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Contraception: What Are Your Options?

contraceptive options With the advancement of science, there are many options for preventing pregnancy. Learning about each type can help you make an educated decision about which method to choose.

What Is the Best Birth Control Method for Me?

Take your time when it comes to determining which birth control method you'll use. Do your homework. Research what is available. Talk to your close friends and see what methods they use and how they like them. And talk to your doctor. Factors that are important to your decision include:
  • Your health
  • Frequency of sexual activity
  • Number of partners
  • Desire to have children in the future

Abstinence

Abstinence is not having sexual intercourse. It is the only 100% effective way to avoid pregnancy and sexually transmitted diseases (STDs), including HIV infection.

The Pill

The pill, also known as the oral contraceptive pill or birth control pill, is a popular form of reversible contraception in the United States. It uses a combination of estrogen and progestin (female hormones) to suppress ovulation (the monthly release of an egg from the ovaries). Taken daily, the chance of becoming pregnant is very low. The pill does not protect against STDs, and is not recommended for women who smoke, have a history of blood clots , or have certain types of cancer.

Mini-pills

These are progesterone-only pills that are a popular choice for women right after giving birth. While these mini-pills are less effective than combination pills, they are often used after delivery because the combination pills can increase your risk of blood clots. If you are nursing, there is insufficient evidence to show that birth control pills will affect your milk supply.

The Male Condom

Male condoms prevent pregnancy by blocking the passage of sperm to the woman. Except for abstinence, latex condoms are the only kind of birth control that also reduces your risk of getting HIV and other STDs. Keep in mind that if you use other forms of birth control, and also want protection against HIV and other sexually transmitted diseases, the man should also use a latex condom. Simultaneous use of a spermicide with condom will further reduce the chance of pregnancy.

The Female Condom

Female condoms work in a similar way as the male condom in preventing the passage of sperm. It may help reduce your risk of getting STDs, but not as effectively as the male condom.

DepoProvera

This is a shot taken every three months that uses progestin to prevent pregnancy. It is highly effective as birth control, but does not protect against STDs.

Intrauterine device (IUD)

An IUD is a T-shaped device inserted through the vagina and into the uterus by a doctor. It prevents fertilization and is a convenient and highly effective form of contraceptive, but offers no protection against STDs. Depending on what type of IUD is used, it can be effective for up to 10 years. IUDs are a good option for women who are being treated for cancer, because they are effective and reversible.

Contraceptive Patch

The patch (eg, Ortho Evra ), worn on the skin, delivers the hormones estrogen and progestin to the bloodstream. The patch is changed weekly. It is as effective as the pill.

Contraceptive Implant

This type of device (eg. Implanon, Nexplanon) is surgically implanted in the arm. The small implant releases a progestin hormone and can provide birth control for three years before it needs to be replaced.

Vaginal Ring

This is a thin, flexible ring that is inserted into the vagina and worn for three-week periods. The ring delivers estrogen and progestin. It is also as effective as birth control pills.

Diaphragms or Cervical Caps

These devices are available by prescription. They are used with spermicides and are inserted in the vagina against the cervix to block the passage of sperm.

Sponge

Available over-the-counter, the sponge is made of plastic foam and has a spermicide. The device is inserted into the vagina before having sex, then removed after. The sponge does not protect against STDs. Compared to the diaphragm, the sponge may not be as effective in preventing pregnancy.

Emergency Contraception

Emergency contraception refers to a series of contraceptive pills taken soon after sexual intercourse to prevent pregnancy. It does not prevent STDs. This method of birth control is not designed for long term use like the other birth control methods.

Surgical Sterilization

Sterilization by surgery is a permanent contraception for people who don’t want children in the future. It does not protect against STDs.
Talk with your doctor to find out what options are within your budget and would work best for your individual situation.

RESOURCES

American Congress of Obstetricians and Gynecologists http://www.acog.org

US Department of Health and Human Services Office on Women's Health http://www.womenshealth.gov

CANADIAN RESOURCES

Sex Information and Education Council of Canada http://www.sieccan.org

The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org

References

Birth control guide. United States Food and Drug Administration website. Available at: http://www.fda.gov/downloads/ForConsumers/ByAudience/ForWomen/FreePublications/UCM282014.pdf. Updated August 2012. Accessed August 18, 2012.

Birth control sponge (Today sponge). Planned Parenthood website. Available at: http://www.plannedparenthood.org/health-topics/birth-control/birth-control-sponge-today-sponge-4224.htm. Accessed August 18, 2012.

Medical eligibility criteria for contraceptive use – 4th ed. 2009. World Health Organization Website. Available at http://whqlibdoc.who.int/publications/2010/9789241563888%5Feng.pdf. Accessed August 18, 2012

Nexplanon (etonogestrel implant). Merck website. Available at: http://www.merck.com/product/usa/pi%5Fcirculars/n/nexplanon/nexplanon%5Fppi.pdf. Updated May 2012. Accessed August 18, 2012.

The vaginal ring: an alternative to birth control pills. EBSCO Patient Education Reference Center website. Available at: http://www.ebscohost.com/pointofcare. Updated May 19, 2010. Accessed July 2, 2010.

9/23/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Kuyoh M, Toritich-Ruto C, Grimes DA, Schulz KF, Gallo M, Lopez LM. Sponge versus diaphragm for contraception. Cochrane Database Syst Rev. 2008;CD003172.

6/7/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Department of Health and Human Services Centers for Disease Control and Prevention. US medical eligibility criteria for contraceptive use, 2010. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/mmwr/pdf/rr/rr59e0528.pdf. Published May 28, 2010. Accessed June 7, 2010.

8/23/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: US Food and Drug Administration. FDA approves ella tablets for prescription emergency contraception. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm222428.htm. Updated August 13, 2010. Accessed August 23, 2010.

1/28/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed : Truitt S, Fraser A, Gallo M, Lopez L, Grimes D, Schulz K. Combined hormonal versus nonhormonal versus progestin-only contraception in lactation. Cochrane Database Syst Rev. 2010;(12):CD003988.

4/15/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Kuyoh M, Toroitich-Ruto C, Grimes D, Schulz K, Gallo M, Lopez L. Sponge versus diaphragm for contraception. Cochrane Database Syst Rev. 2011;(3):CD003172.

3/8/2012 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: In brief: etonogestrel (Nexplanon) contraceptive implant. Med Lett Drugs Ther. 2012;54(1383):12.

3/31/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Patel A, Schwarz EB, et al. Cancer and contraception. Release date May 2012. SFP Guideline #20121. Contraception. 2012 Sep;86(3):191-198.

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