Birth control pills are perhaps the most popular form of contraception. In the United States, an estimated 25% of all women using birth control are on the pill. The pill consists of hormones that prevent ovulation. There are two basic versions of the pill, a progestin-only version, and a combined progestin-estrogen pill. Either formulation comes in different therapeutic amounts so that a patient can find the version that works best. When taken every day and at the same time, birth control pills have a theoretical 0.3% failure rate. However, the realistic failure rate is 9% (1 per 11 women per year) since some women don’t take the pill properly.
Offered as an alternative to taking a pill at the same time every day, birth control patches deliver a small but continuous dose of hormones through the skin. The patch must be changed on the same day each week for three weeks, with one week skipped for the menstrual period. As with the pill, the patch works by preventing ovulation and has a similar failure rate to the pills.
Like the pill and patch, a vaginal ring works by delivering a dose of hormones into the body to prevent ovulation. The vaginal ring is a small flexible plastic ring that is inserted into the vagina once a month. The birth control hormones are absorbed through the vagina. It has a similar effectiveness rate to both the pill and the patch.
For a slightly longer term form of contraception, a birth control shot is available. This shot consists of progestin, which prevents ovulation. The shot is given once every three months and must be done at a medical professional’s office. The shot must be scheduled regularly to prevent loss of effectiveness and if done with correct timing, the failure rate is less than 1%. However, in reality, the failure rate is 3%.
Another form of hormonal birth control is the Nexplanon insert. This progestin-only implant is capable of preventing ovulation for up to three years. A properly-trained clinician must insert and remove the device, which is implanted under the skin of the upper arm during an office visit. Nexplanon has a 0.05% failure rate.
Intrauterine devices, or IUDs, are another long-lasting contraceptive device. These are T-shaped devices placed into the uterus by a doctor during a vaginal exam. There are two forms of IUD’s: one containing a progestin and one that is a non-hormonal copper device. The progestin-containing IUD’s last for 3-5 years and primarily work by thickening the cervical mucous so that sperm can’t enter the uterus and tubes. Their failure rate is about 1-2 women per thousand per year. The copper IUD can be left in place for 10 years and works by making the uterus a hostile place for sperm as the copper ions within the uterine cavity act as a natural spermicide. Copper IUDs have a failure rate of less than 1 woman per 100 per year.
Non-Hormonal Birth Control Options
Among the non-hormonal types of birth control is the diaphragm. In use in some form or other since the late 1800s, a diaphragm is a latex or silicone cover for the cervix that prevents sperm from entering. Diaphragms must be fitted by a doctor for best effectiveness, and medical professionals recommend re-fitting after significant weight gain or loss. Latex diaphragms in particular must be replaced regularly due to the possibility of breaking or tearing as the material ages. Diaphragms have an 88-94% effectiveness rate.
Permanent Birth Control or Sterilization
There are also permanent birth control options available. A method known as Essure permanent sterilization is a non-surgical procedure during which a doctor inserts small flexible coils through the uterus and into the fallopian tubes via a catheter. Over the course of three months, the body will grow around these coils, blocking the fallopian tubes and preventing eggs from reaching the uterus. An effectiveness rate of 99.74% is reported in the first year, though there have been reports of the procedure losing effectiveness with some women over time.
Tubal ligation is a surgical procedure that permanently sterilizes a patient. A surgeon enters the body through small incisions and may either tie, clip, or sever the fallopian tubes. While the procedure has a 99.5% effectiveness rate reported in its first year, there have been cases where the fallopian tubes have reconnected.
At Florida Woman Care of Jacksonville, patient concerns about family planning are taken seriously. Education and communication will ensure that the optimal contraceptive options are explored for optimal results.