Birth control methods and effectiveness – Part I


By Emily Prior
LA Positive Sexuality Examiner

June 13, 2009

birth control comparison
Courtesy of World Health Organization and Johns Hopkins Bloomberg School of Public Health. Click for larger image.

What type of birth control is best for you? Are you aware that there are several different types of birth control options? Do you know the difference between barrier methods, hormonal methods, and surgical methods? This three part series should help to give you information on many of the currently used methods, what they actually do, and their effectiveness at protecting against unwanted pregnancy.

It is important to understand that NO method of birth control, other than abstinence, is 100% effective. Abstinence means not having sex at all. In this case, no penile-vaginal intercourse. (Obviously, homosexual sex would not lead to pregnancy!)

Barrier Methods: A barrier method is one in which some substance is used to block the sperm from reaching the egg. This can be in the form of spermicide, condom, diaphram, cervical cap, and others.

condoms and spermicide
Use of condoms and spermicide protects against unwanted pregnancy even more.

Spermicide when used alone without a condom, other barrier, or hormonal method is about 80% effective. Spermicides do what this sounds like, essentially killing or immobilizing the sperm. It is important for men and women who use spermicides to test different brands. Some people are allergic to some spermicides, which can lead to unpleasant side effects like a rash and itching. If you have a bad reaction to a spermicide, or if you do not know if the reaction is from the spermicide or is an STD, see your doctor. Spermicides DO NOT protect against STDs.

Continuing with the barrier methods, there are male and female condoms, diaphragm, the sponge (although this goes on and off the American market), vaginal suppositories, foams, jellies, and creams. The suppositories, foams, jellies, and creams are all spermicides inserted into the vagina before having intercourse. The sponge should be used with these as well. The spermicides need to be in place about twenty minutes before intercourse, although the sponge can be inserted up to 24 hours prior. These spermicides should be used with condoms, because they are not very effective alone. Unless you are using the sponge, which is effective for repeated acts of intercourse, you should reapply the spermicides before each additional act of intercourse.

Male condoms are usually made of latex, polyurethane, or natural membrane (from sheep intestines). This is one of two methods of birth control that can also protect against STDs. The male condom fits over the penis, and when used properly is about 97% effective at protecting against unwanted pregnancy. It is important to use lubrication (although not an oil-based lubricant as this will break down the condom!) when using condoms. Many condoms also come with a spermicide already in the condom to act as a back-up method. Again, make sure you and your partner are not allergic to either the spermicides or the lubricants. As with all birth control methods, the effectiveness of condoms to protect against pregnancy and STDs relies entirely on the user. If condoms are not stored, put on, nor removed correctly this can lead to unwanted results. Condoms should not be exposed to extreme temperatures and should not be carried in a wallet or other space where the packaging could rub against the condom, causing tears.

Female condoms are not as popular as male condoms and are about 80% effective at reducing unwanted pregnancy. Female condoms can also protect against STDs. The female condom looks like a larger version of a male condom, but is worn inside the vagina. There is a ring at the base that is worn outside of the vaginal opening, covering the labia, while another ring at the other end fits loosely against the cervix, much like a diaphragm. The female condom fits the contours of the vagina, allowing the penis to move freely in and out of the sheath. Again, a water-based lubricant is encouraged. The female condom can be inserted awhile before sexual activity and does not need to be removed immediately after intercourse.

Other barrier methods include the diaphragm, cervical cap, FemCap, and Lea’s Shield. These methods, when used with spermicide, range in effectiveness from about 88% for a diaphragm to about 60% for a cervical cap. Most of this variance is due to the products being misused, either because they were not inserted correctly, not enough spermicide was used, or other factors. This does not mean that these barrier methods should not be used, especially if also used with spermicide and condoms. These methods can protect against unwanted pregnancy, but not STDs.

Part two of Birth Control Methods and Effectiveness will discuss hormonal methods of birth control.

Some information provided in this series comes from the textbook Our Sexuality, by Robert Crooks and Karla Baur.


Author: Leslie Carol Botha

Author, publisher, radio talk show host and internationally recognized expert on women's hormone cycles. Social/political activist on Gardasil the HPV vaccine for adolescent girls. Co-author of "Understanding Your Mood, Mind and Hormone Cycle." Honorary advisory board member for the Foundation for the Study of Cycles and member of the Society for Menstrual Cycle Research.