Intra-Uterine Devices
-Low side effects
-Low cost when averaged out over the lifespan of the device
-Recommended for women in monogamous relationships
-Can be expelled or become dislodged
-Not recommended for women with fibroids
*ParaGard (CopperT)
-Paragard can remain in place for up to 10 years
-Fertility usually resumes immediately upon removal
-Can be accompanied by increase in volume and duration of menstrual flow
-Mirena can remain in place for up to 5 years
-Releases levonorgestrel (LNg), a synthetic progestin, just in the uterus which reduces menstrual volume in time
-Possible delay in return of fertility once Mirena is removed
-Spotting can occur in the initial 6-12 months
-May cause benign ovarian cysts
-Can rarely cause hormonal side effects similar to those seen with oral birth control pills (mood swings, headaches, breast tenderness, acne)
Birth Control Pills
-High rate of efficacy
-Relatively convenient
-Multiple options are available
-Regulates menstrual cycle
-Decreased risk of endometrial and ovarian cancer, endometriosis, PID
-Undesirable risk and side effect profile in some women
-Not always affordable for all women
-Drug interactions
Vaginal ring
-Same as with OCPs
-Use allows for more normal vaginal moisture and flora, which reduces yeast infections in some women
-Protection from pregnancy one month at a time
-Contraindicated with certain pelvic conditions (prolapsed, endometriosis, susceptibility to irritation, etc)
Transdermal birth control path
(Ortho Evra)
(less reliable for women >198lbs)
-Similar as with OCPs, except exposure to synthetic estrogen is ~60% higher, with resultant higher risk profile for thromboembolic events
Depo Provera Injection
-Same as with OCPs
-Effective 24hrs after injection
-Side effects can be significant and long-lasting, including reduction in bone density, depression, and weight gain.
Contraceptive Implants
-Longevity: Different systems last from
3-5 yrs
-Fertility returns relatively quickly after removal
-Can sometimes be difficult to remove
-Potential for scarring
-Side effects can in some cases be significant and long-lasting
Male Condom
-Protects against HIV and certain STDs not contracted from uncovered genital areas
-Convenience and availability
-Some users experience allergies
 Female Condom
 -Protects against HIV and certain STDs
-Can be placed up to 8hrs in advance
-Does not require fitting by and MD
 -Only 1 style is currently available
Female Cervical Cap
Varies 68-91%
-Can be inserted up to 6hr in advance
-Very few side effects
-Several designs on the market
-Relatively low efficacy *Especially in women who have given birth*
-Some types require fitting by an MD
-Not widely available
-Some users experience allergies
Today Sponge
-Immediate and continuous protection for a 24hr period
-One size fits all, and easy to insert
-Removal can be tricky for some
-Some users experience allergies
Diaphragm with contraceptive jelly or foam
-Few side effects
-Can be inserted up to 6hr in advance
-Can be used for intercourse during menses to collect flow
-Requires fitting and periodic re-fitting
-Some users experience allergies
-Some consider method to be “messy”
Vaginal contraceptive film, foam, or inserts
(efficacy max when used in conjunction with a condom)
-Readily available
-Relatively inexpensive
-No protection from HIV/STDs
-Some users experience allergies and/or irritation
-Some consider method to be “messy”
-Must be inserted within an hour before intercourse

* Assumes perfect use. Actual effectiveness rates vary significantly. Statistics from Our bodies, Ourselves (Boston Women’s Health Book Collective, 2005).
** McClure D., & D. Edelman. 1985. Worldwide method effectiveness of the Today vaginal contraceptive sponge. Adv. Contracept. 1: 305-11.

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