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) 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. |