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Sexual Health

Contraceptives

This page explains the pros/cons and costs with all types of contraception. Take a look and consider the questions below before selecting a method.

SHS also carries emergency contraception (morning after pill). Plan B emergency contraception is now available without a prescription. You may purchase this at the Westlawn Pharmacy at Student Health. You need to bring an ID with proof that verifies you are 18 or older. Students who are under 18 must make an appointment with a provider to obtain a written prescription.

Questions to consider when choosing a contraceptive:

• What are the health risks?
• What are the costs (up front, for follow up, for supplies, etc.)?
• How frequently do you have intercourse?
• How effective is the method?
• How does the method affect possible future pregnancy?
• How effective is the method in preventing STI (sexually transmitted infections)?
• Does the method interrupt intercourse?
• How easy is it to use?
• How easy is it for you to remember to use the method?
• Do you need your partner's cooperation to use it?
• Is this method embarrassing to either partner?
• Does it make menstrual periods more difficult?
• Does it cause you to enjoy sex less?

BEHAVIORAL METHODS

Effectiveness: 100%

Approximate cost: Free

How it works: When used to prevent pregnancy, no vaginal intercourse. Abstinence has many different definitions; from a 'safer sex' perspective, it should include no contact with bodily fluids whatsoever, i.e. no anal sex, no oral sex, etc.

Pros	Cons
Does not affect future fertility No side effects Free	Difficult to maintain Range of definitions Still can be exposed to sexually transmitted infections (STI), unless no contact with other bodily fluids

HORMONAL METHODS

Effectiveness: 92-99.7%

Approximate cost: $18-60 per pack at Student Health Service (SHS)

How it works:

• Oral pill taken every day
• Blocks egg production
• Thickens cervical membrane
• Prevents egg implantation

Precautions:

• Pill must be taken at the same time every day
• Avoid smoking
• Pill may be less effective when taken with other medications, be sure to let every provider you see know you are taking a birth control pill
• Do not take while breast feeding or if you think you may be pregnant

Pros	Cons
Regular periods May protect against uterine and ovarian cancers Easy to use Does not interrupt sex No harm to future pregnancy May reduce acne Decreased menstrual cramps and pain Decreased risk of Pelvic Inflammatory Disease (PID) Effective six days after first pill is taken	No sexually transmitted infection (STI) protection Can interact with antibiotics and other drugs Must be taken daily Some side effects may occur during the first month Requires a prescription Increased risk for blood clots in legs

Effectiveness: 92-99%

Approximate costs: $55-60 per month - includes 3 patches, one for each week

How it works:

• Topical patch placed on skins surface which releases hormones to be absorbed through the skin
• Patch in place for one week
• Same as pill - blocks egg production, thickens cervical membrane, prevents egg implantation

Precautions:

• Avoid smoking
• Do not use if breast feeding or if you think you may be pregnant
• May be less effective in women who weigh more than 198 lbs.
• Place patch in a different spot on skin each time to avoid skin irritation
• Do not use creams, oils, powder, or make-up to area where patch is
• May fall off
• Effects can be compromised when taking other medications, be sure to tell all other medical providers that you are on the patch

Pros	Cons
Effective for next menstrual cycle Regular periods Does not interrupt sex Easy to use Does not have to be taken daily Waterproof May reduce acne	Must be changed every week Can leave sticky residue Prescription required No STI protection Increased risk for blood clots in legs Exposes users to higher levels of estrogen than oral contraceptives

Effectiveness: 97-99.7%

Approximate costs: $75-100

How it works:

• Hormonal shot given every 12 weeks
• Blocks egg production
• Thickens cervical mucus
• Prevents egg implantation

Precautions:

• Using this method for long term protection (>5 years) may result in significant bone density loss, only use this method if other options are inadequate. FDA recommends this method be used for no more than 2 years
• Must take calcium supplements to lessen effects to bone density
• Avoid smoking
• Do not take if you think you may be pregnant

Pros	Cons
Effective 24 hours after first injection No daily pill Can be used when breast feeding Can be used by some women who cannot use the pill Effective for 13 weeks Does not interrupt sex Decreases risk for ovarian and endometrial cancers Prevention of endometriosis (disease of uterine lining)	May cause a 6-18 month delay in future pregnancy Causes loss of bone density which may lead to osteoporosis Irregular bleeding, possible cessation of periods Weight gain No immediate discontinuation Depression No STI protection Requires a clinic visit every 11-13 weeks

 

Effectiveness: 99%

Approximate cost: $800+

How it works:

• Soft, flexible tube (2 inches) inserted below skin on the inside of the arm
• Releases steady dose of progestin, which prevents release of eggs
• Lasts 3 years

Precautions:

• Less effective for women overweight or who are taking certain medications
• A backup form of contraception should be used the first 7 days after insertion
  

 

Pros	Cons
Good for up to 3 years Requires no daily attention Does not interrupt sex Fertility usually returns quickly once it is removed	Initial expense is high No STI protection Insertion/removal must be done by a physician May experience irregular bleeding

 

Effectiveness: 69-85%

Approximate cost: $25-35 for one pack (2 pills)

How it works:

• Pills taken within 72 hours of sexual act
• Prevents ovulation
• Disrupts fertilization of egg
• Inhibits implantation

Side effects including: breast tenderness, irregular bleeding, dizziness, and headaches

Precautions:

• First dose must be taken within 72 hours and second dose 12 hours after that
• Do not take if you think you may be pregnant or are breast feeding
• May need to take an anti-nausea medicine
• Next menstrual cycle may be different (heavier, different time, etc.)
• Not as effective as consistent forms of birth control
• Frequent use may cause irregular periods

Pros	Cons
Can be used if regular form of birth control fails Available without a prescription Does not prevent future pregnancy Regular birth control pills can be used when taken in different dosages (contact doctor)	No STI protection Not intended for long term, ongoing pregnancy prevention Nausea May fail if pregnancy has already occurred

INTRAUTERINE DEVICE (IUD)

Effectiveness: 99.2-99.9%

Approximate cost: $400 - 900

How it works:

• Small plastic device inserted in uterus; some methods also release the hormone progestin
• Prevents sperm from fertilizing the egg
• Prevents egg implantation

Precautions:

• Must check the device regularly to ensure the device is in place
• Avoid smoking
• Be sure to do monthly breast checks for lumps
• Do not take if you may be pregnant
• Can be expelled

Pros	Cons
Effective immediately after insertion Does not interrupt sex May reduce menstrual cramping Good for up to 10 years Requires no daily attention Neither partner should feel the device during intercourse	Possible risk to future fertility Spotting Heavier, longer periods May lead to infections No STI protection May increase chance of getting pelvic inflammatory disease (PID) Insertion and removal must be done by a physician

BARRIER METHODS

Effectiveness: 84-91% (Cervical Cap); 86-91% (Diaphragm)

Approximate cost: $125-150

How they work:

• Placed in vagina covering the cervix
• Barrier

Precautions:

• Must be left in for 8 hours after intercourse
• Use with a spermicide cream or jelly
• A new diaphragm is needed every 2 years
• Do not douche or use oil based lubricants
• Wash device thoroughly after each use
• If multiple sex acts occur in 6 to 8 hours, re-apply lubricant

Note: the cervical cap has recently lost its US manufacturer and may be difficult to obtain. SHS no longer fits cervical caps.

Pros	Cons
May be inserted up to 2 hours before intercourse No serious side effects Some STI protection Does not interfere with future pregnancy Generally cannot be felt by either partner during intercourse	Can be dislodged during intercourse Must be professionally fitted, fit must be checked every 1-2 years Requires a prescription Can be messy Allergic reactions Cannot use during menstruation or infection No sexually transmitted infection protection Anatomical variations make use difficult or impossible Increased risk for urinary tract infections

Effectiveness: 91-98%

Approximate cost: $11-35 for boxes of 3 to 12

How it works:

• Soft polyurethane foam shaped like a cervical cap
• Spermicide infused which is activated by dampening sponge
• Kills sperm on contact
• Barrier

Precautions:

• Sponge must remain in place for six hours after intercourse
• Do not use while menstruating
• Do not re-use a sponge

Pros	Cons
No prescription needed Can be inserted in advance, no interruption to intercourse One size fits all Can stay in for 24 hours No need to change or add spermicide in between multiple sex acts	No STI protection May shift during intercourse May aggravate urinary tract Increased risk of yeast infections and toxic shock syndrome May cause irritation due to the spermicide

Effectiveness: 79-95%

Approximate cost: $10-20 for boxes of 3 and 5

How it works:

• Worn inside vagina, bottom ring on outside of body
• Barrier

Precautions:

• Do not use male and female condom at the same time
• Use a water based lubricant
• May want to use spermicide
• Do not re-use a female condom
• Store condoms at room temperature in a place where they will not become punctured (you may want to avoid your purse if you keep pens, safety pins, or other sharp objects in it)

Pros	Cons
No prescription needed Does not effect future fertility Can be used by those with latex sensitivity (it's plastic) Stronger than latex Can be used during oral sex for STI protection - placement is different Can be inserted up to 8 hours before intercourse	Noticeable during sex May be difficult to insert Can break or leak if precautions are not taken Expensive Not as readily available as the male condom

Effectiveness 85-98% effective

Approximate cost: Available free at Student Health Service; (prices range a lot for different brands, types, if purchasing OTC).

How it works:

• Fits over penis
• Keeps sperm from entering vagina
• Barrier

Precautions:

• Do not use a male condom and a female condom at the same time
• Use a water based lubricant
• May want to use a spermicide
• Store at room temperature, avoid heat and sunlight
• Keep in a place where package will not become punctured
• Do not re-use a male condom

Pros	Cons
No prescription needed Easy to carry Readily available STI protection Does not affect future pregnancy Can be used for dental dam - placement is different Only reversible birth control method for men May decrease woman's risk of developing pre-cancerous cells on her cervix Can and should be used for anal sex Can be helpful for premature ejaculation	Reduced sensitivity Can break or leak if precautions are not taken Allergic reaction Interruption to intercourse

Page updated: 7/08/08

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The University of Iowa
Iowa City, Iowa 52242-1100
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