD was placed.
• Copper IUD
  Effective as birth control for ten years from the time of insertion. Coated with copper, and typically results in menses that are heavier than before the IUD was placed.

Permanent Forms of Birth Control
99+% effective

Tubal Ligation
An outpatient surgical procedure to cut and/or burn a segment of each fallopian tube. This prevents egg and sperm from making contact, thus preventing fertilization. Tubal ligation has no long-term health risks or benefits. Some women feel that menses become heavier and more painful after a tubal ligation. It is unclear whether this is an effect of the tubal ligation or possibly an effect of stopping OCP's because they are no longer needed for birth control, or simply a natural change associated with aging.

Vasectomy
Vasectomy involves an outpatient surgical procedure in which the vas deferens is cut to prevent sperm from traveling from the testes to ejaculation. This procedure is performed in an office surgical setting and requires only local anesthetic. There are no long term health risks or benefits associated with vasectomy.