ABOUT CONTRACEPTIVES: the Simplified Version

Talk with your partner about what form of contraception the two of you will use.  The “right” method for you and your partner will be the method that you can commit to using correctly and consistently, and that fits with your sexual health lifestyle.  Consult with a medical provider about contraception; they will assess your medical history and risk factors and help you choose a method of contraception.  Abstinence from sexual activity (oral, anal, vaginal, intimate skin to skin contact) is the only 100% effective way to prevent transmission of STIs and unintended pregnancy.

NON-HORMONAL METHODS
Male Condom: latex or plastic sheaths that are worn on the penis during intercourse.  They prevent pregnancy and reduce the risk of sexually transmitted infections. 
Pros: protects against all STI’s except ones contracted from genital areas not covered. Convenient, widely available, no prescription, can be used for vaginal/oral/anal sex.    
Cons: Reduced spontaneity, reduced sensation, some users may experience allergies.
Notes:  Less than $1 each**, 87-98% effective if used properly*, can become much more effective if used with spermicidal lube and the withdrawal method.  (Using spermicides containing nonoxynol-9 may pose certain risks. It may irritate tissue and increase the risk of transmitting HIV and other sexually transmitted infections.)

Female Condom: a plastic pouch inserted into the vagina to prevent pregnancy and  STI’s.  Upon removal of the inner ring, the condom may be used for anal sex.
Pros: can be placed up to 8 hours in advance, good protection against STI’s, does not require prescription or health care appt., may be used by people allergic to latex, doen’t affect a woman’s natural hormones, may enhance sex play.
Cons: only 1 style currently available, more costly than male condoms, sort of awkward to see once inserted, reduces feeling during intercourse, can be noisy (add extra lube if it is), easy to slip the penis into the vagina or anus if the condom isn’t being held in place.
Notes: 79-95% effective if used properly*, costs about $3.60 each**

Copper IUD: a small T-shaped device inserted into the uterus to prevent pregnancy by changing the lining of the uterus and preventing the way sperm naturally move. 
Pros: Can remain in place for up to 12 years, can be used as emergency contraception if inserted into the uterus up to 5 days (120 hours) after unprotected sex, low side effect profile, fertility resumes immediately after removal.
Cons: can cause heavier and longer periods, high initial cost, best for women in monogamous relationships, can be expelled or become dislodged, doesn’t protect against STI’s. 
Notes: 99% effective*,  can cost between $250-$750 up front to insert**

HORMONAL METHODS
Hormonal IUD: a small T-shaped deceive that is inserted into the uterus and contains the hormone progestin.  It works by changing the lining of the uterus, by affecting the motility of the sperm, and the progestin prevents the ovaries from releasing an egg.
Pros: it can remain in place for up to 5 years, rarely causes the hormonal side effects similar to those of birth control pills/patch/shot/implant.
Cons: possible delay in return of fertility, can cause benign ovarian cysts, doesn’t protect against STI’s.
Notes: 99% effective*, can cost between $250-$750 up front to insert**

Birth Control Pills: There are many birth control pill treatments available.  The combined pill is a hormonal treatment that includes both progestin and estrogen. The Progestin only pill doesn’t include the hormone estrogen. They work by keeping the ovaries from releasing an egg.
Pros: high rate of efficacy, multiple options available, regulates menstrual cycle, causes lighter periods, reduces menstrual cramps, decreased risk of endometrial and ovarian cancer, endometriosis, and pelvic inflammatory disease.
Cons: doesn’t protect against STI’s, can have undesirable side effects such as bleeding between periods, breast tenderness and nausea/vomiting, the hormones may change your sexual desire. 
Notes: 95-99% effective if used properly*, Costs about $15-$50 a month**

Birth Control Patch (Ortho Evra): The patch is small, thin, and sticks directly to the skin.  A new patch is applied every week, for  three  weeks.  It works just like the combined pill by releasing both estrogen and progestin into your system to prevent your ovaries from releasing an egg.
Pros: safe, effective, convenient, no need to remember a pill each day, can cause regular, lighter, and shorter periods, the ability to get pregnant returns quickly after use of the patch stops.
Cons: it doesn’t protect against STIs, can cause bleeding between periods, breast tenderness, nausea and vomiting, can cause a reaction or irritation at patch site, may change your sexual desire.
Notes:  There are many areas on the body the patch can be placed.  99% Effective if used properly*, it is less reliable for women who weigh more than 198 pounds, $15-$50 a month with a prescription**

Vaginal Ring (NuvaRing):  a small ring you put into the vagina once a month, and it stays in the vagina for three weeks.  It releases both progestin and estrogen into the body, and prevents a woman’s ovaries from releasing an egg.
Pros: safe, simple, convenient, and private, can reduce the risk of yeast infections, causes regular, lighter and shorter periods, the ability to become pregnant returns quickly after stopping use, no need to remove the ring during intercourse.
Cons: it doesn’t protect against STI’s, can cause bleeding between periods, breast tenderness, nausea or vomiting, may cause increased vaginal discharge, vaginal irritation or infection, may change your sexual desire, it may be awkward for you to insert and remove the ring.
Notes: They are about 99% effective if used properly*.  They cost about $15-$50 a month with a prescription** 

Birth Control Shot (Depo-Provera): an injection of the hormone progestin into the arm that prevents pregnancy; the shot doesn’t contain the hormone estrogen. Each shot protects for three months.
Pros: effective 24 hours after the injection, safe, convenient and private, easy to get with a prescription,
very effective and long lasting pregnancy protection, good choice for women who are breast feeding
and can help prevent cancer of the lining of the uterus.
Cons: side effects can be significant and long-lasting, it can cause a reduction in bone density, depression, and weight gain, it doesn’t protect against STI’s, it can cause breast tenderness, nausea, headache, nervousness, and change in appetite or sex drive.  The shot can cause women to have heavier and longer periods at first, and then periods become fewer and lighter the longer they use the shot.  Periods may stop completely after a year of use.
Notes: 99.7% effective if used properly*, $35-$75 per injection, plus any exam fees**

Birth Control Implant (Implanon):  a matchstick sized plastic rod that is inserted into the arm to prevent pregnancy.  A health care provider must insert it, and it does not contain estrogen.
Pros:different systems can last from 3-5 years, fertility returns relatively quickly after the implant is removed, it is safe, simple and can be used by women who are breastfeeding.
Cons: it must be inserted and removed by a health care provider, potential for scarring, causes irregular bleeding first 6-12 months, can change your sex drive or appetite. The implant can cause women to have heavier and longer periods at first, but then periods become fewer and lighter the longer they use the shot.  About 1/3 of women stop menstruating one year after use.
Notes: 99% effective if used properly*, it costs about $500 up front**

Emergency Contraception (Plan-B): EC is a safe and effective way to prevent pregnancy after you have unprotected intercourse.  EC is also called the morning after pill.  Note that it is a form of birth control, not abortion.  Each dose requires taking two pills, either at the same time, or preferably, 12 hours apart.
Pros: effective up to 5 days (120 hours) after unprotected intercourse, though it is more effective the sooner it is used
Cons: causes you to immediately have a period, which is usually long lasting, and heavy.
Notes: 95% effective if used properly*, Costs about $30 per dose (2 pills)**

*Talk to a health care provider about which method is right for you and how to effectively use each birth control method listed above.  Note that not all forms of birth control have been presented.  Make an appointment at UMD Health Services by calling 218-726-8155.
**4me @ UMD is a Minnesota family planning program that allows students to receive free contraceptives, condoms, STI testing, annual exams, and sex education.  Go to http://www.d.umn.edu/hlthserv/medical/4me.html to download an application to the program—its free, why not!?