Apr 1, 2003 Table of Contents

Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education Web site.

Information from Your Family Doctor

Birth Control

Am Fam Physician. 2003 Apr 1;67(7):1573-1574.

What kind of birth control is right for me?

The type of birth control (or “contraception”) you choose depends on your needs. Some people only need to prevent pregnancy. Other people also may want to protect themselves or their partners from diseases that can be passed by having sex. These are called sexually transmitted diseases (STDs).

Some forms of birth control are more effective at preventing pregnancy than others. Barrier methods are not as effective as hormone methods or sterilization. Natural family planning can be just as effective if it is practiced with great care and commitment. However, the only way to make sure you do not get pregnant or get someone pregnant is to not have sex.

Barrier Methods

Barrier methods include condoms, the diaphragm, the sponge, and the cervical cap. These methods prevent pregnancy by blocking sperm from getting into the uterus and fertilizing an egg. You have to remember to use barrier methods every time you have sex, and you have to use them the right way every time for them to be effective.

Barrier methods can be made even more effective by putting spermicide on them. Spermicide comes as a foam, jelly, or cream, and kills sperm. Some barrier methods are packaged with spermicide already in them.

Condoms are an especially good choice if you or your partner have sex with other people or if either of you has had sex with other people in the past. Condoms can help prevent the spread of STDs.

Birth Control Pills

Birth control pills work mostly by preventing ovulation (the release of an egg by the ovaries). Most pills include two hormones called estrogen and progestin. Birth control pills can cause some side effects such as nausea, headache, breast swelling, water retention, weight gain, and depression. For the pill to work, you have to take it every day.

The pill may reduce cramping and shorten the number of days of bleeding during the menstrual period.

Hormone Implants, Patches, and Shots

Hormone implants, patches, and shots work much like the pill. They may have some side effects such as headache, and changes in periods, moods, and weight.

With implants and shots you do not have to think about birth control every day. The implants prevent pregnancy for five years. (You can have them removed at any time.) The shots prevent pregnancy for three months. With the patch, you have to remember to put a new patch on your body every week.

IUDs

An intrauterine device, or IUD, is made of flexible plastic. It is put into a woman's uterus by her doctor. It seems to stop sperm from reaching the egg or prevent the fertilized egg from attaching to the uterus.

Some IUDs used in the past were related to serious health problems. Today, IUDs are safer, but they still have some risks. Most doctors prefer to reserve IUDs for women who have already had a baby. The most common side effects of IUDs include heavier bleeding and stronger cramps during periods.

Sterilization

Sterilization is an operation to permanently prevent pregnancy. If you are sure that you do not want to have children or do not want more children, sterilization can be a good choice.

Tubal ligation involves closing off the fallopian tubes in a woman so that eggs cannot reach the uterus. The fallopian tubes are what the eggs travel through to reach the uterus.

Men are sterilized with vasectomy. The man's vas deferens (sperm ducts) are closed off so that sperm can't get through.

Natural Family Planning

Natural family planning requires a couple to learn when in the woman's cycle she can get pregnant (usually four days before and two days after ovulation) and use another kind of birth control or not have intercourse during those days. Natural family planning requires careful planning and commitment.

There are a number of ways to keep track of ovulation. The most effective ways involve using devices to determine when the woman is ovulating, such as a saliva tester or a cervical mucus tester, in combination with keeping track of the woman's menstrual cycle. Many hospitals and churches offer courses in natural family planning.

Withdrawal

Withdrawal is not effective. When a man tries to pull out before ejaculating, he usually leaves behind a small amount of fluid that leaks from the penis before ejaculation. This fluid has enough sperm in it to cause pregnancy.

Emergency Contraception

Emergency contraception (also called “the morning-after pill”) is a dose of certain birth control pills that prevents the sperm from reaching the egg, or prevents a fertilized egg from attaching to the uterus. You have to take these pills within 72 hours of having unprotected intercourse, and another dose usually 12 hours after the first set of pills. Some doses have two, four, or five pills. Side effects include nausea, vomiting, breast tenderness, and headache.

Emergency contraception should not be used as a regular birth control method. It is used for emergencies only, such as if a condom breaks or slips off, if your diaphragm or cervical cap slips out of place, or if you forget your birth control pills two days in a row, and after rape. Emergency contraception usually must be prescribed by a doctor. It is available at many health clinics.


This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.

Copyright © 2003 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests.

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