Birth Control Effectiveness: Hormonal and Surgical Methods

At some point in their lives, nearly all women need to choose a method of pregnancy prevention. When surveying her options, a woman will likely consider birth control side effects, cost, and convenience. Most importantly, she will take into account birth control effectiveness when making her decision. Hormonal and surgical methods are the most effective birth control options.

Surgical Methods of Contraception

The following birth control options are surgical procedures that are meant to be permanent. Individuals who are looking for a permanent and highly effective birth control method might consider one of these surgical procedures.

• Vasectomy is the most effective birth control method for males. It is a surgical sterilization and is almost 100 percent effective, according to Planned Parenthood. During the procedure, a doctor closes or blocks a man’s vas deferens to prevent sperm from leaving the body.
• The surgical procedure for women is called tubal sterilization or tubal ligation. As with a vasectomy, it is nearly 100 percent effective in preventing pregnancy. If a woman is sure that she does not want to have children, and is highly concerned about birth control effectiveness, tubal sterilization might be an appropriate choice for her.

Hormonal Birth Control Options

For women who are interested in using hormonal birth control, there are numerous options available. Hormonal contraceptives are highly effective in preventing pregnancy, and many women can find a method in this group that works for them.

A large number of women choose to use oral contraceptives, commonly referred to as “the Pill.” For women who always use oral contraceptives correctly, meaning that they take the pills regularly and at the same time every day, less than one out of 100 will become pregnant each year. For women who do not always take the pill as directed, the number jumps to eight women out of 100.

The birth control patch, also known by its brand name Ortho Evra, is another hormonal method. A woman keeps a small patch stuck somewhere on her skin for three weeks at a time, and it releases the hormones progestin and estrogen to prevent ovulation. With the birth control patch, less than one out of 100 women will get pregnant with perfect use, and approximately eight women out of 100 with non-perfect use.

The birth control shot is often referred to by its brand name, Depo-Provera, and its effects last for three months. Out of 100 women who always receive the Depo-Provera shot as indicated, only one will become pregnant in a given year. Out of 100 women who do not take the shot as directed, three will become pregnant.

Another common method is the birth control vaginal ring, or the NuvaRing. When using the NuvaRing, a woman places the small device inside her vagina for three weeks at a time, and it works like other hormonal methods to release estrogen and progestin. Just like the birth control patch and the pill, less than one of 100 women who use the NuvaRing perfectly will still get pregnant, and eight of 100 who do not use it correctly will become pregnant.

An IUD, or intrauterine device, is placed in a woman’s uterus. Less than one woman out of 100 who use an IUD will become pregnant in a given year. Depending on the brand, an IUD can last for five to 12 years.

The birth control implant, Implanon, is inserted into a woman’s arm and releases the hormone progestin to prevent ovulation. As with the IUD, less than one woman out of 100 who use Implanon will become pregnant every year. The birth control implant can last for up to three years. For women who would like a highly effective hormonal method that does not require taking a daily pill, Implanon could be one of the best birth control options.

It is important to remember that other factors can modify hormonal birth control effectiveness, including medications such as St. John’s Wort or antibiotics. A woman should discuss any possible medical interactions with her doctor or websites like live casino games when she is deciding on a method of contraception. Additionally, none of these surgical or hormonal birth control methods protect against sexually transmitted diseases or infections, so a woman should also use a condom if this protection is necessary.

Choosing Birth Control Method

Women do not know enough about the range of contraception available to them, especially long-term methods, says Toni Belfield, Director of Information at the Family Planning Association (FPA). Many women rely on the pill for convenience but there are lots of other options and non-hormonal methods are increasingly popular because they offer women a choice.

Contraceptive Implants and Injections

• Implanon – A tiny implant that is placed beneath the skin. It slowly releases progestogen into the bloodstream, preventing pregnancy. Pros: Lasts for three years. Cons: It can temporarily change menstrual patterns.
• DepoProvera and Noristerat – These are injections of progestogen, preventing ovulation and pregnancy. Pros: You are protected for 8-12 weeks. Cons: You need to rebook for repeat injections.

The Coil (IUD/IUS)

• IUD (Intrauterine Device or ‘coil’) – A copper or plastic part that is inserted into the uterus to prevent conception. Pros: A long-term method lasting five years. Cons: Possible side effects include heavy periods.
• IUS (Intrauterine System) such as Mirena. A plastic part that is inserted into the uterus, releasing progestogen to prevent pregnancy. Pros: fewer side effects as it does not reach the bloodstream. A long-term method lasting five years. It can also help ease heavy periods. Cons: Needs to be fitted by a health professional.

Natural Family Planning

• New research* shows that natural family planning (Sympto-thermal method) is just as effective as the pill if done properly. It involves taking your temperature first thing, noting it on a chart, and monitoring cervical mucus. Fertility UK has a list of teachers across the UK. Pros: Natural, non-hormonal, puts you in touch with your body. Cons: requires a time investment of three to six months to do the charting.
• Persona – A helping hand in charting your cycle. The Persona kit contains sticks that you pee on to test fertility. A traffic light system: Red sticks mean stop, green means go. Pros: easier than remembering to take your temperature. Cons: the kits are quite expensive. If it is a ‘red’ day you will need to use some form of contraception.
• CycleBeads – a string of coloured beads that help you to monitor your cycle. Based on the Standard Days Method of charting (for cycles between 26-32 days).

Barrier Methods

• Male and female condoms, the cap and diaphragm. These work by preventing sperm reaching the uterus. Pros: non-hormonal, come in assorted flavours, textures and sizes. Cons: Can reduce spontaneity and sensation.
• Cervical caps are quite small and need to be fitted over the cervix. Pros: non-hormonal. Cons: You will need to be shown how to fit it the first time. Can be fiddly to use.
• Diaphragms are slightly larger and you will need to be fitted for the right size. If used correctly they are a cheap and reliable form of contraception.

Oral Contraceptives

There are two types of contraceptive pill: –

• The combined pill contains oestrogen and progestogen and prevents ovulation. Some brands are stronger than others so ask for a low-dose pill if you have experienced side effects such as mood swings and bloating. Pros: highly effective. Cons: You need to remember to take it at the same time each day and some women report reduced libido.
• The mini-pill (POP) contains progestogen and is suitable for smokers over the age of 35.

Permanent Methods of Contraception

Speak to your doctor about sterilisation or vasectomy for a partner If you don’t want to have children or have completed your family.

Emergency Birth Control

Morning After Pill – for accidents only and not intended to be used as a regular contraceptive. It contains a high dose of hormones. You need to take it within 72 hours of unprotected sex. You can also use the IUD as an emergency contraceptive for up to five days post-sex. Emergency contraception will cost around £26 if purchased from a pharmacy.