Women's Health

Do You Trust Your Birth Control?

So What's Right for You?
Of course, just because sterilization provides very effective protection, that doesn't mean it's the appropriate choice for you, especially if you plan to get pregnant in the future. Consequently, your age may play a major role in that decision. Age may also affect what kind of contraception you can afford and which contraception best fits into your lifestyle and level of sexual activity.

Another consideration is protection against sexually transmitted disease, which is one reason why Dr. Trussell and others advocate using two methods of contraception. "A dual method strategy where one uses condoms and birth control pill, for example, would provide not only extremely effective contraception protection but also protection against sexually transmitted diseases," says Dr. Trussell.

It you're deciding whether to go on oral contraceptives, you should consider how good a pill taker you are, or whether you've had success with this method in the past. If you have trouble remembering to take the pill each day, you might consider the patch, which has a sticky side that you attach to a part of the body and change weekly, or the ring, which is a device that is inserted into the vagina.

Health status and sensitivity to side effects are other considerations. If you are already at high risk for stroke, for example, oral contraceptives might not be a good choice. However, oral contraceptives might be ideal if you have acne or severe PMS or perimenopause symptoms. Likewise, contraceptives such as diaphragms and spermicides can increase risk of urinary tract infections, particularly among those who are already prone to them, but are nonetheless favored by many women over 30.

"The cardinal rule of contraceptive is that a woman or a couple needs to find a method that they can use correctly and consistently," Trussell says. "We have a variety of contraceptives, and choice is good, because it increases the likelihood that an individual woman or couple can find the methods that is best for them."

Percentage of Women with an Unintended Pregnancy During the First Year of Typical Use and the First Year of Perfect Use of Contraception *
Method	Typical Use	Perfect Use
Male sterilization	0.15	0.10
Female sterilization	0.5	0.5
IUD: Copper T	0.8	0.6
IUD: levonorgesterel-containing intrauterine system	0.1	0.1
Depo-Provera	3	0.3
NuvaRing	8	0.3
Ortho-Evra patch	8	0.3
Combined pill and mini-pill	8	0.3
Male condom	15	2
Diaphragm	16	6
Withdrawal	27	4
Spermicides	29	18
No method	85	85

* Adapted from Trussell, J. Contraceptive Technology, eighteenth edition revised. Ardent Media, 2004.

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