Condoms & Contraception: A Comparative Guide.

Taken From: Consumer Reports - http://www.consumerreports.org/cro/health-fitness/health-care/condoms-and-contraception-205/a-comparative-guide/index.htm

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) Progestin intrauterine system (Mirena)
Three-month pill (Seasonale) Diaphragm
Patch (Ortho Evra) Cervical cap
Ring (NuvaRing) Surgical sterilization
Mini-pill (progestin only) Transcervical sterilization (Essure)
Injection (Depo-Provera) Spermicides
Male condom Periodic abstinence
Female condom Vasectomy
Copper intrauterine device (ParaGard)

 

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.