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To choose a birth control method that is right for you, you need facts. This brochure describes birth control methods, how they work, their strengths and weaknesses, and side effects. Choosing the birth control method that is best for you is not easy. We hope this information will help you make a choice that is right for you.

Diaphragm

The diaphragm can be highly effective if used with a contraceptive gel, foam, or cream spermicide each and every time you have intercourse. The diaphragm has a very high pregnancy rate if it is not used right. A doctor or nurse practitioner must fit it. Then you must be sure the diaphragm covers your cervix each time it is used. It must be put in place with fresh spermicide just before intercourse and left in for at least six hours after intercourse. The diaphragm is also useful for intercourse during menstruation. It will temporarily retain the blood flow.

Condom

The condom is similar to the diaphragm in effectiveness. The condom must be used each and every time intercourse occurs, even during menstruation. Unlike the diaphragm, it can be purchased over the counter without a doctor's prescription. It is the only method that, when used correctly, is effective against the transmission of some sexually transmitted diseases.

Combination Birth Control Pill

Estrogen and progestogen in the standard birth control pill is very effective. The pills are taken daily for 21 days and stopped for 7 days to allow menstrual flow. Missing pills will increase your pregnancy change slightly.

Progestogen-Only Birth Control Pill

This is not the standard birth control pill. It is often prescribed if you have side effects or problems with combination birth control pills. The pregnancy rate is slightly higher, but the pill is still very effective. It is equal to the intrauterine device in effectiveness. As with any of the progestogen-only pills, irregular and unpredictable bleeding can be a side effect.

Intrauterine Device (IUD)

There are two types of IUDs.

• The Progestasert releases progesterone into your uterus and into your bloodstream. It must be removed and reinserted every year.
• Copper T380A or Paragard can be left in place for up to ten years.

Pregnancy rates are very low with either IUD. About one third of women have bleeding and/or cramping to the point where they ask to have the device removed. One third of women have no side effects. One third have some increase in menstrual flow and cramping with their menstrual period. There is a slight increased risk of pelvic infection linked with the use of an IUD. The risk is highest during the month right after it is inserted.

Depo-Provera

Depo-Provera is a progestogen given as an injection once every three months. It is very effective. Menstrual irregularity is a common side effect at first. In a while, most women have no menstrual periods.

Norplant

Norplant is six capsules that are inserted underneath the skin of the inner side of the upper arm. They can be left in for up to five years. They are very effective. Irregular and unpredictable bleeding is a common side effect. At this time, there is no way to predict how you would do on Norplant. Both insertion and removal are minor surgical procedures, which must be done by a trained doctor or nurse practitioner.

Female Sterilization

Female sterilization is permanent. Reversal is very difficult and requires major surgery. Therefore, it is only for women who are certain they will not want a pregnancy even if they enter a new relationship. It is a surgical procedure requiring a small cut at the umbilicus (belly button) under local or general anesthesia.