MSD Manual

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Comparing Contraceptive Methods

Comparing Contraceptive Methods

Method

Convenience

Side Effects

Other Considerations

Hormonal methods

Implants require action only once every 3 years.

A doctor inserts a small rod that contains a progestin under the skin of the inner arm.

Irregular or no menstrual periods during the first year

Headaches and weight gain

Restrictions for use are generally less than those for contraceptives that contain estrogen.

An incision is required to remove implants.

An injection is given by a doctor every 3 months.

Irregular bleeding (more or less frequent menstrual periods), which becomes less frequent with time

After 2 years, often no menstrual periods while injections are being used

Weight gain, headache, and a temporary decrease in bone density

The levonorgestrel-releasing IUD requires action only once every 3 or 5 years, depending on the type used.

IUDs are inserted and removed by a doctor.

Irregular bleeding and/or no menstrual period

Rarely, perforation of the uterus

Occasionally, the IUD is expelled.

Daily action is usually required.

With combination oral contraceptives (estrogen plus a progestin), a woman typically takes the contraceptive every day for 3 weeks, followed by an inactive tablet every day for 1 week.

Progestin-only oral contraceptives are taken every day at the same time of day.

A visit to the doctor is required periodically to have the prescription renewed.

Combination oral contraceptives: Breakthrough bleeding (usually only during the first few months of use)

Nausea, bloating, fluid retention, increased blood pressure, breast tenderness, headaches, and weight gain

Increased risk of blood clots

Progestin-only oral contraceptives: Side effects similar to those of contraceptive implants

Women who are older than 35 and who smoke should not take oral contraceptives.

Women who take oral contraceptives are less likely to have menstrual cramps Menstrual Cramps Menstrual cramps are pains in the lowest part of the torso (pelvis), a few days before, during, or after a menstrual period. The pain tends to be most intense about 24 hours after periods begin... read more , premenstrual dysphoric disorder Premenstrual dysphoric disorder A short discussion of prolonged grief disorder. Depression is a feeling of sadness and/or a decreased interest or pleasure in activities that becomes a disorder when it is intense enough to... read more (a severe form of premenstrual syndrome), acne, and abnormal uterine bleeding Abnormal Uterine Bleeding (AUB) Abnormal uterine bleeding is bleeding from the vagina that occurs frequently or irregularly or lasts longer or is heavier than normal menstrual periods. The most common type of abnormal bleeding... read more Abnormal Uterine Bleeding (AUB) . They are also less likely to develop osteoporosis Osteoporosis Osteoporosis is a condition in which a decrease in the density of bones weakens the bones, making breaks (fractures) likely. Aging, estrogen deficiency, low vitamin D or calcium intake, and... read more Osteoporosis and several types of cancer (such as endometrial cancer Cancer of the Uterus Cancer of the uterus develops in the lining of the uterus (endometrium) and is thus also called endometrial cancer. Endometrial cancer usually affects women after menopause. It sometimes causes... read more Cancer of the Uterus and ovarian cancer Ovarian Cancer Ovarian cancer, which typically starts on the surface of the ovaries, is not usually diagnosed until it is advanced. Ovarian cancer may not cause symptoms until it is large or has spread. If... read more ).

Women apply a new patch every week for 3 weeks, then remove it and leave it off for 1 week.

A visit to the doctor is required periodically to have the prescription renewed.

Similar to those of oral contraceptives

Skin irritation at the application site

Restrictions are similar to those of oral contraceptives.

Depending on when women start using the patch, they may need to use a backup method of birth control during the first week of use.

Women insert a ring once every 3 weeks, then remove it and not use it for 1 week. Or they may leave the ring in place for 4 or even 5 weeks, then remove it and replace it with a new one. A new ring is used each time.

A visit to the doctor is required periodically to have the prescription renewed.

Generally similar to those of oral contraceptives, except that irregular bleeding is typically less frequent with the ring

Restrictions are similar to those of oral contraceptives.

Depending on when women start using the ring, they may need to use a backup method of birth control during the first week of use.

Rings may be expelled. If they are expelled and then reinserted within 3 hours, no backup method of birth control is needed.

Barrier methods

Women may insert a cervical cap up to 40 hours before sexual intercourse. They must leave it in place for at least 6 hours after intercourse, but it should not stay in place for longer than 48 hours.

Allergic reactions and skin irritation

This method cannot be used during menstruation.

Men apply a condom immediately before every act of sexual intercourse.

Condoms for women are inserted into the vagina, and the penis is carefully guided into the condom.

Condoms are discarded after one use.

Condoms are available over the counter.

Allergic reactions and irritation

Latex condoms are the only contraceptives that provide protection against all common sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection. Condoms made of a synthetic material such as polyurethane, polyisoprene, or silicon rubber provide some protection, but they are thinner and more likely to tear.

Condoms must be used correctly to be effective.

This method requires diligence and cooperation by the sex partner.

Women insert the sponge before sexual intercourse. The sponge can be inserted in advance and is effective for 24 hours. It must be left in place for at least 6 hours after intercourse. It is discarded after one use.

Sponges are available over the counter.

Allergic reactions and vaginal dryness or irritation

Sponges may be difficult to remove. They must be removed after 30 hours.

Sponges are less effective than diaphragms.

Women insert a diaphragm before sexual intercourse. The diaphragm should be left in place for at least 6 to 8 hours and may be left in place for up to 24 hours. For most diaphragms, a doctor fits the diaphragm and checks the fit at least once a year and after childbirth. The SILCS diaphragm is an exception The SILCS diaphragm is a single-size contraceptive barrier device that does not require fitting by a doctor.

The spermicidal cream or gel used with a diaphragm may make insertion messy.

Allergic reactions, irritation, and urinary tract infections

After initial insertion of the diaphragm, additional cream or gel should be inserted into the vagina before each act of intercourse.

Other methods

Copper IUD

Copper IUDs require action only once every 10 years.

IUDs are inserted and removed by a doctor.

Bleeding and/or pain

Rarely, perforation of the uterus

Occasionally, the IUD is expelled.

Women keep track of their fertile days by

  • Using a calendar

  • Checking their cervical mucus almost every day

  • Checking their cervical mucus plus body temperature and other symptoms almost every day

None

This method requires diligence by women and abstinence from sexual intercourse several days a month. It is less effective for women with irregular menstrual cycles.

Withdrawal method

Men withdraw their penis from the vagina before ejaculation.

Self-control and precise timing are required.

None

This method is less effective than other methods because sperm may be released before ejaculation and because the man may not withdraw before ejaculation.