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What is the best method of birth control?

Copper IUD

Now that co-payments are (hopefully) falling by the wayside for birth control, it’s time to think less about cost and more about failure rates, because not all methods of birth control are equal.

There are many factors to consider when choosing a method of birth control. Some people dislike the idea of hormones while others think that an IUD is scary. I’m going to eventually tackle risks and myths for every method of contraception (I have already posted about IUDs, male condoms with spermicide, and for certain pills that contain drospirenone, like Yaz); however, the first thing to consider when thinking about contraception is the failure rate, meaning how well will this medication/intervention prevent me from getting pregnant? Once you know the potential benefit then you can balance that against the risks. Every medication and intervention requires an analysis of the risk:benefit ratio. And that ratio will mean different things to different women (and men).

So here are the first-year contraceptive failure rates, meaning the percentage of women who will unintentially get pregnant in the first year using a method of contraception (source: Guttmacher Institute). It’s important to realize that there is “perfect use” and then “typical use.” Perfect use is what happens in a closely monitored study, typical use is what happens in every day life. There is a big variation between perfect and typical use for methods that require more user participation. For example, if you forget your pill one day or show up 5 days late for your Depo-provera shot, that affects the performance of the product. However, once an IUD is in or your tubes are tied, well, that’s typically that.

Medically speaking the most effective method of contraception is the Mirena IUD (or intrauterine system as the manufacturer likes to call it) followed closely behind by vasectomy. However, practically speaking the best method of contraception is the one that has the lowest failure rate, that is safe for you, that you feel comfortable with, and that you are willing to use.

Think about these statistics and talk with your health care provider about the best method of birth control for you.


13 thoughts on “What is the best method of birth control?

  1. Why isn’t the ring on here?

    Posted by Emily Lu (@a_singledrop) | August 11, 2011, 2:54 pm
  2. Why isn´t homosexuality here?

    Posted by Esteban | August 13, 2011, 4:08 am
    • Because sam sex relations are not at risk of causing pregnancy, therefor contraception is not needed. It’s comparing apples to oranges. It’s the same reason by being menopausal isn’t included: the baseline risk of pregnant is nil. You have to be in a position where conception is possible to require contraception.

      Posted by Dr. Jen Gunter | August 14, 2011, 6:08 am
  3. I think you need to give a litle explanation about each method I know I can google it but still!!!!!!!!!!!!

    Posted by bajwa007 | June 23, 2012, 11:49 pm
  4. I wish they would break down the Fertility Awareness based methods. I am using Marquette, which is a NFP method using the ClearBlue Easy fertility monitor (off label) (along with LAM) to manage my fertility in the PostPartum. I very much would like for it to be effective as I want to wait the recommended 9 months to conceive after Cesarean, but all the mainstream data groups this with simple calendar observation . . .

    Posted by Ellen Mary | March 28, 2014, 6:14 pm


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