Only abstinence provides complete protection from pregnancy and STD/HIV. Condoms are the only other method that prevent STD/HIV infection. Condoms are the method of choice among sexually active teens. Along with condoms, withdrawal (an unreliable method) is the method most frequently practiced by teens that use contraception. Young women involved in serious relationships are more likely to use a reliable method of pregnancy prevention, such as the pill, than those who are just beginning to have intercourse.

Nonprescription contraceptives are available in drug stores, grocery stores and variety stores. Prescription contraceptives are available through prescriptions that are filled by a pharmacist. The contraceptive injection (Depo-Provera) is available through doctor's offices and health clinics. Most contraceptive methods are available free or at greatly reduced prices through health and family planning clinics.

Contraceptive Summary
A summary of contraceptive methods commonly used by teens follows. Maximum effectiveness is only achieved when contraceptives are used consistently and correctly.

 

Abstinence

• Effectiveness: 100%
• Possible side-effects: None

 

Birth Control Pills

• Effectiveness: 99% with perfect use, 92% with typical use.
• Description: The "pill" is the most popular form of reversible contraception in the United States. The pill is actually a series of pills (20-28 per package) containing synthetic estrogen and/or progesterone that regulate(s) egg production and the menstrual cycle. Birth control pills accomplish some or all of the following: inhibit ovulation, thicken cervical mucus (preventing sperm entry), change the lining of the uterus, and alter the rate of ovum transport. Birth control pills must be prescribed by a doctor or family planning clinic. Birth control pills should be taken daily, as close as possible to the same time each day. Different kinds of pills are available. Speak with your doctor about the options. Birth control pills do not offer protection against HIV/STDs.
• Cost: A year's supply of birth control pills costs between $100 and $300.
• Advantages: Pills are easy to take, and no interruptions are necessary before or during intercourse. Women who take birth control pills usually have more regular periods with reduced menstrual flow and cramping.
• Possible side-effects: Slight breast enlargement and less acne are side effects of the pill. Other side effects include nausea or vomiting, weight gain or loss, spotty darkening of the skin, nervousness, loss of hair, change in appetite, mood changes, change in sex drive (commonly a decrease), increase in body hair, and an increase in vaginal discharges and yeast infections.

 

Condom

• Effectiveness: 98% with perfect use, 85% with typical use.
• Description: The male condom is a barrier method-it is designed to keep sperm and egg from uniting. The condom is a thin, soft flexible sheath of latex, polyurethane or animal tissue that fits over the erect penis to prevent semen from being transmitted. Condoms are available in a variety of sizes, shapes and colors. Some are lubricated, and some are treated with spermicides. The chief drawback of a condom is that it must be put on after the man has become aroused but before penetration. Typical user failure rate is mostly due to misuse of the condom and to failure to put the condom on before intercourse begins. The expiration date must be checked before using. Condoms must be stored correctly to prevent deterioration. Latex condoms should be used with water-based lubricants, because oil-based lubricants, such as Vaseline, weaken the rubber.
• Cost: A single condom costs anywhere from about $0.50 - $1.50. Condoms are available in drugstores and variety stores and are often free at health clinics.
• Advantages: Latex and polyurethane condoms help protect against STDs, including Herpes and HIV. Some complain that sensation is dulled; however, many of the newer condoms are very thin but are also strong; they conduct heat well and allow quite a bit of sensation to be experienced.
• Possible Side-effects: Few medical problems are associated with the use of condoms. Infrequently, people are allergic to latex. Some condoms are lubricated with the spermicide nonoxynol-9 that can cause irritation, increasing the risk of STD transmission.

 

Condom Plus Spermicide (see above and below for more information on condoms and spermicide)

• Effectiveness: 98% with perfect use, 85% with typical use. Evidence suggests that using condoms with spermicide increases efficacy, but conclusive data has not been documented.
• Description: The effectiveness of condoms and spermicide can increase by up to 2.5% when they are used together. In case the condom breaks, spermicide will help kill the sperm. The expiration date must be checked before using.
• Cost: A single condom costs anywhere from about 50 cents to $1.50. Condoms are available in drugstores and variety stores and are often free at health clinics. The cost per use is about $0.50 - $2.50.
• Possible Side-effects: The frequent use of the spermicide nonoxynol-9 can cause irritation, increasing the risk of STD transmission.

 

Contraceptive Injection (Depo-Provera)

• Effectiveness: 99% with perfect use, 97% with typical use.
• Description: Depo-Provera is an injection a woman gets from a doctor or nurse every three months. The shot contains a hormone that prevents the woman from becoming pregnant in ways similar to the pill. Requires prescription and office visits. Does not offer protection against HIV/STDs.
• Cost: A year's protection with Depo-Provera costs about $150.
• Advantages: This method is very convenient since no applications or interruptions are necessary before or during intercourse. Depo-Provera does not rely on a woman's memory in order to be effective.
• Possible Side-effects: Menstrual spotting, weight gain, headaches, breast tenderness, dizziness and mood changes have been reported. However, these side effects are infrequent. In about half of the women who use Depo-Provera, menstruation stops completely after a year of use. Depo-Provera may delay fertility (up to a year in some cases) until its effects wear off. The return to fertility seems to be affected by a woman's height and weight.

 

Contraceptive Patch (Ortho Evra)

• Effectiveness: 99% with perfect use, typical use data not yet available; appears to be less effective in women weighing more than 198 pounds.
• Description: Skin patch worn on the lower abdomen, buttocks, or upper body that releases the hormones progestin and estrogen into the blood stream. It prevents her from becoming pregnant in ways similar to the pill. Available by prescription. Does not offer protection against HIV/STDs.
• Cost: Similar to the pill.
• Advantages: Convenience and decreased pregnancy risk due to "forgetting" to take a daily pill; it's applied once a week for 3 weeks and not worn during the fourth week for menstrual period.
• Possible Side-effects: Similar to oral contraceptives - combined pill.

 

 

Diaphragm with Spermicide

• Effectiveness: 94% with perfect use, 84% with typical use.
• Description: A dome-shaped latex disk with a flexible rim that covers the cervix so that sperm cannot reach the uterus. A spermicide is applied to the diaphragm (on the side facing the cervix) before insertion. Can be inserted an hour before intercourse and left in place at least six hours after; can be left in place for 24 hours. Additional spermicide should be applied for repeated intercourse. Requires a fitting and a prescription. Does not offer protection against HIV/STDs.
• Cost: $30-$50.
• Advantages:No hormonal side-effects. Generally cannot be felt by either partner.
• Possible Side-effects: Irritation and allergic reactions to spermicide or latex. Some women may experience urinary tract infection. There is a risk for Toxic Shock Syndrome when it is kept in place longer than recommended.

 

Female Condom

• Effectiveness: 95% with perfect use, 79% with typical use.
• Description: A lubricated (oil-based) polyurethane pouch with flexible rings at each end, that prevents sperm from reaching the egg. This barrier method has a closed end is inserted into the vagina like a diaphragm (see description below) holding it in place. The outer ring rest outside the vaginal opening. It should only be used once and discarded.
• Cost: The female condom costs about $2.50 for one. Female condoms can be covered by Medicaid if prescribed and free female condom programs may be available in your area.
• Advantages: No hormonal side effects. Recent research suggests that female condoms can offer similar rates of protection against STDs. Can be inserted up to 8 hours prior to intercourse and can be used without an erection. Non-prescription.
• Possible Side-effects: Vaginal and vulval irritation may occur. Users must be careful that the outer ring remains outside the vagina, and that the penis does not slip outside the pouch. Be sure to understand instructions clearly. Using the female condom correctly improves with practice. It should not be used with the male condom as it can reduce the efficacy of both.

 

IUD (Intrauterine Device)

• Effectiveness: 99% with perfect use, 99% with typical use.
• Description: A T-shaped device inserted into the uterus by a health professional. It prevents fertilization of the egg. Does not offer protection against HIV/STDs.
• Cost: Exam, insertion, device and follow-up can cost $250-450. It can work out to be less per year than most other types of birth control.
• Advantages: Extremely effective against pregnancy. After insertion by physician, can remain in place for up to one or 10 years, depending on type. No hormonal side effects.
• Possible Side-effects: Cramps, bleeding, pelvic inflammatory disease, infertility, it can be expelled without user knowledge, and rarely can cause perforation of uterus.

 

Spermicide

• Effectiveness: 85% with perfect use, 71% with typical use.
• Description: Spermicide is a barrier method available in the following forms: foam, cream, jelly, film, and suppositories. It contains a chemical that kills sperm. Spermicide is inserted with deep into the vagina before intercourse. Like condoms, spermicide can be purchased at any drugstore. Spermicide has an effectiveness rate of 85% with perfect use. Typical user failure results in reduced efficacy from incorrect and inconsistent use.
• Cost: The cost per use is about 50 cents to $2.50.
• Advantages: Few medical problems are associated with the use of spermicide so it can be used by most women. Can be inserted up to an hour before intercourse and still remain effective.
• Possible Side-effects: Some women dislike applying spermicide, and some complain of messiness and leakage. Occasionally, a woman or her partner may have an allergic reaction to the spermicide. The frequent use of the spermicide nonoxynol-9 can cause irritation, increasing the risk of STD transmission.

 

Vaginal Contraceptive Ring (NuvaRing)

• Effectiveness: 99% with perfect use, typical use data not yet available.
• Description: A flexible ring about 2 inches in diameter that is inserted into the vagina. It releases the hormones progestin and estrogen, preventing pregnancy. Once it's inserted it remains in the vagina for 3 weeks, and then is removed for 1 week. Requires a prescription. Does not offer protection against HIV/STDs.
• Cost: Similar to the pill.
• Advantages: Prevents against pregnancy for 1 month.
• Possible Side-effects: Vaginal discharge, vaginitis, irritation. Similar to oral contraceptives - combined pill. If the ring is expelled and remains out for more than 3 hours, another birth control method must be used until ring has been used continuously for 7 days.