Planned Parenthood Columbia Willamette

Contraception

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People have used birth control methods for thousands of years. Today, we have many safe and effective birth control methods available to us.

Contraception, or birth control, is a way for people to prevent or plan pregnancy.

Choose a method that’s right for you.

There are many things to think about when trying to find a birth control method that fits you and your life. Besides abstinence (not having sex), no method works 100% of the time to prevent pregnancy. But there are many choices that are safe and work the majority of the time. A Planned Parenthood health care provider can talk with you about all of your birth control choices and help you pick the one that works best for you.

Learning about different methods may help you choose which method is best for you. Talking with your partner before having sex* can help you make informed, responsible decisions about your health. The best method is the one that you like and can use correctly and consistently.

Learn More: For more detailed information on contraception, talk to your health care professional, call 1-888-576-7526 for the health center nearest you.

Sexually Transmitted Infections (STI) Protection:

Most birth control methods provide little or no protection against STIs. The latex and polyurethane condoms are birth control methods that provide protection against most STIs, including HIV. Always use a condom in addition to your other method of birth control for protection against STIs.

Looking for Emergency Contraception? Click here.

 

Choosing a Birth Control Method

If you want the best pregnancy protection with the least amount of hassle?

  • Choose an IUD (Mirena or Paragard) or an implant (Nexplanon).

Want to “skip” your periods?

  • Try a hormonal IUD (Mirena), an implant (Nexplanon), the shot (Depo Provera) or continuous cycling on pills or the ring.

Have endometriosis?

  • A hormonal IUD (Mirena) is recommended to help control cramping and bleeding.

Have migraines?

  • Consider an IUD (Mirena or Paragard), an implant (Nexplanon) or shot (Depo Provera). Estrogen-containing methods may not be safe to use.

Smoke and are over 35?

  • Consider an IUD (Mirena or Paragard), implant (Nexplanon) or shot (Depo Provera). Estrogen-containing methods may not be safe to use.

Want to be able to get pregnant soon after stopping a method?

  • Consider an IUD (Mirena or Paragard), an implant (Nexplanon), or the pill, ring or patch. The shot (Depo Provera) may delay getting pregnant for several months after stopping it.

 


IUDs (Intrauterine Devices) - Most (99.9% Effective)

 

IUDs are small, “T-shaped” devices made of flexible plastic that are inserted into the uterus by a health care provider.

 

Hormonal IUD (Mirena® )

 

The hormonal IUD can prevent pregnancy for up to five years, and is the most effective contraceptive method currently available in the United States. It contains a small amount of progestin (much less than in systemic methods like pills).

Pros:

  • Long-term, effective use up to five years
  • No need to think about birth control daily or do anything on a regular basis
  • Decreased menstrual blood loss and cramping
  • Can be used while breastfeeding
  • Can be used by women who cannot take estrogen
  • Some people may not have periods while using this

Cons:

  • Does not protect against STIs
  • During the first 3-6 months, side effects may include irregular bleeding (which decreases after 3-6 months), headaches, acne, and breast tenderness
  • If pregnancy does occur, slightly increased risk of ectopic (tubal) pregnancy

 

Copper IUD (Paragard® )

 

The copper IUD prevents pregnancy for up to 12 years. It can also be used as emergency contraception if inserted within five days after unprotected intercourse.

Pros:

  • Long-term, effective use up to twelve years
  • No need to think about birth control daily
  • Does not contain hormones
  • Can be used while breastfeeding

Cons:

  • Does not protect against STIs
  • Menstrual periods may be heavier with more cramping
  • If pregnancy does occur, slightly increased risk of ectopic pregnancy

 

Implant - Most (99.9% Effective)

 

The implant (brand name Nexplanon®) is a small, soft, plastic rod containing progestin (a hormone) that is placed under the skin in the upper arm by a health care provider.

 

Pros:

  • Long-term, effective use up to three years
  • No need to think about birth control daily
  • Can be used by people who cannot take estrogen
  • Can be used while breastfeeding

Cons:

  • Does not protect against STIs
  • Side-effects may include irregular bleeding or no bleeding at all
  • May be less effective in people over 130% of their ideal body weight

 

Birth Control Shot - Moderate (97% Effective)

 

The shot (brand name Depo-Provera®) is an injectable hormone (progestin only) that offers contraceptive benefits for 3 months. Timing of health center visits for the shot is extremely important.


Pros:

  • Prevents pregnancy for 3 months, so only needed four times per year
  • Can be used by people who cannot take estrogen
  • Can be used while breastfeeding
  • For some, periods may stop altogether

Cons:

  • Does not protect against STIs
  • Side effects may include irregular bleeding
  • Possible delay in return of fertility for up to 18 months
  • Possible weight gain (on average, five lbs in first year)
  • Possible decrease in bone density, which is reversible once Depo-Provera® is stopped

 

Pills - Moderate (92% Effective)

 

There are many different types of birth control pills. Some contain a combination of estrogen and progestin (hormones), while others contain progestin only. You should take the pill at the same time every day for it to be most effective and have the fewest side effects.


Pros:

  • Decreased menstrual cramps and menstrual blood loss
  • Less acne
  • Regular menstrual cycles
  • Some protection from cancer of the ovaries and uterine lining

Cons:

  • Does not protect against STIs
  • Mild side effects, including headaches, breast tenderness, nausea, and vaginal bleeding, may occur but usually go away after 1-3 months
  • Must be taken at same time daily—may be hard to remember to take the pill daily
  • Oral contraceptives containing estrogen must not be taken by people with certain types of migraine headaches, or who smoke and are over age 35
  • Serious risks, although rare, can be life threatening, and include blood clots, stroke or heart attacks. (Note: These risks are greater if you are carrying a pregnancy to term or for people who smoke)

 

Ring - Moderate (92% Effective)

 

The ring is a small, flexible ring that is self-inserted into the vagina once a month. It contains the same hormones (estrogen and progestin) as birth control pills. The ring is easily inserted at home into the vagina and does not need to be removed during intercourse.


Pros:

  • No need to think about birth control daily
  • Decreased menstrual cramps and menstrual blood loss
  • Less acne
  • Regular menstrual cycles
  • Some protection from ovarian and uterine lining cancer
  • Less hormone-related side effects than other methods

Cons:

  • Does not protect against STIs
  • May cause vaginal irritation and discharge
  • Mild side effects (including headaches, nausea, breast tenderness and vaginal bleeding) may occur but usually go away after 1-3 months
  • Serious risks, although rare, can be life- threatening, and include blood clots, stroke
  • or heart attacks (Note: These risks are greater for if you are carrying a pregnancy to term or for people who smoke)
  • Must not be used by people who smoke and are over the age of 35
  • Must not be used by people with certain types of migraine headaches

 

Patch - Moderate (92% Effective)

 

The patch is a thin, beige patch that sticks to the skin. The sticky part of the patch contains the same hormones (estrogen and progestin) as birth control pills. The patch is applied to the upper arm, buttocks or pelvis 1 time per week for 3 weeks, and then it is removed for 1 week allowing for a period.


Pros:

  • No need to think about birth control daily
  • Regular menstrual cycles
  • May continue your regular activities while wearing the patch (like swimming or exercising)
  • Decreased menstrual cramps and menstrual blood loss
  • Some protection from ovarian and uterine lining cancer

Cons:

  • Does not protect against STIs
  • May cause skin irritation
  • Mild side effects (including headaches, nausea, breast tenderness and vaginal bleeding) may occur but usually go away after 1-3 months
  • Serious risks, although rare, can be life-threatening, and include blood clots, stroke or heart attacks. (Note: These risks are greater if you are carrying a pregnancy to term or for people who smoke)
  • Must not be used by people who smoke and are over the age of 35
  • Must not be used by people with certain types of migraine headaches

 

Male Condoms – Less (86% Effective)

 

A condom is placed over the penis before having sex, and should cover the entire shaft of the penis. A water- soluble lubricant, such as K-Y ® Jelly or Astroglide®, may increase effectiveness and comfort.
Do not use oil-based lubricants, such as petro-leum jelly or baby oil, which can weaken latex and might cause the condom to tear or break.

Types of Condoms:

  • Latex: Most common type. Available in a variety of styles. Helps protect against transmission of most STIs and HIV.
  • Polyurethane: For people with latex sensi- tivity. Helps protect against transmission of most STIs and HIV.
  • Natural membrane: Protects against pregnancy and bacterial infections, but does not offer as much protection against viral infections such as HIV/AIDS.

How to Use:

  • Place on erect penis before sex. Use one at a time and use a new condom each time. Never reuse.
  • To prevent breakage, store condoms at room temperature and use before expiration date.
  • Provides protection from most STIs
  • Allows men to share responsibility for birth control
  • No side effects, unless allergic to latex or spermicide
  • Low cost; readily available without exam or prescription
  • Can be used while breastfeeding


Pros:

  • Provides protection from most STIs
  • Allows shared responsibility for birth control
  • No side effects, unless allergic to latex or spermicide
  • Low cost; readily available without exam or prescription
  • Can be used while breastfeeding

Cons:

  • Must be used with every act of intercourse
  • Condoms may break
  • Less effective at preventing pregnancy than other methods

 

Female Condoms- Less (86% Effective)

 

A pouch-like polyurethane condom is inserted into the vagina and is held in place by a small, flexible ring. A larger ring sits outside the labia, and the penis is inserted inside the condom. A water-based lubricant should be placed inside the condom and/or on the penis before sex. You must make sure the penis remains inside the condom.

How to Use: Lubricate the closed end of the condom. Squeeze together the sides of the inner ring at the closed end of the condom and insert it into the vagina up to the cervix. Let the outer ring hang about an inch outside the vagina.


Pros:

  • Provides protection from most STIs
  • Can be purchased without exam or prescription
  • Does not depend on partner cooperation
  • Can be used by those who are allergic to latex

Cons:

  • May cause vaginal irritation
  • Noisy
  • May slip during intercourse
  • Higher failure rate than other methods

 

Diaphragm - Less (84% Effective)

 

A diaphragm is a barrier method that is inserted into the vagina before sex. It must be used with spermicide (See also: Spermicidal Methods on page 16). A diaphragm requires a fitting for the correct size, and practice inserting it so that it is placed correctly into the vagina.

How to Use: Before having sex, the diaphragm is filled with the recommended amount of spermicide and inserted into the vagina, blocking the cervix. After ejaculation, the diaphragm must be left in place for six hours. Upon removal, it can be washed and used again.


Pros:

  • Contain no hormones
  • Can be inserted prior to sexual activity
  • Can be used while breastfeeding
  • Can be reused

Cons:

  • Does not protect against STIs
  • Significantly less effective than hormonal methods or long acting methods.
  • Cannot be used by those allergic to spermicide.
  • Non-latex diaphragms are available for those with latex allergies
  • Insertion/removal may be difficult for some people
  • Higher failure rate than other methods

 

Fertility Awareness - Least (75% Effective)

 

Fertility awareness-based methods (FAMs) are ways to track ovulation (the release of an egg) in order to prevent pregnancy. Some people call FAMs “natural family planning.”

Must abstain from sexual intercourse or use a barrier method during her fertile days to avoid pregnancy. Several methods can be used to determine your fertile days, including monitoring body temperature and evaluating changes in cervical mucus. Understanding your fertile days is very important and necessary to use this method. There are classes available to learn more about fertility and the importance of periodic abstinence to avoid unintended pregnancy.

How to Use: Use one or more methods to track your cycle and determine fertile days. Chart cycle on calendar and abstain from intercourse or use a barrier method on all fertile days.


Pros:

  • No medical or hormonal side effects
  • No exam needed
  • Low cost

Cons:

  • Does not protect against STIs
  • Must have regular menstrual cycles
  • Requires cooperation of partner
  • Requires months of training and planning
  • Higher failure rate than other methods

 

Withdrawal - Least (73% Effective)

 

Not recommended as a reliable method. This requires withdrawal of a penis out of and away from the vagina before ejaculating. No semen can spill on or near the vagina for this method to be effective. Sperm can live in pre-ejaculate fluid, so even if the penis is withdrawn prior to orgasm, there is still the potential for pregnancy. Withdrawal requires self-control and intimate knowledge of your sexual response.

How to Use: Penis is withdrawn from vagina prior to ejaculation


Pros:

  • Can prevent pregnancy when no other method is available
  • Free

Cons:

  • Does not protect against STIs
  • Requires good self-control
  • Not recommended for teens or sexually inexperienced people
  • Higher failure rate than other methods

 

Spermicide - Least ( 71% Effective)

 

Contraceptive Cream, Jelly, Film, Foam Spermicides, most contain- ing nonoxynol-9, are available over-the-counter at most pharmacies and convenience stores. Spermicide is available in creams, jellies, film, foam, and suppositories. Spermicide is more effective when combined with a barrier method, like condoms.

How to Use: Insert into vagina, covering the cervix. Should be applied at least 10 minutes, but no more than one hour, before sex.


Pros:

  • No hormonal side effects
  • Low-cost, readily available
  • No exam or prescription needed

Cons:

  • Does not protect against STIs, and may, in some cases, increase risk of infection
  • Nonoxynol-9, the ingredient in spermicides, has been shown to cause skin irritation in some people, and may increase the risk of urinary tract infections
  • Spermicides should not be used for if you are high risk for HIV infection
  • People who have intercourse multiple times daily should choose another method
  • Spermicides should not be used for anal sex
  • Higher failure rate than other methods

 

Abstinence - Most (100% Effective)

 

When trying to prevent pregnancy, abstinence is the choice not to engage in sexual intercourse with a partner. If all sexual contact is avoided, there is no risk of pregnancy or STIs. However, if only some forms of sexual activity are eliminated, such as vaginal intercourse, there are still risks for STIs through oral or anal sex.

How to Use: Avoid genital or oral-to-genital sex play with a partner


Pros:

  • No risk of STIs or pregnancy
  • No side effects
  • Free

Cons:

  • Requires commitment by both partners

 


Permanent Birth Control Methods

 

Vasectomy - Most (99.9% Effective)

 

In this form of permanent contraception, a health care provider closes or blocks the tubes that carry sperm so that sperm will not be ejaculated. After 15-20 ejaculations, sperm should no longer be in the ejaculatory fluid. A simple lab test can be done to make sure that sperm are no longer in the ejaculatory fluid.

Pros:

  • Permanent, irreversible protection against pregnancy
  • No lasting side effects
  • Low lifetime cost
  • Can be done in office; does not require hospitalization

Cons:

  • Does not protect against STIs
  • Rarely, tubes reconnect and pregnancy occurs
  • Surgical procedure complications, such as mild bleeding or infection

 

Essure® (Permanent Contraception) - Most (99% Effective)

 

Essure® is a non-surgical option for female permanent contraception that is 99.8% effective. Two very small coil-like devices are inserted into the fallopian tubes by a provider using an instrument called a hysteroscope. Within three months, tissue grows around the inserts and blocks the fallopian tubes, creating a permanent method of birth control. An x-ray test needs to be performed three months after the insertion of the devices to confirm the fallopian tubes are blocked.

Pros:

  • Permanent, irreversible protection against pregnancy
  • No incision or surgery required
  • Can be performed in a physician’s office without general anesthesia
  • Procedure takes about 15 minutes
  • Does not contain hormones
  • Return to normal activities in one day
  • Low cost after initial investment

Cons:

  • Does not protect against STIs
  • Must use another method of birth control for at least three months after the procedure
  • Not all people undergoing the procedure will have a successful placement of the device in the fallopian tubes
  • Procedure complications may include mild bleeding, infection and uterine perforation

 

Tubal Ligation* - Most (99.5% Effective)

 

Often called “getting your tubes tied,” this method of female permanent contraception permanently blocks your fallopian tubes. It is effective immediately after the operation.

Pros:

  • Permanent, irreversible protection against pregnancy
  • No lasting side effects
  • Low cost after initial investment

Cons:

  • Does not protect against STIs
  • Rarely, tubes reconnect and pregnancy occurs
  • Requires anesthesia and surgical procedure, both of which may cause complications or side effects (such as mild bleeding or infection)
  • If pregnancy occurs, it is more likely to be an ectopic (tubal) pregnancy
  • Expensive up-front cost

 


Emergency Contraception


Emergency Contraception

 

What is EC? Emergency Contraception (EC, also known as ella®, Next Choice™ or Plan B®) is a safe and effective way to prevent pregnancy after unprotected sex or birth control failure. Emergency contraception (EC) is available when you’ve had unprotected sex or experienced a contraceptive failure (condom broke, forgot to take the pill) and want to prevent pregnancy.

EC does not harm an established pregnancy, nor will it cause an abortion. EC works by preventing the release of an egg from the ovaries or preventing its implantation in the uterus.


When would I use EC?

  • You didn’t use birth control and don’t want to get pregnant.
  • The condom broke.
  • You forgot to use birth control.
  • You were raped or forced into having sex.
  • There’s a possibility your method of birth control didn’t work.

EC is most effective if taken in the first 24 hours, and up to 89% effective if taken in the first 72 hours after unprotected sex. EC may still work up to 120 hours (five days) after unprotected sex. The sooner you take EC, the more effective it will be. You can get EC in advance to keep in case of an emergency.

Plan B One-Step, Next Choice, Levonorgestrel Tablets are made of the progestin. Ella blocks the body’s own progestin. Both types of EC work by keeping the ovaries from releasing eggs, which is ovulation. Pregnancy cannot happen if there is no egg to join with sperm.

EC pills should only be used in emergencies as a back-up method, and should not take the place of regular, reliable birth control.

Side effects that may occur include dizziness, headaches, breast tenderness, nausea, belly pain or period cramps or bleeding between periods. Taking EC with food can help reduce some symptoms.

EC can affect your next period. It could be early or late, lighter or heavier, or shorter or longer. It may also be the same as usual.

Taking EC does not affect your ability to become pregnant in the future.

After taking EC: Continue using your usual birth control method. You should get your period within four weeks after finishing EC. If you don’t, return to your healthcare provider for a pregnancy test and a review of your options.

EC does not protect against HIV or other sexually transmitted diseases (STDs). If you’ve had unprotected sex, consider scheduling an appointment for an STD test.

If you are 17 years or older, EC is available at Planned Parenthood or a pharmacy without a prescription. You will need to show proof of age when purchasing EC.

If you are under the age of 17 you can get a consultation and prescription for EC from Planned Parenthood or by visiting your health care provider.

Copper IUD (99% Effective)

The copper IUC (ParaGard®) can also be used as EC. It reduces the risk of pregnancy by more than 99% if inserted within 5 days of unprotected sex. It may also be left in place to be used for birth control for up to 12 years.

Pros:

  • Most effective form of EC
  • Effectiveness not changed by patient weight

Cons:

  • Does not protect against STDs
  • Needs to be placed by a health care provider

Ella® (75 – 89% Effective)

A pill that can be taken up to 5 days after unprotected sex to prevent pregnancy.

Pros:

  • May prevent unintended pregnancy
  • May keep the pills on hand as backup to regular birth control method

Cons:

  • Does not protect against STDs
  • Has decreased effectiveness for people weighing more than 194 lbs
  • Side effects may include irregular bleeding and nausea

Next Choice® (75 – 89% Effective)

A pill that can be taken up to 3 days after unprotected sex to prevent pregnancy.

Pros:

  • May prevent unintended pregnancy
  • May keep the pills on hand as backup to regular birth control method
  • Available over the counter without a prescription

Cons:

  • Does not protect against STDs
  • Has decreased effectiveness for people weighing more than 154 lbs
  • Side effects may include irregular bleeding and nausea

 

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