Some people think that birth control methods (contraception) and safe sex are the same thing. They’re really not. Contraception means using techniques, medications, or products to help prevent pregnancy during sexual intercourse. These include everything from condoms ("rubbers") to "the pill" to things like the diaphragm or an IUD (intra-uterine device). Safer sex means taking actions to lower the risk to you and your partner of getting sexually-transmitted diseases (STDs) during sexual activity. Because STDs can be spread through all kinds of sexual activity besides intercourse (like oral sex or even kissing when it comes to herpes), safer sex is a little more complicated. Sometimes, the two go hand-in-hand. Condoms are pretty effective as a contraceptive, and they’re great for protecting you against STDs. Most of the time, you have to use two different methods to prevent both: a condom for STDs, and the pill as a contraceptive. There are many methods to choose from. If you’re sexually active, or thinking about it, you need to know this stuff. Good information NOW means good decisions, and gives you control over your health, and your life. Remember that abstinence from sexual intercourse or risky sexual behaviors is a 100% effective way to protect yourself against pregnancy and sexually-transmitted diseases. Birth Control Method— The Rhythm Method (Natural Birth Control) Ratings Safer sex—not effective Pregnancy prevention—not effective How it works The rhythm method means having sexual intercourse only during the time of the month when you’re infertile. Obviously, it’s risky. The only effective way to use the rhythm method to prevent pregnancy is to carefully track your cycle changes and avoid sexual intercourse during your most fertile time (before, during, and after you ovulate). You have to: take your temperature each morning (it rises at ovulation, then falls at the start of your infertile period). check your vaginal mucus each evening (it becomes more abundant and stretchy about five days before ovulation, and very wet and slippery during ovulation. It then lessens during the 10 –16 days of infertility). Pros and consThe positive side of the rhythm method is that it’s completely natural and any woman can use it anytime. But in practice, this form of birth control isn’t very effective. It’s complicated to keep track of your cycle. Natural fluctuations in your cycle can be confusing or difficult to track. Abstaining from sex on your fertile days can be hard and takes a lot of self-control. So, your chances of becoming pregnant are much higher if this is the only form of birth control you use. The rhythm method in no way helps to prevent contracting STDs. Effects on your periodThis birth control method doesn’t effect your period in a physical way. It just increases your awareness of your cyclical changes. Birth Control Method— Male Condom Ratings Safer sex—very effective Pregnancy prevention—pretty effective How it works—mechanical barrierA thin, latex covering that fits over the penis and shields sperm from entering the vagina during sex. To help prevent breakage, some condoms have an extra space at the end to catch sperm after a man ejaculates. Certain types of condoms also come with spermicide (chemical that kills sperm). Pros and cons The condom works great when it comes to preventing STDs. Also, it’s cheap and easy to get. The down sides are: Only 88% effective against pregnancy (and that’s when it’s used properly). Must interrupt sex to put it on (it can only be put on an erect penis). It must be applied absolutely correctly without being torn. It needs to be held on the penis until withdrawal. Effects on your period None. Birth Control Method— Female Condom Ratings Safer sex—very effective Pregnancy prevention—pretty effective How it works—mechanical barrier Made from a material twice as strong as latex, the female condom is larger than the male condom, and it fits in the vagina. It blocks semen, viruses, and skin contact. There are firm plastic rings at each end; one holds it in place inside the vagina, the other hangs outside the body. The penis must be guided inside the condom when intercourse begins. When the penis is fully inserted, the outer ring lies flat against the body and the condom remains in place. Pros and consBesides abstinence, it’s the most effective way to shield yourself from STDs. The male condom comes in at a close second in terms of disease prevention, but the female condom is more effective because it covers more skin area. Another bonus is it can be inserted before foreplay, so it doesn’t “ruin the mood.” In terms of pregnancy prevention, it’s 90% effective—a bit more than a male condom. It’s a little awkward to use at first, but you’ll get the hang of it. Don’t use a male and female condom together because they pull each other out of place. Effects on your periodNone. Birth Control Method— Diaphragm Ratings Safer sex—not effective Pregnancy prevention—pretty effective How it works—mechanical and chemical barrierFlexible, cup-like container used with spermicide, that fits over the cervix and blocks sperm passage through the cervical opening. A spring around the rim holds the diaphragm in place. Pros and consA diaphragm MUST be used with spermicide, and an additional application of spermicide must be inserted each time before intercourse. In terms of pregnancy prevention, a diaphragm is 90% effective when used with spermicide. You may put a diaphragm in 1 –2 hours before sex and must leave it in for 6 –8 hours after sex for it to be effective. This can be a plus since you can prepare ahead of time. There are a few downsides. It provides minimal protection against STDs. It must be prescribed and fitted by a health practitioner. Effects on your periodNone, although it is not recommended to use a diaphragm during menstruation because the blood is retained in the vagina, and may create conditions that encourage STDs. Birth Control Method— Cervical Cap Ratings Safer sex—not effective Pregnancy prevention—pretty effective How it works—mechanical and chemical barrierThe cap is just a smaller version of the diaphragm that fits over the cervix and stays in place by suction. It works the same way as the diaphragm, but generally has a snugger fit. Pros and consA cervical cap is effective when inserted up to one day before having sex, or just before sex. You can leave it in for up to 2 days total, so caps give you a somewhat flexible timeframe. Cervical caps must be prescribed and fitted by a health practitioner. They are about 90% effective in preventing pregnancy if well fitted and used properly. But you must insert additional spermicide each time you have sex, and you must leave the cap in 6 –8 hours after intercourse. The drawbacks are that the spermicide may irritate you or your partner and it can cause a rather unpleasant vaginal odor or discharge. Effects on your periodNone. But the cap should not be worn during menstruation. Birth Control Method— The Pill (oral contraception) Ratings Safer sex—not effective Pregnancy prevention—very effective How it works—hormonalThe pill basically tricks your body into thinking you’re pregnant. It comes in two forms and a variety of dosages. One form combines the synthetic hormones estrogen and progesterone. It prevents ovulation so you stop producing eggs. This pill does not prevent the womb lining from developing. The second (and slightly less effective) form of the pill is progesterone only. This pill (sometimes known as the mini-pill) thickens your cervical mucus, making it difficult for sperm to get through the cervix and meet the egg. If an egg does get fertilized, it’s very hard for it to survive because this pill prevents the womb lining from developing. Pros and consThe major plus side of the pill is that it is 97 –100% effective in preventing pregnancy. But this stat only applies to women who take the pill EVERYDAY. Some research shows that the pill (with estrogen and synthetic progesterone) reduces the risk of ovarian and endometrial cancer. There are various scientific opinions about the risk of breast cancer associated with the pill. Some women experience weight gain, headaches, mood changes, reduced sex-drive, and breast tenderness. Also, the pill doesn’t protect you from STDs, so you have to use a condom or some other form of barrier protection to prevent disease. The pill is available by prescription only, so you need to go to your doctor and discuss whether it’s right for you. Effects on your periodYou experience a “false period” while taking the pill. This happens during the days of the month when you’re taking the reminder sugar pills in your pack or no pill at all. It’s a false period because you’re not really ovulating. You still bleed like a normal period, but generally, these “false periods” are light, absolutely regular, and almost pain free. With the mini-pill (progestogen only), the length of your cycle varies between 23 and 33 days—but it can also be shorter. Breakthrough bleeding and spotting is common between periods. Many women with irregular cycles experience no bleeding at all. Birth Control Method— Norplant (surgical implants) Ratings Safer sex—not effective Pregnancy prevention—very effective How it works—hormonalSurgical implants that look like six match-sized sticks surgically inserted into your upper-arm. They contain progestogen and can be left in place for up to five years. These implants release the hormone at certain intervals to inhibit ovulation and sperm mobility over the course of five years. Pros and consImplants are 99% effective in preventing pregnancy. They’re ideal for women who have a hard time sticking to a daily pill regimen or don’t want to be pregnant for a long time. There are some downsides though. Like the pill, implants provide NO protection against STDs, so you should still use condoms. Implants can also cause weight gain, headaches, dizziness, breast tenderness, and decreased bone density. Your doctor can help you decide if implants are a good option for you. Effects on your periodAbout the same as the progestogen-only pill (mini-pill). The length of your cycle varies between 23 and 33 days—but it can also be shorter. Breakthrough bleeding and spotting is common between periods. Many women with irregular cycles experience no bleeding at all. Irregular cycles may adjust after one year. Birth Control Method— Depo-Provera Ratings Safer sex—not effective Pregnancy prevention—very effective How it works—hormonalSometimes called a “depo shot,” Depo-Provera is a progestogen-only hormone shot you get every 3 months. It works by suppressing FSH (follicle-stimulating hormone), which disrupts the egg production and your menstrual cycle. Pros and cons This method is 99% effective in preventing pregnancy. It’s a highly-effective form of birth control and less of a hassle than daily birth control pills. But, it can have some of the same side effects as the progestogen-only pill including acne, weight gain, breast tenderness, depression, and lower sex drive. Also, it doesn’t prevent STDs at all, so you still have to use a condom. You have to get shots every 3 months—so if you’re needle-shy, this may not be the best choice for you. Effects on your periodYou may experience menstrual irregularities while you are taking Depo-Provera and it can alter your periods when you stop getting the shots. Birth Control Method— IUD (Intra-uterine Device) or coil Ratings Safer sex—not effective Pregnancy prevention—very effective How it works—mechanical Next to condoms and the pill, an IUD is the third most popular form of birth control. It’s a device made of rubber-like substances wrapped with thin copper wire and must be inserted and removed by a trained doctor. An IUD fits inside the uterus causing the lining to change so a fertilized egg cannot implant. The copper in the wire also kills sperm and eggs. Removal threads protrude down in the vagina. Pros and consAn IUD is 98 –99% effective in preventing pregnancy. It’s a low maintenance form of birth control because you don’t have to think about it everyday. Occasionally, an IUD can carry vaginal and cervical infections into the uterus so you need to get a thorough exam before fitting, and once a year thereafter. Effects on your periodAn IUD often causes heavier bleeding and more painful cramps (sometimes between periods) so it’s not suitable for women with heavy or painful periods. Sometimes, cramps and bleeding occur for a few days after the IUD is inserted. If this persists, it’s important to talk to a doctor. Learn about different birth control methods and read helpful information at BeingGirl.com.