Encyclopedia of Health and Medicine

266 The Reproductive System
Method Male or Availability Ease of Use Effectiveness When Used
Female
Correctly
fertility awareness both personal commitment requires diligent effort 75 to 99 percent
methods (FAMs)
from both partners
intrauterine device female prescription only; requires no attention once 99 percent
(IUD) health-care provider inserted
must insert
can stay in the UTERUS for
5 to 12 years, depending
on type
oral contraceptives female prescription only daily or weekly pill 99 percent
spermicide female OTC must apply before each 70 to 85 percent
sexual act
tubal ligation female requires surgery requires no effort after nearly 100 percent (1 in 300 failure
OPERATION
rate)
permanent
vasectomy male requires in-office requires no effort after nearly 100 percent (1 in 500 failure
operative procedure operation rate)
permanent
Common forms of contraception include barrier
methods, hormonal methods, mechanical
methods, chemical methods, surgical methods,
timing methods, and continuous abstinence. Some
methods, such as oral contraceptives (birth control
pills) and diaphragms, require a doctor’s prescription.
Others are invasive, such as intrauterine
devices (IUDs), TUBAL LIGATION, and VASECTOMY. Still
other methods of contraception are available for
purchase without prescription or physician
approval, sold in locations from grocery and drugstores
to dispenser machines in public bathrooms.
Most public health departments freely hand out
over-the-counter (OTC) methods of contraception,
notably condoms.
Contraceptive effectiveness relies primarily on
proper use of the method and varies widely
among methods as well as within a particular
method. The most reliable methods of contraception
are those that are in place or effective without
any effort at the time of sexual activity.
Methods that have the ability to provide nearly
100 percent prevention of pregnancy may actually
result in much lower prevention when not used
properly. Only about 40 percent of women take
oral contraceptives precisely as the label instructions
direct, for example, raising the risk for unintended
pregnancy.
Many people combine methods to optimize
protection from pregnancy, for example using barrier
contraception (condom or diaphragm) with
chemical methods (spermicides). Only condoms
(male or female) also provide protection against
SEXUALLY TRANSMITTED DISEASES (STDS). A woman
who takes oral contraceptives to prevent pregnancy
but has more than one sexual partner also
needs the protection of a condom. Partners also
should wear condoms for sexual activity during
outbreaks of GENITAL HERPES and if they are HIV
positive or have HUMAN PAPILLOMAVIRUS (HPV) or
HEPATITIS B or C.
Emergency contraception is available through
pharmacies in the United States without a doctor’s
prescription. Emergency contraception, also called
the “morning after pill,” is a high DOSE of an oral
contraceptive. The hormones in the medication