ContraceptiveCondoms, diaphragms, spermicides, the Pill, the sponge, cervical caps, injectable contraceptives, implants, the rhythm method, IUDs… With so many contraceptive options on the market, and others on the way, how do you know which is best for you?

The first step in making an informed decision is to gather the necessary facts. We can help you there.

Every method has advantages and disadvantages, but a good starting point for the decision process is to consider the fact that many of us need both birth control and protection from sexually transmitted diseases (STDs). If, for example, you have several sexual partners, your risk of getting a sexually transmitted infection is very real, and it makes sense to think about about STD protection as well as birth control.

The best protection against STDs is offered by the male condom–specifically those made from latex. Spermicides have been shown to help prevent some STDs, but recent research suggests they can also irritate the vagina and cervix; in some studies, actually increasing the risk of sexually transmitted infection. (The jury is still out.) There is a female condom on the market, but we don’t yet know how effective it is for disease prevention.

We should point out here that the contraceptive effectiveness of male condoms is not stellar; 14% of women who rely on them for birth control get pregnant within the first year of use. So if you’re choosing condoms for disease protection, you might want to consider an additional method of birth control.

The issue of STD protection may also apply to some who have only one partner now–if, for example, there is worry about past STD infection or a chronic condition like herpes. But for some couples, STDs are simply no longer a concern. Their focus is on preventing an unintended pregnancy. That means choosing a birth control method that is safe, effective, and fits with lifestyle and personality. Reviewing the options in a general way may help you weigh the personal pros and cons of each.

The Pill, IUDs (intrauterine devices), and injectable or implantable contraceptives all lend themselves to spontaneous lovemaking–no need to stop and roll on a condom, look for spermicides, or insert a barrier. On the other hand, these out-of-sight options are among the most expensive. The hormones used in the Pill, injectables, and implants can confer extra benefits to some women (decreased acne, decreased menstrual pain, decreased symptoms at menopause) but for others they can be problematic and in some cases dangerous.

Are you a forgetful person? Have difficulty sticking to a routine? If so, the Pill may pose problems for you. (One study suggests that a third of women forget to take the daily dose.) Some women might be better served with an IUD, which can be left in place, out of sight and out of mind, for up to 10 years, or the Norplant implant, which is surgically inserted and works for up to 5 years. The injectable contraceptive Depo-Provera, another option, requires clinic visits every three months.

Maybe you’ve reached the point in your life where you are absolutely certain you don’t want any (or any more) children. In that case, you might want to consider sterilization: tubal ligation for women, vasectomy for men.

What if you don’t like the idea of taking the Pill or having hormones injected or implanted in your body? What if you have a medical risk factor that excludes the use of a hormonal method? What if the idea of an IUD makes you cringe? What if you’re on a really tight budget or only have sex once in a blue moon? There are options that address all of these concerns, including the diaphragm, cervical cap, or the sponge (when it finally becomes available again in this country).

There are also, of course, religious or philosophical objections to certain forms of birth control. For many, natural methods (rhythm method, fertility awareness, or withdrawal) are the only practical options, short of abstinence.

What if you need contraception right now, this minute, because of an emergency–a sexual assault, a broken condom, forgotten pills, a dislodged diaphragm, or any other circumstance that can put a woman at risk for pregnancy? Emergency contraception is the answer.

The contraceptive method you choose must address your personal needs for birth control and disease protection. It has to be affordable, readily available, and philosophically acceptable. But unless you choose a non-medical method (like rhythm) or an over-the-counter method (like condoms), it’s not really a choice you can (or should) make on your own. Many of the most effective methods of birth control require you to consult your healthcare provider. And choosing a contraceptive method should be based on your needs and your medical history. The more you know about the available options, the greater your chance of finding the right one for you.

Contraceptive choices: finding the method that’s right for you
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