If you suffer from side effects of hormonal birth control or are just looking to get off of hormones, it is important to look at all of your options and understand what is involved in each form of contraception. You can check out my guide to hormonal birth control HERE, and ensure you are informed when making the right choice for YOU!
Mechanical Barriers for contraception
- Male condom
This is one of the most popular forms of non hormonal birth control, as it provides adequate protection against pregnancy as well as sexually transmitted infections. Unintended pregnancy when used correctly and consistently is around 3%, however can be around 14% during the first year of use. Failure rates occur with improper placement of the condom on the penis, using oil based lubricants (which can cause breakage) and poor withdrawal technique.
- Female condom
The female condom is similar to the male condom, as it is intended for one time use, however is used in less than 1% of women in the united states. There is an internal anchor (closed end) placed inside the vaginal canal and an open end placed outside of the vaginal canal. This prevents pregnancy by creating a barrier to passage of semen through the vagina. The female condom can be inserted in the vaginal canal up to 8 hours before intercourse. This can be difficult to place inside the vagina, can cause some discomfort, and if left in place for a prolonged period of time can cause urinary tract infections. Estimated unintended pregnancy rates can be as high as 15% in 6 months of use.
The diaphragm is inserted in the vagina before intercourse so that it is covering the cervix opening and is lined with spermicidal cream or jelly and acts as a barrier to the passage of sperm. Typical failure rates within the first year are estimated to about 20%. Prolonged use can increase the risk for urinary tract infections, and diaphragms must be properly fitted in order to be effective.
- Cervical Cap
Fits over the base of the cervix & must be filled with spermicide prior to insertion and can be left in place as long as 8 hours before insertion. Typical failure rates can range from 20-40%. Candidates for the cervical cap must be properly fitted for one, and have no prior history of abnormal pap results.
- Spermicidal Agent
These come in the form of vaginal foams, suppositories, jellies, tablets and creams and must be inserted into the vaginal canal before sexual intercourse. These may reduce the risk for sexually transmitted infections and work by directly attacking the sperm. With perfect use failure rates are about 6% in the first year but with typical use can be as high as 26%. Vaginal irritation is possible and allergic reactions can happen with this form of contraception.
Other forms of contraception
- IUD- Copper IUD
The copper IUD is the non hormonal IUD and is placed in the uterus with a string that hangs into the vaginal canal. The copper IUD works based on creating a “foreign body reaction” in the uterus which creates an unfavourable environment for implantation. The failure rate for the copper IUD is 0.6% within one year of use, however comes with a very low risk (1%) of uterine perforation at the time of insertion and does not protect against sexually transmitted infections. The copper IUD may increase painful periods and the amount of blood lost during the menstrual period.
- Periodic abstinence (Natural family planning)
This method involves periodically avoiding sexual intercourse during a woman’s fertile period. This method assumes a few things including:
- Sperm can only fertilize an egg for 48 hrs after intercourse
- An egg is only capable of fertilization 24 hours after ovulation
- Ovulation occurs between days 12-16 of a woman’s cycle
The unintended pregnancy rate for this method is approx. 25%. It is true that an egg is only capable of fertilization for 24 hours after ovulation, however sperm can live in the female reproductive tract for up to 5 days and not all women ovulate during days 12-16 of their cycle. Here, it is important to track your cycle [Find my free guide for tracking your cycle] & monitor your cervical mucous [Free guide here!] in order to more accurately determine when exactly you ovulate. It is best to track your cycle for at least 6 months before starting this method of contraception so that you are aware of your possible fertility window. You may also want to consider using ovulation predictor kits in order to increase accuracy and add more information to your other tracking methods.
- Coitus Interruptus “The pull out method”
This method of contraception involves withdrawing the penis from the vagina before ejaculation and it’s effectiveness depends solely on the man’s ability to effectively withdraw before ejaculation. If this method is used perfectly, failure rates (unintended pregnancy) are still 4% within the first year, and in typical use, failure rates are approximately 22%.
If you have any questions about the best contraception options for YOU, fill out the contact form!
Dr. Laura, ND