Common forms of contraception include bar-
rier methods, hormonal methods, mechanical
methods, chemical methods, surgical methods,
timing methods, and continuous abstinence. Some
methods, such as oral contraceptives (birth control
pills) and diaphragms, require a doctor’s prescrip-
tion. Others are invasive, such as intrauterine
devices (IUDs), TUBAL LIGATION, and VASECTOMY. Still
other methods of contraception are available for
purchase without prescription or physician
approval, sold in locations from grocery and drug-
stores to dispenser machines in public bathrooms.
Most public health departments freely hand out
over-the-counter (OTC) methods of contraception,
notably condoms.
Contraceptive effectiveness relies primarily on
proper use of the method and varies widely
among methods as well as within a particular
method. The most reliable methods of contracep-
tion are those that are in place or effective with-
out any effort at the time of sexual activity.
Methods that have the ability to provide nearly
100 percent prevention of pregnancy may actually
result in much lower prevention when not used
properly. Only about 40 percent of women take
oral contraceptives precisely as the label instruc-
tions direct, for example, raising the risk for unin-
tended pregnancy.
Many people combine methods to optimize
protection from pregnancy, for example using bar-
rier contraception (condom or diaphragm) with
chemical methods (spermicides). Only condoms
(male or female) also provide protection against
SEXUALLY TRANSMITTED DISEASES (STDS). A woman
who takes oral contraceptives to prevent preg-
nancy but has more than one sexual partner also
needs the protection of a condom. Partners also
should wear condoms for sexual activity during
outbreaks of GENITAL HERPESand if they are HIV
positive or have HUMAN PAPILLOMAVIRUS (HPV) or
HEPATITISB or C.
Emergency contraception is available through
pharmacies in the United States without a doctor’s
prescription. Emergency contraception, also called
the “morning after pill,” is a high DOSEof an oral
contraceptive. The hormones in the medication266 The Reproductive System
Method Male or Availability Ease of Use Effectiveness When Used
Female Correctly
fertility awareness both personal commitment requires diligent effort 75 to 99 percent
methods (FAMs) from both partners
intrauterine device female prescription only; requires no attention once 99 percent
(IUD) health-care provider inserted
must insert can stay in the UTERUSfor
5 to 12 years, depending
on type
oral contraceptives female prescription only daily or weekly pill 99 percent
spermicide female OTC must apply before each 70 to 85 percent
sexual act
tubal ligation female requires surgery requires no effort after nearly 100 percent (1 in 300 failure
OPERATION rate)
permanent
vasectomy male requires in-office requires no effort after nearly 100 percent (1 in 500 failure
operative procedure operation rate)
permanent