Healthcare Information

Birth control methods comparison chart

The Pill
Combination low dose hormone formulation Estrogen prevents egg maturation and progestin stops lining of uterus from preparing to receive egg; cervical plug may impede sperm penetration.

Main Advantages

  • Most effective reversible method for preventing pregnancy if directions followed;
  • Easy to use; lighter, more regular periods; fewer menstrual cramps;
  • Lower risk of PID (pelvic inflammatory disease) and ovarian cysts;
  • Protects against cancer of the ovaries and uterine lining;
  • May lessen benign lumpy breast disease;
  • Does not impair fertility;
  • May reduce risk of ectopic pregnancy (outside uterus).
Main Drawbacks and Precautions
  • Nuisance side effects (in 10-12% of users): nausea, headaches, weight gain, reaction with other drugs, e.g. antibiotics; and breakthrough bleeding which may call for brand change. Missed pill requires back-up contraception for rest of month;
  • Slight risk of blood pressure elevation;
  • Possibly raises blood lipid (fat) levels;
  • Possible rise in cardio- and cerebrovascular risks — far greater with smoking;
  • May aggravate diabetes and epilepsy;
  • May increase risk of cervical cancer and (rarely) non-malignant liver tumours.
Suitability: Best people to use it
Good for women under 35 (some say under 40). Not for smokers, especially if over 30, nor for women with high blood pressure, heart problems, diabetes, high cholesterol/blood fats, liver, kidney or gall-bladder disease, epilepsy or jaundice. (See product package list for contraindications).

Convenience, Availability & Cost
Easy to use for women with regular lifestyle; requires daily pill swallowing, whether or not having regular intercourse. Periodic medical checkups advised while on it. Available by prescription. Discuss benefits vs. drawbacks and drug interaction with physician.

Estimated Failure Rate:
Among average users: 2 — 2.5%
Among reliable, consistent users: 0.5%

IUD (IUD Intrauterine device)
Mechanism unclear, but foreign body in uterus triggers collection of white blood cells (which kill sperm) and hostile uterine environment impedes implantation of fertilize egg. May prevent fertilization by harming sperm.

Main Advantages
  • Highly effective;
  • Inexpensive;
  • Once fitted, usually unfelt/unnoticed;
  • Needs replacing only once every 2-2 ½ years;
  • Convenient, effective, long-lasting;
  • Easily removed and reinserted if necessary;
  • Doesn’t generally disturb intercourse;
  • No daily equipment needed;
  • No effect on breastfeeding;
Main Drawbacks and Precautions
  • Chance of unnoticed slippage or expulsion;
  • Must regularly feed for string to check placement;
  • Increased risk of PID, possibly with resultant infertility (especially in women with many partners);
  • May increase menstrual bleeding and cramping;
  • Rare chance of uterine perforation during insertion;
  • Possibly higher risk of ectopic pregnancy (outside uterus), miscarriage and septic abortion if conception accidentally occurs with IUD in place.

Suitability Best people to use it
Good candidates: monogamous women not exposed to STDs (sexually transmitted diseases), not suitable for women at risk of STDs;
Poor candidates: teenagers, women with multiple sex partners;
Often best suits women who had all desired children, or not allowed for some reason to take the Pill.

Convenience, Availability & Cost
Inserted by physician. Once in place can remain for 2 ½ years, often without trouble. Must feel for string to ensure it is in place. Available from physician or family planning clinic.

Estimated Failure Rate:
Among average users: 4 %
Among reliable, consistent users: 1.5%

Condom (Condom with spermicide)
Thin shealth over erect penis traps sperm, prevents entry into cervix so egg can’t be fertilized. Best used with spermicide; newer spermicide-impregnated brands still need water-based sperm-killing foam or jelly (NOT Vaseline or petroleum jelly).

Main Advantages
  • Easy availability in many stores and pharmacies without prescription;
  • Latex brands help protect against sexually transmitted diseases (e.g. AIDS, gonorrhea);
  • Gives men an active role in birth control;
  • Offers good protection if used consistently and carefully;
  • Lambskin types not recommended.
Main Drawbacks and Precautions
  • Inhibits spontaneous lovemaking;
  • Unaesthetic; may reduce pleasurable (erotic) sensation;
  • Possible allergy to latex or other condom material and/or spermicide;
  • Can break (1-3 tears per 100 untested brands);
  • May slip off;
  • Requires care on removal to avoid spills.
Suitable Best people to use it
Good to protect against STDs. Often first method tried by teenagers; good if can incorporate as regular part of lovemaking; not fully reliable for people who are likely to use incorrectly or inconsistently (e.g., teens).

Convenience, Availability & Cost
Readily obtained in many stores and any pharmacy; must be put on before any genital contact; shop around for best brand; must use with lubricant and spermicide. Advice available from family planning centres, family doctor.

Estimated Failure Rate:
Among average users: 14% +
Among reliable, consistent users: 2 — 8%

Female Sterilization (Female Sterilization Tubal ligation)
Fallopian tubes occluded (clipped), cauterized (burned), or cut to prevent egg from reaching uterus.

Main Advantages

  • Highly effective;
  • One time, relatively simple procedure, with few complications;
  • Done as “day” / outpatient or in-hospital procedure;
  • Back to work in a few days.

Main Drawbacks and Precautions

  • Usual risks of surgery and anaesthetic (very few);
  • Irreversible in most cases.

Suitability Best people to use it
Good candidates: women who have completed child-bearing;
Not suitable for those with doubts about future desire for childbearing or fear of infertility.

Convenience, Availability & Cost
Minor operation done by physician in hospital,often as “day surgery”; woman usually back to work (fully active) in a few days.

Estimated Failure Rate:
Among average users: Very low:0.015 — 0.04%
Among reliable, consistent users: Very low:0.015 — 0.04%

Male Sterilization (Male Sterilization Vasectomy)
Sperm-conducting tubes (vas deferens) cut, clipped or tied to prevent sperm getting through penis into vagina.

Main Advantages

  • Highly effective;
  • One only, simple outpatient office procedure, done in 20 minutes;
  • Done under local anaesthetic;
  • Less risky than female sterilization.

Main Drawbacks and Precautions

  • Some post-op pain;
  • Occasional infection (cleared by antibiotics);
  • Usually irreversible;
  • Sometimes (unwarranted) fears of post-vasectomy impotence.

Suitability Best people to use it
Good candidates: men who have fulfilled desire for paternity;
Not suitable if anxious about sex life, potency or virility.

Convenience, Availability & Cost
Minor operation done by physician on request; usually in doctors; office or as hospital “outpatient”.

Estimated Failure Rate:
Among average users: Very low: 0.15%
Among reliable, consistent users: Very low: 0.15%

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