Which Contraceptive Method is Right For Me?
By Sharon F. Hinson, MD

NOTE: Hormonal contraceptives do not provide protection against STIs (sexually transmitted infections) or HIV.  Using condoms in combination with your choice of contraceptive method is the only means of reducing the transmission of these infections.  In addition, cigarette smoking increases the risk of serious cardiovascular side effects, especially if you are over age 35.  Women using any type of hormonal contraception are strongly advised not to smoke.

Oral Contraceptive Pills (OCPs)
Birth control pills are a safe and effective means of contraception for the majority of women of reproductive age.  They work to prevent pregnancy by preventing the release of an egg from the ovary and to thicken cervical mucous/secretions, which makes it more difficult for sperm to reach the uterus.  Birth control pills contain both estrogen and progestin.  Estrogen and progesterone are sex hormones produced in the body which assist in regulating reproduction.  OCPs should be taken every day at approximately the same time in order for them to be effective.  The first three weeks of pills contain hormones; the fourth week of pills is “hormone free” and a menstrual period occurs.  It is extremely important to start the next pack of pills on time due to the possibility of an egg being released from the ovary if the “hormone free” interval is extended beyond 7 days.  Taken correctly, birth control pills have a failure rate of 0.3%.  The price of OCPs varies depending on insurance coverage and whether a name brand or generic is prescribed.  Typical cost ranges from $20-50 per pack.

Ortho Evra Transdermal Patch
The patch also contains estrogen and progestin; therefore, it works to prevent pregnancy the same way birth control pills do.  The patch is applied once a week for three weeks in a row.  The fourth week is “patch free,” at which time a menstrual period occurs.  The effectiveness of the patch when used correctly and consistently is similar to that of birth control pills.  The cost of the patch is approximately $30-40 per month.

Nuva Ring

The ring is very flexible and contains estrogen and progestin.  The hormones are absorbed in the vagina and work to prevent pregnancy in the same manner as birth control pills.  The vaginal ring is a monthly method; a single ring is inserted into the vagina and left in place for three weeks, then removed.  During the fourth week, which is “ring free,” a period should occur.  The effectiveness of the ring in preventing pregnancy is similar to that of birth control pills when used correctly and consistently.  The cost of Nuva Ring is approximately $30-40 per month.

Depo Provera

Depo Provera is an injection of progestin given intramuscularly every 12 weeks (4 times per year).  It is an extremely effective method of birth control when used correctly and injections are not late or missed.  Depo has a failure rate of 0.3% when used perfectly.  Its primary mechanism in preventing pregnancy is inhibiting ovulation.  Using Depo can lead to a decrease in bone density; therefore, it is advised that women get adequate calcium either through dietary sources or oral supplements.  Also, weight bearing exercise helps to maintain healthy bone mass.  Women using Depo Provera can expect a change in the pattern of their menstrual cycle.  During the first several months, one’s period may be irregular, with unpredictable bleeding or spotting.   After receiving several injections for the fist 6-12 months, many women may stop having a period altogether, while some may continue to have episodic spotting or bleeding.  Since Depo Provera injections are not immediately reversible, one should be prepared for this transition in their menstrual cycle.  The cost of a single Depo Provera injection is approximately $30-40 per month. 

Male Condoms

Male latex condoms are readily available and free of charge at Student Health Services.  Using condoms alone as a method of birth control is only 85% effective with typical use.  Condoms are effective in preventing the sexual transmission of HIV and can help reduce the risk of other STIs such as Chlamydia, gonorrhea, and trichomonas.  However, condoms are not as effective in preventing STIs that are primarily transmitted by skin to skin contact, such as genital warts and herpes.

Spermicidal Gel/Jelly/Suppositories

Spermicides are commonly used in combination with condoms as a back-up contraceptive.  Spermicidal gels work as chemical agents to attack sperm and reduce their motility and ability to survive.  The gel itself acts as a barrier to help prevent sperm from entering the opening of the cervix.  The failure rate with typical use is 29%.  These gels are available over the counter and are generally inexpensive.  

Each of these contraceptive methods is available through Student Health Services.  Call 704-687-4617 to schedule an appointment.