Between the polar opposites of contraception, abstinence (0 percent failure rate) and doing nothing to prevent pregnancy (85 percent failure rate), there are myriad choices. If sexually transmitted disease is a concern, only male and female condoms offer protection.
| Pill (estrogen & progestin) Back to top | |
| Failure rate(pregnancies per 100 users per year) | Less than 1 if used perfectly; 8 in typical use. |
| Price | $20-$50 per 28-day cycle |
| How it's used | Daily pill for 3 weeks, then an inactive pill for 1 week, producing withdrawal bleeding |
| How it works | Prevents ovulation and thickens cervical mucus to prevent sperm from passing. |
| Advantages | Long-term use reduces lifetime risk of ovarian and endometrial cancers. Typically eases menstrual symptoms such as cramps. |
| Disadvantages | Can cause nausea, breast tenderness, spotting, moodiness, and headaches. Estrogen raises blood-clot risk slightly for healthy users, and significantly for smokers or those with high blood pressure. |
| Three-month pill (Seasonale) Back to top | |
| Failure rate (pregnancies per 100 users per year) | Less than 1 if used perfectly. Method is too new for typical use statistics. |
| Price | $115 for 3 months |
| How it's used | Daily pill for 12 weeks, then inactive pill for 1 week, producing withdrawal bleeding. |
| How it works | Same as pill. |
| Advantages | Same as for pill. Suppresses periods for 3 months at a time. |
| Disadvantages | Side effects same as for pill. Irregular bleeding can occur during the first cycles. |
| Patch (Ortho Evra) Back to top | |
| Failure rate (pregnancies per 100 users per year) | Less than 1 if used perfectly. Method is too new for typical use statistics. |
| Price | $40 per 28-day cycle |
| How it's used | Patch put on buttocks, abdomen, upper torso, or arm weekly for 3 weeks, then left off for 1 week, producing withdrawal bleeding. |
| How it works | Same as pill, except that hormones do not pass through digestive system. |
| Advantages | Same as for pill. No need to take a daily pill. |
| Disadvantages | Side effects same as for pill. Can detach from or irritate skin. Less effective in women weighing more than 200 pounds. |
| Ring (NuvaRing) Back to top | |
| Failure rate (pregnancies per 100 users per year) | Less than 1 if used perfectly. Method is too new for typical use statistics. |
| Price | $38 per 28-day cycle |
| How it's used | Hormone-impregnated polymer ring worn in vagina for 3 weeks, then removed for 1 week, producing withdrawal bleeding. |
| How it works | Same as pill, except that hormones do not pass through digestive system. |
| Advantages | Same as for pill. No need to take a daily pill. Can remove for up to 3 hours without compromising effectiveness. |
| Disadvantages | Side effects same as for pill. May cause vaginal irritation or discharge. If dislodged or removed for more than 3 hours, must use backup contraception for 7 days. |
| Mini-pill (progestin only) Back to top | |
| Failure rate (pregnancies per 100 users per year) | Less than 1 if used perfectly; 8 in typical use. |
| Price | $30-$50 per 28-day cycle |
| How it's used | Daily pill. |
| How it works | Thickens cervical mucus to block sperm. |
| Advantages | Can be used when health prevents use of pills with estrogen. |
| Disadvantages | Possible irregular bleeding. May raise cholesterol levels. Must take pill at same time each day. |
| Injection (Depo-Provera) Back to top | |
| Failure rate (pregnancies per 100 users per year) | Less than 1 if used according to schedule; 3 in typical use. |
| Price | $57 per injection plus cost of office visit |
| How it's used | A progestin injection every 3 months, usually at the doctor's office. |
| How it works | Same as mini-pill. |
| Advantages | Frequently suppresses periods completely. |
| Disadvantages | Can cause weight gain. Should not be used for more than 2 years because of bone thinning risk. May take 1 year or more to regain fertility after stopping use. |
| Male condom Back to top | |
| Failure rate (pregnancies per 100 users per year) | 2 if used perfectly; 15 if used typically. |
| Price | $0.25-$1 per use |
| How it's used | Put over erect penis prior to or during foreplay. |
| How it works | Sheath prevents sperm from entering vagina and uterus. |
| Advantages | Very effective in preventing sexually transmitted disease. |
| Disadvantages | Interrupts foreplay. May interfere with sensation. May break or slip off during use. |
| Female condom Back to top | |
| Failure rate (pregnancies per 100 users per year) | 5 if used perfectly; 21 if used typically. |
| Price | $3 per use |
| How it's used | Insert into vagina prior to or during foreplay. |
| How it works | Sheath covers vagina and cervix, prevents sperm from entering uterus. |
| Advantages | No hormonal side effects. Helps prevent sexually transmitted disease. |
| Disadvantages | Interrupts sexual foreplay. Large and awkward to use. |
| Copper intrauterine device (ParaGard) Back to top | |
| Failure rate (pregnancies per 100 users per year) | Less than 1. |
| Price | $250 to $300 every 10 years plus cost of office visit |
| How it's used | T-shaped copper device Inserted into uterus at doctor's office. Can leave in place for up to 10 years. |
| How it works | Believed to inhibit passage of sperm and maturation of eggs. |
| Advantages | Fertility returns soon after removal. No hormonal side effects. |
| Disadvantages | Can occasionally fall out. May increase menstrual cramps and bleeding. Rarely, can perforate uterus. |
| Progestin intrauterine system (Mirena) Back to top | |
| Failure rate (pregnancies per 100 users per year) | Less than 1. |
| Price | $300 to $400 every 5 years plus cost of office visit |
| How it's used | T-shaped plastic device, with progestin, inserted into uterus at doctor's office. Can leave in place for 5 years. |
| How it works | Same as mini pill. |
| Advantages | Fertility returns soon after removal. May lessen menstrual cramps and bleedings, or stop periods. |
| Disadvantages | Can occasionally fall out. Rarely, can perforate uterus. Irregular spotting for first 3 to 6 months. |
| Diaphragm Back to top | |
| Failure rate (pregnancies per 100 users per year) | 6 if used perfectly; 16 if used typically. |
| Price | $30 to $40, plus cost of fitting and spermicide |
| How it's used | Rubber dome placed over cervix before intercourse and left in place for 6 to 24 hours. Used with spermicide. |
| How it works | Prevents sperm from passing from vagina into uterus. |
| Advantages | Can be inserted prior to foreplay. No hormonal side effects. Does not interfere with normal menstrual cycle. |
| Disadvantages | Must plan ahead for use. Must remember to have on hand if away from home. |
| Cervical cap Back to top | |
| Failure rate (pregnancies per 100 users per year) | For women who have not delivered vaginally, 9 in perfect use, 16 in typical use. For others who have, 26 in perfect use and 32 in typical use. |
| Price | $100-$200, plus cost of fitting and spermicide |
| How it's used | Silicon or latex rigid covering placed over cervix before sex and left in place for 8 to 48 hours. Used with spermicide. |
| How it works | Prevents sperm from passing from vagina into uterus. |
| Advantages | Can be inserted prior to foreplay. No hormonal side effects. Does not interfere with normal menstrual cycle. |
| Disadvantages | Must plan ahead for use. Must remember to have on hand if away from home. |
| Surgical sterilization Back to top | |
| Failure rate (pregnancies per 100 users per year) | Less than 1. |
| Price | $2,500 to $4,000 |
| How it's used | Fallopian tubes cut, blocked, or tied off in laparoscopic surgery. |
| How it works | Prevents sperm from reaching eggs. |
| Advantages | Does not affect hormones or menstrual cycle. |
| Disadvantages | Irreversible. Inappropriate for women who may wish to have more children. |
| Transcervical sterilization (Essure) Back to top | |
| Failure rate (pregnancies per 100 users per year) | Less than 1. |
| Price | $2,000 to $3,000 |
| How it's used | Coils inserted into fallopian tubes using instrument passed through the cervix. |
| How it works | After three months, scar tissue forms that blocks tubes, preventing passage of eggs. |
| Advantages | Does not affect hormones or menstrual cycle. |
| Disadvantages | Irreversible. Inappropriate for women who may wish to have more children. |
| Spermicides Back to top | |
| Failure rate (pregnancies per 100 users per year) | 15 if used perfectly; 29 if used typically. |
| Price | $1 to $1.50 per use |
| How it's used | Jelly, suppository, foam, or cream inserted into vagina no more than 1 hour before intercourse. |
| How it works | Chemicals block cervix and kill sperm. |
| Advantages | Can buy without a prescription at drugstores and some supermarkets. |
| Disadvantages | Can leak. High failure rate if not used carefully. Those with nonoxynol-9 may irritate penis or vagina and may raise risk of sexually transmitted disease. |
| Periodic abstinence Back to top | |
| Failure rate (pregnancies per 100 users per year) | 1-9 if used perfectly; 25 if used typically. |
| Price | No cost |
| How it's used | Abstention from intercourse during fertile days of the menstrual cycle. |
| How it works | Fertile period determined by examining menstrual cycle, cervical mucus, and/or resting body temperature. |
| Advantages | Only acceptable method in some religions. No physical or hormonal side effects. |
| Disadvantages | High failure rate if used incorrectly, or if woman has irregular cycle. |
| Vasectomy Back to top | |
| Failure rate (pregnancies per 100 users per year) | Less than 1. |
| Price | $250 to $1,000 |
| How it's used | Sperm tubes tied or sealed in outpatient surgery via incision in the scrotum. |
| How it works | Sperm blocked from mingling with ejaculate so cannot cause pregnancy. |
| Advantages | Does not affect sexual performance. Does not require action by woman. |
| Disadvantages | Irreversible. Not appropriate for men who may wish to father more children. |