Birth Control Methods

Non-Hormonal Options:

• Lactational Amenorrhea Method (LAM):

  • LAM is a way for breastfeeding to temporarily prevent pregnancy. It must be used correctly to work and can be up to 98% effective if all the conditions below are met. Lactation means your body is making breastmilk and amenorrhea means you aren’t having a monthly period, so essentially breasfeeding hormones may stop your body from releasing eggs and it isn’t possible to get pregnant if you don’t release an egg. Researchers believe that for LAM to work these three conditions must be met:

    • Baby is under 6 months old AND

    • Baby is fully breastfed (baby gets no other liquid or food, not even water) or nearly-fully breastfed (baby gets vitamins, water, or other fluids or nutrients once in a while and they do not disrupt the frequency of feedings) AND

    • Menstruation has not returned. This means you have not had vaginal bleeding for 2 or more days in a row (not counting bleeding during the first 2 months after giving birth)

    • Other possible favorable conditions include:

      • No pacifier, bottle or artificial nipple use

      • No sleeping for more than 5 hrs in a row for baby

      • A lot of side lying positioning during nursing

• Fertility Awareness Method (FAM):

  • FAM is a form of birth control that does not utilize drugs or devices. This method is used as a way of tracking ovulation to prevent pregnancy. Utilizing a combination of calendar tracking, rhythm method, basal body temperature readings, and recognition of changes in cervical mucus and other fertility signs increases the efficacy of this method. Although it is not as effective as hormonal methods, in monogamous relationship it can provide 77 - 98% efficacy.

• Non-hormonal IUD - Paragard

  • Copper IUD prevents sperm from reaching and fertilizing the egg. It may prevent the egg from attaching in the womb. If fertilization of the egg does occur, the physical presence of the device prevents the fertilized egg from implanting into the lining of the uterus. Copper IUDs may remain in the body for 10 years. The failure rate of a copper IUD is less than 1%, but a small percentage of women may experience expulsion of the device and have to have it reinserted.

• Diaphragm - Caya®

  • A diaphragm is a shallow, flexible cup made of latex or soft rubber that is inserted into the vagina before intercourse, blocking sperm from entering the uterus. Spermicidal cream or jelly should be used with a diaphragm. The diaphragm should remain in place for 6 to 8 hours after intercourse to prevent pregnancy, but it should be removed within 24 hours. Newer diaphragms, such as Caya®, are designed to fit most people and do not require fitting

• Male condoms

  • This condom is a thin sheath that covers the penis to collect sperm and prevent it from entering the woman's body. Male condoms are generally made of latex or polyurethane, but a natural alternative is lambskin (made from the intestinal membrane of lambs). Latex or polyurethane condoms reduce the risk of spreading sexually transmitted diseases, except for lambskin condoms. Male condoms are disposed of after a single use.

• Female condoms

  • These are thin, flexible plastic pouches. A portion of the condom is inserted into a woman's vagina before intercourse to prevent sperm from entering the uterus. The female condom also reduces the risk of STDs. Female condoms are disposed of after a single use. 

• Contraceptive sponges

  • These are soft, disposable, spermicide-filled foam sponges. One is inserted into the vagina before intercourse. The sponge helps block sperm from entering the uterus, and the spermicide also kills the sperm cells. The sponge should be left in place for at least 6 hours after intercourse and then removed within 30 hours after intercourse. 

• Spermicides

  • A spermicide can kill sperm cells. A spermicide can be used alone or in combination with a diaphragm or cervical cap. The most common spermicidal agent is a chemical called nonoxynol-9 (N-9). It is available in several concentrations and forms, including foam, jelly, cream, suppository, and film. A spermicide should be inserted into the vagina close to the uterus no more than 30 minutes prior to intercourse and left in place 6 to 8 hours after intercourse to prevent pregnancy. Spermicides do not prevent the transmission of STDs and may cause allergic reactions or vaginitis

Hormonal Options:

• Hormonal IUD - Mirena, Kyleena, Liletta, and Skyla

  • Hormonal IUDs release a progestin hormone (levonorgestrel) into the uterus. The released hormone causes thickening of the cervical mucus, inhibits sperm from reaching or fertilizing the egg, thins the uterine lining, and may prevent the ovaries from releasing eggs. The failure rate of a hormonal IUD is less than 1%, but a small percentage of women may experience expulsion of the device and have to have it reinserted.

• Hormonal implant - Nexplanon

  • Implantable rod. Each rod is matchstick-sized, flexible, and plastic surgically inserted under the skin of the upper arm. The rod releases a progestin and can remain implanted for up to 5 years. This method has a failure rate of less than 1%.

• Injectable method - Depo-Provera®

  • Depot medroxyprogesterone acetate is a progestin injectable given in the arm or buttocks once every 3 months. This method has contraceptive efficacy rate of 99.6%

• Progestin-only pills (POPs)

  • POPs may interfere with ovulation or with sperm function and/or thicken cervical mucus, making it difficult for sperm to swim into the uterus or to enter the fallopian tube. POPs alter the normal cyclical changes in the uterine lining and may result in unscheduled or breakthrough bleeding. These hormones do not appear to be associated with an increased risk of blood clots and are during lactation. When used correctly, at the same exact time every day, they have a 99% efficacy rate.

• Combined oral contraceptives (COCs, "the pill")

  • COCs contain a synthetic estrogen and a progestin, which functions to inhibit ovulation. A person takes one pill daily, preferably at the same time each day> when used correctly COCs are over 99% effective.

• Contraceptive patch - Ortho Evra®

  • Thin, plastic patch that sticks to the skin and releases hormones through the skin into the bloodstream. The patch is placed on the lower abdomen, buttocks, outer arm, or upper body. A new patch is applied once a week for 3 weeks, and no patch is used on the fourth week to enable menstruation. Currently, Ortho Evra® is the only patch that is FDA approved and is considered 92 - 99.7% effective in preventing pregnancy.

• Vaginal ring - NuvaRing®

  • The ring is thin, flexible, and approximately 2 inches in diameter. It delivers a combination of ethinyl estradiol and a progestin. The ring is inserted into the vagina, where it continually releases hormones for 3 weeks. Removal is done on the fourth week and reinserted a 7 days later. Efficacy is at 91 - 99%

Emergency Contraceptives:

• Emergency contraceptive pills (ECPs)

  • Emergency hormonal pills, taken either as a single dose or two doses 12 hours apart, that are intended for use in the event of unprotected intercourse. If taken prior to ovulation, the pills can delay or inhibit ovulation for at least 5 days to allow the sperm to become inactive. They also cause thickening of cervical mucus and may interfere with sperm function. ECPs should be taken as soon as possible after semen exposure and should not be used as a regular contraceptive method. Pregnancy can occur if the pills are taken after ovulation or if the woman has unprotected sex in the same cycle.

• Copper IUD

  • The copper IUD is the most effective method of emergency contraception. The device can be inserted within 120 hours of unprotected intercourse. The method is nearly 100% effective at preventing pregnancy and has the added benefit of providing a highly effective method of contraception for as long as the device remains in place.