Contraceptive methods that don’t depend on you remembering to take or use them. sexwise.org.

uk/contraception

Contraceptive implant Intrauterine device (IUD) Intrauterine system (IUS) Contraceptive injection Sterilisation

What is it? A small, flexible rod put under the skin of A small plastic and copper device is put A small, T-shaped, progestogen-releasing, An injection of progestogen. The fallopian tubes in women or the tubes
the upper arm releases progestogen. into the uterus (womb). plastic device is put into the uterus carrying sperm in men (vas deferens) are
(womb). cut, sealed or blocked.

Effectiveness Perfect use: over 99%. Perfect use: over 99%. Perfect use: over 99%. Perfect use: over 99%. Overall failure rate is about 1 in 200 for
Typical use: over 99%. Typical use: over 99%. Typical use: over 99%. Typical use: around 94%. females and 1 in 2,000 for males.

Advantage Works for 3 years but can Works for 5 or 10 years depending on Works for 3, 4 or 5 years but can be taken Works for 8 or 13 weeks – you don’t have Sterilisation is permanent with no long or
be taken out sooner. type but can be taken out sooner. out sooner. Periods often become lighter, to think about contraception during short-term serious side effects.
shorter and less painful. this time.

Disadvantage It requires a small procedure to fit and Periods may be heavier, longer or more Irregular bleeding or spotting is common Can’t be removed from the body so side Shouldn’t be chosen if in any doubt about
remove it. painful. in the first 6 months. effects may continue while it works and having children in the future.
for some time afterwards.

Contraceptive methods that you have to use and think about regularly or each time you have sex.

Contraceptive Contraceptive Combined pill Progestogen-only External Internal Diaphragm/cap Fertility awareness
patch vaginal ring (COC) pill (POP) condom condom with spermicide methods

What is it? A small patch stuck A small, flexible, plastic A pill containing estrogen A pill containing A very thin latex (rubber) Soft, thin polyurethane A flexible latex (rubber) or Fertile and infertile times
to the skin releases ring put into the vagina and progestogen, taken progestogen, taken polyurethane (plastic) or sheath that loosely lines silicone device, used with of the menstrual cycle
estrogen and releases estrogen and orally. orally. synthetic sheath, put over the vagina and covers spermicide, is put into the are identified by noting
progestogen. progestogen. the erect penis. the area just outside. vagina to cover the cervix. different fertility indicators.

PERFECT USE MEANS USING THE METHOD CORRECTLY EVERY TIME. TYPICAL USE IS WHEN YOU DON’T ALWAYS USE THE METHOD CORRECTLY.

Effectiveness Perfect use: over 99%. Perfect use: over 99%. Perfect use: over 99%. Perfect use: over 99%. Perfect use: 98%. Perfect use: 95%. Perfect use: 92–96%. Perfect use: up to 99%.
Typical use: around 91%. Typical use: around 91%. Typical use: around 91%. Typical use: around 91%. Typical use: around 82%. Typical use: around 79%. Typical use: 71–88%. Typical use: around 76%.

Advantage Can make bleeds regular, One ring stays in for Often reduces bleeding Can be used if you Can be put in any time No physical side effects,
lighter and less painful. 3 weeks – you don’t and period pain, smoke and are Condoms are the best way to help protect before sex. and can be used to
have to think about and may help with over 35. yourself from sexually transmitted infections. plan as well as prevent
contraception every day. premenstrual symptoms. pregnancy.

Disadvantage May be seen and can You must be comfortable Missing pills, vomiting Late pills, vomiting or May slip off or split if Not as widely You need to use the right Need to avoid sex or use
cause skin irritation. with inserting and or severe diarrhoea can severe diarrhoea can not used correctly or if available as male size. If you have sex again a condom at fertile times
removing it. make it less effective. make it less effective. wrong size or shape. condoms. extra spermicide is needed. of the cycle.

Last updated April 2018 | Copyright FPA | sexwise.org.uk/contraception

 www.fda.gov/birthcontrol
BIRTH CONTROL GUIDE
This birth control chart provides high-level information about different birth control options. It is meant for educational purposes for the general public. This chart is not meant to be a
complete list of all available birth control options. Talk to your healthcare provider about the best birth control choice for you. If you do not want to get pregnant, there are many birth control
options to choose from. No one product is best for everyone. Some methods are more effective than others at preventing pregnancy. Check the pregnancy rates on this chart to get an
idea of how effective a method is at preventing pregnancy. The pregnancy rates tell you the number of pregnancies expected per 100 women during the first year of typical use. Typical use
shows how effective the different methods are during actual use (including sometimes using a method in a way that is not correct or not consistent). The only sure way to avoid pregnancy
is not to have sex.

Number of Some Risks or Side Effects*

Methods pregnancies expected Use This chart does not list all of the risks
(per 100 women)* and side effects for each product.
Sterilization Surgery for less than 1 Onetime procedure. Pain
Women Permanent. Bleeding
Infection or other complications after surgery
Sterilization Surgery less than 1 Onetime procedure. Pain
Most Effective

for Men Permanent. Bleeding

Infection
IUD Copper less than 1 Inserted by a healthcare provider. Cramps
Lasts up to 10 years. Heavier, longer periods
Spotting between periods
IUD with Progestin less than 1 Inserted by a healthcare provider. Irregular bleeding
Lasts up to 3-5 years, depending on the type. No periods (amenorrhea)
Abdominal/pelvic pain
Implantable Rod less than 1 Inserted by a healthcare provider. Menstrual Changes Mood swings or depressed mood
Lasts up to 3 years. Weight gain Headache
Acne
Shot/Injection 6 Need a shot every 3 months. Loss of bone density
Irregular bleeding/bleeding between periods
Headaches Weight gain
Nervousness Dizziness
Abdominal discomfort
Oral Contraceptives 9 Must swallow a pill every day. Spotting/bleeding between periods
“The Pill” (Combined Pill) Nausea
Breast tenderness
Headache
Oral Contraceptives 9 Must swallow a pill every day. Spotting/bleeding between periods
“The Pill” (Extended Nausea
Continuous Use Breast tenderness
Combined Pill)
Headache
Oral Contraceptives 9 Must swallow a pill at the same time every day. Spotting/bleeding between periods
“The Mini Pill” (Progestin Nausea
Only) Breast tenderness
Headache
Patch 9 Put on a new patch each week for 3 weeks Spotting/bleeding between menstrual periods
(21 total days). Nausea Stomach pain
Don’t put on a patch during the fourth week. Breast tenderness Headache
Skin irritation
Vaginal Contraceptive 9 Put the ring into the vagina yourself. Keep the Vaginal discharge, discomfort in the vagina, mild irritation
Ring ring in your vagina for 3 weeks and then take it Headache Mood changes
out for one week. Nausea Breast tenderness
Diaphragm with 12 Must use every time you have sex. Irritation
Spermicide Allergic reactions
Urinary tract infection
Sponge with 12-24 Must use every time you have sex. Irritation
Spermicide

Cervical Cap with 17-23 Must use every time you have sex. Irritation
Spermicide Allergic reactions
Abnormal Pap test
Male Condom 18 Must use every time you have sex. Irritation
Provides protection against some STDs. Allergic reactions
Least Effective

Female Condom 21 Must use every time you have sex. Discomfort or pain during insertion or sex
Provides protection against some STDs. Burning sensation, rash or itching

Spermicide Alone 28 Must use every time you have sex. Irritation
Allergic reactions
Urinary tract infection
OTHER CONTRACEPTION
Emergency Contraceptives (EC): May be used if you did not use birth control or if your regular birth control fails (such as a condom breaks). It should not be used as a regular form
of birth control. Emergency contraception prevents about 55 - 85% of predicted pregnancies.
Levonorgestrel 1.5 mg 7 out of every 8 women who Swallow the pills as soon as possible within 3 Menstrual changes Lower stomach (abdominal) pain
(1 pill) would have gotten pregnant days after having unprotected sex. Headache Nausea
Levonorgestrel .75 mg will not become pregnant Dizziness Vomiting
(2 pills) after taking this EC.
Breast pain Tiredness
Ulipristal Acetate 6 or 7 out of every 10 women Swallow the pills within 5 days after having Headache Nausea
who would have gotten unprotected sex. Abdominal pain Menstrual pain
pregnant will not become Tiredness Dizziness
pregnant after taking this EC.

*For more information on the chance of getting pregnant while using a method or on the risks of a specific product, please check the product label or Trussell, J. (2011).”Contraceptive failure in the United States.” Contraception 83(5):397-404.
Birth
Control
Choosing the method
that’s right for you
Contents
Family planning services......................... 1
How to use this brochure........................ 2
Implant..................................................... 3
IUD/IUS..................................................... 5
Sterilization.............................................. 7
Depo-Provera®: The shot ........................ 9
Pill/ring/patch........................................ 11
Birth control pills................................ 11
Vaginal ring: NuvaRing®..................... 12
The patch.......................................... 13
Cervical barriers:
Diaphragms/cervical caps.................... 15
Condoms................................................ 17
Fertility awareness methods (FAMs).... 19
Emergency contraception..................... 21
Spermicides........................................... 23
Not having sex (abstinence).................. 25
How well will my method work?........... 26
Additional resources............................. 28
Questions to ask.................................... 29
Family planning
services
Get advice on which method is best for you.
Use this brochure to help you think about your choices.
You may not find all the answers to your questions here.
Before you decide on a birth control method, talk with
your health care provider or visit your local reproductive
health clinic or health department.
You might qualify for low-cost or free services in your
area. For more information, call 211info (dial 2-1-1) or
visit 211info.org. Your call will be private.
Reproductive health clinics provide birth control
services and:
• Health education and counseling
• Annual wellness visits
• Screening exams such as breast exams and Pap tests
• Pregnancy tests
• Counseling, testing and treatment for sexually
transmitted diseases (STDs) and HIV/AIDS
• Information and referral to other health and social
services
Anyone can get services at reproductive health clinics.
It’s important to take care of your health and get
regular checkups.
To learn more about reproductive health services and
education, visit www.healthoregon.org/rh.
Don’t forget to visit our website at ccare.oregon.gov or
on Facebook @OregonCCare.

1
How to use this
brochure
This brochure provides information about common
birth control methods. At the end of each method, you
will find a quick reference to how effective it is and
notes to keep in mind.
EXAMPLE: BIRTH CONTROL PILLS

9 /100

This example shows that, The icons in this

within the first year of example tell you this
taking birth control pills, an method goes great
average of 9 pregnancies with condoms, does
occurs for every 100 not protect against
women taking them. Talk STDs and HIV/AIDS and
with your provider for more requires a prescription.
information about your See below for each
method’s pregnancy risk. icon’s definition.

Key to icons

This method is great with condoms!

Private

Get it and forget it

Protects against STDs and HIV/AIDS

Does not protect against STDs and HIV/AIDS

Needs a prescription or doctor’s visit

No prescription needed

22
Implant
The implant is a single, small,
HOW

soft rod about two inches long and

1/10-inch wide. The rod is put under
the skin of the inner upper arm. You can
feel it, but it is not easy to see.
The implant has one hormone. Tiny amounts
of the hormone are released for three years.
It prevents pregnancy by stopping the release
of an egg and thickens cervical mucus to stop
sperm from reaching the egg.

The implant is put in with numbing medicine

WHEN

and can be inserted as long as you are not

pregnant. It takes only a few minutes. The
implant can be removed any time and most
women will release eggs soon after.

A trained health care provider inserts and

WHERE

removes the implant during a clinic visit.

You do not have to worry about taking a

ADVANTAGES

pill every day. The implant only needs to be

replaced every three years. There may be
less pain or cramping during periods and less
anemia with the implant. You can get pregnant
again as soon as is normal for you once the
implant is removed. The implant may be
removed at any time.

3
DISADVANTAGES/SIDE EFFECTS The implant can cause less bleeding or irregular
bleeding during your period or no bleeding at all.
There might be slight pain, itching or
scarring in the area where the implant is
put in and removed.
You should not use the implant if you have breast
cancer now.

0.05 /100

4
IUD/IUS
The IUD (ParaGard non-hormonal copper
HOW

intrauterine device) or IUSs (hormonal

intrauterine systems) are small pieces of
plastic or metal. They are put inside your
uterus to prevent pregnancy. ParaGard has
copper that kills sperm but does not have
chemicals or hormones. IUSs use the same
hormone used in birth control pills. These
thicken the cervical mucus to stop sperm from
reaching the egg and stop the egg from moving
through the tubes so it can’t get fertilized.

An IUD or IUS can be put in the uterus at any

WHEN

time as long as you are not pregnant. These

work very well for women of any weight. You
can get one even if you have never had a
pregnancy or if you are a teen.

• You do not have to think about birth control

ADVANTAGES

every time you have sex.

• IUDs and IUSs provide protection from
some cancers.
• IUSs make periods lighter and less painful.
• You can get pregnant again as soon as is
normal for you once the IUD/IUS is removed.
• IUDs and IUSs work for 3–12 years.
• You can use these while breastfeeding.
• The IUD/IUS may be removed at any time.

5
DISADVANTAGES/SIDE EFFECTS • You need an appointment with a trained health
care provider to insert or remove an IUD/IUS.
• Insertion and removal may be uncomfortable
and sometimes difficult.
• With the IUD, some women may have changes
in their periods.
• You may have increased cramps.
• You must be able to feel for the strings.

You should not have an IUS/IUD placed if

RISKS

you have:
• Breast, cervical or uterine cancer now
• Problems with the shape of your uterus
• An infection in your uterus or pelvis
• Unusual bleeding from your vagina
• An allergy to ParaGard IUD copper

If you develop any of the signs below, contact

WARNING SIGNS

your provider right away:

• Period late (possible pregnancy), abnormal
spotting or bleeding
• Abdominal pain, pain with intercourse
• Exposure to STDs, abnormal vaginal discharge
• Not feeling well, fever, chills
• String missing, shorter or longer

IUS

0.2/100
IUD

0.8/100

6
Sterilization
Sterilization is permanent birth
HOW

control. Parts of the reproductive

system are blocked forever so the
sperm and egg cannot meet.

Sterilization can be done any time for

WHEN

men and any time when a woman is

not pregnant. Be sure you do not want
a child or any more children before you
take this step.

In a man, the surgery is called a vasectomy.

WHERE

It can be done in a clinic. Vasectomy blocks

the two tubes that carry sperm, called the
vas deferens, so sperm cannot pass through
the penis.
In a woman, sterilization can be done in two
ways. A surgery, called tubal ligation, cuts
and ties the fallopian tubes. This is done in
a hospital or surgical center. The second
procedure uses contraceptive coils called
Essure®. Essure blocks the two fallopian tubes
so an egg cannot pass through them to be
fertilized. The Essure procedure is done without
surgery during a clinic visit.

Sterilization needs to be done only once. It

ADVANTAGES

works very well. Male sterilization is cheaper

and safer than female sterilization. Tubal
ligations are effective immediately.

7
DISADVANTAGES/SIDE EFFECTS There are some risks in having minor surgery,
so talk it over with your health care provider.
The surgery can cost too much for some people
who do not have insurance or money to pay for
it, but it saves money over time. Check with your
local family planning agency to see if you qualify
for a free or low-cost vasectomy. It takes about
three months to clear sperm out of your system
after a vasectomy. Use another birth control
method until tests confirm there are no sperm.
Essure takes up to three months for the tubes
to become blocked. Use another birth control
method until tests confirm the tubes are blocked.
There should be no bad side effects after the
surgery. Sex drive is not changed for males
or females. The man still has an erection and
ejaculates (cums), but the fluid has no sperm.
The woman still has monthly periods.

There is some risk of bleeding, infection or failure

RISKS

with sterilization. It is important people are sure

they don’t want any future children because this
is a permanent method.
Some Essure patients have reported mild to bad
reactions to the method including removal and
surgery. It is best to consult with your provider to
weigh the risks and benefits with Essure.

FEMALE STERILIZATION

0.5/100

MALE STERILIZATION

0.15/100

8
Depo-Provera®
“The shot”
Your health care provider gives
HOW

the Depo-Provera (or Depo) shot

about every 12 weeks. It has one
hormone and works by stopping
your body from releasing an egg.
It also thickens cervical mucus to
stop sperm from reaching an egg.

You can start Depo any time as long as

WHEN

you are not pregnant.

A health care provider gives you a shot during a

WHERE

clinic visit.

The shot works very well and lasts three months.

ADVANTAGES

You do not have to take a pill every day. It is a

private method not noticed by others. You can
use Depo while breastfeeding and it protects
against some cancers.

There is no way to stop the shot’s effects once

DISADVANTAGES/SIDE EFFECTS

given. It must wear itself out. You will have

changes in your periods. At first bleeding might
happen at odd times. Most people stop having
periods after a few shots. Other side effects
might include weight gain and headaches. It
may take up to 10 months before you can get
pregnant when you stop Depo.

9
RISKS You should not use Depo if you have breast
cancer now. Depo may cause you to lose
bone calcium. Calcium returns when you stop
using Depo.

6/100

10
PILL / RING / PATCH

Birth control pills

Birth control pills have hormones
HOW

that prevent pregnancy by stopping

the release of an egg and making
the cervical mucus thicker.

You take some types of pills at the same

WHEN

time every day; you can take other types anytime

during the day. Please consult with your provider
about which type you are taking.

You get a prescription for birth control pills from

WHERE

your health care provider.

Birth control pills are easy to use and work

ADVANTAGES

very well if used the right way. Periods may be

more regular, lighter and less painful. It can help
women be at lower risk for some cancers. The
pill can help with acne. You can get pregnant
again as soon as is normal for you once you stop
taking the pill.

It may be hard for some people to remember to

DISADVANTAGES/SIDE EFFECTS

take the pill or to take it at the same time of day.

Some women have sore breasts, headaches,
nausea, bleeding between periods or mood
changes such as depression or irritability.

11
PILL / RING / PATCH

Vaginal ring
NuvaRing®
The vaginal ring is a soft,
HOW

flexible ring you place in your

vagina. It releases a steady flow of hormones. It
prevents pregnancy by stopping the release of an
egg and makes fluids around the cervix thicker.

You leave the ring in place for three weeks and

WHEN

then remove it for one week. Your period usually

starts two or three days after you remove the
ring and might not stop all the way before you
insert the next ring. Insert a new ring at the end
of the fourth week.

You get a prescription for the vaginal ring from

WHERE

your health care provider.

The ring is easy to use and works very well

ADVANTAGES

if used the right way. It may have fewer side

effects than other birth control with hormones.
Your periods will be more regular, lighter and
less painful. It can help with acne. You can get
pregnant again as soon as is normal for you once
you stop using the NuvaRing.
DISADVANTAGES/SIDE EFFECTS

Some women may notice the ring, but most

women do not. If the ring is out of your vagina
for more than 48 hours during the three weeks
you are using it, reinsert the ring as soon as
possible. If this happens you must use a backup
birth control method for seven days to prevent
pregnancy. A few women have headaches,
vaginal discharge, nausea, irregular bleeding,
cramps or sore breasts. Side effects may go
away in two to three months.

12
PILL / RING / PATCH

The patch
The birth control patch has
HOW

hormones that enter your body through your skin.

It prevents pregnancy by stopping the release
of an egg and makes fluids around the cervix
thicker. It is smaller than the size of a condom
wrapper. You wear the patch under your clothes.

Use the patch on a four-week cycle. Put on a

WHEN

new patch each week on the same day of the

week for three weeks. You do not wear a patch
during the fourth week. Put on a new patch
at the end of the fourth week. Your menstrual
period should start during the fourth week.

You get a prescription for the patch from your

WHERE

health care provider.

The patch is easy to use and works very well

ADVANTAGES

when used the right way. It stays on when you

shower, bathe, swim or exercise. Your periods
may be lighter and less painful. It can help with
acne. You can get pregnant again as soon as is
normal for you once you stop using the patch.
DISADVANTAGES/SIDE EFFECTS

A small number of women have skin irritation

where the patch is placed. There is a slight
chance it may not work as well for women who
weigh 198 pounds or more. You need to put it
on the right way so it sticks to your skin. Some
women have sore breasts, headaches, nausea
or cramps using the patch. Most women have
no major side effects. The patch releases more
estrogen than birth control pills so some women
may have more side effects with the patch.

13
RISKS: BIRTH CONTROL PILLS, RING AND PATCH You should not use birth control pills, the vaginal
ring or patch if you are pregnant or:
• Have breast cancer now
• Have ever had a heart attack, stroke,
or a blood clot or clotting problems
• Have certain liver diseases or liver tumors
• Have a certain kind of migraine headache
• Have high blood pressure
• Have some heart conditions
• Smoke 15 or more cigarettes a day or are
aged 35 or older
• Ever had a complex organ transplant

PILLS

9/100
RING

9/100
PATCH

9/100

14
Cervical barriers:
Diaphragms/cervical caps

The diaphragm is a small

HOW

rubber cup that you fill with

contraceptive gel (spermicide).
You place it in your vagina to cover
your cervix. Other cervical barriers
(the cap) are like the diaphragm, but
smaller. These methods prevent sperm from
getting into your uterus and meeting an egg.
There are two types: one that comes in many
sizes that your health care provider fits to you
and one that fits women of all sizes.

You insert the diaphragm or cervical cap with

WHEN

contraceptive gel a few hours before you have

sex. These must stay in place for at least
six hours after sex but should not stay in the
vagina any longer than 24 hours.

Your health care provider fits one type of

WHERE

diaphragm or cervical cap and teaches you

how to use it. Another diaphragm (Caya®) is
one-size-fits-all that shapes to fit any woman’s
body. It is easy to insert and you can get it at
the store or clinic.

Your partner will not be able to feel the

ADVANTAGES

diaphragm if it’s put in correctly. Diaphragms

do not change your period and you can safely
breastfeed your baby.
You can reuse diaphragms but must care for
and clean them.

15
DISADVANTAGES/SIDE EFFECTS The diaphragm must be inserted the right way
before you have sex. You might need a new
size diaphragm after having a baby, or losing
or gaining a lot of weight. A few people are
allergic to the rubber or contraceptive gel. If
you have itching or burning, talk to your health
care provider.

There are no serious health risks in using a

RISKS

diaphragm. The diaphragm should stay in at least

six hours after sex but no longer than 24 hours.
This would keep you from getting toxic shock
syndrome.

12/100

16
Condoms
A condom is put over an erect
HOW

penis before the penis touches the

vagina. Sperm are trapped inside the
condom and cannot get into the vagina.
Use a new condom each time you have sex.
Condoms are made out of latex, plastic or
lambskin. Only plastic or latex condoms protect
against HIV/AIDS or STDs.
Condoms with spermicides are not
recommended for oral or anal sex; they can be
used for vaginal sex.
Internal or female condoms are soft plastic,
not latex, with a ring at each end. The internal
condom does not allow the penis to touch the
vagina. Sperm goes into the condom and not
the vagina.
Lubricants: You can safely use silicone and
water-based lubricants with condoms.

Condoms are put on or inserted

WHEN

right before sex.

WHERE

You can get condoms at most drug stores,

grocery stores or clinics. No prescription
is needed.

Latex rubber condoms and internal condoms

ADVANTAGES

protect you from HIV/AIDS and most STDs.

Condoms do not cost a lot. You do not need a
prescription. Condoms work very well if used
every time you have sex. If you have a latex
allergy, you can use plastic condoms. Condoms
come in many sizes.

17
DISADVANTAGES/SIDE EFFECTS It’s best if condoms are close at hand to use
right before having sex. Check the expiration
date and do not use them if expired. Use a new
condom each time you have sex. Do not double
up on condoms or both types of condoms at
the same time. Sometimes condoms break or
come off. To make space for semen, pinch the
top of the condom and roll it all the way down
the hard penis. A few people may be allergic to
latex rubber or the liquid in condom packages.
If you have burning or itching, try changing
brands or talk with your health care provider. If
you use a lubricant, choose a silicone lubricant
without nonoxynol-9.

Condoms have no known health risks except

RISKS

for a possible latex allergic reaction.

MALE CONDOM

18/100
INTERNAL OR FEMALE CONDOM

21/100

REMEMBER – ALWAYS USE LATEX OR PLASTIC

CONDOMS TO PREVENT STDs AND HIV/AIDS.

18
Fertility awareness
methods (FAMs)
Fertility awareness methods
HOW

(FAMs) teach you to know your

body’s fertile time. You do not
have sex near the time an egg
is released. This is the time
when you can get pregnant.
There are different FAMs –
standard days method, two day
method, ovulation method and more.
Consult with a health provider to decide
what method might work best for you.

You record body signs every day and follow

WHEN

all the FAM rules. Some people use a

calendar, others use a string of 32 colored
beads called CycleBeads® or a phone app to
track fertile days.
A FAM can be used after giving birth while
breastfeeding, but this is not the best time to
learn a FAM because your periods might not be
regular. Try to learn a FAM before pregnancy.

Ask your clinic about a FAMs class. Learn

WHERE

about changes in your cervical mucus and

body temperature to know when you can
get pregnant.

FAMs have no health risks. The methods can

ADVANTAGES

help you get pregnant or prevent a pregnancy.

FAMs help you understand how your body
works. Anyone who has concerns about using
birth control or hormones can use this method.

19
DISADVANTAGES/SIDE EFFECTS FAM works if you check and record your body
signs every day. It is hard for some couples to
learn and practice FAM. Others find it hard not
to have sex during the time of the month when
an egg is ready. Couples need to plan ahead to
prevent or plan a pregnancy.
FAM takes time and practice.

STANDARD DAYS METHOD

24/100
TWO DAY METHOD

24/100
OVULATION METHOD

24/100

20
Emergency
contraception
You use emergency contraception
HOW

(EC) to prevent pregnancy after sex if

birth control wasn’t used or was used
the wrong way. EC will not work if
you are already pregnant. Emergency
contraceptives are the copper IUD or pills.
Three types of EC are:
• ella® (may not work well if you weigh more
than 193 pounds)
• One Step® (may not work well if you weigh
more than 154 pounds)
• ParaGard® copper IUD (works at any weight)
WHEN

EC works better the sooner you take it but can

work up to five days after sex. Use backup birth
control, such as condoms, after taking EC until
your next period. You may be pregnant if your
period is more than one week late.

Use EC if:
ADVANTAGES

• You didn’t use birth control.

• Your condom broke.
• Your partner did not withdraw or “pull out”
on time.
• You missed using or taking your birth control
on time.
• You were forced to have sex.
• Sex “just happened.”

21
DISADVANTAGES/SIDE EFFECTS EC pills do not work as well as other birth control
methods that you use all the time. EC does
not work if you are already pregnant. EC may
cause nausea, vomiting, dizziness, sore breasts,
spotting or abdominal pain. If you vomit within
two hours after taking EC, call your health care
provider. You may have to take the pill again.
Some women do not feel well for a day or so
after taking EC.

Emergency contraceptive pills or a copper IUD

EFFECTIVENESS

after sex without birth control greatly lower your

risk of getting pregnant. These methods vary in
effectiveness based on time passed, a person’s
body and the type of the method.
• One Step is 89% effective when used within
three days after unprotected sex.*
• Ella is 85% effective when used within five days
after unprotected sex.*
• The IUD is 99% effective when used within five
days after unprotected sex.
* How well these methods work depends on
your weight. Talk to your provider about what
is best for you.

(ella®) (One Step)

22
Spermicides
Spermicides are chemicals that
HOW

kill sperm. Spermicides come in

many forms: foam, gel, cream,
film, suppository and tablet.

Put spermicides in the vagina

WHEN

before sex and follow package

instructions.

You can get spermicides at most

WHERE

drug stores, grocery stores and clinics.

No prescription is needed.

Spermicides do not cost a lot. You do not need

ADVANTAGES

a prescription.

Spermicides must always be close at hand

DISADVANTAGES/SIDE EFFECTS

to use right before having sex. You must

use more spermicide each time you have
sex. Spermicides work best when used with
condoms or cervical barriers every time you
have sex. Spermicides can be messy and leak
out of your vagina. A few people may be allergic
to spermicides. If you or your partner have
burning or itching, try changing brands or talk
with your health care provider.

23
RISKS Spermicides have no known health risks except
for a possible allergic reaction. You should not
use spermicides with nonoxynol-9 if you have
sex with someone with HIV; it can increase the
risk of infection. Spermicides used alone will not
protect you from HIV or STDs.

28/100

24
Not having sex
(abstinence)
You decide not to have
HOW

sex. Choose a partner

who has made the
same choice. Talk about
sex activities you want and
those you don’t want.

At any time in your life you may decide not to

WHEN

have sex. You can change your mind anytime

and choose another birth control method to
prevent a pregnancy, HIV and other STDs. Learn
about birth control.

Not having sex is free, always available and

ADVANTAGES

protects you from pregnancy and STDs including

HIV. Abstinence is something a person can
choose at any time of their life. Many people
have times when they choose not to have sex.

It can be challenging for some people to not

DISADVANTAGES

have sex. There is no protection if you change

your mind and have sex. You need to know
about birth control and always keep condoms,
emergency contraceptive (EC) pills or your
preferred method of choice on hand. Oral and
anal sex cannot create a pregnancy but you can
still get STDs.

0/100

25
 How well will my
method work?
How well your birth control method works depends
on your age, partner support and how well you use
the method.
The table below shows you how well a method might
work for the typical user. A typical user does not use
the method every time or does not use it according to
instructions every time.

Number of pregnancies per 100 women

in the first year of using method
Method Rates
MOST EFFECTIVE Implant 0.05/100
IUS 0.2/100
Less than 1 IUD 0.8/100
pregancy per 100 Female sterilization 0.5/100
women in a year Male sterilization 0.15/100
Depo-Provera 6/100
6–12 pregnancies Birth control pill 9/100
per 100 women in Vaginal ring 9/100
a year Contraceptive patch 9/100
Diaphragm 12/100
Male condom 18/100
Female condom 21/100
Fertility awareness methods
18 or more Standard days 24/100
pregnancies per 100 method
women in a year Two day method 24/100
Ovulation method 24/100
Withdrawal 22/100
Spermicides 28/100
LEAST EFFECTIVE No method 85/100

26
 How to make your
method most effective
Implant After procedure, little or nothing
IUS to do or remember.
IUD Female and male
sterilization: Use another
Female sterilization
method for first 3 months.
Male sterilization
Depo-Provera Depo-Provera: Get repeat
injections on time.
Birth control pill
Pills: Take a pill each day.
Vaginal ring
Patch, ring: Keep in place,
Contraceptive patch change on time.
Diaphragm Diaphragm: Use correctly
Male condom every time you have sex.
Female condom
Condoms, withdrawal,
Fertility awareness spermicides: Use correctly
methods every time you have sex.
Standard days Fertility awareness-based
method methods: Abstain or use
Two day method condoms on fertile days.
Newest methods (standard
Ovulation method
days method and two day
Withdrawal method) may be the easiest
Spermicides to use and consequently
No method more effective.

Emergency contraception (EC) ranges in

effectiveness based on the type and when it
is taken. EC can be taken up to five days after
unprotected sex.

27
Methods that may work, but
must be used the right way
Breastfeeding
Breastfeeding can prevent pregnancy if:
• The mother has not started her period again.
• The mother is only breastfeeding. The baby is not
fed baby food, juice or formula and is less than six
months old.

Withdrawal (pulling out)

Sperm do not reach the egg.
• A person pulls their penis out away from their partner’s
vagina before they ejaculate (cum).
• It may be hard to pull out. How well it works depends on
the person knowing when they will ejaculate.
• If they do not pull out in time, people can still get and
use emergency contraception pills.
• Withdrawal does not protect against STDs including
HIV/AIDS.

Additional resources
Oregon Contraceptive Care (CCare):
Find out more about Oregon clinics and birth control
at www.healthoregon.org/rh.

Bedsider:
Additional birth control information is available at
www.bedsider.org.

EC and birth control information:

Download an EC brochure in English and other
languages at www.healthoregon.org/rh.
Need EC? Use this EC locator at
http://eclocator.not-2-late.com/search.asp.

28
28
Questions to ask
Reproductive health is an important part of your life.
Reproductive health services help you decide if or when
to have children. The services help you take better care
of your health and have more control over your life.
There are many birth control methods. No one method
is best for everyone at every stage of life. You can
choose a birth control method to meet your needs.
Think about which method is best for you.
Consider writing down the questions you have for your
provider in advance.
Ask your provider:
• How does this method work?
• How do I use it?
• How well does this method work?
• What should my partner know?
• What could be the side effects?
Ask yourself:
• How often do I want to have a period?
• Do I want to have a baby? If so, when?
• Can I remember to use a method every day?
• Am I comfortable touching my vaginal area?
• How do I want to include my partner in this decision?
• What does my partner need to know about this method?
• Will both my partner and I like this method?
• How do I feel about getting shots?
• Do I need a method no one else will notice?
• Do I know where I can get emergency contraception if
I need it?

29
29
You may qualify for low or no-cost birth
control. For the clinic nearest you, contact
211info (dial 2-1-1) or www.211info.org.
Or contact your local clinic.

To learn more about reproductive

health services and education, visit
www.healthoregon.org/rh.
Don’t forget to visit the website at
http://ccare.oregon.gov or on Facebook
@OregonCCare.

PUBLIC HEALTH DIVISION

Reproductive Health Program

You can get this document in other

languages, large print, braille or a format
you prefer. Contact the Reproductive
Health Program at 971-673-0355 or
email [email protected]. We
accept all relay calls or you can dial 711.
OHA 8737 (05/2017)
 Family Planning
Contraceptive Methods

South Carolina Department of Health and Environmental Control www.scdhec.gov/familyplanning

 Table of Contents
Preconception Health........................................................................................5
Reproductive Anatomy......................................................................................6
How Pregnancy Happens.................................................................................7
Methods of Birth Control..................................................................................8
Abstinence............................................................................................................9
Sterilization (Men and Women)........................................................................9
IUD (Intrauterine Device)................................................................................. 10
Implants............................................................................................................... 10
Contracteptive Injection (The Shot).............................................................. 11
Contraceptive Patch.......................................................................................... 11
Birth Control Pills (Combined Oral Contraceptives)................................ 12
Vaginal Ring........................................................................................................ 13
Condoms – Female.......................................................................................... 13
Condoms – Male............................................................................................... 14
Diaphragm.......................................................................................................... 15
Spermicides (Creams, Jellies, Foams, Suppositories and Film)........... 15
Natural Family Planning (NFP)....................................................................... 16
Emergency Contraception............................................................................. 16
Notes.................................................................................................................... 17
Notes.................................................................................................................... 18
 Family Planning: Contraceptive Methods

Preconception Health
Preconception health is a woman’s health before she becomes pregnant. It means knowing
how health conditions and risk factors could affect a woman or her unborn baby if she
becomes pregnant. For example, some foods, habits, and medicines can harm your baby
— even before he or she is conceived. Some health problems, such as diabetes, also can
affect pregnancy.

Folic Acid
All women of reproductive age should get 400 mcg of folic acid each day
to get enough folic acid to help prevent some birth defects. Folic acid is
a B vitamin. Our bodies use it to make new cells. Think about your skin,
hair, and nails. Folic acid is very important because it can help
prevent some major birth defects of the baby’s brain and spine.

Human Trafficking
Human trafficking is the trade of humans for the purpose of forced labor, sexual slavery,
or commercial sexual exploitation for the trafficker or others. Human trafficking is a crime
against the person because of the violation of the victim’s rights through coercion and
because of their commercial exploitation. Human trafficking does not necessarily involve
the movement of the person from one place to another. Call the National Human Trafficking
Hotline at 888-373-7888 or Text (SMS): 233733 (Text “HELP” or “INFO”).

Sexual Assault
Sexual Assault is any unwanted sexual activity carried out by force, manipulation or
coercion. If you are raped or sexually assaulted, it is NEVER your fault even if you were
drunk or using drugs. Call the National Sexual Assault Hotline at 800-656-HOPE (4673).

Substance Use
A substance use disorder (SUD), also known as a drug use disorder, is a medical condition
in which the use of one or more substances leads to a clinically significant impairment or
distress.

5
Family Planning: Contraceptive Methods

Reproductive Anatomy
Uterus
female (womb) where Ovaries
contain egg cells
babies grow.

Cervix
opening at bottom
Fallopian Tubes
of the uterus
a tube from the ovary to
the uterus
Vagina
passageway from outside
the body to the uterus

male Vas Deferens

tubes that carry sperm

Urethra
tube carrying semen to penis

Penis Seminal
delivers semen into the vagina Vesicles
stores sperm
in fluid
Testes Prostate Gland
produce sperm makes fluid that combines
with sperm
Scrotum
skin pouch that holds testes Semen
a mixture of fluid and sperm

6
 Family Planning: Contraceptive Methods

How Pregnancy Happens

male female
During sex between a man and a woman Each month, an egg is released from one
(intercourse), the penis enlarges and becomes of the ovaries (ovulation).
hard (erection) and is inserted into the vagina.
egg
sperm

During male climax (ejaculation), millions of The egg travels through the fallopian tube
sperm are deposited into the vagina. on its way to the uterus.

If the sperm and the egg meet

in the fallopian tube, the egg is
fertilized. If the egg is not fertilized, the egg
and the uterus lining pass out of the
body (menstruation or “period”).
The fertilized egg moves
through the tube to the uterus
(womb) and attaches to the wall. Facts:
• A woman is born with all the eggs she will ever have.
• Sperm production begins at puberty and continues
throughout a man’s life.
baby • Sperm can live for 72 hours outside of a man’s body.
• Any activity that puts sperm near the vagina can result in
The fertilized egg grows pregnancy.
into a baby.
Symptoms of Pregnancy
• Missed period
• Nausea and vomiting (morning sickness)
• Breast tenderness
• Feeling tired
• Going to the bathroom (peeing) more often
If you have any of these signs, take a home pregnancy test
(available at your drugstore) and/or call your health care
provider or clinic.

7
Family Planning: Contraceptive Methods

What is the chance

Methods of Birth Control
of getting pregnant? Birth Control Method

Abstinence Implant Contraceptives Sterilization for

Nexplanon Women

IUD (intrauterine device)

Less than 1 in 100 Sterilization for Men Liletta, Mirena, or Paragard®

Contraceptive Birth Control Pills Vaginal

About 1–6 in 100, Injection (combined oral Contraceptive
Contraceptive
depending on the Depo Provera contraceptives) Patch
Ring
method

Male Condom Diaphragm with Female Condom

Spermicide

About 12–28 in 100, Natural Family Planning Withdrawal Spermicide creams,

depending on the (NFP) jellies, foams,
method suppositories and film

About 85 in 100
No Method

When should it be used? Emergency Contraception

After unprotected sex
or birth control failure. Emergency contraception may
DO NOT use as help prevent pregnancy when
regular birth control. used as directed.

8
 Family Planning: Contraceptive Methods

Abstinence
Abstinence means not having sex (intercourse) or keeping sperm away from the vagina.
Sperm anywhere near the vagina can cause a pregnancy. Many people use abstinence at
different times in their lives. If you choose to use this method, you must talk about it with
your partner. This method takes a strong commitment from both of you to make it work.

How well does abstinence prevent pregnancy?

• Abstinence is 100 percent effective. If you don’t have sex, you will not get pregnant.

Sterilization
Both men and women can be sterilized. Sterilization is a
permanent method of birth control. If you are a woman, after
you are sterilized you will NEVER be able to get pregnant. If
you are a man, after you are sterilized you will NEVER be able
to father a child. You should not be sterilized unless you are
sure that you do not want any more children. To consent for
sterilization, you must be at least 21 years old, understand what
sterilization means, and be able to make this decision yourself.
Male sterilization is called a vasectomy. This surgery is done in
the health care provider’s office. The health care provider cuts
and seals the tubes that carry the man’s sperm.
Female sterilization is called a tubal ligation. This surgery may
be done as an outpatient procedure. The fallopian tubes that
carry the woman’s eggs are cut and sealed.

How well does sterilization prevent pregnancy?

• Sterilization is 99 percent effective.

How to use sterilization:

• Talk to your health care provider for more information about
this method of birth control.

9
Family Planning: Contraceptive Methods

IUD (Intrauterine Device)

An IUD is a small piece of flexible plastic or metal that contains copper or a hormone. Your
health care provider puts the IUD into the uterus through the vagina. The IUD works up to
10 years. Your health care provider can remove it before the 10 years are up.

How well does the IUD prevent pregnancy?

• There is about a 99 percent chance you will not get pregnant while using an IUD.

How to use the IUD:

• To make sure your IUD is in place, check the string once a month, after your period or if
you have unusual cramps or bleeding. Never pull on the string.

Implant
The implant is a small, rod-shaped contraceptive
(birth control). It is inserted under the skin of the
upper part of a woman’s arm. The implant contains
a hormone called progestin. The implant works by
preventing the egg’s release from the ovary.

How well does the implant prevent

pregnancy?
• There is about a 99 percent chance that you will
not get pregnant when using the implant.

How to use the implant:

• C
 heck the site where the implant was
inserted about once a month. Check with your
health care provider if you cannot feel the
contraceptive implant.

10
 Family Planning: Contraceptive Methods

Contracteptive Injection (The Shot)

Contraceptive injection is a birth control shot.

How well does the shot prevent

pregnancy?
• If you use it correctly every time, there is about a 99
percent chance that you will not get pregnant.

How to use the shot:

• Every 13 weeks, you should get a shot from your
health care provider.

Contraceptive Patch
The contraceptive patch contains hormones that
prevent pregnancy.

How well does the patch prevent

pregnancy?
• If you use it correctly every time, there is about a
99 percent chance you will not get pregnant.
How to use the patch:
• Once a week for three weeks in a row, stick a
patch to the lower abdomen, hips, upper back, or
back part of the upper arm. After the third week,
leave the patch off for one week so you can have
your period.

11
Family Planning: Contraceptive Methods

Birth Control Pills

Combined oral pills and Pregestin-only pills are birth control pills that contain hormones
that prevent pregnancy. One pill is taken every day for the month

How well does the pill prevent pregnancy?

• If you use it correctly every time, there is
about a 99 percent chance you will not get
pregnant.

How to use the pill:

• Take one pill every day at the same time. You
will be given instructions on when to start
your pills and what to do if you miss one.

12
 Family Planning: Contraceptive Methods

Vaginal Ring
The vaginal ring contains hormones that prevent
pregnancy. No special accuracy is required for ring
placement; hormones are absorbed from anywhere in
the vagina.

How well does the vaginal ring prevent

pregnancy?
• If you use it correctly every time, there is about a 99
percent chance you will not get pregnant.

How to use the ring:

• Insert the ring anywhere into the vagina and leave it
in place for three weeks. After the third week, remove the ring and leave it out for one
week so you can have your period.

Condom – Internal (Female)

An internal (female) condom is a throwaway, single-use polyurethane covering that is
placed into the vagina. It works by stopping sperm from reaching the womb.

How well does the internal condom prevent pregnancy?

• If you use it correctly every time, you have about a 95 percent chance of not getting
pregnant. The chance of pregnancy is even less if you use female condoms PLUS
another kind of birth control.

How to use the internal condom:

1. Gently insert the inner ring into the vagina and feel it go up.
2. Place the index finger inside of the condom and push the inner ring as far as it will go.
3. Make sure the condom is inserted straight, and is not twisted inside the vagina.
4. The outer ring should remain on the outside of the vagina.

13
Family Planning: Contraceptive Methods

Condom – External (Male)

An external condom is a throwaway, single-use thin covering made of latex, polyurethane,
or a natural membrane that fits over an erect penis. It works by preventing the sperm from
reaching the womb. External condoms come in many colors, styles and sizes.

How well does the external condom prevent pregnancy?

• If your partner uses male condoms correctly every time, there is about a 98 percent
chance that you will not get pregnant. The chance of pregnancy is
even lower if you use external condoms PLUS another form of
birth control.

Use a condom every time you have sex.

• Use a new condom every time you have sex. If you
notice a tear or hole in the condom, do not use it. Do
not open condom packages with your teeth or other
sharp objects.
• Do not wear more than one condom at the
same time.

How to use an external condom

1. Place the unrolled condom over the tip of the
erect penis. Hold onto the end to leave a little
space for semen.
2. Check the expiration date. If the expiration
date has passed, don’t use the condom.

14
 Family Planning: Contraceptive Methods

Diaphragm
The diaphragm is a shallow, flexible rubber cup that fits high
inside the vagina. It covers the cervix and blocks sperm
from reaching the womb. A spermicide (such as gel or
cream) is also used with the diaphragm.
• It can be inserted in the vagina up to six hours before sex.
• Does not have side effects unless you are allergic to latex
or spermicide.

How well does the diaphragm prevent pregnancy?

• If you use it correctly every time, there is about a 94 percent chance you will not get
pregnant.

Spermicides
Creams, Jellies, Foams, Suppositories & Film
Creams, jellies, foams, suppositories and film all contain spermicides (a chemical that kills
sperm). Spermicides work by blocking the cervix (opening to the uterus) and by killing
sperm.

How well do spermicides prevent pregnancy?

• If you use spermicides correctly every time, there is about an 82 percent chance you will
not get pregnant. The chance of pregnancy is even less if you use spermicides PLUS
another kind of birth control.

General information for all spermicides

• Do not use any product if the package was open when you bought it.
• Check the expiration date. Use the spermicide before it expires.
• Read the package instructions to be sure you understand the time needed for the
product to spread and work.

15
Family Planning: Contraceptive Methods

Natural Family Planning (NFP)

NFP is a method where couples do not have sex on
“fertile days.” Fertile days are the days of the month
when a woman is most likely to get pregnant. Fertile
days are the days just before, during, and just after
an egg is released (ovulation). Using this method, a
woman records her temperature, type of vaginal fluid
and period (menstrual cycle) on a calendar each day.
This record helps predict when she is most likely to get
pregnant.

How well does the NFP method prevent pregnancy?

• If you use this method correctly every time and have regular periods, there is a 95-97
percent chance you will not get pregnant.

How to use the NFP method

• The health care provider will tell you how to use this method.

Emergency Contraception
Using emergency contraceptive can stop a pregnancy before it starts. Emergency contraceptive
pill(s) or the cooper IUD can be used within 5 days (or 120 hours) of unprotected sex. The
hormones prevent the egg’s release and interfere with the movement of the sperm. Emergency
contraceptive should be used sooner rather that later to reduce the possibility of getting
pregnant. If you are already pregnant, emergency contraception will not work. Emergency
contraceptive can be less effective for women whose weight is greater than 160 lbs.

How well does emergency contraception prevent

pregnancy? EXCLAMATION-TRIANGLE
• If you use emergency contraception, there is about a 75 percent After using emergency
chance you will not get pregnant. Emergency contraception works contraception, it is a
best if it is taken as soon as possible after unprotected sex. good idea to begin
using a regular method
of birth control.
How to use emergency contraception:
• Your health care provider will tell you how to take the pills.
16
 Family Planning: Contraceptive Methods

Notes

17
Family Planning: Contraceptive Methods

Notes

18
 Schedul
your visi e
today! t

Call: 1-855-4-SCDHEC
www.scdhec.gov/familyplanning

Fami l y Pl a nni n g
www.scdhec.gov/familyplanning

This publication was made possible by grant number FPHPA046220-01-00 from the
Department of Health and Human Services, Office of Population Affairs.

CR-010232 4/20