• What is it?

An IUD is a small, soft, T-shaped device made of plastic or metal with a string attached. A healthcare professional put the IUD in the uterus (womb) to prevent pregnancy by stopping the egg and sperm from meeting. There are two types of IUD (copper and hormonal). They work in different ways to help prevent pregnancy.

• Hormonal IUD or IUS

The IUS thickens the mucus in the cervix, making it harder for the sperm to get to the egg and thins the uterus lining. This makes it less likely that a fertilized egg will attach to it. It also may stop the ovaries from releasing an egg. The IUD can help prevent pregnancy for 3 to 5 years.

• Copper IUD

This IUD has a copper wire wrapped around it. It changes the lining of the uterus so that if an egg is fertilized, it’s less likely to attach to it and slows the sperm movement, so it is harder to get to the egg. Depending on the type of copper IUD, it can help prevent pregnancy for up to 10 years.

• How to use it?

Your gynecologist inserts an IUD. The best time to have an IUD inserted is during your period, as this is when your cervix is most open. The whole procedure takes less than five minutes. Some women usually choose to take over-the-counter pain medication (ibuprofen) before the procedure since the insertion may cause some mild cramping.

You must check to see if the string is in the right place every month. Your healthcare provider will teach you how to feel for the strings when inserted.

The copper IUD protects you from pregnancy as soon as it is inserted. If your hormonal IUD is inserted on days 1 to 7 of your period, it works right away to prevent pregnancy, but if it is on any other day, you need an extra form of birth control (e.g., condoms, abstinence) for seven days.

Once inserted, an IUD can be removed on request or at the time of expiration, approximately 3 to 10 years later. Removal takes about two to three minutes by your gynecologist. You may experience some normal cramping and bleeding as a result, but this should go away quickly.

• Advantages

• They’re predominantly hassle-free. You do not have to remember to do anything or take any birth control medicines regularly. It can help prevent pregnancy for 3 to 10 years (depending on the type).
• IUDs do not contain estrogen, a hormone that some women can’t take
• If you decide to get pregnant, you can have the IUD taken out.
• If you use an IUD for several years, it costs less overall than many other types of birth control. That’s because there are no costs after you have it inserted.
• They’re safe to use if you’re breastfeeding

• The copper IUD can be used as emergency contraception (EC) for seven days after unprotected sex or contraceptive failure.
• The copper IUD may lower your risk of cancer of the uterus.

• What it doesn’t protect you from

• An IUD doesn’t protect you from sexually transmitted infections (STIs) and HIV.

• Common Side Effects

• Irregular periods (spotting, heavier or longer periods) 
• Pain when your IUD is put in and cramping, or backaches for a few days after
• More cramping during your periods (Copper IUD)

• Effective level (used properly and not) / Failure rate

• IUDs are so effective because there’s no chance of making a mistake.  The copper IUD is 99.2% effective in preventing pregnancy. The hormonal IUD is more than 99% effective in preventing pregnancy.

• Who can’t use it?

• You can’t use a copper IUD if you have an allergy to copper
• You can’t use a hormonal IUD if you have liver disease or breast cancer
• You can’t use an IUD if you have an STD, have a recent pelvic infection, are pregnant, have a cervix or uterus cancer, or have unexplained vaginal bleeding.

• What to do if it falls out?

The IUD rarely falls out. It usually happens when a woman is on her period during the first three months after getting the IUD or if her flow is heavy. Another reason could be because of a small uterus. This typically includes women who are under 20 or have never been pregnant. 

An IUD can come out partially without falling out completely. If this happens, it will need to be removed since it can not prevent pregnancy in this state. Another possibility is a perforation (stabbing) through the uterus (womb), which must be surgically removed. If this happens, you need to see your doctor and not have sex without utilizing another form of birth control.

• Where to find it?

What is it?

Contraceptive implants are a long-term birth control option: a flexible plastic rod about the size of a matchstick placed under the skin of the upper arm. The implant releases a low, steady hormone dose to prevent the sperm from reaching the egg and typically suppress ovulation.

How to use it?

You must see your doctor to get an implant. After conducting a physical exam, the implant will be inserted under the skin of your upper arm and can stay in place for up to three years. Implant insertions take just a few minutes. They’re done with a local anesthetic, which makes the procedure painless.

After insertion, you will have a small bandage covering the insertion site. Some bruising, scarring, pain, or bleeding at the insertion site may occur after the procedure.

If you get the implant during the first five days of your period, it’s immediately effective, but if the implant is inserted at any other point, you should use a backup form of birth control for seven days.

Advantages

You do not need to worry about birth control for three years

If you want to get pregnant, you can be fertile as soon as it is removed 

It is appropriate for women who can’t use birth control containing estrogen

Almost anyone, at any age, can have an implant

What it doesn’t protect you from

no protection against sexually transmitted infections (STIs)

Common side effects

Abdominal or back pain

Changes in vaginal bleeding patterns, including the absence of menstruation

Decreased sex drive

Headaches

Mood swings and depression

Nausea or upset stomach

Potential interaction with other medications

Sore breasts

Vaginal inflammation or dryness

Weight gain

Effective level (used properly and not) / Failure rate

It is one of the highest levels of effectiveness of all contraceptives and has a more than 99% effectiveness rate

 Who can’t use it?

If you are:

allergic to any components of the implant

have had severe blood clots, a heart attack, or a stroke

have liver tumors or liver disease

have known or suspected breast cancer or a history of breast cancer

have undiagnosed abnormal genital bleeding

taking some medications that might counteract the implant (talk to your healthcare provider)

What if I’m late?

If you have forgotten to replace the implant after three years, use condoms until it is replaced.

Where to find it?

Injectable Birth control

What is it?

Injectable contraceptives are long-term hormonal birth control available in a progestin-only form and hormones combined with progestin and estrogen hormones. 

Combined injectable contraceptives (CICs) are a form of hormonal birth control consisting of monthly injections of combined formulations containing estrogen and progestin to stop the release of an egg each month and prevent pregnancy. It also makes it difficult for sperm to move through the cervix.

How to use it?

Injectables are prescribed by a doctor and administered only four times a year. The first shot should be given during the first five days of a regular menstrual cycle and should be administered differently after labor and during the period of breastfeeding. The drug is given in the buttocks or the upper arm. You have to remember to get a new shot every three months to get its full effects.

If you get your first injection during the first 5 days of your period, it takes 24 hours to become effective, but if it is at any other time, you need to use an extra form of birth control for 7 days. 

Advantages

it doesn’t interrupt sex

it’s an option if you can’t use estrogen-based contraception

you don’t have to remember to take it every day

it’s safe to use while you’re breastfeeding

it’s not affected by other medicines

it may reduce heavy, painful periods and help with premenstrual symptoms for some women

many of the symptoms  usually go away after 2 or 3 months

Though the return of fertility is a bit delayed and that too more with DMPA but more than 80% of women conceive within 1 year after stopping the contraceptive measures.

What it doesn’t protect you from

Injectable contraception does not protect against sexually transmitted diseases and HIV.

Common side effects

Mild Headaches

Acne

Mood Swings

Irregular Periods

Depression

Tender Breasts

Less Interest In Sex

Upset Stomach (Nausea)

Weight Gain

Brittle Bones

Bloating

Effective level (used properly and not) / Failure rate

With perfect use (this means you follow the exact directions all the time), the injection is 99.8% effective, and with typical use (this means not following the exact directions), the injection is 94% effective

Who can’t use it?

It is less effective on women who are obese. 

It is not recommended for women with unexplained vaginal bleeding, liver disease, breast cancer, and blood clots.

What if I miss or I’m late for my injection?

If your last injection was 13 to 14 weeks ago, you should still be protected from pregnancy. You need to have your injection right away before 14 weeks have passed.

If your last injection was over 14 weeks ago, use a backup form of birth control and see your healthcare provider right away for your next injection. If you’ve had unprotected sex, you need to get emergency contraception.

Where to find it?

Progestin-only Pills (POPs)

What is it?

The progestin-only pill (POP) is a type of birth control pill often called the “Mini-Pill” because it doesn’t contain estrogen and comes in a pack of 28 pills. Progestin is a female hormone that works by preventing the release of eggs from the ovaries and changing the cervical mucus and the lining of the uterus.

Young and adult women who can’t take estrogen due to an underlying medical condition, sensitivity, or an unwanted side effect are prescribed this pill. They are also used for treating menstrual period problems, cramps, and other conditions.

How to use it?

It is beneficial to take the pill when you start your period or the first Sunday after your period begins. You have to take one pill every day at the same time. Every pill is an “active” pill, meaning that all the pills contain progestin, unlike combination pill packs with inactive pills or “placebo” pills in the last row of the pack.  If you’re sexually active, be sure to use a backup barrier method of birth control (condom) for the first 7 days after starting to prevent pregnancy.

There are 2 different types of POP:

3-hour progestogen-only pill (traditional progestogen-only pill) – take within 3 hours of the same time each day

12-hour progestogen-only pill (desogestrel- a synthetic progestogen- progestogen-only pill) – taken within 12 hours of the same time each day

There’s no break between packs of pills – when you finish a pack, you start the next one the next day. Follow the instructions that come with your pill packet – missing pills or taking the pill alongside other medicines can reduce its effectiveness.

Advantages

Can help clear up acne

Doesn’t require surgery

No interruption of foreplay or intercourse

Can be used by women who cannot take estrogen

Can be used by women who are over 35 and smoke

What it doesn’t protect you from

sexually transmitted infections (STIs).

Common side effects

Spotting can last a few days until your body gets used to it or for as long as you are taking it

Not having a period is also common

Acne

Bloating

Weight gain

Headaches

Dizziness

Mood changes

Breast tenderness

Abdominal pain

Nausea

Effective level (used properly and not) / Failure rate

If taken correctly, it’s more than 99% effective.

Who can’t use it?

Pregnant women

If you do not want your periods to change

If you take other medicines that may affect the pill. Talk to your doctor for more information.

Get unexplained bleeding in between periods or after sex

Have developed arterial disease or heart disease or have had a stroke

Have liver disease, severe cirrhosis, or liver tumors

Have breast cancer or have had it in the past

What if I miss or I’m late?

If you’re less than 3 hours (traditional progestogen-only pill) or less than 12 hours (desogestrel progestogen-only pill) late taking the pill, then take the late pill as soon as you remember. Take the pill remaining pills as usual. This might mean that you will have to take 2 pills on the same day. 

The pill will still work, and you’ll be protected against pregnancy – you do not need to use additional contraception. If you are confused about the pills you have missed, keep taking it but don’t have sex or use a backup method of birth control (condom) until you can talk with your health care provider.

If you become sick with vomiting or severe diarrhea within three hours after taking it, keep taking the Pill every day. Do not have sex or use a backup method (condom) until 2 days after the vomiting has stopped. If you have very severe diarrhea (6 to 8 watery poos in 24 hours), then this might also mean that the pill does not work correctly.

If you missed your pill for 2 days and had unprotected sex, you may need emergency contraception. 

Where to find it?

• What is it?

The pill is a type of birth control, also known as the combined pill or oral contraceptive pill, containing estrogen and progestogen designed to be taken orally every day by women. The pill works by stopping the ovaries from releasing an egg each month and thickens the fluid around the cervix (opening to the uterus or womb) to prevent the sperm from entering. 

• How to use it?

When you start the pill for the first time or after a break from the pill, it can take up to 12 days to start working to prevent pregnancy. This depends on whether you start with the hormone or sugar /placebo pills. You have to take one pill around the same time every day. 

You will usually have your period while taking the sugar pills. You can skip your period by missing the sugar pills and continuing to take the hormone pills each day. 

• Advantages

• Can be used to skip your period
• Make your periods lighter, more regular, and less painful 
• improve acne
• Reduce your chance of getting cancer of the uterus (womb), ovaries, and bowel 
• Help with symptoms of polycystic ovary syndrome (PCOS) and endometriosis.

• What it doesn’t protect you from

STI protection: No. Use external condoms or internal condoms to help protect yourself from STIs.

• Common side effects

• irregular vaginal bleeding
• nausea 
• sore or tender breasts
• headaches
• bloating 
• acne
• mood changes

• Effective level (used properly and not) / Failure rate

It’s 99% effective at preventing pregnancy with perfect use and 91% effective with typical use

• Who can’t use it?

• If you are a 35-year-old or over smoker or stopped smoking less than a year ago
• you take certain medicines
• you’re breastfeeding a baby less than 6 weeks old
• If you have had heart disease or stroke
• Get regular migraines
• Have breast cancer or have a family history of breast cancer
• you’re immobile for an extended time or use a wheelchair
• you’re at a high altitude (more than 4,500m) for more than a week.

• active disease of the liver or gallbladder
• diabetes with complications

If you’re healthy, don’t smoke, and there are no medical reasons for you not to take the pill, you can use it until you’re 50 years old. You’ll then need to change to another method of contraception.

• What if I miss or I’m late?

• If you missed 1 active (hormonal) pill or started a pack 1 day late, take an active (hormonal) pill as soon as possible and then continue taking pills daily. If you missed the pills during the first week and had unprotected sex, you should use emergency contraception for maximum protection, in addition to taking today’s active birth control pill.

• If you missed 2 or more active (hormonal) pills or started a pack 2 or more days late, take 2 active (hormonal) pills as soon as possible and then continue taking pills daily. You may take one at the moment of remembering, and the other at the regular time, or both at the same time. Use condoms or abstain from sex until you have taken active (hormonal) pills for 7 days in a row.

• If you missed the pills in the third week of the pack, you should continue taking the active (hormonal) pills in your current pack daily. After taking all the active pills, discard the pack without taking the 7 inactive pills and begin a new pack the next day.

• If you missed any inactive (non-hormonal) pills, discard the missed inactive (non-hormonal) pill(s) and continue as scheduled. 

• Where to find it?

• • What is it?

  The contraceptive patch is a very thin and smooth adhesive tape securely attached to your skin. It is attached to an easily reachable area of your body, such as the lower abdomen, buttock, shoulder blade, or the outer part of the shoulder.

  The patch contains a combination of hormones, which stops ovulation and thickens the cervical mucus, making it less permeable for the sperm.  Hormones are absorbed into the blood through the skin, bypassing the stomach, so this method is suitable for people suffering from gastrointestinal diseases. It doesn’t interfere with daily activities, and it doesn’t come off upon contact with water.

  • How to use it?

  The patch needs to be removed and changed every week for 3 weeks. After three patches, you will have a patch-free week which allows you to have your period.

  The contraceptive patch should be applied to clean, dry, non-hairy skin. Do not use any lotions, make-up, creams, powders, or anything else on the area of the skin before you apply the patch. These can interfere with the patch’s stickiness and make it more likely to fall off. Do not use on areas of skin that are irritated or broken. 

  Each time you change your patch, you should use a different place to avoid skin irritation. You should check each day to ensure that the patch has not fallen off.

  Patches come in a protective pouch and should be kept in the pouch until use. It should be stored at room temperature (not in the fridge or freezer). The used patches should be folded, sticky-side together, before discarding. They should not be flushed down the toilet. 

  You have to keep the patches away from them if you have children since they still contain hormones. Patches should be stored in a child-proof container before being thrown away.

  • Advantages
  • Needs to be applied only once a week
  • Its presence can be verified by sight
  • Does not detach with exposure to water or sweat
  • May improve acne in many cases
  • May improve bone strength due to the estrogen content
  • May reduce the risk of benign breast disease, as well as uterine endometrial and ovarian cancers
  • What it doesn’t protect you from
  • It does not protect against sexually transmitted infections (STIs), including HIV.
  • Common side effects
  • Nausea
  • Breast pain
  • Headache
  • Skin irritation at the patch site
  • Mood changes
  • Changes in menstrual bleeding
  • Weight gain
  • Effective level (used properly and not) / Failure rate

  Despite seeming like nothing more than a piece of bandaid, it is 99.4% effective.

  • Who can’t use it?

  Birth control patches are not recommended for people who weigh more than 90 kg or have a body mass index (BMI) higher than 30 kg/m2. This is because the dosage of medication delivered by the patch can not be adjusted, and therefore there will be the risk of blood clots.

  • What if it falls off?
  • It is unlikely that your contraceptive patch will fall off, as it has been carefully designed to minimize this. If it should become partially detached or fall off, what you should do depends on how long ago it came off.
  • If it was less than 24 hours ago, reattach the same patch in the same location (as long as it is still sticky) or replace it with a new patch.
  • If it was more than 24 hours ago, you must apply a new patch and use a backup birth control method for the first seven days afterward.
  • If it was less than 48 hours, reapply it as quickly as possible if it is still sticky, but if it is not, replace it with a new patch. Do not use anything (such as tape) to try to hold a patch in place that is no longer sticky.
  • If it has been off for 48 hours or longer, or if the time that it has been detached is uncertain: start a whole new patch cycle by applying a new patch as soon as possible. This is now week 1 of the patch cycle. 
  • If you have sex within the following seven days, you need to use additional contraception such as condoms. If you have had sex within the previous five days, you may need to take additional emergency contraception. 
  • If you forget to take the patch off at the end of week 3, take the patch off as soon as possible and apply the next patch on the usual start day of the next patch cycle. This may mean that you do not have a seven-day patch-free break.
  • If you replace the patch with a new one, the day you replace the patch will become the new day of the week you change your patch.
  • Where to find it?

• • What is it?

    The vaginal ring is a soft, flexible piece of plastic that contains synthetic hormones to be absorbed inside the vagina. It is a hormonal method of contraception obtained by prescription. These hormones help regulate your fertility similarly to how natural hormones work.

    How to use it?

    You need a prescription from your healthcare provider and be sure to tell your healthcare provider if you are allergic to any medicine. 

    The device is inserted into your vagina, which remains for three weeks. It is removed during the fourth week to allow your menstrual period to occur. At the end of the fourth week, the process is repeated. The vaginal ring begins to work immediately, but a second form of birth control should be used during the first seven days of your first month’s use of the vaginal ring.

    To insert a vaginal ring: IMAGE

    Find a comfortable position, such as standing with one leg up, squatting, or lying down. Separate your labia with one hand. Squeeze together the opposite sides of the vaginal ring between your thumb and index finger with your other hand.

    Gently push the vaginal ring deep inside your vagina. An applicator, similar to a tampon, can help with insertion. The exact placement of the ring doesn’t change its effectiveness.

    Try pushing the vaginal ring deeper inside your vagina if you feel discomfort.

    Keep the ring in place for three weeks.

    You don’t need to remove the vaginal ring during sex. But if you prefer, you can remove the ring for up to three hours and then reinsert it.

    To remove a vaginal ring: IMAGE

    Hook your index finger under the rim of the ring or grasp the ring between your index finger and middle finger and gently pull it out.

    Discard the used vaginal ring. Don’t flush it down the toilet.

    Wait one week to insert a new ring. Withdrawal bleeding usually begins two to three days after removing the ring. You may still be bleeding when you insert the new ring.

    Advantages

    It only requires the user to change it once a month

    It is a good alternative to contraceptive implants or intrauterine devices

    What it doesn’t protect you from

    The vaginal ring does NOT protect against the transmission of sexually transmitted diseases.

    Common side effects

    Headaches

    Dizziness

    Nausea

    Breast tenderness

    Fatigue

    Moderate weight gain

    Change of appetite

    Breakthrough bleeding or spotting

    Vaginal infection or irritation and increased discharge

    Depression

    Decreased sex drive

    Abdominal pain

    Diarrhea

    An increased risk of blood-clotting problems, heart attack, stroke, liver cancer, gallbladder disease, and toxic shock syndrome

    Effective level (used properly and not) / Failure rate

    If used ideally, the ring is a highly effective form of birth control, but it has a 91% effectiveness rate since humans are prone to errors.

    Who can’t use it?

    Smokers 

    Are older than age 35 and smoke

    Have high blood pressure, diabetes, liver disease, unexplained vaginal bleeding

    Have a history of breast or uterine cancer, blood clots, heart attack, or stroke

    Allergic to hormones or sensitive to any components of the vaginal ring

    Taking certain medications for hepatitis C

    Migraines with aura or, if you’re over age 35, any migraines

    What if it falls out?

    If the vaginal ring accidentally falls out, rinse it with cool or warm — not hot — water and reinsert it within two hours. 

    If the vaginal ring remains outside of your vagina for longer than two hours, reinsert the vaginal ring as soon as possible and use backup contraception for a week if the expulsion occurs during the first or second week of vaginal ring use. 

    Discard the ring if the expulsion occurs during the third week of using the vaginal ring and start using a new ring right away, which might cause breakthrough spotting or bleeding. Use a backup method of contraception until you have used the new ring continuously for seven days.

    Where to find it?

Do NOT use male and female condoms at the same time.

• What is it?

The female condom, also called an internal condom, is a birth control device that acts as a barrier to keep sperm from entering the uterus to prevent pregnancy. It also protects against sexually transmitted infections (STIs).

The female condom is a soft, loose-fitting pouch with a ring on each end. One ring is inserted into the vagina to hold the female condom. The ring at the open end of the condom remains outside the vagina. The outer ring helps keep the condom in place and is also used for removal. The female condom can be used during anal sex, too.

• How to use it? IMAGE

You insert a female condom is similar to putting in a tampon. It may seem a little tricky at first, but all you need is a little practice. Here’s how you do it:

• Be careful not to tear it when you open the package.
• Put the condom in before contact between the penis and vagina or anus.
• Put lubricant on the closed end of the condom.
• Find the most comfortable position to put it in. You may prefer to lie down, squat, or stand with one leg on a chair.
• Squeeze the ring on the closed end of the condom together and insert it in your vagina as far as it will go, just like a tampon. For anal sex, put it as far as it will go.
• Let go of the ring so that it opens and stays in place.
• Let the ring on the other end hang about an inch outside your vagina or bottom.
• Use a new condom every time you have sex.

• Advantages

• Protection from STIs
• Your partner doesn’t need to remove their penis as soon as they ejaculate
• Suitable for people who are allergic to latex
• An erect penis isn’t required to keep it in place
• Can be used or anal sex
• Female condoms also make life easier by allowing you to prepare for sex. You can put one in up to 8 hours in advance. Your partner may also have a more comfortable experience since female condoms can fit various penis sizes. You may also enjoy extra stimulation to your clitoris from the outer ring.

• Common side effects

• If you are allergic to human-made latex, nitrile, or polyurethane
• Discomfort during insertion, a burning sensation, itching, or a rash

• Effective level (used properly and not) / Failure rate

Female condoms work almost as well as male condoms as long as you use them correctly, they are about 95% effective,

• Who can’t use it?

• Are allergic to polyurethane or synthetic latex
• Are at high risk of pregnancy — younger than age 30, have sex three or more times a week, had a previous contraceptive failure with vaginal barrier methods, or not likely to consistently use the female condom
• Aren’t comfortable with the insertion technique
• Have vaginal abnormalities that interfere with the fit, placement, or retention of the female condom

• What if?

• The condom breaks

• The condom slips out of the vagina

• The penis slips between the vagina and the outer surface of the condom

• The outer ring of the condom gets pushed into the vagina during sex

Change it as soon as you realize and take emergency contraception.

• • • Where to find it?

What is it?

The contraceptive sponge is a type of birth control that contains spermicide which kills sperm. It is a soft circular disposable device inserted deep into the vagina and placed over the cervical opening to kill sperm before entering the uterus and fertilizing an egg.  The sponge prevents pregnancy by blocking the entrance to your uterus and slowing the sperm down with the spermicide.

The sponge can be used alone or with condoms. To best prevent pregnancy, you should use both. Not only that, but condoms can help avoid contracting STIs.

How to use it?

You first moisten the sponge with water and then insert it into the vagina. This blocks sperm from entering the uterus. Next, a spermicide that is absorbed in the sponge is continually released. This will decompose the sperm and prevent them from reaching the egg.

Inserting the Sponge IMAGE

Wash your hands before inserting the sponge to prevent germs from entering your vagina.

To activate the spermicide, you have to wet the sponge with at least two tablespoons of water. You can not use saliva.

You will know the spermicide is active when you gently squeeze the sponge, which gets foamy.

Fold the sides away from the removal loop to make the sponge narrow. Then, insert the sponge in your vagina with the dented side going in first.

Once you release it, the sponge will unfold and cover the cervix. The string loop side should be facing out to cover the cervix tightly. Check the position and fit by sliding your fingers around the edges of the sponge. The sponge will be held in place by the walls of your upper vagina.

The maximum time to insert the sponge before sexual intercourse is 24 hours. It must be left in place for at least 6 hours after intercourse to allow the spermicide to kill the sperm. 

You are protected from pregnancy even if you have intercourse more than once. It should not be left in place for more than 30 consecutive hours. You will no longer be protected against pregnancy upon removal of the sponge.

Removing the Sponge

Wash your hands.

Use the string loop to pull the sponge out of your vagina. 

If the sponge turns upside down, find the loop by sliding your finger around the edge of the sponge, or grab the edge with two fingers and carefully pull it out. 

If the sponge sticks to the cervix, use your finger to lift it away from one side.

After taking out the sponge, you should check to ensure that the entire sponge has been removed and then throw it away.

Contact your doctor if you couldn’t remove the sponge or only remove part of it.

The sponge is for single use only. Do not flush a used sponge in the toilet but instead throw it away in a waste container.

Advantages

Does not hinder the sexual experience

Effective immediately if used correctly

Small and inexpensive

You don’t have to see a doctor before using the sponge

Can be inserted up to an hour before sex, effective for 24 hours

Can have intercourse an unlimited number of times with each wear

What it doesn’t protect you from

The sponge does not protect against STDs and may increase your risk of getting HIV and other STDs. That’s because the spermicide in sponges contains a chemical that can irritate your vagina, making it easier for STD germs to enter.

Common side effects

The sponge and the spermicide it releases may cause:

Vaginal irritation or dryness

Urinary tract or vaginal infection

An increased risk of contracting STIs, including HIV

Effective level (used properly and not) / Failure rate

For women who have never given birth and use the sponge ideally every time, it’s about 91% effective and 88% with typical use (not perfect).

For women who have given birth and use the sponge ideally every time, it’s about 80% effective and 76% with typical use.

Who can’t use it?

Sensitive or allergic to spermicide or polyurethane

Have a vaginal abnormality that does affect the way the contraceptive sponge fits

Have frequent urinary tract infections

Have a history of toxic shock syndrome

Recently has given birth, had a miscarriage, or had an abortion

Are at high risk of contracting HIV, or one has HIV or AIDS

Younger women (less than age 30) who have sex three or more times a week

Where to find it?

What is it?

Spermicide is a contraceptive containing chemicals that kill sperm or stop it from moving. Spermicide isn’t a very effective birth control method when used alone. You can improve its effectiveness by using a barrier method form of birth control like a condom, diaphragm, or cervical cap.

It stops pregnancy two ways, by blocking the entrance to the cervix and preventing the sperm from moving well enough to swim to your egg. 

It’s available in many forms, including cream, gel, foam, film, suppository ( a small, solid pill), and tablet.

Types

Gels, jellies, and creams

These come in different consistencies and textures, but all contain about 1 to 5% of the spermicide chemical. They are inserted into the vagina using a syringe-like applicator.

Foam 

It contains a high level of spermicidal chemical, about 12.5 percent, and can irritate the genitals. This is also placed using a syringe-like applicator.

Film

A spermicidal film is a thin translucent layer of spermicide placed on the vagina and absorbed. You insert it by folding it in half twice, then putting it on your finger and sliding it deep into the vagina. It contains about 28% of the spermicide chemical.

You have to apply it 30 minutes before sex, or the vagina will not fully absorb it. It needs to be stored in a cool, dry place, and make sure your hands are completely dry while applying it. Otherwise, the film might dissolve before you get a chance to use it. 

Other types

Spermicides are also available as tablets or suppositories. Tablets and suppositories should be inserted high into the vagina near the cervix approximately 30 minutes before intercourse so that they fully dissolve. 

How to use it?

Since there are different types of spermicide, check the directions that come in the package. If you don’t use spermicide correctly, it won’t work as well.

Inserting spermicide into your vagina is usually pretty straightforward — it’s similar to putting in a tampon. First, check the expiration date. Then, into a comfortable position — you can stand with one foot on a chair, lie down, or squat — then gently insert the cream, film, foam, gel, or suppository deep into your vagina using your fingers or the applicator that came in the package.

Timing is essential when it comes to spermicide. Some spermicide must be put in your vagina at least 10-15 minutes before sex. And many others are only effective for 1 hour after you apply them. 

You’ll need to add more spermicide if you want to have sex more than once. However, using spermicide several times a day can irritate and increase your risk for STDs.

Advantages

Doesn’t interrupt sex

Doesn’t have hormones

They have no lasting effect on a woman’s hormones

They can be conveniently tucked into your pocket or purse.

What it doesn’t protect you from

Spermicide doesn’t protect against sexually transmitted infections. Using it several times a day may increase your risk for HIV and other STIs. That’s because the chemical in spermicide can irritate your vagina and make it easier for STD germs to enter your body. Adding condoms to the mix helps protect you from STDs and gives you an extra boost in pregnancy prevention. 

Common side effects

Recurring urinary tract infections due to irritation 

Irritation increases your risk for HIV and other STDs 

Allergic to spermicide (soreness or irritation)

Allergic reaction may lead to itching, burning, or redness

Effective level (used properly and not) / Failure rate

72% effective at preventing pregnancy

Who can’t use it?

All women can safely use spermicides except those at high risk for HIV infection or already have HIV infection.

Where to find it?

What is it?

A diaphragm is a form of reusable birth control that is a small, dome-shaped cup you insert into your vagina to block sperm from entering your uterus. For added protection, diaphragms are meant to be used with spermicide. The diaphragm can be put in right before you have sex or up to six hours before you have sex.

There are two kinds of diaphragms:

Flat Ring Diaphragm: Can be folded into an oval and easily inserted with an applicator provided with it.

Arcing or Coil Spring Diaphragm: Is a little hard to fold and forms an irregular circle but can be inserted using only your fingers.

How to use it? IMAGE

First, you need a prescription to get one.

Before you put it in

A diaphragm is most effective when it’s used with spermicide. Apply a teaspoon of spermicide into the dome, spread it around the rim, and then insert. 

Don’t use petroleum jelly or other oil-based creams in your diaphragm. These products may create tiny holes in the silicone. Be sure to check the expiration date because it may not be as effective if it expires.

How to put it in

Find the best position to insert your diaphragm by lying down, squatting, or standing with one leg propped up. Whatever position you choose, the idea is that your legs should be wide open and your knees bent.

To use the diaphragm, follow these steps:

Wash your hands well

Apply spermicide to the diaphragm.

Fold the diaphragm in half and hold it in one hand, with the dome pointing down. Use your other hand to keep your vagina open.

Place the diaphragm into your vagina and use your fingers to push the diaphragm as far into the vagina as you can.

Use your finger to wrap the front rim up. It’s helpful to aim for your belly button.

After placing the diaphragm, check to see if it’s placed correctly. Try inserting your finger into your vagina again to see if you can feel any part of your cervix through the diaphragm. If the device doesn’t cover your cervix, remove the diaphragm and try reinserting.

You shouldn’t be able to feel the diaphragm once it is in place. If placed correctly, it will stay put even if you cough, squat, sit, walk, or run.

When to take it out

Leave your diaphragm in for at least six hours after having sex. If you plan to have sex again that same day, leave it in and apply more spermicide into your vagina beforehand.

You shouldn’t leave the device in for longer than 24 hours. Doing so may lead to a severe bacterial infection called toxic shock syndrome.

How to take it out

Wait at least six hours after having sex to remove your diaphragm. 

Then, follow these steps:

Wash your hands well

Find a comfortable position — lying down, squatting, or standing with one leg propped.

Place your index finger into your vagina. Hook it over the rim of the diaphragm.

Gently pull the diaphragm down and out of your vagina. Be careful not to tear the device with your fingernails.

Diaphragm aftercare

After you take your diaphragm out, take care to prevent bacteria from settling into the diaphragm. This will preserve the product’s continuous use. With proper care, a diaphragm can last from 2 to 10 years.

You should:

Check for holes or other damage. Try filling the dome with water to see if it has leaks. You shouldn’t use a damaged diaphragm. Any holes will allow sperm to enter the cervix and into the uterus.

Rinse it off and let it air dry.

Store in a cool, dry container.

Advantages

Effective as soon as you start using it, it’s easy to stop using it, too.

Doesn’t interrupt sex. You can put your diaphragm in up to 2 hours before you have sex (that’s how long the chemicals in spermicide work). 

Don’t have hormones

Can use them over and over

Can have sex during menstruation

Either partner cannot feel the device

Portable and can be carried in your purse with ease

Can be used while breastfeeding

Can be used if you have medical problems or smoke.

What it doesn’t protect you from

The diaphragm does not protect from sexually transmitted infections.

Common side effects

Genital irritation, red or swollen vulva/vagina due to silicone sensitivity or by the chemicals in the spermicide 

Latex allergies

Irregularities of the vagina or cervix could create additional risks

Some people get urinary tract infections (UTIs)

Irregular spotting or bleeding, 

Effective level (used properly and not) / Failure rate

If you use your diaphragm ideally every time you have sex, it’s 94% effective. But with typical use, it is  88% effective.

Who can’t use it?

If either partner is allergic to latex or spermicide

If inherited problems and surgery change the elasticity or shape of the vagina, the diaphragm is not the best form of birth control

Get frequent urinary tract infections 

Have a history of toxic shock syndrome 

Where to find it?

What is it?

A cervical cap is a silicone cup you insert in your vagina to cover your cervix and keep sperm out of your uterus. Your vaginal muscles hold the cup in place and stop it from being moved during intercourse. The cervical cap is best effective when used with spermicide, which kills any sperm that come into contact with the cap. 

Cervical caps are smaller than diaphragms and shaped slightly differently. Diaphragms are shaped like a dish, and cervical caps look like hats.

You can leave the cervical cap in longer than a diaphragm (up to 2 days), but diaphragms are slightly more effective at preventing pregnancy. Consult your doctor to help you decide which one is better for you.

How to use it? IMAGE

The cervical cap should be inserted before intercourse. You will need to apply a small amount of spermicide to the hole and the edge of the cap. Pinch the cap so it folds in half, bowl side up to insert. Push the cap into your vagina and down towards your rectum. Then push the cervical cap as far back as you can so that it covers your cervix.

You can leave the cervical cap in place for up to 48 hours. There is no need to reapply spermicide every time you have sex but remember to leave the cap in place for at least eight hours after intercourse.

To remove the cap, insert your finger into your vagina and gently push on the dome of the cap. This will release the suction that is holding the cap on your cervix. Pull the strap located on the front of the cap and remove the device.

Wash the cervical cap in warm water and mild, antibacterial hand soap. Let it air dry or pat with a towel, and store it in its protective case.

Advantages

Can be inserted in advance without interrupting intimacy

Can be used multiple times

No side effects from hormones

Small and easy to carry

Requires less spermicide than a diaphragm

Rarely hinders the sexual experience

May be used for repeated intercourse within 48 hours

What it doesn’t protect you from

The cervical cup does not prevent STDs.

Common side effects

Can cause vaginal irritation

Some women wind up getting frequent urinary tract infections

If you’re allergic to spermicide or silicone, you shouldn’t use a cervical cap

Effective level (used properly and not) / Failure rate

The cervical cap is fairly effective—better with spermicide. The cervical cap is 86% effective if you have never given birth and is 71% effective if you have.

Who can’t use it?

Currently, have a vaginal or cervical infection 

Have an abnormal Pap smear, and the cause is not known. 

An abnormally shaped cervix

A history of pelvic inflammatory disease (PID)

Are at high risk of or have HIV/AIDS

If you are younger than age 30 and have sex three or more times a week; 

Have vaginal bleeding or have a vaginal or cervical infection

Recently gave birth or had a miscarriage or an abortion

Recently had cervical surgery

Where to find it?

What is it?

An IUD with a small, soft, T-shaped device made of plastic or metal has a string and a copper wire wrapped around it. It changes the uterus lining so that a fertilized egg is less likely to attach to it and slows the sperm movement to make it harder to get to the egg. 

How to use it?

For a copper IUD to work as emergency contraception, a doctor or nurse must put it in within 5 days after you have unprotected sex. The copper prevents pregnancy by interfering with the way sperm moves, making it hard for sperm to swim well enough to get to an egg.

Effective level (used properly and not) / Failure rate

The Copper IUD reduces your chances of getting pregnant by more than 99.9 percent if you get it put in within 5 days of unprotected sex. It’s the most effective kind of emergency contraception there is. Unlike morning-after pills, it works the same no matter how much you weigh. 

One of the most convenient things about getting an IUD as emergency contraception is that it keeps giving you super-effective birth control for up to 12 years. You won’t have to think about emergency contraception again until you stop using the IUD.

What is it?

The emergency contraceptive pill or the ‘Morning After Pill’ is a safe and effective way to prevent pregnancy after unprotected sex, contraceptive failure, or a sexual assault. Emergency contraceptive pills work by delaying ovulation (the release of an egg during the monthly cycle). If fertilization and implantation have already happened, ECPs will not interrupt the pregnancy.

How to use it?

Despite its name, women do not have to wait until the morning after sex to take it. It is more effective the sooner you take it. ECPs are pills that can be taken up to 120 hours (5 days) after having unprotected sex. Some types work best when taken within 72 hours (3 days) after intercourse.

Advantages

You can buy the morning-after pill in advance to always have it on hand 

No serious side effects 

Requires you only to take one pill

What it doesn’t protect you from

Emergency contraception does not protect against STDs. 

Common side effects

Irregular bleeding, spotting, or heavier bleeding

Headache

Dizziness

Breast tenderness

Fatigue

Stomach pain

Effective level (used properly and not) / Failure rate

The effectiveness rate varies from 87% to 90% for the 3-day pill and from 72% to 87% for the 5-day pill. 

Who can’t use it?

Females who are pregnant

Where to find it?

There are a few different types of tubal sterilization procedures: 

1. Tubal ligation: is a surgical procedure that permanently closes, cuts, or removes pieces of the fallopian tubes.
2. Bilateral salpingectomy: is a surgical procedure that removes the fallopian tubes entirely.
3. Essure sterilization: is a tiny coil put in the fallopian tubes to block them.

Advantages

• Never worrying about getting pregnant
• Do it once, and never have to think about it again
• It’s safe for almost all women and has an extremely low failure rate
• The procedure does not affect your hormones, menstruation, or sexual desire.

What it doesn’t protect you from

Sterilization does not protect you from STDs.

• Common side effects
• A very rare risk that your tubes may reconnect themselves, leading to a pregnancy
• Possible complications with surgery, like bleeding, infection, or a reaction to anesthesia
• For the Essure method, the coils may move out of place and damage the uterus during insertion.

Effective level (used properly and not) / Failure rate

It’s permanent and more than 99% effective at preventing pregnancy.

Who can’t use it?

• Having undergone prior abdominal surgery
• Have pelvic inflammatory disease, diabetes, or lung disease
• If you are overweight

How to use it?

These three necessary conditions must be all met for it to be successful. If they are not met, it is time to start using other forms of contraception.

You breastfeed around the clock. This means that your baby is fed only from your breast, and no other food, water, or liquids are given to the baby.

Your baby must be six months of age or less.

Your periods (including spotting) haven’t returned since childbirth.

Advantages

Prevents pregnancy right away.

It’s free and safe.

It doesn’t interrupt sex.

It reduces bleeding after you deliver your baby.

Breastfeeding may reduce your chance of getting breast cancer.

What it doesn’t protect you from

It does not protect you from STDs.

Common side effects

Breastfeeding can lower vaginal lubrication (getting wet when aroused), making sex uncomfortable. 

And some people find that nursing makes their breasts feel less sexual.

Effective level (used properly and not) / Failure rate

If all the conditions are met, it is 99% effective. During the first 3 months, the chance of pregnancy is practically zero. When it is between 3 and 6 months, the chance of pregnancy is less than 2%, and about 6% after 6 months (assuming mom’s menstrual periods have not yet returned).