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Birth Control Briefing

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How well does it work? It’s 99 percent effective with typical use.


  • Convenient
  • No pills to take or rings or patches to change
  • One particular brand (Mirena) can cause lighter menstrual flows.


  • Must be inserted by a physician
  • Spotting between periods is common for the first few months
  • One brand (ParaGard) can increase menstrual flow and, in some cases, lead to anemia
  • Cramps or backaches
  • Can slip out or puncture the wall of the uterus, though this usually doesn’t happen—the risk is 2 to 10 percent.
  • Can cause infection—this is rare (especially after the first three weeks after insertion) but possible, especially if patient has been exposed to chlamydia or gonorrhea.

The Sponge
This is a small polyurethane sponge treated with spermicide. You insert the sponge up to thirty hours before you have sex and remove it within thirty hours after. After being off the market for years, the Today Sponge returned in 2005.

How well does it work? Not well. It’s only 85 percent effective with perfect use. With typical use, thirty out of one hundred women will get pregnant while using the sponge. That’s really high!


  • Convenient: Can be carried in a purse and inserted up to thirty hours before intercourse
  • Available over the counter


  • No protection against sexually transmitted diseases
  • Far less effective than other methods
  • Should not be used during menstruation
  • Can be difficult to insert properly and/or remove

In 2006 the FDA approved Implanon, a tiny rod inserted under the skin of the upper arm that releases progestin. Implanon can safely be used in teens and can stay in place for up to three years.

How well does it work? It’s almost 100 percent effective.


  • Convenient—no effort required
  • Helps acne—59 percent of women in clinical trials who had acne said it lessened or went away after they started using Implanon.


  • Must be inserted and removed by a physician
  • Expensive
  • Can cause irregular bleeding (although many women stop having their periods at all)

The Female Condom
OK, I admit it. I’ve never had a single patient who has used the female condom. But you should know it’s an option. It’s basically a latex pouch inserted into the vagina before sex. Like traditional condoms, it provides a roadblock that (theoretically) sperm can’t penetrate. It does provide some measure of protection against STIs. Like condoms, it’s not considered highly effective for birth control: As many as fifteen out of one hundred times the female condom will fail, leading to pregnancy or STIs. Important note: You can’t use both a female condom and a traditional condom at the same time. You have to use just one or the other.

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