If you are in a sexual relationship and not ready to change diapers, push a baby stroller, and take on the lifetime responsibility of raising a child, then it is time to learn birth control basics. Pregnancy prevention is not just a job for women. It takes two to tango.
Not all birth control is equal. Some methods work better than others. Permanent or long-acting methods are more effective as they do not require any daily effort. They are low maintenance. Daily options, like the pill, require daily compliance. Remembering to do anything every day is a challenge. I forget my multivitamin more often than I remember it.
Studies validate that some women are highly compliant with their birth control choice, while others are not. Condoms only work if you put them on your penis from start to finish every time you have sex. Birth control pills only work if she swallows them daily.
45% of US pregnancies are unintended
Almost half of the pregnancies in the United States are unintended. Even more frightening, half of the unintended pregnancies occurred in women who were using birth control at the time of conception (Guttmacher). Before you have sex, educate yourself on the different methods of birth control. The woman has the right to choose her method of birth control. A man, who is not ready to parent, owes it to himself to understand pregnancy precautions. Otherwise, use a condom or choose not to have sex.
Vasectomy
Vasectomy is a minor surgery done on a man to prevent pregnancy permanently. Two tubes, called the vas deferens, are cut to stop sperm from mixing with semen. It is a simple, out-patient procedure done under local anesthesia. It is a safe and effective form of permanent contraception with only a 1/1000 rate of failure.
Tubal ligation is a surgical procedure for women. The fallopian tubes are cut, clamped, or removed. When the fallopian tube is blocked, the egg released from the ovary during ovulation can not reach the sperm. Tubal ligation is a highly effective, permanent birth control method with a failure rate of about 1/1000.
Nexplanon is the brand name for the only available implant in the US. It is a single four cm rod inserted just under the skin of the inner arm. It is small, thin, and about the size of a toothpick. The location on the arm makes it discreet and unnoticeable. It contains slow-releasing progesterone to stop the ovary from releasing an egg. Nexplanon is the most effective reversible birth control method available.
The Intrauterine device (IUD)
An IUD is a small T-shaped device inserted into the cavity of the uterus. There is one hormone-free IUD and four progesterone IUDs. IUDs are highly effective birth control that offers hassle-free contraception for years. IUDs are over 99% effective at preventing pregnancy.
The Shot
Depo-Provera is a hormonal injection that a woman receives every three months. It contains a type of progesterone called medroxyprogesterone acetate. The hormone prevents an egg from being released (ovulation). To be effective, the shot must be given every three months. Some women may experience unpredictable spotting after the first injection. Eventually, many women may not have a cycle at all. A lack of periods is normal on Depo-Provera and can be a benefit many women enjoy.
The Vaginal Ring
Nuvaring is a monthly form of birth control where a small, flexible ring is inserted into the vagina. It releases a steady, low dose of estrogen and progesterone, which is absorbed through the walls of the vagina. The hormones prevent ovulation. The ring is inserted into the vagina and left in place for three weeks. Then, it is removed for seven days to trigger a menstrual cycle. The Nuvaring does not need to be removed during sex. Most men can not feel it, and those who do report they do not mind.
The Patch
The Xulane patch is like a small sticker that is placed on the skin. It releases estrogen and progesterone, which are absorbed through the skin. The hormones prevent ovulation. One patch is placed each week for three weeks a month. In the fourth week, she does not use the patch. The withdrawal of hormones triggers a menstrual cycle. The patch must be used correctly to prevent pregnancy.
The Pill
Birth control pills work by preventing ovulation. Like the ring and the patch, oral contraceptives release estrogen and progesterone. There are a variety of brands, doses, and regimens. The most important aspect of the pill is that it must be taken daily to prevent ovulation. Skipping or missing pills may lead to ovulation. Some brands contain only progesterone and work in the same manner. Compliance with daily pills varies widely. It is not uncommon for users to forget a pill from time to time. This decreases the effectiveness of the pill.
Condoms
Condoms are very effective at preventing pregnancy. Male condoms slip over the penis. Female condoms are placed like a pouch inside of the vagina. Condoms create a physical barrier blocking sperm from reaching the egg. Condoms also offer protection against sexually transmitted infections that are passed via fluid transmission. These include HIV, gonorrhea, chlamydia, and trichomoniasis. Condoms work very well to prevent pregnancy when used correctly. Condoms must be used 100% of the time from start to finish during sex.
Spermicide
Spermicide is a chemical deposited into the vagina to kill sperm. It comes as gel, foam, or cream. Spermicide is not a highly effective form of contraception when used alone. Typically, it is used as a supplemental method along with condoms or a diaphragm to decrease the risk of an unplanned pregnancy.
Diaphragm
A diaphragm is a silicone cup that is inserted into the vagina to provide a physical cover to the cervix. This protective shield blocks sperm from reaching the egg. The cervix is the opening of the uterus located at the back of the vagina. Spermicide should be applied to the device before insertion to decrease the risk. Diaphragms must be placed correctly to be effective. Most studies on typical use quote an effectiveness rate of 88% (Guttmacher).
The Pull-Out Method
The pull-out method is a technique of withdrawing the penis from the vagina before ejaculation. Pulling out has an annual failure rate of 20%, making it one of the least effective ways to prevent pregnancy. About four million sperm are released in pre-ejaculatory fluid (precum). It only takes one sperm to make a baby.
Emergency Contraception
Emergency contraception is a pill containing high dose progesterone. It is commonly called “the morning after” pill. The dose is designed to delay or to prevent ovulation. Emergency birth control brands should be used within 72 hours of unprotected sex. Common brands, such as Plan B and Next Choice, are available over the counter. Prescription EllaOne (ulipristal acetate) can be used up to 5 days after unprotected sex. These methods decrease the risk of pregnancy by 70%. Emergency contraception is called Plan B and not Plan A for a reason.
Trust and dialogue
Trust is an important aspect of sex. Whether you are having sex with a long term partner or an anonymous hookup, trust is key. Asking about birth control is a sign of respect for your partner and an indication of your own maturity. Having a dialogue about pregnancy prevention demonstrates you understand sex has consequences.
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Photo by Simone van der Koelen on Unsplash
Previously published on Medium.com.