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Online Pharmacy > Prescription Drugs & Medications > by Category > Birth Control
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Updated December 2003
The Food and Drug Administration has approved a number of birth control methods. The choice of birth control depends on factors such as a person's health, frequency of sexual activity, number of sexual partners, and desire to have children in the future. Failure rates, based on statistical estimates, are another key factor. The most effective way to avoid both pregnancy and sexually transmitted disease is to practice total abstinence (refrain from sexual contact).
Failure Rates in this chart are based on information from clinical trials submitted to the FDA during product reviews. This number represents the percentage of women who become pregnant during the first year of use of a birth control method. For methods that the FDA does not review, such as periodic abstinence, numbers are estimated from published literature. For comparison, about 85 out of 100 sexually active women who wish to become pregnant would be expected to become pregnant in a year.
Serious medical risks from contraceptives, such as stroke related to oral contraceptives, are relatively rare. This chart is a summary of important information, including risks, about drugs and devices approved by the FDA for contraception and sterilization. It is not intended to be used alone, and a health professional should be consulted regarding any contraceptive choice. Review product labeling carefully for more information on use of these products.
FDA Approval Date: Latex: Use started before
premarket approval was required. Polyurethane: cleared in 1989;
available starting 1995.
Description: A sheath placed over the erect
penis blocking the passage of sperm.
Failure Rate (number of pregnancies expected per
100 women per year): 11 (a, b)
Some Risks: Irritation and allergic reactions (less
likely with polyurethane)
Protection from Sexually Transmitted Diseases (STDs):
Except for abstinence, latex condoms are the best protection
against STDs, including gonorrhea and AIDS.
Convenience: Applied immediately before
intercourse; used only once and discarded. Polyurethane condoms
are available for those with latex sensitivity.
Availability: Nonprescription
FDA Approval Date: 1993
Description: A lubricated polyurethane sheath
shaped similarly to the male condom. The closed end has a
flexible ring that is inserted into the vagina.
Failure Rate (number of pregnancies expected per
100 women per year): 21
Some Risks: Irritation and allergic reactions
Protection from Sexually Transmitted Diseases (STDs):
May give some STD protection; not as effective as latex condom
Convenience: Applied immediately before
intercourse; used only once and discarded.
Availability: Nonprescription
FDA Approval Date: Use started before
premarket approval was required.
Description: A dome-shaped rubber disk with a
flexible rim that covers the cervix so that sperm cannot reach
the uterus. A spermicide is applied to the diaphragm before
insertion.
Failure Rate (number of pregnancies expected per
100 women per year): 17 (b, d, e)
Some Risks: Irritation and allergic reactions,
urinary tract infection. (c) Risk of toxic shock syndrome, a rare
but serious infection, when kept in place longer than recommended.
Protection from Sexually Transmitted Diseases (STDs):
None
Convenience: Inserted before intercourse and
left in place at least six hours after; can be left in place for
24 hours, with additional spermicide for repeated intercourse.
Availability: Prescription
FDA Approval Date: 2002
Description: A dome-shaped rubber disk with a
valve and a loop that is held in place by the vaginal wall.
Covers the upper vagina and cervix so that sperm cannot reach the
uterus. Spermicide is applied before insertion.
Failure Rate (number of pregnancies expected per
100 women per year): 15
Some Risks: Skin irritation, spotting,
discomfort (female and male partners), urinary tract infection.
Theoretical risk of toxic shock syndrome.
Protection from Sexually Transmitted Diseases (STDs):
None
Convenience: Inserted before intercourse and
left in place at least 8 hours after; can be left in place for up
to 48 hours, with additional spermicide for repeated intercourse.
Availability: Prescription
FDA Approval Date: Prentiff Cap--1988; FemCap--2003
Description: A soft rubber cup with a round rim,
which fits snugly around the cervix.
Failure Rate (number of pregnancies expected per
100 women per year): Prentiff Cap--17; FemCap--23 (b, d, e)
Some Risks: Irritation and allergic reactions,
abnormal Pap test. (c) Risk of toxic shock syndrome, a rare but
serious infection, when kept in place longer than recommended.
Protection from Sexually Transmitted Diseases (STDs):
None
Convenience: May be difficult to insert; can
remain in place for 48 hours without reapplying spermicide for
repeated intercourse.
Availability: Prescription
FDA Approval Date: 1983 (Not currently
marketed)
Description: A disk-shaped polyurethane device
containing the spermicide nonoxynol-9.
Failure Rate (number of pregnancies expected per
100 women per year): 14-28 (d, e)
Some Risks: Irritation and allergic reactions,
difficulty in removal. (c) Risk of toxic shock syndrome, a rare
but serious infection, when kept in place longer than recommended.
Protection from Sexually Transmitted Diseases (STDs):
None
Convenience: Inserted before intercourse and
protects for repeated acts of intercourse for 24 hours without
additional spermicide; must be left in place for at least six
hours after intercourse; must be removed within 30 hours of
insertion. Is discarded after use.
Availability: Nonprescription; not currently
marketed
FDA Approval Date: Use started before
premarket approval was required. Since November 2002, only one
active ingredient has been allowed.
Description: A foam, cream, jelly, film,
suppository, or tablet that contains nonoxynol-9, a sperm-killing
chemical
Failure Rate (number of pregnancies expected per
100 women per year): 20-50 (studies have shown varying
effectiveness rates)
Some Risks: Irritation and allergic reactions,
urinary tract infections (c)
Protection from Sexually Transmitted Diseases (STDs):
None
Convenience: Instructions vary; check labeling.
Inserted between 5 and 90 minutes before intercourse and usually
left in place at least six to eight hours after.
Availability: Nonprescription
FDA Approval Date: First in 1960; most recent
in 2003
Description: A pill that suppresses ovulation by
the combined actions of the hormones estrogen and progestin. A
chewable form was approved in November 2003.
Failure Rate (number of pregnancies expected per
100 women per year): 1-2
Some Risks: Dizziness; nausea; changes in
menstruation, mood, and weight; rarely, cardiovascular disease,
including high blood pressure, blood clots, heart attack, and
strokes
Protection from Sexually Transmitted Diseases (STDs):
None
Convenience: Must be taken on daily schedule,
regardless of frequency of intercourse. Women using the chewable
tablet must drink 8 oz. of liquid immediately after taking.
Availability: Prescription
Brand names: Alesse®, Apri®, Aviane®,
Brevicon®, Demulen®, Desogen®, Estrostep®, Genora®, Jenest®,
Levlen®, Levlite®, Levora®, Lo/Ovral®, Loestrin®, Low-Ogestrel®,
Microgestin®, Mircette®, Modicon®, Necon®, Norinyl®,
Nordette®, Nortrel®, Ogestrel®, Ortho-Cept®, Ortho-Cyclen®,
Ortho-Novum®, Ortho Tri-Cyclen®, Ovcon®, Ovral®, Tri-Levlen®,
Tri-Norinyl®, Triphasil®, Trivora®, Yasmin®, Zovia®.
Generic names / chemical substances: ethinyl
estradiol and drospirenone, ethinyl estradiol and ethynodiol,
ethinyl estradiol and desogestrel, ethinyl estradiol and
norethindrone, ethinyl estradiol and norgestimate, mestranol and
norethindrone, ethinyl estradiol and levonorgestrel, ethinyl
estradiol and norgestrel.
FDA Approval Date: 1973
Description: A pill containing only the hormone
progestin that reduces and thickens cervical mucus to prevent the
sperm from reaching the egg.
Failure Rate (number of pregnancies expected per
100 women per year): 2
Some Risks: Irregular bleeding, weight gain,
breast tenderness, less protection against ectopic pregnancy
Protection from Sexually Transmitted Diseases (STDs):
None
Convenience: Must be taken on daily schedule,
regardless of frequency of intercourse.
Availability: Prescription
Brand names: Nor-QD®, Ortho Micronor®,
Ovrette®,
Generic names / chemical substances: norethindrone,
norgestrel, POP (progestogen-only Pill).
FDA Approval Date: 2003
Description: A pill containing estrogen and
progestin, taken in 3-month cycles of 12 weeks of active pills
followed by one week of inactive pills. Menstrual periods occur
during the 13th week of the cycle.
Failure Rate (number of pregnancies expected per
100 women per year): 1-2
Some Risks: Similar to oral contraceptives--combined
pill
Protection from Sexually Transmitted Diseases (STDs):
None
Convenience: Must be taken on daily schedule,
regardless of frequency of intercourse. Since users will have
fewer periods, they should consider the possibility that they
might be pregnant if they miss scheduled periods. May have more
unplanned bleeding and spotting between periods than with 28-day
oral contraceptives.
Availability: Prescription
Brand names: Seasonale®
FDA Approval Date: 2001
Description: Skin patch worn on the lower
abdomen, buttocks, or upper body that releases the hormones
progestin and estrogen into the bloodstream.
Failure Rate (number of pregnancies expected per
100 women per year): 1-2 (Appears to be less effective in women
weighing more than 198 pounds.)
Some Risks: Similar to oral contraceptives--combined
pill
Protection from Sexually Transmitted Diseases (STDs):
None
Convenience: New patch is applied once a week
for three weeks. Patch is not worn during the fourth week, and
woman has a menstrual period.
Availability: Prescription
Brand names: Ortho Evra patch®
FDA Approval Date: 2001
Description: A flexible ring about 2 inches in
diameter that is inserted into the vagina and releases the
hormones progestin and estrogen.
Failure Rate (number of pregnancies expected per
100 women per year): 1-2
Some Risks: Vaginal discharge, vaginitis,
irritation. Similar to oral contraceptives--combined pill
Protection from Sexually Transmitted Diseases (STDs):
None
Convenience: Inserted by the woman; remains in
the vagina for 3 weeks, then is removed for 1 week. If ring is
expelled and remains out for more than 3 hours, another birth
control method must be used until ring has been used continuously
for 7 days.
Availability: Prescription
FDA Approval Date: 1998-1999
Description: Pills containing either progestin
alone or progestin plus estrogen
Failure Rate (number of pregnancies expected per
100 women per year): Almost 80 percent reduction in risk of
pregnancy for a single act of unprotected sex
Some Risks: Nausea, vomiting, abdominal pain,
fatigue, headache
Protection from Sexually Transmitted Diseases (STDs):
None
Convenience: Must be taken within 72 hours of
having unprotected intercourse.
Availability: Prescription
FDA Approval Date: 1992
Description: An injectable progestin that
inhibits ovulation, prevents sperm from reaching the egg, and
prevents the fertilized egg from implanting in the uterus.
Failure Rate (number of pregnancies expected per
100 women per year): less than 1
Some Risks (serious medical risks from
contraceptives are rare): Irregular bleeding, weight gain, breast
tenderness, headaches
Protection from Sexually Transmitted Diseases (STDs):
None
Convenience: One injection every three months.
Availability: Prescription
FDA Approval Date: 2000
Description: An injectable form of progestin and
estrogen
Failure Rate (number of pregnancies expected per
100 women per year): less than 1
Some Risks: Changes in menstrual cycle, weight
gain. Similar to oral contraceptives--combined.
Protection from Sexually Transmitted Diseases (STDs):
None
Convenience: Injection given once a month.
Availability: Prescription
FDA Approval Date: 1990
Description: Six matchstick-sized rubber rods
that are surgically implanted under the skin of the upper arm,
where they steadily release the contraceptive steroid
levonorgestrel.
Failure Rate (number of pregnancies expected per
100 women per year): less than 1
Some Risks: Irregular bleeding, weight gain,
breast tenderness, headaches, difficulty in removal
Protection from Sexually Transmitted Diseases (STDs):
None
Convenience: Implanted and removed by health-care
provider in minor outpatient surgical procedure; effective for up
to five years.
Availability: Prescription. In July 2002,
Norplant's manufacturer announced that it will no longer
distribute the Norplant system. Women using the system should
contact their doctors about what their contraceptive options will
be after the five-year expiration date of their Norplant systems.
FDA Approval Date: 1976 (f)
Description: A T-shaped device inserted into the
uterus by a health professional.
Failure Rate (number of pregnancies expected per
100 women per year): less than 1
Some Risks: Cramps, bleeding, pelvic
inflammatory disease, infertility, perforation of uterus
Protection from Sexually Transmitted Diseases (STDs):
None
Convenience: After insertion by physician, can
remain in place for up to one or 10 years, depending on type.
Availability: Prescription
FDA Approval Date: N/A
Description: To deliberately refrain from having
sexual intercourse during times when pregnancy is more likely.
Failure Rate (number of pregnancies expected per
100 women per year): 20
Some Risks: None
Protection from Sexually Transmitted Diseases (STDs):
None
Convenience: Requires frequent monitoring of
body functions (for example, body temperature for one method).
Availability: Instructions from health-care
provider
FDA Approval Date: Early 1970s (g)
Description: The woman's fallopian tubes are
blocked so the egg and sperm can't meet in the fallopian tube,
preventing conception. (h)
Failure Rate (number of pregnancies expected per
100 women per year): less than 1
Some Risks: Pain, bleeding, infection, other
post-surgical complications, ectopic (tubal) pregnancy.
Protection from Sexually Transmitted Diseases (STDs):
None
Convenience: One-time surgical procedure that
requires an abdominal incision.
Availability: Surgery
FDA Approval Date: 2002
Description: Small metallic implant that is
placed into the fallopian tubes. The device works by causing scar
tissue to form, blocking the fallopian tubes and preventing
conception. (h)
Failure Rate (number of pregnancies expected per
100 women per year): less than 1
Some Risks: Mild to moderate pain after
insertion, ectopic (tubal) pregnancy.
Protection from Sexually Transmitted Diseases (STDs):
None
Convenience: Minor surgical procedure, permanent
sterilization. Device is inserted through the vagina using a
catheter. Women must rely on another birth control method during
the first three months, until placement is confirmed with an X-ray
procedure.
Availability: Prescription
FDA Approval Date: N/A
Description: Sealing, tying, or cutting a man's
vas deferens so that the sperm can't travel from the testicles to
the penis. (h)
Failure Rate (number of pregnancies expected per
100 women per year): less than 1
Some Risks (serious medical risks from
contraceptives are rare): Pain, bleeding, infection, other minor
postsurgical complications
Protection from Sexually Transmitted Diseases (STDs):
None
Convenience: One-time surgical procedure.
Availability: Surgery
(a) Projected from six-month study and adjusted for use of emergency contraception.
(b) If spermicides are used with barrier methods, be sure that the spermicide is compatible with the condom or diaphragm (won't cause it to weaken or break). Oil-based lubricants (such as petroleum jelly or baby oil) will cause latex to weaken and should not be used with these methods.
(c) Spermicides used alone, with barrier devices, or with condoms can cause irritation to the skin lining the vagina, especially when the spermicide is used frequently. There is a possibility that spermicide might increase the risk of acquiring some sexually transmitted diseases because of disruption of the vaginal skin. Spermicide has not been proven to be effective against bacteria and viruses in people. Therefore, there is no reason to use spermicide during pregnancy.
(d) Medications for vaginal yeast infections may decrease effectiveness of spermicides.
(e) Less effective for women who have had a baby because the birth process stretches the vagina and cervix, making it more difficult to achieve a proper fit.
(f) First approval date of currently marketed IUDs. Some IUDs were sold before premarket approval was required. Those products are no longer on the market.
(g) Sold before premarket approval was required (1976).
(h) A contraceptive option for people who don't want children. Considered permanent because reversal is typically unsuccessful.
(Source: Food and Drug Administration 12/03: www.fda.gov)
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