Options for Reproductive Health Care

Created by: Ed Stern, UWSP Department of Biology, 2004

Summary of contraceptive advantages, possible side effects and safety concerns, and non-contraceptive benefits of various birth control methods. In general, contraception poses few serious health risks for most users. This table is only a brief summary of the advantages, side effects/safety concerns, and non-contraceptive benefits of the major methods of birth control. Therefore, it is important that you discuss the use of contraceptives with your health care provider and have a good, comprehensive understanding of the issues.

Method Contraceptive Advantages Disadvantages/Side Effects/Possible Safety Concerns Non-contraceptive Benefits
Abstinence Prevent pregnancy, STDs Psychological; peer pressure; relationship stress if both not in agreement on this method May enhance self-image; reduced stress regarding pregnancy and STIs if both are in agreement with this method
None/Chance None Pregnancy; contract STDs None
Rhythm/Family Planning [1] Acceptable to those with moral/religious concerns about birth control; inexpensive Requires high motivation; unreliable; unsuitable for irregular cycles; must abstain from coitus for up to two weeks/month Both partners share responsibility
Breastfeeding No medical or hormonal side effects for infant Requires high motivation; requires full time participation; effective only if first menses has not occurred; ovulation (and risk of conception) typically will occur 2 weeks before first menses Infant may have reduced chance of infection and allergy and increased nutritional benefits
Barrier: Spermicide only [2] Non-prescription; readily available; inexpensive High failure rate when used alone; can cause penile, vaginal irritation; some studies have found increased HIV seroconversion is commercial sex worker using spermacides May provide lubrication
Barrier: Male latex condom Non-prescription; readily available; inexpensive Reaction to latex (use polyurethane); decrease in spontaneity; loss of sensation but can be minimized by small amount of lubricant added inside tip of condom Reduced risk of STDs
Barrier: Female condom Non-prescription; readily available Awkward for some to use; noisy; not to be used with male condom Reduced risk of STDs, a barrier option the woman has control of
Diaphragm [3]/ Cervical cap [3] Reusable; does not alter hormones Prescription, fitting required; reaction to latex; may increase risk of TSS, urinary tract infection; need to use spermicide with diaphragm Some protection against cervical STDs, reduced risk of PID
Sponge [4] Non-prescription; easily inserted; effective for repeated intercourse over several hour period Slight risk of TSS; must be left in place for 6 hours after use; may have problems with removal; contains spermicide May destroy some bacteria?
Intrauterine device (IUD) No diminished sensation, spontaneity; nothing to remember; very low failure rate Prescription, fitting; possibility of uterine perforation during insertion; increased menstrual cramping and bleeding; increased risk of PID; presence of string; must be checked periodically due to possibility of expulsion ParaGard [9] and Mirena [10] may reduce risk of ectopic pregnancy; Mirena may reduce menstrual cramps and flow
Hormonal: Combination pill, skin patch, vaginal ring, injection [5] Ease of use; no loss of spontaneity; low failure rate Prescription; cardiovascular problems; nausea, headaches, spotting, weight gain May decrease menstrual pain, PMS, bleeding; protect against ovarian and endometrial cancer, PID, and ectopic pregnancy; reduce acne
Hormonal: Progestin only Minipill Can be used by women that have had problems with estrogen pills Prescription; may be menstrual irregularity; higher failure rate than combination pills Does not affect lactation; decreased menstrual pain, blood loss
Hormonal: Implant Norplant [6] Ease of use; very low failure rate Prescription; infection at implant site; difficult to remove; irregular periods; weight gain, acne Does not affect lactation; reduced menstrual cramps, blood loss
Hormonal: Injection Depo-Provera Ease of use; continuous protection; very low failure rate Prescription, office visit; weight gain; headaches; depression; irregular periods; reduction in circulating estrogen may cause reduced bone mass formation and estrogen deprivation symptoms, ? increased risk of cardiovascular disease Does not affect lactation; may reduce risk of PID and ovarian and endometrial cancer; may be useful for sexually active women unable to reliably use another form of contraception
Sterilization [7] Continuous protection; no interruption of sex Both sexes: may be minor surgical complications; not reversible; expensive; Women: risk of ectopic pregnancy Women: reduced risk of ovarian, endometrial cancer, PID; Men: none known
Emergency contraception [8]: combination pill Preven Up to 75% effective within first 72 hours Nausea, vomiting, cramping N/A
Emergency contraception [8]: progestin-only pill Plan B Up to 85% effective within first 72 hours Less risk of nausea, vomiting N/A
Emergency contraception [8]: Copper-T IUD Up to 99% effective within first 5 days Women at risk for STDs run higher risk of developing PID None

Abbreviations Used: IUD = Intrauterine Device; LAM = Lactational Amenorrhea Method; PID = Pelvic Inflammatory Disease; PMS = Premenstrual Syndrome; STD = Sexually Transmitted Disease; TSS = Toxic Shock Syndrome.

The above information summarized and modified from Hatcher, R.A. et al. (2003) and Hatcher, R.A. et al. (2004).

Footnotes:

  1. Fertility Awareness Method (FAM). Includes calendar, basal body temperature, and cervical mucus methods.
  2. While foams, creams, and gels are effective immediately, suppositories and films require 10-15 minutes to dissolve.
  3. With spermicide.
  4. Available in Canada, currently awaiting approval in U.S.
  5. Lunelle injection not currently available in U.S.
  6. Currently implanted Norplant capsules only. No longer available as of July 2002.
  7. Vasectomy in men, tubal ligation in women.
  8. Emergency Contraception should not be used if you are pregnant.
  9. Copper-T IUD.
  10. Progestin-only IUD.