Contraception

One-half of unplanned pregnancies occur among the 10 percent of women who do not use contraception.The remainder of unintended pregnancies result from contraceptive failure.

Advantages and Disadvantages of Various Birth Control Methods

Method

Advantages

Disadvantages

Diaphragm

Inexpensive; some protection against STDs other than HIV

Not to be used with oil-based lubricants; latex allergy; urinary tract infections

Cervical cap (Prentif Cavit)

Inexpensive; some protection against STDs other than HIV

Damaged by oil-based lubricants; latex allergy; toxic shock syndrome; decreased efficacy with increased frequency of intercourse; difficult to use

Intrauterine device

Long-term use (up to 10 years)

Increased bleeding, spotting or cramping; risk of ectopic pregnancy with failure; risk of infertility; no protection against HIV and other STDs

Oral combination contraceptive

Decreased menstrual flow and cramping; decreased incidence of pelvic inflammatory disease, ovarian and endometrial cancers, ovarian cyst, ectopic pregnancy, fibrocystic breasts, fibroids, endometriosis and toxic shock syndrome; highly effective

Increased risk of benign hepatic adenomas; mildly increased risk of blood pressure elevation or thromboembolism; no protection against HIV and other STDs; nausea

Method

Advantages

Disadvantages

Progestin-only agent

Compatible with breastfeeding; no estrogenic side effects

Possible amenorrhea; must be taken at the same time every day; no protection against HIV; nausea

Depot-medroxy-progesterone acetate (Depo-Pro-vera)

Decreased or no menstrual flow or cramps; compatible with breast-feeding; highly effective

Delayed return of fertility; irregular bleeding; decreased libido; no protection against HIV; nausea

Levonorgestrel implant (Norplant)

Decreased menstrual flow, cramping and ovulatory pain; no adherence requirements; highly effective

Costly; surgical procedure required for insertion; no protection against HIV

Tubal ligation

Low failure rate; no adherence requirements

Surgery; no protection against HIV and other STDs

Vasectomy

Low failure rate; no adherence requirements; outpatient procedure

Surgical procedure; postoperative infection; no protection against HIV

Condoms (male and female)

Inexpensive; some protection against HIV infection and other STDs

Poor acceptance by some users; latex allergy; not to be used with oil-based lubricants

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