Contraception - the Choice for YOU

Decide if and how you want to be involved sexually.

How do you know which ones might be easier for you to get or use?
Or which ones protect you against sexually transmitted infections?
Or which have any side effects to consider?
Or how effective each method is in preventing pregnancy?
Or how much it costs?

There are just so many questions, and sometimes the answers seem so technical, when all you really want are answers that youll understand and remember. If you need contraception (birth control), who can you go to for more information? Where can you go to get a birth control method? To help you answer these questions, read on and decide for yourself what method best meets your needs.

Condom

What is it? It is a latex sheath that fits over an erect penis, acting as a barrier to decrease the transmission of semen during vaginal, anal, and oral intercourse. It can come in different colors, styles, and lubrication (often spermicides). Some condoms are made with polyurethane. Other condoms made from animal skin (not latex) are less effective in preventing STIs.

How does it work? It traps the ejaculate, preventing sperm from getting near the egg. Make sure to check the expiration date. The right side of the condom must face out before touching the erect penis. Squeeze the tip of the condom to get the air out before rolling down condom down to base of penis. When ejaculation is complete, pull out, holding rim of condom at base.

Benefits The condom helps protect against both STI transmission and HIV infection, and pregnancy. No prescription is needed, comes in a variety of sizes, is easy to carry and has no known side effects, other than the occasional latex allergy.

Things to note (effectiveness) It is 86% - 97% effective as a birth control method; 97% when used correctly with a contraceptive foam, film, or jelly. Before ejaculation, there are small amounts of ejaculate that leak out when penis is erect. If this gets on the side of the condom being inserted (the outside), the condom becomes ineffective. Air inside condom can cause breakage. Each condom is good for one ejaculation.

Cost At local Rutgers Student Health Center Pharmacies, a package of 12 is $2.95 or 25 cents each.

*Regardless of your method of birth control, we recommend always using a condom to decrease transmission of sexually transmitted infections.

Female Condom

What is it? It is a polyurethane sheath that fits inside the vagina canal and extends to cover externally.

How does it work? The ring on the inside of the sheath is squeezed and inserted in the vaginal canal to cover the cervix. The ring at the other end of the sheath is left outside the vagina, slightly covering external genitals.

Benefits It protects against transmission of HIV, stis and sperm (for pregnancy). It is easily accessible; a good substitute if allergic to latex.

Disadvantages There is a greater possibility for this method to slide out with lubrication. It could be difficult with various positions, and may seem slightly noisy.

Things to note (effectiveness) It is 79% - 95% effective. It may or may not increase in sensitivity compared to the male condom.

Cost They are available for $11.40 for 3 at Rutgers Student Health Centers Pharmacies.

Diaphragm What is it? It is a flexible ring covered with thin, soft latex. It makes a shallow cup and fits inside the vagina, covering the cervix. A prescription is required to assure a good fit.

How does it work? Before intercourse, place about 2 teaspoons of spermicide within the dome and around rim and insert it into the vagina against the cervix and behind the pubic bone. The spermicide kills any sperm and the diaphragm physically blocks sperm from entering the cervix. It must be left in for 6-8 hours after ejaculation.

Benefits It can remain in place for at least 6, and never longer than 24 hours, but should be inserted no sooner than 6 hours ahead of time.Can also be used during menstruation (cup-like shape captures menstrual flow). There are no physical side effects, except for the occasional latex allergy.

Disadvantages It does not protect against STIs or HIV. It may take practice to use effectively. Spermicide must be added for each additional act of intercourse. May increase urinary tract infections with heavy use.

Things to note (effectiveness) It is from 80% - 94% effective. When used with spermicide (e.g., Nonoxynol-9), effectiveness is closer to 97%. It must be specially fitted by a clinician and refitted if body weight changes by 10 or more pounds, or if there is any change to the cervix (eg., from LEEP, cryo or childbirth).

Cost At Rutgers Student Health Center Pharmacies, diaphragms cost as little as $25 each, but can vary with different brands. Spermicide is sold separately.

Spermicide

What is it? Coming in many forms, spermicides are jellies, foams, suppositories, and films (VCFs) that are placed inside the vagina and create a chemical barrier with Nonoxynol-9 to kill sperm. Its effectiveness on certain bacteria is inconclusive.

How does it work? It is inserted as deep as possible inside the vagina. As a film or suppository it must be allowed to dissolve for 10-15 minutes before intercourse. Intercourse must occur within 60 minutes of application. Recommended for use with other chemical and barrier methods (condom, diaphragm, the pill, etc.).

Benefits Small packaging, convenient, inexpensive, readily available and has no serious side effects.

Disadvantages While it can immobilize sperm to help prevent pregnancy, it is not very effective used alone. It can also cause allergic reactions in some people based on specific ingredients or irritation if used several times a day.

Things to note (effectiveness) It is 74% - 94% effective when used alone. It can be helpful for extra lubrication and with other barrier methods to improve their effectiveness.

Cost At Rutgers Student Health Center Pharmacies, it can cost between $4 - $9. VCFs are $1.85 for 3.

NuvaRing.

What is it? Released in 2002, it is a 2-inch, soft, flexible, transparent ring of hormones that you insert in your vagina like a diaphragm.

How does it work? Similar to oral contraceptives, it releases a steady flow of estrogen and progestin to form a hormonal barrier. The ring remains in the vagina for 21 days, and is removed for the next seven days (to allow for menstruation). A new ring is inserted for each cycle.

Benefits Lasts for three weeks, self inserted, convenient.

Disadvantages No STI or HIV protection. Requires motivation to replace on schedule. Other disadvantages similar to oral contraceptive pill.

Things to note (effectiveness) It is 98 - 99% effective when used correctly. Requires prescription.

Cost Call the pharmacy for latest pricing

Oral Contraceptive Pill

What is it? It is a chemical method in pill form made of two synthetic hormones, estrogen and progestin. It is taken every day at the same time; a prescription is required.

How does it work? The hormones do three things: inhibits ovulation by suppressing the necessary hormones, thickens the cervical mucus, making it difficult for sperm to enter the uterus, and thins the lining of the uterus (the endometrium), interfering with the implantation of a fertilized egg.

Benefits It may lessen menstrual flow and cramps, PMS (premenstrual syndrome). It is reversible, safe for most women and may improve acne.

Disadvantages There is no STI or HIV protection. It can be difficult to keep a regimented schedule. In first 3 months of use, may cause nausea, headaches,fluid retention, and depression. There is also a small risk of developing blood clots, high blood pressure or a heart attack or stroke.

Things to note (effectiveness) It is 99% effective when taken correctly (mainly a human error problem). The pill can be very effective if you remember to take it everyday at the same time. Check-ups are needed every few months. There are many kinds of birth control pills, each with different levels of the two hormones to try. They all come in monthly packs.

Cost The cost varies greatly. At Rutgers Student Health Center Pharmacies, a pack costs $12 or more, with a few, more expensive exceptions.

Emergency Contraception

What is it? It is a specific dose of hormones to decrease your risk of conception after having unprotected sex or having method of birth control fail (eg., a condom break during use). Not recommended as a birth control method.

How does it work? Emergency Contraceptive Pills (ECPs) contain hormones that work by temporarily stopping ovulation. Also, they may stop a fertilized egg from attaching to the uterus.

Benefits ECPs cut down the risk of pregnancy by 95% if taken in the first 12 hours of unprotected intercourse, and by 85% if taken within 13 - 72 hours of unprotected sex. The US Food and Drug Administration stated that ECPs are safe and have no lasting effects. Talk to your health care provider to learn if there is any reason you should not take ECP.

Disadvantages It is common to experience nausea (and sometimes vomiting) after taking ECPs. Talk to your health care provider about how to minimize this side effect.

For more information about ECPs, come to any health center. For a list of practitioners who prescribe it from anywhere in the country, call 1-888-NOT-2-LATE. ECPs are also referred to as The Morning After Pill.

Cost ECPs are available by prescription at Rutgers Student Health Centers for approximately $12.

Ortho Evra Transdermal Patch

What is it? Released in 2002, it is a very thin, 11/4 square inch beige, smooth, transdermal patch of birth control hormones applied directly to your skin (buttocks, abdomen, upper torso or upper outer arm).

How does it work? Similar to oral contraceptives, it releases estrogen and progestin - in this case through your skin and into your bloodstream, to form a hormonal barrier. You change the patch yourself weekly on the same day of the week, three weeks with a patch, one week without a patch (to allow for menstruation).

Benefits It is convenient, reliable, and reversible.

Disadvantages There is no STI or HIV protection. Requires discipline to follow regime for regular planning. Other disadvantages similar to oral contraceptive pill.

Things to note (effectiveness) It is 99% effective when used correctly. Requires prescription.

Cost Call the pharmacy for latest pricing

Intrauterine Device

What is it? The intrauterine device (IUD) is a small piece of flexible plastic which is inserted into the uterine cavity by a health care provider. It can stay in as long as contraception is desired or prescribed.

How does it work? Different IUDs work in different ways. It may speed passage of the egg to uterus or increase prostaglandin production, preventing the sperm from reaching or fertilizing the egg. It can affect the mobility of sperm, thicken cervical mucus or thin the endometrium. Progestasert must be replaced every year; Copper 7 (also known as ParaGuard) must be replaced every 10 years.

Benefits It is basically a long-term method; no other preparations are needed once inserted.

Disadvantages Insertion may be uncomfortable. No protection against STIs or HIV. Possible cramping, spotting, irregular bleeding, longer periods with heavier bleeding, and/or uterine perforation at insertion (rare). It may lead to Pelvic Inflammatory Disease (PID), or increased risk of ectopic pregnancy.

Things to note (effectiveness) It is about 98% - 99% effective (increased by use of spermicide). Important - this method is advised for women who have already had at least one child, are in a stable, long-term, mutually monogamous relationship and have no history of PID.

Cost The Rutgers Student Health Centers rarely prescribe this method any longer, but will advise where to go for it.

Mirena.

What is it? Recently approved by the FDA for use in this country, it is light, plastic, T - shaped intrauterine contraceptive device, fitted and placed in the uterus by your health care provider.

How does it work? Similar to oral contraceptives, it releases a steady flow of estrogen and progestin to thicken cervical mucus and thin the endometrium.

Benefits Lasts for five years, convenient.

Disadvantages No STI or HIV protection. Requires motivation to replace on schedule. Takes body a few months to adjust to hormones. Other disadvantages similar to other intrauterine devices.

Things to note (effectiveness) It is 99.9% effective. Requires prescription.

Cost Call the pharmacy for availability.

Depo-Provera

What is it? Depo-Provera is a chemical injection of progestin into a muscle mass, shoulder or buttocks, good for 3 months. A prescription is required.

How does it work? (Refer to Oral Contraceptive Pill.) It inhibits ovulation, thickens cervical mucus, and thins menstrual tissue.

Benefits It is good for three months, contains no estrogen and may lessen menstrual flow and cramps.

Disadvantages There is no sti or hiv protection. May cause nausea, dizziness, spotting, irregularity of menstrual flow, temporary weight gain and/or breast tenderness. The side effects may remain for the whole 3 months or more, and return of the menstrual cycle and fertility may be delayed up to 1 to 1 and 1/2 years.

Things to note (effectiveness) It is over 99% effective against pregnancy. There is a possible decrease in risk for PID (Pelvic Inflammatory Disease), endometrial and ovarian cancers. Only 4 injections per year are needed.

Cost At Rutgers Student Health Center Pharmacies, each injection costs approximately $50.

Natural Planning & Awareness

What is it? It is determining when a female is most fertile with careful watching and recording of her menstrual cycle.

How does it work? By observing the two major fertility signs: noting changes in cervical mucus and body temperature.

Benefits The techniques, once learned, are easy to follow and inexpensive. Both females and males can learn about the menstrual cycle; can increase communication and cooperation between partners.

Disadvantages There is no sti or hiv protection. It is the least effective way to prevent pregnancy; failure rate is high (12-25%). Period of abstinence needed to determine females menstrual cycle. It can be a difficult method to follow without a partners support. Menstrual cycle must have a regular pattern.

Things to note (effectiveness) The effectiveness against pregnancy can be as low as 75%. Requires a commitment to stay with the method, comfort talking with your partner, touching your own body and avoiding vagina/penis penetration during fertile days. This method is more useful to use for couples when trying to conceive.

Cost The Rutgers Student Health Centers can provide counseling. Depending on the cost of consultation elsewhere, it is usually inexpensive. A basic thermometer can be purchased or ordered at many pharmacies.

Menstrual Cycle

What is it? Approximately every 28-30 days (everyones cycle is different and may be longer or shorter), if she is not pregnant, a woman sheds the lining of the uterus (called the endometrium). This process is called menstruation or the period. The day that bleeding starts is considered the first day of a cycle.

How does it work? The uterine lining prepares itself every month to receive an egg (ovum) that has been fertilized by a sperm. If no fertilization has occurred, the lining separates from the uterus, passes through the cervix (opening of the uterus) and exits the vagina as menstrual flow.

If you dont want to become pregnant, things to think about... To avoid pregnancy, sperm should be kept away from the egg for the period around ovulation (time of egg release). Women usually ovulate 14 days before menstruation. It is, however, possible to ovulate anytime during the cycle, including, rarely, when a woman is menstruating. The egg can live up to 72 hours, after which it disintegrates if not fertilized. Since sperm can survive up to 5 days in the body if conditions such as cervical mucus are nurturing, a woman can become pregnant during those days.

Things to note Ovulation usually occurs 14 days before menstruation. Carefully monitoring the menstrual cycle for 6 months (basal body temperature and cervical mucus, and calendar documentation) can provide you with information about when you are most likely to become pregnant, and therefore, when to abstain from unprotected vaginal - penile intercourse. Guessing about safe times isnt an effective method, so come to the health service and speak with a clinician if this is your birth control method.

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