Contraception Methods: What You Should Know
What form of contraception protects against pregnancy and sexually transmitted infections?
The only reliable form of contraception that protects against both pregnancy and STDs is barrier protection, such as male and female condoms. Other forms of contraception, such as hormonal methods like birth control pills, patch, vaginal ring, implants like NEXPLANON or IUDs only protect against pregnancy, and not sexually transmitted infections.
Any person with multiple partners or with exposure to a partner that has multiple partners should be using barrier protection to protect against sexually transmitted infections. They should also consider using an additional form of contraception to decrease the risk of unintended pregnancy.
What are the failure rates with different forms of contraception?
To truly understand failure rates of contraception, we should know the difference between typical vs. perfect use. Typical use is how the average person will use contraception—occasionally missing doses or not always using the condom correctly for instance. Perfect use means the barrier method or other contraceptive was used in strict adherence to the manufacturer’s recommendations every time.
Average failure rates when using condoms are about 15 out of 100 unintended pregnancies per year. Hormonal methods with typical use have about a five to 10 percent failure rate, with perfect use being only one to two percent. IUDs and NEXPLANON have similar perfect to typical use failure rates of less than one percent per year.
What are the benefits of long-acting reversible contraceptives?
Long-acting contraceptives are the first line of defense for patients’ contraceptive needs, with the greatest benefit being low failure rates. These are implantable devices that once placed, can stay in for years at a time, providing excellent contraception with the minimal daily inconvenience. Certain implantable devices, like NEXPLANON, or progesterone containing IUDs like Mirena or Kyleena, also provide hormonal suppression of the lining of the uterus called the endometrium, which is what sheds during menstruation. Suppressing the lining can cause very light periods or even no periods at all.
What are the potential risks for IUD placement?
The overall risk of IUD placement is low. The procedure itself does require a pelvic exam with a speculum. The procedure usually lasts approximately five minutes. The patient can expect some pelvic pressure and pelvic cramps when the device is inserted that can continue for the first 24 hours. The overall serious complication rate is quite low. Primary concerns are infection ( less than one percent) of the uterus, expulsion after placement (two to 10 percent) and uterine perforation: which only about one in 1000 patients experience this rare complication.
Do IUDs cause infertility?
There is no evidence that any currently manufactured IUDs used in the U.S. cause infertility. Before the FDA regulated medical devices, there were poorly made IUDs that were known to increase the risk of pelvic inflammatory disease and infertility. These were subsequently removed from the market due to these risks. Unfortunately, this stigma has persisted despite robust safety data available about the IUDs currently in use.