Порівняння поширених методів контрацепції

Hormonal

Oral contraceptives (OCs)

0.3%

9%

67%

Pill taken daily

Progestin-only pills: Taken at the same time every day

Bloating, breast tenderness, nausea, headache

Combined estrogen-progestin OCs: Increased risk of venous thromboembolism

Progestin-only OCs: Irregular bleeding

Transdermal patch (estrogen, progestin)

0.3%

9%

67%

Weekly application and removal

Similar to OCs

Local irritation

Vaginal ring (estrogen, progestin)

0.3%

9%

67%

Monthly application (inserted vaginally) and removal

Similar to OCs

Progestin injection (eg, depot medroxyprogesterone acetate)

0.2%

6%

56%

Injection every 3 months

Amenorrhea, irregular bleeding, weight gain, headache, mood changes

Subdermal progestin implant

0.05%

0.05%

84%

Implant every 3 years (some evidence supports ovulation suppression to 5 years)

Amenorrhea, irregular bleeding, headache, weight gain

Levonorgestrel-releasing intrauterine devices (IUDs)

0.4% (3-year IUD: 13.5 mg), 0.2% (5-year IUD: 19.5 mg), or 0.2–0.6% (8-year IUD: 52 mg)

Same as perfect use

78–80%

Insertion every 3, 5, or 8 years (depending on type)

Spontaneous expulsion, uterine perforation (rare)

Irregular bleeding, amenorrhea

Pericoital

Condom, external (male)*

2%

18%

43%

Used with every episode of sexual intercourse

Allergic reaction

Condom, internal (female)*

5%

21%

41%

Used with every episode of sexual intercourse

Allergic reaction

Diaphragm with spermicide

6%

12%

57%

Used with every episode of sexual intercourse

May be inserted up to 2 hours before intercourse

Should be left in place ≥ 6 hours (and ≤ 24 hours) after intercourse

Occasionally vaginal irritation

Increased incidence of urinary tract infections (UTIs)

Cervical cap with spermicide

10–13%

18% (higher among parous women)

N/A

Used with every episode of sexual intercourse

May be inserted 15 minutes to 40 hours before intercourse

Should be left in the vagina for ≥ 6 hours (and ≤ 48 hours) after intercourse

Possibly vaginal irritation or ulceration if left in place for > 48 hours

Contraceptive pH regulator gel

7%

14%

—

Used within 1 hour before each episode of sexual intercourse

Vulvovaginal burning, itching, urinary tract and yeast infection

Contraceptive sponge

(containing sustained-release spermicide)

9% for nulliparous women

20% for parous women

12% for nulliparous women

24% for parous women

36%

Used with every episode of sexual intercourse

May be inserted ≤ 24 hours before intercourse

Must remain in place for ≥ 6 hours after intercourse (should remain in a total of ≤ 30 hours after insertion)

Allergic reaction, vaginal dryness or irritation

Spermicide alone

18%

28%

—

Must be placed in the vagina at least 10 to 30 minutes and no more than 1 hour before each episode of sexual intercourse

Because efficacy is limited, often used with other barrier methods

Vaginal burning, irritation, rash, increase in urinary tract infections

Other

Copper IUD (intrauterine copper contraceptive, see IUD)

0.6%

Same as perfect use

78–80%

Insertion every 10 years

Spontaneous expulsion, uterine perforation (rare)

Increased menstrual blood loss, pelvic pain

Fertility awareness–based methods (periodic abstinence)

4% or higher, depending on method

24%

47%

Training, effort, and multiple steps required for the more effective methods

No likely systemic or significant local adverse effects

Withdrawal method

4%

22%

46%

Used with each episode of sexual intercourse

Requires cooperative partner

Permanent contraception (sterilization)

Tubal sterilization

0.5%

Same as perfect use

100%

Requires a procedure (typically done in an operating room)

Usually permanent

Vasectomy

0.15%

Same as perfect use

100%

Requires a procedure (done in an office) and a local anesthetic

Usually permanent