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Things to consider about birth control
By Mayo Clinic staffYour age, health, emotional maturity, marital status and even your religious convictions come into play when you choose a contraceptive method. Knowing your options is part of the decision process, but an honest assessment of yourself, your partner and your relationship is just as important. Most people have to make some trade-offs. They will, for instance, deal with the mild side effects of some hormonal contraceptives in exchange for superior effectiveness, or forgo the convenience of an IUD for the low cost of a barrier method. Ideally, you and your partner can discuss the options and reach a mutually beneficial decision. For complete information, consider raising the following questions with your health care professional.
What is the method's effectiveness?
The efficacy of any method depends on whether it's used consistently and correctly. Still, the failure rates of some methods are significantly higher than others'. Different people are satisfied with varying levels of effectiveness.
Is it reversible?
The method you choose depends on your life stage and reproductive goals. If you plan to have children at some point in the future, you may want a method that's easily stopped or quickly reversible. If you're certain that you would never desire pregnancy, you may prefer a permanent method.
Is it convenient?
The word "convenient" can be defined in a number of ways, depending on your perspective. For some, convenience means fewer trips to a health care professional. If your schedule is chaotic, you might want to select a method that doesn't require much planning or adhering to a rigid schedule. In that case, a method that's long-acting might fit more easily into your daily routine. For others, the idea of convenience suggests ease of use, no bothersome side effects or no disruption of the sexual experience. It's important to decide what type of birth control is best tailored to your lifestyle.
Can you afford it?
Some methods are inexpensive, while others can be more costly. Consult with your insurance provider if you're unsure about your coverage, and then weigh the expense factor in your choice.
Are health risks involved?
You may want to consider your tolerance for the possible side effects associated with a particular birth control method. Allergic responses to various components of contraceptives could be another determining factor. Some methods, particularly those that contain estrogen, pose the risk of rare but serious side effects. These may occur more often in women with specific characteristics, such as those who smoke and are 35 or older. Consider whether your medical history or lifestyle conflicts with the use of these methods.
Will the birth control method provide protection from STDs?
Unless you're in a mutually monogamous relationship, use condoms to protect yourself from contracting infections such as HIV/AIDS, genital herpes and gonorrhea.
Is the method acceptable to your sexual partner?
Your partner may have birth control preferences that are similar to or different from your own. Discussing all the birth control options with him or her helps you determine which method is acceptable to both of you.
Is the method compatible with your religious beliefs or cultural practices?
Some forms of birth control may be considered a violation of certain religious laws or cultural traditions. Weigh the techniques described here against your particular convictions.
Does the method offer any noncontraceptive benefits?
Besides preventing pregnancy, some contraceptives provide additional benefits such as more predictable, lighter menstrual cycles or a decreased risk of STDs. If these benefits are important to you, they may influence your birth control decision.
At-a-glimpse comparison of birth control methods
| Method | Effectiveness rate | Most common side effects, risks | Major benefits | Cost, availability |
|---|---|---|---|---|
| Cervical cap | 86% in women who haven't had children; possibly lower in women who have had children | Side effects rare; high failure rate; doesn't protect against STDs | Reusable; reversible | $72 and up per cap; $50-$200 for fitting |
| Combination birth control pills | 92% | Rarely causes life-threatening complications; no STD protection | Highly effective; reversible | $9-$60 a month; $35-$175 per exam |
| Male condom | 85% Up to 95% when used with vaginal spermicide |
Latex allergies; interrupts sexual activity; may alter sensation | Proven protection against STDs, including HIV | Less than $1 per condom; *OTC |
| Female condom | 79% | Irritation of vagina and vulva, noisy | Protection against STDs, can be used by latex-allergic | $3 per condom; OTC |
| Diaphragm | 84% | Side effects rare; interrupts sexual activity; no STD protection | Reusable; reversible | $30-$50 per diaphragm; $50-$200 for fitting |
| Emergency contraception | 98%-99% — Plan B pills; 99% or higher — IUD |
Nausea, abdominal pain, fatigue, headache, menstrual changes, no STD protection | Only option for post-sex birth control; highly effective | $8-$25 for Plan B pills; $200-$400 per IUD |
| Essure | 99% or higher | Short-term procedural discomfort; not immediately effective; difficult to reverse; no STD protection | Highly effective; permanent | $1,300-$3,000 |
| Implant | 99% when implanted properly | Irregular bleeding; acne, headaches, breast tenderness and weight changes; no STD protection | Highly effective; long-lasting; cost-effective | $180 per device; $50-$200 per exam |
| Injection | 97% | Irregular menstrual bleeding, mild weight gain; no STD protection | Highly effective; reversible | $30-$75 per shot; $35-$125 per exam |
| Intrauterine device (IUD) | 99% or higher | Increased risk of pelvic infection; expensive if removed early; no STD protection | Highly effective; long-lasting; cost-effective | $200-$400 per device; $50-$200 per exam |
| Natural family planning | 87% — calendar; 80% — basal body temperature; 78% — cervical mucus; 86% — TwoDay; 80%-87% — symptothermal; 98% — lactational amenorrhea; 88% — standard days | Restricts sexual activity; requires sophisticated knowledge of reproduction; no STD protection | No side effects; immediately reversible | No cost |
| Progestin-only birth control pills | 92% | Irregular menstrual bleeding, mild weight gain; no STD protection | Highly effective; reversible | $30-$60 per month; $35-$125 per exam |
| Skin patch | 99% | Rarely causes life-threatening complications; no STD protection | Highly effective; reversible | $50 for a month's supply of three patches; $35-$175 per exam |
| Spermicides | 71% | Nonoxynol-9 allergies; no STD protection | Easy to use; reversible | $1-$1.50 per use; OTC |
| Sponge | 84% Possibly higher in women who have had children |
Vaginal dryness, itching or soreness; no STD protection | Easy to use; reversible | $2.50 for a single sponge |
| Tubal ligation | 99% or higher | Short-term procedural discomfort; potential complications from surgery; difficult to reverse; no STD protection | Highly effective; permanent | $2,500-$4,000 |
| Vaginal ring | 92% | Vaginal infections and irritation, irregular vaginal bleeding, headaches, breast tenderness, weight gain or loss, nausea, vomiting, bloating, decreased sex drive (libido), and depression; no STD protection | Highly effective, reversible | $35-$50 per month; $35-$175 for initial exam |
| Vasectomy | 99% or higher | Occasional swelling, bruising of scrotum; rare infection; difficult to reverse; no STD protection | Highly effective; permanent | $250-$1,000 |
| Withdrawal | 73% | High failure rate; no STD protection | Doesn't require any devices; always available | No cost |
*Note: OTC means "over the counter."
Emerging birth control methods
