Pill

One pill by mouth every day at the same time

There are two types of oral contraceptive pills; the most common pills are combined with both estrogen and progestin and the less common is progestin only. The combined pills can treat many other conditions not related to pregnancy prevention such as heavy or irregular bleeding; they are also protective for uterine and ovarian cancers. The combined pill may cause some nausea or breast tenderness early on. Progestin only pills, sometimes called “mini-pills,” are less common but a great options for someone who can’t use estrogen and wants to take daily pills. They are commonly used by moms who are breastfeeding. Progestin only pills may cause irregular bleeding and spotting. 

How Well Does It Prevent Pregnancy?

Efficacy for pregnany prevention (out of 100 users with TYPICAL use over one year)


7-9 people out of 100 will get pregnant

How Long Does it Last?

The pill is taken daily at the same time.

Short Acting             Long Acting

How Does This Option Get Started or Stopped?

Patient controlled: Patient decides when to start/stop, but requires a prescription from a provider.

Patch

Band-aid like patch worn on the skin, new patch each week for 3 weeks, then one week off

Like the combined pill, the estrogen and progestin of the patch have similar benefits and side effects but the active hormones are absorbed through the skin instead of being swallowed like a pill. The patch can treat many other conditions not related to pregnancy prevention, such as heavy or irregular bleeding. The patch also reduces the risk of uterine and ovarian cancers. The patch may cause some nausea or breast tenderness early on.

How Well Does It Prevent Pregnancy?

Efficacy for pregnany prevention (out of 100 users with TYPICAL use over one year)


7-9 people out of 100 will get pregnant

How Long Does it Last?

The patch is changed every week for 3 weeks and then no patch for the 4th week.

Short Acting             Long Acting

How Does This Option Get Started or Stopped?

Patient controlled: Patient decides when to start/stop, but requires a prescription from a provider.

Ring

Plastic ring worn inside the vagina, removed once a month

Like the combined pill, the estrogen and progestin of the ring have similar benefits and side effects but the active hormones are absorbed through the vagina. The ring can treat many other conditions not related to pregnancy prevention, such as heavy or irregular bleeding. The ring also reduces the risk of uterine and ovarian cancers. The ring may cause some nausea or breast tenderness early on. Some people use the ring continuously to avoid having periods.

How Well Does It Prevent Pregnancy?

Efficacy for pregnany prevention (out of 100 users with TYPICAL use over one year)


7-9 people out of 100 will get pregnant

How Long Does it Last?

The monthly ring is changed every 3 weeks and it’s removed on the 4th week.

Short Acting             Long Acting

How Does This Option Get Started or Stopped?

Patient controlled: Patient decides when to start/stop, but requires a prescription from a provider.

Shot

Shot in the belly, arm, or bum every 3 months

The depo shot is progestin only and may cause spotting and irregular bleeding. Some people may not bleed at all, and this is normal. For some, weight changes may occur (gain or loss).

How Well Does It Prevent Pregnancy?

Efficacy for pregnancy prevention (out of 100 users with TYPICAL use over one year)

4-5 people out of 100 will get pregnant

How Long Does it Last?

The depo shot is injected every 3 months.

Short Acting             Long Acting

How Does This Option Get Started or Stopped?

Provider dependent: To start or stop this method, you need to see a provider for the injection or there may be a injection you could do on your own but requires a prescription.

Implant

Match size plastic rod inserted by a skilled provider in the underside of upper arm, lasts for 4+ years, may be removed anytime sooner

The implant may cause spotting and irregular bleeding early on, this can last for a few months or for the entire time you are using the implant. Some people may eventually not bleed at all. It’s impossible to predict how your bleeding will happen, but this is a normal and expected effect. The implant is not noticeable to others.

How Well Does It Prevent Pregnancy?

Efficacy for pregnancy prevention (out of 100 users with TYPICAL use over one year)

Less than 1 person out of 100 may get pregnant using the implant in the first year.

How Long Does it Last?

The implant lasts up to 5 years. It can be removed anytime sooner.

Short Acting             Long Acting

How Does This Option Get Started or Stopped?

Provider dependent: To start or stop this method, you need to see a provider for the insertion and removal.

IUD

Tiny T-shaped device inserted by a skilled provider in the uterus, lasts from 3-12 years, may be removed anytime sooner

There are two classes of intrauterine devices (IUDs): one without hormones (has copper) and one with progestin. The copper one lasts up to 12 years and expected side effects are heavier bleeding and stronger cramps. The progestin ones are expected to cause spotting and irregular bleeding, although some some people may eventually not bleed at all. The progestin IUD is also FDA approved for treating heavy bleeding. The IUD is not noticeable to others and doesn’t interfere with tampons or intercourse. The insertion may cause some short-term cramping.

How Well Does It Prevent Pregnancy?

Efficacy for pregnancy prevention (out of 100 users with TYPICAL use over one year)

Less than 1 person out of 100 may get pregnant using the IUD in the first year

How Long Does it Last?

The IUD lasts between 3 to 12 years. The hormonal IUDs last 3-7 years and the copper IUD lasts 12 years. It can be removed anytime sooner.

Short Acting             Long Acting

How Does This Option Get Started or Stopped?

Provider dependent: To start or stop this method, you need to see a provider for the insertion and removal.

Cervical Cap/Diaphragm

Reusable barrier inserted through the vagina to cover the cervix, must be used with spermicide and placed before sex

These barrier methods must be used with spermicide each time you have sex for maximum effectiveness. Some people have irritations to the spermicide. This method has no hormones.

How Well Does It Prevent Pregnancy?

Efficacy for pregnancy prevention (out of 100 users with TYPICAL use over one year)

12-24 people out of 100 may get pregnant using the diaphragm or cap with spermicide in the first year. Without spermicide that risk of pregnancy is a lot higher.

How Long Does it Last?

The cervical cap/diaphragm is used at the time of sex.

Short Acting             Long Acting

How Does This Option Get Started or Stopped?

Patient controlled: Patient decides when to start/stop.

Vaginal gel

Vaginal gel used before sex to alter the pH, preventing sperm from reaching egg

This gel is inserted into the vagina 1 hour before sex and must be used each time. This is a new product, but is considered very safe and is free from hormones.

How Well Does It Prevent Pregnancy?

Efficacy for pregnancy prevention (out of 100 users with TYPICAL use over one year)

14 people out of 100 may get pregnant using this vaginal gel in the first year.

How Long Does it Last?

The vaginal gel is used at the time of sex.

Short Acting             Long Acting

How Does This Option Get Started or Stopped?

Patient controlled: Patient decides when to start/stop, but requires a prescription from a provider.

Fertility Awareness

Tracking daily symptoms to identify days to avoid unproteced sex based on body temperature, cervical mucus, and period cycle

This method can be tracked in an app or on a calendar and requires no supplies or hormones. It is also a very effective way to track ovulation for anyone trying to get pregnant.

How Well Does It Prevent Pregnancy?

Efficacy for pregnancy prevention (out of 100 users with TYPICAL use over one year)

24 people out of 100

How Long Does it Last?

Fertility awareness method means daily recording of symptoms and temperature.

Short Acting             Long Acting

How Does This Option Get Started or Stopped?

Patient controlled: Patient decides when to start/stop.

Tubal ligation

One time permanent surgical procedure to prevent eggs from traveling

This surgical procedure usually requires general anesthetic (i.e. going to sleep) and is usually done in the hospital.  It may be reversible, in some cases, with another major surgery – you should only have a tubal ligation if you are very sure you do not want any / more children.  This surgery requires some recovery time and has associated risk of bleeding, infection or injury to nearby organs such as the bladder or bowel. 

How Well Does It Prevent Pregnancy?

Efficacy for pregnancy prevention (out of 100 users with TYPICAL use over one year)

Less than 1 will get pregnant

How Long Does it Last?

Tubal ligation means cutting the fallopian tubes and your doctor will likely remove the tubes completely to reduce your chance of ovarian cancer.

Short Acting             Long Acting

How Does This Option Get Started or Stopped?

Provider dependent: To start or stop this method, you need to see a provider. But because it’s considered permanent, it is very hard to stop (reverse).

Vasectomy

One time permanent surgical procedure to prevent sperm from traveling

This surgical procedure requires local numbing medicine and can be done in a clinic without a scalpel. Recovery time is relatively short. It may be reversible. but requires major surgery. Post procedure, you must wait 3 months and have your semen checked before a vasectomy is fully effective.

How Well Does It Prevent Pregnancy?

Efficacy for pregnancy prevention (out of 100 users with TYPICAL use over one year)

Less than 1 will get pregnant

How Long Does it Last?

Vasectomy means cutting the vas deferens and this is permanent and rarely reversible.

Short Acting             Long Acting

How Does This Option Get Started or Stopped?

Provider dependent: To start or stop this method, you need to see a provider. But because it’s considered permanent, it is very hard to stop (reverse).

Withdrawal/Pull Out Method

Pulling out the penis before ejaculation into the vagina

This method requires no supplies and is free of hormones. It does require partner(s) cooperation.

How Well Does It Prevent Pregnancy?

Efficacy for pregnancy prevention (out of 100 users with TYPICAL use over one year)

20 out of 100 will get pregnant

How Long Does it Last?

Pulling out is used at the time of sex

Short Acting             Long Acting

How Does This Option Get Started or Stopped?

Patient controlled: Patient decides when to start/stop.

Condoms

Thin sheath placed over erect penis before sex

This method is free of hormones, reduces the risk of sexually transmitted infections and can be available without a prescription. Condoms must be used and removed properly every time you have sex.

How Well Does It Prevent Pregnancy?

Efficacy for pregnancy prevention (out of 100 users with TYPICAL use over one year)

13-18 out of 100 will get pregnant

How Long Does it Last?

Condom is used at the time of sex

Short Acting             Long Acting

How Does This Option Get Started or Stopped?

Patient controlled: Patient decides when to start/stop.

Internal condoms

Thin, soft barrier pouch with a ring at the end, placed inside the vagina before sex. Also commonly used for anal sex.

This method is made of nitrile, free of hormones, and reduces the risk of sexually transmitted infections. Usually requires a prescription though could be purchased on line directly from the one manufacturer in the USA. 

How Well Does It Prevent Pregnancy?

Efficacy for pregnancy prevention (out of 100 users with TYPICAL use over one year)

21 out of 100 will get pregnant

How Long Does it Last?

Internal condom is used at the time of sex

Short Acting             Long Acting

How Does This Option Get Started or Stopped?

Patient controlled: Patient decides when to start/stop.

Emergency Contraception (EC)

Oral pills or IUD used as soon as possible within 5 days (120 hours) of unprotected sex to decrease the chance of pregnancy.

There are two types of pills and two types of IUDs that can be used after unprotected sex. The sooner you use one of these methods, the higher the chance of preventing pregnancy. IUDs are a good option if you are interested in using a long term method. Both the IUD with progestin (brand name Liletta) or IUD with copper (brand name Paragard) are safe to use up to 5 days after unprotected sex. The more commonly known type of EC pill, sometimes known as Plan B or Next Choice is available without a prescription and without age restrictions. If you have Medicaid, you can also get it at no cost without a prescription, but you have to ask the pharmacist to “use the standing order for EC”.  Another type of pill, brand name Ella requires a prescription and is more effective for anyone over 165 pounds. Ask your provider for a prescription and get it filled ahead of time.  Emergency contraception works differently than abortion pills. Emergency contraception pills are not the pills used for an abortion. Emergency contraception works by stopping the release of the egg (ovulation) or preventing the egg and sperm to join, decreasing the chance of a pregnancy. The abortion pill ends a pregnancy.

How Well Does It Prevent Pregnancy?

Efficacy for pregnancy prevention (out of 100 users with TYPICAL use over one year)

Efficacy varies based on when you used EC in your menstrual cycle.  The sooner you use it,  the higher chance of pregnancy prevention.  The IUD is more effective than pills for EC. 

How Long Does it Last?

The pills can be taken each time you think you may be at risk of pregnancy (i.e., condom breaks, forgot your pills, mistimed your cycle).  The IUD can be used long term,  for the duration of the device (6-12 years depending on the type you select),  but can be removed sooner. 

How Does This Option Get Started or Stopped?

Depending on the method, patient can decide or it requires a provider visit.

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