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The Pill has hormones that suppress ovulation, the process when an egg is released from the ovaries. Without ovulation, there is no egg and thus, pregnancy cannot occur. There are two main types of pills. The combined pill contains both estrogen and progestin, and the Minipill has only progestin. The Minipill works slightly differently than the combined pill because it causes the mucous membrane of the cervix to thicken so that a fertilized egg cannot implant itself in the uterus. Probably the combined Pill is the most widely perscribed oral contraceptive and it comes in either twenty-one or twenty-eight day packs. With the twenty-eight day one, you take twenty-one hormone pills and then seven reminder pills and menstruate, and with twenty-one pill packs you take twenty-one pills and then have your period. You need a prescription for the Pill. Pros: When taken regularly, the Pill is as high as 99% effective in preventing pregnancy, makes period lighter and shorter, and helps to get rid of annoying PMS symptoms including cramps. Some birth control pills have also been proven to help clear up acne. Cons: Remember that the Pill does NOT protect against STDs or AIDS. Pair it with a condom (see below).
Seasonale (middle, left)
Seasonale is the brand name for the new, extended-cycle birth control pill that was recently approved by the Food and Drug Administration (FDA). It has lower doses of estrogen and progestin than the regular Pill, and comes with eighty-four active pills, followed by seven placebo (reminder) pills. Thus, the number of times you menstruate is reduced to four times a year. You're probably wondering, is this healthy? Throughout history, women would have fewer periods anyway because they were pregnant so much. You need a prescription. Pros: Fewer periods means saying bye-bye to PMS symptoms, and anemia and endometriosis, which has been known to cause pelvic pain and infertility. When taken regularly (at the same time everyday), it is 99% effective at preventing pregnancy and it may reduce the risk of ovarian and endometrial cancer. Cons: Does not protect against STDs and HIV and has side affects similar to regular bith control pills including nausea, vomiting, breast tenderness, weight gain and some breakthrough bleeding (within the first couple months). Seasonale may have more breakthrough bleeding than the regular Pill (although usually it isn't that big of a deal anyway). Not recommended for women with high blood pressure, diabetes or obesity. Smokers should talk to their doctors about it before going on the Pill.
The Patch
The birth control patch releases estrogen and progestin through the skin and into the bloodstream. This paper-thin, beige, 1 3/4 inch square clings to skin like a strong band-aid and can be applied to your stomach, butt or upper torso (not the breasts). It is worn for exactly one week and then changed, three times. The week you go patch-free, you will get your period. Pros: The patch is an easy solution to women who have a difficult time remembering to take the Pill daily. The user can swim, shower and exercise while wearing the patch, which is also so thin that no one will know you are wearing it. Cons: It does not protect against STDs or HIV and has similar side effects as the Pill. Women who smoke run a very high risk of cardiovascular side effects and are strongly encouraged not to use the patch. Available with a prescription.
The Shot
Birth control injections are hormones injected into the arm, butt or thigh to prevent pregnancy. There are currently two types in the U.S.: the progestin-containing Depo-Provera, the twelve-week injection, and Lunelle, the monthly shot that contains both progestin and estrogen. Both shots are highly effective birth control methods, with the monthly shot being 99% effective, and Depo-Provera marking in at 99.7% effective. Pros: The shot can help regulate your period and reduce cramps and bleeding. The twelve-week injection is also safe to use while breast-feeding. Cons: Neither injection protects you from STDs and HIV. It may be inconvenient to have to go get shots every month or every three months. The twelve-week shot is not recommended for women who want to get pregnant within the year, and side effects include irregular periods, weight gain, mood changes, acne or headaches. Visit your OB-GYN for more info.
Female Condom
The female condom is a polyurethane sheath with a flexible ring at the end that fits against the cervix inside the vagina and extends out to cover the labia (vaginal lips). The female condom prevents pregnancy and provides some protection against STDs and HIV. It is around 97% effective when used perfectly, although the actual rate is about 79%. Pros: The female condom contains no side effects nor hormones and is available without a prescription at many drug stores. Since it is not made from latex, there are fewer ill side effects and it does not have nonoxynol-9. You can insert it yourself and it is less likely to break than male condoms. Cons: It can be difficult to insert, so practice before you try to have sex with it in place. It may also reduce pleasure, although studies may be even with that of the male condom.
Diaphragm
The diaphragm is available in one size without a prescription at most drugstores and costs around $1-2 dollars each, although they are usually sold in packs of five. It is a shallow cap made of latex rubbber that is inserted into the vagina just before having sex and covers the cervix (at the end of the vagina). It is around 80% effective in preventing pregnancy. Pros: It does not contain any hormones and does not require direct involvement of male partner. The effective protection lasts up to six hours. Cons: Provides very, very (if any) protection from STDs and HIV and is not nearly as effective in preventing pregnancy as the Pill, shot, patch or male condom. It can be difficult to insert and it may increase your risks of contracting a painful urinary tract infection (UTI). Diaphragms are also really expensive ($50-150), although they can last for around two years. Medicaid sometimes covers some of the fees.
Condoms are thin membranes that guys wear while having sex and is effective in preventing pregnancy AND STDs and HIV. In the condom world, latex ones are the most effective in preventing pregnancy. Five to seven percent of people are allergic to latex, so wearing it can cause burning or itching. So, there's polyurethane, a thinner membrane that makes sex feel more natural, and is a highly effective, safe bet for those allergic to latex. Then there is the animal membrane, which we do not recommend. It does NOT protect against most STDs, but it still does prevent pregnancy. It does not prevent HIV, which is smaller than sperm and can pass through the material. Condoms are 97% effective in preventing pregnancy, although for most couples, they are around 87% effective (because of being used wrongly, slippage or breakage). Condoms are 87% effective at stopping HIV.
The woman inserts spermicide into her vagina before having sex, and the birth control method comes as a gel, foam, cream, suppository, film or tablet. It works by killing the sperm, but it does not really protect against STDs and HIV. It is around 74% effective, 94% with perfect usage and is available without a prescription. Pros: It does not contain any hormones and does not involve the male or interrupt sex. Cons: Not as effective as the Pill, shot, patch or male condom, and increases risk of a UTI or irritation.