Contraception

Keep in mind that most birth control does NOT protect you from HIV or other sexually transmitted diseases (STDs) like gonorrhea , herpes , and Chlamydia . Other than not having sex, the best protection against STDs and HIV is by using a male or female latex condom.

Here is a list of birth control methods with estimates how well they work in preventing pregnancy when used correctly, for each method:

• Continuous Abstinence – This means not having sexual intercourse (vaginal, anal, or oral intercourse) at any time. It is the only sure way to prevent pregnancy and protect against HIV and other STDs. This method is 100% effective at preventing pregnancy and STDs.

• The Male Condom – Condoms are called barrier methods of birth control because they put up a block, or barrier, which keeps the sperm from reaching the egg. Only latex or polyurethane (because some people are allergic to latex) condoms are proven to help protect against STDs, including HIV. "Natural” or “lambskin” condoms made from animal products also are available, but lambskin condoms are not recommended for STD prevention because they have tiny pores that may allow for the passage of viruses like HIV, hepatitis B and herpes. Male condoms are 84 to 98% effective at preventing pregnancy. Condoms can only be used once. You can buy them at a drug store. Condoms come lubricated (which can make sexual intercourse more comfortable and pleasurable) and non-lubricated (which can also be used for oral sex). It is best to use lubrication with non-lubricated condoms if you use them for vaginal or anal sex. You can use KY jelly or water-based lubricants, which you can buy at a drug store. Oil-based lubricants like massage oils, baby oil, lotions, or petroleum jelly will weaken the condom, causing it to tear or break. Always keep condoms in a cool, dry place. If you keep them in a hot place (like a billfold, wallet, or glove compartment), the latex breaks down, causing the condom to tear or break. Latex or polyurethane condoms are the only method other than abstinence that can help protect against HIV and other sexually transmitted diseases (lambskin condoms do not).
• Oral Contraceptives – Also called “the pill,” contains the hormones estrogen and progestin and is available in different hormone dosages. A pill is taken daily to block the release of eggs from the ovaries. Oral contraceptives lighten the flow of your period and can reduce the risk of pelvic inflammatory disease (PID), ovarian cancer, benign ovarian cysts, endometrial cancer, and iron deficiency anemia. It does not protect against STDs or HIV. The pill may add to your risk of heart disease, including high blood pressure, blood clots, and blockage of the arteries, especially if you smoke. If you are over age 35 and smoke, or have a history of blood clots or breast, liver, or endometrial cancer, your doctor may advise you not to take the pill. The pill is 95 to 99.9% effective at preventing pregnancy. Some antibiotics may reduce the effectiveness of the pill in some women.

Most oral contraceptives are swallowed in a pill form. There are extended cycle pills, brand name Seasonale, which have 12 weeks of pills that contain hormones (active) and 1 week of pills that don’t contain hormones (inactive). While taking Seasonale, women only have their period 4 times a year when they are taking the inactive pills. There are many different types of oral contraceptives available, and it is important to talk to your doctor or nurse about which one is best for you. You will need a prescription for oral contraceptives.

• Progestasert IUD (Intrauterine Device) –This IUD is a small plastic T- shaped device that is placed inside the uterus by a doctor. It contains the hormone progesterone, the same hormone produced by a woman’s ovaries during the monthly menstrual cycle. The progesterone causes the cervical mucus to thicken so sperm cannot reach the egg, and it changes the lining of the uterus so that a fertilized egg cannot successfully implant. The Progestasert IUD can stay in your uterus for one year. This IUD is 98% effective at preventing pregnancy. You will need to visit your doctor to have it inserted and to make sure you are not having any problems. Not all doctors insert IUDs so check first before making your appointment.
• The Female Condom – Worn by the woman, this barrier method keeps sperm from getting into her body. It is made of polyurethane, is packaged with a lubricant, and may protect against STDs, including HIV. It can be inserted up to 24 hours prior to sexual intercourse. Female condoms are 79 to 95% effective at preventing pregnancy. There is only one kind of female condom, called Reality, and it can be purchased at a drug store.
• Depo-Provera – With this method women get injections, or shots, of the hormone progestin in the buttocks or arm every 3 months. It does not protect against STDs or HIV. Women should not use Depo-Provera for more than 2 years in a row because it can cause a temporary loss of bone density that increases the longer this method is used. The bone does start to grow after this method is stopped, but it may increase the risk of fracture and osteoporosis if used for a long time. It is 97% effective at preventing pregnancy. You will need to visit your doctor for the shots and to make sure you are not having any problems.
• The Patch (Ortho Evra) –This is a skin patch worn on the lower abdomen, buttocks, or upper body. It releases the hormones progestin and estrogen into the bloodstream. You put on a new patch once a week for three weeks, and then do not wear a patch during the fourth week in order to have a menstrual period. The patch is 98 to 99% effective at preventing pregnancy, but appears to be less effective in women who weigh more than 198 pounds. It does not protect against STDs or HIV. You will need to visit your doctor for a prescription and to make sure you are not having problems.
• Surgical Sterilization (Tubal Ligation or Vasectomy) – These surgical methods are meant for people who want a permanent method of birth control. In other words, they never want to have a child or they do not want more children. Tubal ligation or “tying tubes” is done on the woman to stop eggs from going down to her uterus where they can be fertilized. The man has a vasectomy to keep sperm from going to his penis, so his ejaculate never has any sperm in it. They are 99.9% effective at preventing pregnancy.

Today’s pills have lower doses of hormones than earlier birth control pills. This has greatly lowered the risk of side effects; however, there are both benefits and risks with taking birth control pills. Benefits include having more regular and lighter periods, fewer menstrual cramps; and a lower risk for ovarian and endometrial cancer, and pelvic inflammatory disease (PID). Serious side effects include an increased chance, for some women, of developing heart disease, high blood pressure, and blood clots. Minor side effects include nausea, headaches, sore breasts, weight gain, irregular bleeding and depression. Many of these side effects go away after taking the pill for a few months. Women who smoke, are over age 35, or have a history of blood clots or breast or endometrial cancer are more at risk for dangerous side effects and may not be able to take the pill. Talk with your doctor or nurse about whether the pill is right for you.

Some people wrongly believe that if they take birth control pills, they are protecting themselves not only from getting pregnant but also from infection with HIV and other sexually transmitted diseases (STDs). Birth control pills or other types of birth control, such as intrauterine devices (IUDs), Depo-Provera, or tubal ligation will NOT protect you from HIV and other STDs.

The male latex condom is the only birth control method that is proven to help protect you from HIV and other STDs. If you are allergic to latex, there are condoms made of polyurethane that you can use. Condoms come lubricated (which can make sexual intercourse more comfortable and pleasurable) and non-lubricated (which can be used for oral sex).

It is important to only use latex or polyurethane condoms to protect against HIV and other STDs. "Natural” or “lambskin” condoms have tiny pores that may allow for the passage of viruses like HIV, hepatitis B and herpes. If you use non-lubricated condoms for vaginal or anal sex, you can add lubrication with water-based lubricants (like KY jelly) that you can buy at a drug store. Never use oil-based products, such as massage oils, baby oil, lotions, or petroleum jelly, to lubricate a condom. These will weaken the condom, causing it to tear or break.
It is very important to use a condom correctly and consistently – which means every time you have vaginal, oral, or anal sex. If you do not know how to use a condom, talk with your doctor or nurse. Don’t be embarrassed. Also, do not assume that your partner knows how to use a condom correctly. Many men have never had anyone show them how. The biggest reason condoms fail is due to incorrect use. Male condoms can only be used once. Research is being done to find out how effective the female condom is in preventing HIV and other STDs.