How to decide
With so many options, choosing
a form of contraception can be
daunting. Begin with a few
Do you need to protect against STIs?
How important is convenience?
What about effectiveness? Only abstinence is
100% effective, but other methods come close.
Review this slideshow, then ask your doctor,
nurse, or family planning specialist which options
are best for you.
Fertility awareness - Also called natural family
planning, fertility awareness means avoiding
sex when the woman is most fertile.
The most reliable way to do this is to watch
for changes in cervical mucous and body
temperature. To use this method correctly,
it's best to get training from a health care
Pros: No medications or devices.
Cons: Limits spontaneous sex, less reliable
than pill or sterilisation.
Spermicide contains a chemical that kills sperm. It comes in the
form of foam, jelly, cream, film, sponge or pessary that is
placed inside the vagina before sex. Some types must be put in
place 30 minutes ahead of time.
Frequent use may cause tissue irritation,
increasing the risk of infections and STIs.
Spermicides are most often used along with
other contraceptive methods
Pros: Easy to use.
Cons: May increase the risk of STIs, best used
with backup method.
The latex condom is the classic barrier
method. It prevents sperm from
protecting against pregnancy and
Condoms are about 85% effective but
can be up to 99% effective with proper
Cons: Only effective if used correctly
every time. Can’t be reused.
The female condom is a thin plastic pouch that
lines the vagina and can be put in place any
time before sex but before the penis comes
into contact with the vagina or genital area.
Users grasp a flexible, plastic ring at the
closed end to guide it into position. It's
somewhat less effective than the male
Pros: Widely available, some protection
against STIs, conducts body heat better than a
Cons: Can be noisy, five out of 100 users get
pregnant, not reusable. Should not be used
with a male condom, to avoid breakage.
The diaphragm is a rubber dome that is
placed over the cervix before sex. It is
used with a spermicide.
If used correctly, they are estimated to be
92-96% effective in preventing pregnancy.
Pros: One device can last two years.
Cons: Must be fitted by a doctor, no STI
protection. Can't be used during your
period due to a risk of toxic shock
A cervical cap is similar to a diaphragm,
The cap slips into place over the cervix,
blocking entry into the uterus. It is used
with spermicide. The success rate is
similar to that of the diaphragm.
Pros: Can stay in place for up to 48
Cons: Initially must be fitted by a
doctor, no protection against STIs. Can’t
be used during your period.
The contraceptive sponge is made of foam
and contains spermicide. It is placed
against the cervix up to 24 hours before
sex. The sponge is around 90% effective,
but unlike the diaphragm or cervical cap,
no fitting by a doctor is required.
Cons: Difficult to insert correctly, no STI
protection. Can't be used during your
The most common type of contraceptive pill
(combined pill) uses the hormones oestrogen
and progestogen to prevent ovulation.
The other type of pill is the progestogen-only
pill (POP). When taken on schedule, the pill is
over 99% effective at preventing pregnancy.
Pros: More regular, lighter periods or no
periods, depending on the type of pill. Less
Cons: No STI protection. May cause side
effects, including breast tenderness, spotting,
serious blood clots and raised blood pressure.
Some women should not use contraceptive
Women who have trouble remembering a daily
pill could consider the contraceptive patch.
The patch is worn on the skin and changed only
once a week for three weeks with a fourth
week that is patch-free.
The patch releases the same types of hormones
the contraceptive pill and is just as effective.
Pros: More regular, lighter periods with less
period pain, no need to remember a daily pill.
Cons: May cause skin irritation or other side
effects similar to contraceptive pills. Doesn't
protect against STIs.
The vaginal ring is a soft plastic ring that is
worn inside the vagina.
The ring releases the same hormones as
the pill and patch and is just as effective It
is removed every 21 days and replaced a
week later following a "ring-free" week.
Pros: Lighter, more regular periods, only
replaced every month.
Cons: May cause vaginal irritation or other
side effects similar to pills and the patch.
Doesn’t protect against STIs.
The contraceptive injections, known as DepoProvera and Noristerat, are hormonal
Depo-Provera protect against pregnancy for
up to 12 weeks, and Noristerat protects
against pregnancy for up to eight weeks.
Both Noristerat and Depo-Provera are 99%
effective in preventing pregnancy.
Pros: Only injected a few times a year, highly
Cons: May cause spotting and other side
effects. Doesn't protect against STIs.
Prolonged use of Depo-provera may increase
risk of osteoporosis.
The contraceptive implant is a matchsticksized rod that is placed under the skin of the
It releases the same hormone that’s in the
contraceptive injection, but the implant
protects against pregnancy for three years.
It is highly effective.
Pros: Lasts three years, highly effective.
Cons: May cause side effects, including
irregular bleeding. Doesn't protect against
IUDs and IUSs
IUD stands for intrauterine device, a Tshaped piece of plastic that is placed inside
the uterus by a doctor.
IUDs contain copper and can remain in the
uterus for five to 10 years. An IUS, or
interuterine system, is a similar T-shaped
device that contains the hormone
progestogen. It can remain in place for up to
five years. Both types make it more difficult
for sperm to fertilise the egg and are 99%
Pros: Long-lasting, low-maintenance.
Cons: Side effects can include painful or
Sterilisation - Tubal ligation
If you're sure you won't want biological
children in the future, you may be ready
for permanent sterilisation.
The traditional method for women is
called tubal ligation or "having your
tubes tied." A surgeon closes off the
fallopian tubes, preventing eggs
from making their journey out of the
ovaries. (The banding method is shown
Pros: Permanent, nearly 100% effective.
Cons: Requires surgery, may not be
reversible. Doesn't protect against STIs.
Sterilisation - Tubal implants
A newer procedure makes it possible to
block the fallopian tubes without surgery.
Small implants of metal or silicone are
placed inside each tube. Scar tissue
eventually grows around the implants
and blocks the tubes. Once an X-ray
confirms the tubes are blocked, no other
form of birth control is needed.
Pros: Permanent, no surgery, almost 100%
Cons: Takes a few months to become
effective. May increase the risk of pelvic
Besides condoms, a vasectomy is the
only birth control option available to
It involves surgically closing the
vasdeferens – the tubes that carry sperm
reproductive system. This prevents the
release of sperm but doesn't interfere
Pros: Permanent, almost 100% effective.
Cons: Requires surgery, not effective
immediately, may not be reversible.
Emergency contraception works after
unprotected sex to help avoid pregnancy.
This is an option if a woman has had
unprotected sex or suspects her usual
Though it is often called the "morning
after pill", the Levonelle (prescriptiononly) or Levonelle One Step (over the
counter levonorgestrel) pill can be taken
up to 72 hours (up to three days) and the
ellaOne pill (prescription –only) up to 120
hours (up to 5 days) after unprotected sex
or contraception method failure.
The IUD (coil) can be fitted up to five days
after unprotected sex or contraception
Pulling out before the man ejaculates,
known as the withdrawal method, is not
a foolproof method of birth control.
Some ejaculate (fluid that contains
sperm) may be released before the man
actually begins to climax.
In addition, some men may not have the
willpower to withdraw in time.
Pros: Free, no need for devices or
Cons: Hard to do correctly. No protection