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{{Short description|none}}
{{Use American English|date=February 2023}}
{{
There are many methods of [[birth control]] (or [[Birth control|contraception]]) that vary in requirements, [[Side effect|side effects]], and [[effectiveness]]. As the technology, education, and awareness about contraception has evolved, new contraception methods have been theorized and put in application. Although no method of birth control is ideal for every user, some methods remain more effective, affordable or intrusive than others. Outlined here are the different types of [[Safe sex|barrier methods]], [[Hormonal contraception|hormonal methods]], various methods including [[spermicide]]s, [[Emergency contraception|emergency contraceptives]], and surgical methods<ref name="
While many methods may prevent conception, only [[Condom|male]] and [[Female condom|female condoms]] are effective in order to prevent [[Sexually transmitted infection|sexually transmitted infections]].
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===Hormonal methods===
The [[Intrauterine device|IUD (intrauterine device)]] is a T-shaped device that is inserted into the [[uterus]] by a trained medical professional. There are two different types of IUDs, a copper or a [[Hormonal intrauterine device|hormonal]] IUD.<ref name="
[[Oral contraceptive pill|Oral contraceptives]] are another option, these are commonly known as '[[Combined oral contraceptive pill|the pill]]'. These are prescribed by a doctor and must be taken at the same time every day in order to be the most effective. There are two different options, there is a [[Combined oral contraceptive pill|combined pill]] option that contains both of the hormones [[estrogen]] and [[Progestogen (medication)|progestin]]. The other option is a progestin-only pill. The failure rate of both of these oral contraceptives is 7%.<ref name="
Some choose to get an [[Injection (medicine)|injection]] or a shot in order to prevent [[pregnancy]]. This is an option where a [[Health professional|medical professional]] will inject the hormone [[Progestogen (medication)|progestin]] into a woman's arm or [[buttocks]] every 3 months to prevent pregnancy. The [[failure rate]] is 4%.<ref name="
Women can also get an [[Implant (medicine)|implant]] into their upper arm that releases small amounts of [[hormone]]s to prevent [[pregnancy]]. The implant is a thin rod-shaped device that contains the hormone progestin that is inserted into the upper arm and can prevent pregnancy for up to 3 years. The failure rate for this method is 0.1%.<ref name="
The patch is another simple option, it is a skin patch containing the hormones progestin and estrogen that is absorbed into the [[Circulatory system|blood stream]] preventing [[pregnancy]]. The patch is typically worn on the lower abdomen and replaced once a week. The failure rate for this is 7%.<ref name="
The hormonal vaginal [[Contraceptive vaginal ring|contraceptive ring]] is a ring that contains the hormones [[Progestogen (medication)|progestin]] and [[estrogen]] that a woman inserts into the [[vagina]]. It is replaced once a month and has a failure rate of 7%.<ref name="
===Barrier methods ===
The [[Diaphragm (birth control)|diaphragm]] or [[cervical cap]] is a small shallow cup-like cap that is inserted into the vagina with spermicide to cover the cervix and block sperm from entering the uterus. It is inserted before sexual intercourse and comes in different sizes. It has a failure rate of 17%.<ref name="
A [[Contraceptive sponge|sponge]] can also be used as a contraceptive method. Like the diaphragm, the contraceptive sponge contains [[spermicide]] and is inserted into the vagina and placed over the [[cervix]] to prevent [[sperm]] from entering the [[uterus]]. The sponge must be kept in place 6 hours after sexual intercourse before it can be removed and discarded. The failure rate for women who have had a baby before is 27%; For those who have not had a baby, the failure rate is 14%.<ref name="
The [[Condom|male condom]] is typically made of [[latex]] (but other materials are available, such as [[Lambskin condom|lambskin]], to avoid [[Latex allergy|allergies]]). The male condom is placed over the male's penis and prevents the sperm from entering the partner's body. It can prevent pregnancy, and STDs such as, but not limited to, HIV if used appropriately. Male condoms can only be used once and are easily accessible at local stores in most countries. The failure rate is 13%.<ref name="
The [[female condom]] is worn by the woman; it is inserted into the vagina and prevents the sperm from entering her body. It can help prevent [[Sexually transmitted infection|STDs]] and can be inserted up to 8 hours before intercourse. The failure rate is 21%.<ref name="
===Other methods===
[[Spermicide]]s come in various forms such as: gels, foams, creams, film, suppositories, or tablets. The spermicides create an environment in which sperm can no longer live; they are typically used in addition to the male condom, diaphragm, or cervical cap. They can be used by themselves by putting them into the vagina no more than an hour before intercourse and kept inside the vagina for 6–8 hours after intercourse. The failure rate is 21%.<ref name="
In the [[fertility awareness-based method]] a woman who has a predictable and consistent menstrual cycle tracks the days that she is fertile. The typical woman has approximately 9 [[Fertility|fertile]] days a month and either avoids intercourse on those days or uses an alternative birth control method for that period of time. The failure rate is between 2-23%.<ref name="
[[Lactational amenorrhea]] (LAM) is an option for women who have had a baby within the past 6 months and are breastfeeding. This method is only successful if it has been less than 6 months since the birth of the baby, they must be fully breastfeeding their baby, and not having any periods.<ref name="
The '[[Coitus interruptus|pull out method]]' or [[coitus interruptus]] is a method where the male will remove his penis from the vagina before ejaculating; [[Fertilisation|this prevents sperm from reaching the egg and can prevent pregnancy]]. This method has to be done correctly every time and is best if used in addition to other forms of birth control in order to prevent pregnancy. It has a failure rate of approximately 22%.<ref>{{Cite web|title=What is the Effectiveness of the Pull-Out Method?|url=https://www.plannedparenthood.org/learn/birth-control/withdrawal-pull-out-method/how-effective-is-withdrawal-method-pulling-out|access-date=2021-11-18|website=www.plannedparenthood.org|language=en}}</ref>
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===Emergency contraceptives===
A [[Copper IUDs|copper IUD]] can be used as an [[Emergency contraception|emergency contraceptive]] as long as it is inserted within 5 days of intercourse.<ref name="
There are two different types of [[Emergency contraception|emergency contraceptive pills]], one contains [[ulipristal acetate]] and can prevent pregnancy if taken within 5 days of intercourse. The other contains [[levonorgestrel]] and can prevent pregnancy if taken within 3 days of intercourse. This option can be used if other birth control methods fail.<ref>{{Cite web|title=What Kind of Emergency Contraception Is Best For Me?|url=https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception/which-kind-emergency-contraception-should-i-use|access-date=2021-11-18|website=www.plannedparenthood.org|language=en}}</ref>
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===Surgical methods===
[[Tubal ligation]] is also known as 'tying tubes'. This is the surgical process that a medical professional performs. This is done by closing or tying the fallopian tubes in order to prevent sperm from reaching the eggs. This is often done as an [[outpatient surgical procedure]] and is effective immediately after it is performed. The failure rate is 0.5%.<ref name="
A [[vasectomy]] is a minor surgical procedure where a doctor will cut the [[vas deferens]] and seal the ends to prevent sperm from reaching the penis and ultimately the egg. The method is usually successful after 12 weeks post-procedure or until the sperm count is zero. The failure rate is 0.15%.<ref name="
==User dependence==
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Because of their systemic nature, hormonal methods have the largest number of possible side effects.<ref>{{cite web |last=Staff |first=Healthwise. |title=Advantages and Disadvantages of Hormonal Birth Control |url=http://healthlinksbc.org/kb/content/frame/tw9513.html |access-date=2010-07-06 }}</ref>
Combined hormonal contraceptives contain estrogen and progestin hormones.<ref name="
Hormonal contraceptives can come in multiple forms including injectables. Depot medroxyprogesterone acetate (DMPA), a progestin-only injectable, has been found to cause amenorrhea; however, the irregular bleeding pattern returns to normal over time.<ref name="
===Sexually transmitted disease prevention===
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Other barrier methods, such as [[Diaphragm (contraceptive)|diaphragms]] may provide limited protection against infections in the upper genital tract. Other methods provide little or no protection against sexually transmitted diseases.
==Effectiveness
===Cost and cost-effectiveness===▼
Family planning is among the most cost-effective of all health interventions.<ref name=Tsui>{{cite journal |author1-link=Amy Tsui| vauthors = Tsui AO, McDonald-Mosley R, Burke AE | title = Family planning and the burden of unintended pregnancies | journal = Epidemiologic Reviews | volume = 32 | issue = 1 | pages = 152–74 | year = 2010 | pmid = 20570955 | pmc = 3115338 | doi = 10.1093/epirev/mxq012 }}</ref> Costs of contraceptives include method costs (including supplies, office visits, training), cost of method failure ([[ectopic pregnancy]], [[Miscarriage|spontaneous abortion]], induced abortion, birth, child care expenses) and cost of side effects.<ref name=Trussell2009>{{cite journal | vauthors = Trussell J, Lalla AM, Doan QV, Reyes E, Pinto L, Gricar J | title = Cost effectiveness of contraceptives in the United States | journal = Contraception | volume = 79 | issue = 1 | pages = 5–14 | date = January 2009 | pmid = 19041435 | pmc = 3638200 | doi = 10.1016/j.contraception.2008.08.003 }}</ref> Contraception saves money by reducing [[unintended pregnancy|unintended pregnancies]] and reducing transmission of [[sexually transmitted infection]]s. By comparison, in the US, method related costs vary from nothing to about $1,000 for a year or more of reversible contraception.▼
During the initial five years, vasectomy is comparable in cost to the IUD. Vasectomy is much less expensive and safer than tubal ligation.▼
Since ecological breastfeeding and fertility awareness are behavioral they cost nothing or a small amount upfront for a thermometer and / or training. Fertility awareness based methods can be used throughout a woman's reproductive lifetime.▼
Not using contraceptives is the most expensive option. While in that case there are no method related costs, it has the highest failure rate, and thus the highest failure related costs. Even if one only considers medical costs relating to preconception care and birth, any method of contraception saves money compared to using no method.▼
The most effective and the most cost-effective methods are long-acting methods. Unfortunately these methods often have significant up-front costs, requiring the user to pay a portion of these costs prevents some from using more effective methods.<ref name=Cleland>{{cite journal | vauthors = Cleland K, Peipert JF, Westhoff C, Spear S, Trussell J | title = Family planning as a cost-saving preventive health service | journal = The New England Journal of Medicine | volume = 364 | issue = 18 | pages = e37 | date = May 2011 | pmid = 21506736 | doi = 10.1056/NEJMp1104373 }}</ref> Contraception saves money for the public health system and insurers.<ref>{{Cite journal|last1=Jennifer J. Frost|last2=Lawrence B. Finer|last3=Athena Tapales|date=2008|title=The Impact of Publicly Funded Family Planning Clinic Services on Unintended Pregnancies and Government Cost Savings|url=http://muse.jhu.edu/content/crossref/journals/journal_of_health_care_for_the_poor_and_underserved/v019/19.3.frost.html|journal=Journal of Health Care for the Poor and Underserved|language=en|volume=19|issue=3|pages=778–796|doi=10.1353/hpu.0.0060|pmid=18677070|s2cid=14727184|issn=1548-6869}}</ref>▼
===Effectiveness calculation===
Failure rates may be calculated by either the [[Pearl Index]] or a [[decrement table|life table method]]. A "perfect-use" rate is where any rules of the method are rigorously followed, and (if applicable) the method is used at every act of intercourse.
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For instance, someone using oral forms of hormonal birth control might be given incorrect information by a health care provider as to the frequency of intake, or for some reason does not take the pill one or several days, or not go to the pharmacy on time to renew the prescription, or the pharmacy might be unwilling to provide enough pills to cover an extended absence.
===Effectiveness comparison===
The table below color codes the '''typical use''' and '''perfect use''' [[failure rate]]s, where the failure rate is measured as the expected number of pregnancies per year per woman using the method:
:{| class="wikitable sortable"
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{{reflist|group=note|refs=<ref name="parous">''[[Parity (medicine)|Parous]]'' refers to those who ''have'' given birth.</ref><ref name="nulliparous">''[[Parity (medicine)|Nulliparous]]'' refers to those who have ''not'' given birth.</ref>}}
{{reflist|30em|refs=<ref name="trussell2011">{{cite journal | vauthors = Trussell J | title = Contraceptive failure in the United States | journal = Contraception | volume = 83 | issue = 5 | pages = 397–404 | date = May 2011 | pmid = 21477680 | pmc = 3638209 | doi = 10.1016/j.contraception.2011.01.021 }}</ref><ref name="trussell2007">{{cite book |last1=Trussell |first1=James |year=2007 |chapter=Contraceptive Efficacy |editor1-last=Hatcher |editor1-first=Robert A. |editor2-first=James |editor2-last=Trussell |editor3-first=Anita L. |editor3-last=Nelson |name-list-style=vanc |title=Contraceptive Technology |edition=19th |___location=New York |publisher=Ardent Media |isbn=978-0-9664902-0-6 |chapter-url=http://www.contraceptivetechnology.org/table.html |pages=[https://archive.org/details/contraceptivetec00hatc/page/773 773–845] |url-access=registration |url=https://archive.org/details/contraceptivetec00hatc/page/773 }}</ref>}}
▲==Cost and cost-effectiveness==
▲Family planning is among the most cost-effective of all health interventions.<ref name=Tsui>{{cite journal |author1-link=Amy Tsui| vauthors = Tsui AO, McDonald-Mosley R, Burke AE | title = Family planning and the burden of unintended pregnancies | journal = Epidemiologic Reviews | volume = 32 | issue = 1 | pages = 152–74 | year = 2010 | pmid = 20570955 | pmc = 3115338 | doi = 10.1093/epirev/mxq012 }}</ref> Costs of contraceptives include method costs (including supplies, office visits, training), cost of method failure ([[ectopic pregnancy]], [[Miscarriage|spontaneous abortion]], induced abortion, birth, child care expenses) and cost of side effects.<ref name=Trussell2009>{{cite journal | vauthors = Trussell J, Lalla AM, Doan QV, Reyes E, Pinto L, Gricar J | title = Cost effectiveness of contraceptives in the United States | journal = Contraception | volume = 79 | issue = 1 | pages = 5–14 | date = January 2009 | pmid = 19041435 | pmc = 3638200 | doi = 10.1016/j.contraception.2008.08.003 }}</ref> Contraception saves money by reducing [[unintended pregnancy|unintended pregnancies]] and reducing transmission of [[sexually transmitted infection]]s. By comparison, in the US, method related costs vary from nothing to about $1,000 for a year or more of reversible contraception.
▲During the initial five years, vasectomy is comparable in cost to the IUD. Vasectomy is much less expensive and safer than tubal ligation.
▲Since ecological breastfeeding and fertility awareness are behavioral they cost nothing or a small amount upfront for a thermometer and / or training. Fertility awareness based methods can be used throughout a woman's reproductive lifetime.
▲Not using contraceptives is the most expensive option. While in that case there are no method related costs, it has the highest failure rate, and thus the highest failure related costs. Even if one only considers medical costs relating to preconception care and birth, any method of contraception saves money compared to using no method.
▲The most effective and the most cost-effective methods are long-acting methods. Unfortunately these methods often have significant up-front costs, requiring the user to pay a portion of these costs prevents some from using more effective methods.<ref name=Cleland>{{cite journal | vauthors = Cleland K, Peipert JF, Westhoff C, Spear S, Trussell J | title = Family planning as a cost-saving preventive health service | journal = The New England Journal of Medicine | volume = 364 | issue = 18 | pages = e37 | date = May 2011 | pmid = 21506736 | doi = 10.1056/NEJMp1104373 }}</ref> Contraception saves money for the public health system and insurers.<ref>{{Cite journal|last1=Jennifer J. Frost|last2=Lawrence B. Finer|last3=Athena Tapales|date=2008|title=The Impact of Publicly Funded Family Planning Clinic Services on Unintended Pregnancies and Government Cost Savings|url=http://muse.jhu.edu/content/crossref/journals/journal_of_health_care_for_the_poor_and_underserved/v019/19.3.frost.html|journal=Journal of Health Care for the Poor and Underserved|language=en|volume=19|issue=3|pages=778–796|doi=10.1353/hpu.0.0060|pmid=18677070|s2cid=14727184|issn=1548-6869}}</ref>
▲== References ==
{{Birth control methods}}
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