Methods that work

Abstinence
What is it?
Abstinence is defined here as not having any kind of sex (oral, anal or vaginal) and not engaging in any activity that puts you or your partner in contact with either of your bodily fluids (semen, vaginal fluids and blood).
Does it work?
With perfect use, abstinence is effective in preventing pregnancy and sexually transmitted diseases. The upside:
It has no medical or hormonal side effects, and doesn't cost anything. Abstinence is a way to postpone taking the physical and emotional risks that may come with sexual relationships until you feel you are ready to handle them. The downside:
Abstinence only works if you don't have sex of any kind. If you decide to have sex, you will need to choose another method from this chart to continue to protect yourself from pregnancy and disease. How can I get it?
Just do it (or rather, don't). If you are in a relationship, talk with your partner about your decision to be abstinent and why it is important to you. Even if you have been sexually active before, you can still decide to become abstinent again for any amount of time that is right for you.

Condom
What is it?
A polyurethane or latex sheath worn on the penis collects semen, preventing sperm from entering a woman's vagina.
Does it work?
With perfect (which means using a condom the right way, each and every time you have sex) use, two women in 100 will become pregnant in one year. With typical use, 15 women in 100 become pregnant in one year.
The upside:
Polyurethane or latex condoms (not animal skin) provide good protection against most STDs, including HIV. Plus, they are cheap and easy to find at any drugstore without a prescription.
The downside:
Condoms must not be used with any oil-based lubricants like Vaseline or massage oil. Use a water-based lube, like K-Y, instead. Condoms can break (especially if they aren't put on correctly) and they can leak if not withdrawn carefully.
How can I get it?
At drugstores, supermarkets and online; they cost 35 cents to $1 each. They are often available free at family planning clinics.

Female Condom
What is it?
A thin polyurethane sheath, shaped like a sock with flexible rings at each end. The ring at the closed end holds the pouch in place inside the vagina, while the ring at the open end remains outside the vagina. The pouch collects semen and prevents it from entering the vagina.
Does it work?
With perfect use, five out of 100 women will become pregnant in one year. With typical use, 21 out of 100 women will become pregnant in one year.
The upside:
Protects against STDs, including HIV, and you can get it without a prescription. Also, you can insert it up to eight hours before having sex. If you (or your partner) are allergic to latex and want to use condoms, this is a good alternative.
The downside:
The outside ring can slide inside the vagina during sex; and it is important to make sure that the penis doesn't slip around the side of the condom. It can be awkward to use at first and it must be removed right after sex, before you stand up, to prevent semen leakage. This can not be used simultaneously with a male condom.
How can I get it?
Buy it at drug- stores or supermarkets or get it from family planning clinics; the cost is $2 to $2.50 each.

Birth Control Pill "The Pill"
What is it?
A woman takes a pill that contains either a combination of artificial estrogen and progestin or progestin only every day. The pill works by preventing ovulation, increasing cervical mucus to block sperm, and creating a thin uterine environment.
Does it work?
With perfect use, less than one woman in 100 will become pregnant in one year. With typical use, eight women in 100 become pregnant in one year.
The upside:
If taken correctly, the pill provides non-stop protection from pregnancy. It can also make a woman's periods more regular, reduce cramps, and shorten or lighten a woman's period.
The downside:
Offers no protection against STDs, including HIV. Side effects can include nausea, headaches and moodiness. If you miss 2 or more daily pills during a cycle, or you are late starting a new cycle of pills, you should use condoms until you have taken pills for seven days in a row.
How can I get it?
Through a prescription from a health care provider; the cost runs $15 to $35 a month, depending on the pill brand, plus the cost of the visit to your health care provider and an examination, if needed.

Depo-Provera "The Shot"
What is it?
A woman gets an intramuscular shot of the artificial hormone progestin every three months (12 weeks), which keeps her from getting pregnant.
Does it work?
With typical use, three women out of 100 will get pregnant in one year. With perfect use, less than one woman in 100 will become pregnant in a year using this method.
The upside:
Once you get the shot, you don't have to think about birth control for three months.
The downside:
Offers no protection against STDs, including HIV, and can cause weight gain, irregular periods and depression.
How can I get it?
Requires a visit to your health care provider every three months for administration of the shot; the cost is about $30 to $75 per shot, plus the cost of the office visit.

Ortho Evra "The Patch"
What is it?
The woman wears one patch for seven days, three weeks in a row, and then goes one seven-day week without the patch. The patch releases estrogen and progestin and works by preventing ovulation, increasing cervical mucus to block sperm, and creating a thin uterine environment.
Does it work?
No studies have yet been published, but it is assumed that with typical use, the patch would be more effective than a birth control pill; typical use of the pill results in eight out of 100 women becoming pregnant in one year. With perfect use of the patch, less than one woman in 100 will become pregnant.
The upside:
Weekly dosing and the ability to visually verify the patch is in place make it more likely to be used successfully. Women may also experience more regular, lighter or shorter periods.
The downside:
Provides no protection against STDs, including HIV. Requires a back-up method for the first seven days unless started on the first day of menstruation. May cause local skin irritation or rash, vaginal spotting, nausea, headaches or moodiness. When worn, the patch may be difficult to hide. Smokers should not use the patch.
How can I get it?
Requires a prescription. Cost is $30 to 35 per month, plus a visit to a physician.

NuvaRing "The Ring"
What is it?
A flexible, soft ring that releases synthetic estrogen and progestin to prevent pregnancy. The ring is inserted in the vagina, where it remains for 21 days. It is then removed and kept out for seven days.
Does it work?
No studies have yet been published, but it is assumed that with typical use, the ring would be more effective than a birth control pill; typical use of the pill results in eight out of 100 women becoming pregnant in one year. With perfect use of the ring, less than one woman in 100 will become pregnant.
The upside:
Effective immediately and easy to confirm it is in place.
The downside:
Does not protect against STDs, including HIV. The ring should be kept refrigerated to prolong its life. Side effects may include nausea, headaches and vaginal discomfort. Smokers should not use the ring.
How can I get it?
Requires a prescription. Cost is $30 to 35 per month, plus a visit to a physician.

The Today Sponge "The Sponge"
What is it?
A disposable sponge that is inserted into the vagina before sex. The sponge contains spermicide, activated by getting it a little bit wet before putting it in.
Does it work?
The sponge is more effective for women who have never had children. With perfect use, 9 women in 100 using the sponge will get pregnant over the course of a year. With typical use, 11 women in 100 will become pregnant.
The upside:
The sponge is available from drugstores without a prescription, and can be used for 24 hours, no matter how many times you have sex.
The downside:
Offers no protection against HIV or other STDs. The spermicide may irritate the inside of the vagina or smell or taste bad. It also takes practice to be able to insert the sponge correctly, and it must be left in the vagina for 6 hours after the last time you have sex.
How can I get it?
You can buy the sponge at drug-stores or supermarkets. They are sold in boxes of 3 or 12 and cost about $2.50 each.

Diaphragm
What is it?
A woman uses spermicide to coat the inside and outer-edge of this dome-shaped silicone or latex cup with a flexible rim. Then she inserts it to the back of her vagina so that it covers the cervix, where it blocks sperm.
Does it work?
With perfect use, six women out of 100 will become pregnant in one year. With typical use, 16 women out of 100 will become pregnant in one year.
The upside:
It can be put in place up to six hours before sex and can stay there for 24 hours (though fresh spermicide should be applied each time you have sex).
The downside:
Offers no protection against HIV or other STDs, and can increase the risk of urinary tract infections and toxic shock syndrome. Can't be used with oil-based lubricants because they can damage the diaphragm. Can be messy (thanks to the spermicide) and clumsy to use until you get the hang of it. Also, it has to stay in place for six hours after the last time you have sex and then needs to be washed thoroughly with soap and water.
How can I get it?
Through a prescription from a health care provider; the cost is about $30 to $50 plus the cost of spermicide and the exam and fitting for the diaphragm. A replacement every two years is recommended.

Cervical Cap/FemCap
What is it?
A woman uses spermicide to coat the inside of this hat-shaped silicone rubber cap. Then she inserts it into the back of her vagina so that is covers the cervix, where it blocks sperm.
Does it work?
With perfect use, nine women out of 100 will become pregnant. With typical use, 20 women out of 100 will become pregnant in one year.
The upside:
Can be worn for up to 48 hours. An attached strap aids in removal.
The downside:
Does not protect against STDs, including HIV. Must stay in place for six hours after the last time you have sex. It only comes in three sizes, so it may not be an option for everyone. Some women or their partners may feel discomfort while using FemCap. Needs to be washed thoroughly with soap and water. Replacement every two years is recommended.
How can I get it?
A fitting by a physician is required. The cost of the FemCap is $15 to $75, not including the cost of the examination.

HIV cannot be spread by casual contact such as kissing, hugging, touching, playing sports, or a toilet seat.

Lea's Shield
What is it?
A woman uses spermicide to coat the inside of this oval silicone rubber device. Then she inserts it into the back of her vagina so that is covers the cervix, where it blocks sperm.
Does it work?
With perfect use, nine women out of 100 will become pregnant. With typical use, 15 women out of 100 will become pregnant in one year.
The upside:
Can be worn for up to 48 hours. An attached strap aids in removal.
The downside:
Does not protect against STDs, including HIV. Some women or their partners may feel discomfort while using the shield. It has to stay in place for eight hours after the last time you have sex and then needs to be washed thoroughly with soap and water. Should be replaced every six months.
How can I get it?
A prescription is required. The cost of the shield is $15 to $75.

IUD
What is it?
A small device that contains copper or a synthetic progestin hormone that is inserted into a woman's uterus. There are two types: copper and progestin.
Does it work?
Using a copper IUD, less than one woman in 100 will become pregnant in a year; using a progestin IUD, two women in 100 will become pregnant.
The upside:
It provides effective pregnancy protection and lasts a long time-a copper IUD can stay in place for up to ten years, and a progestin IUD lasts one year.
The downside:
Doesn't protect against STDs, including HIV. Side effects can include: spotting between periods, heavier periods, and increased cramping. Risk of spontaneous expulsion of the IUD; approximately 2% to 10% of users expel their IUD within the first year, in some cases without knowing.
How can I get it?
Requires a visit to a health care provider; cost is about $150 to $400 for insertion, and removal costs about $100.

Tubal Ligation
What is it?
In a surgical procedure, a woman's fallopian tubes are blocked or cut so that sperm and egg cannot unite.
Does it work?
Less than one woman in 100 will become pregnant in a year.
The upside:
It can be a permanent form of birth control; there are no lasting side effects.
The downside:
Doesn't protect against STDs, including HIV. If the procedure fails, there's an increased risk of tubal (ectopic) pregnancy-where a fertilized egg starts to develop in one of the fallopian tubes.
Another downside:
Although tubal ligation may be reversed, it's complicated, expensive, and doesn't always work. It is recommended only for women who are sure they do not want to have children in the future.
How can I get it?
Requires a visit to a health care provider; it can be expensive, and depends on where you have the procedure done and how much of the cost your insurance will cover. Estimated cost ranges from $1200 to $2500.

Vasectomy
What is it?
In a surgical procedure, a man's vas deferens-the tubes that transport sperm to the semen-are blocked or tied off.
Does it work?
Less than one woman in 1,000 becomes pregnant in one year.
The upside:
It can be a permanent form of birth control; there are no lasting side effects.
The downside:
Doesn't protect against STDs, including HIV. Although reversal of the procedure is possible, it is not always successful. Not recommended for men who want children in the future. After a vasectomy, it takes about six weeks for all the sperm to be cleared, so another method must be used until a follow-up check shows no sperm in the semen.
How can I get it?
Requires a visit to a health care provider; it can be expensive depending on where you have it done and how much your insurance will cover. Estimated cost ranges from $350 to $755.

What doesn't work very well

The Rhythm Method
What is it?
A woman keeps track of her menstrual cycle, and has sex only during the "safe" (or infertile) days.
Does it work?
With typical use, 25 women out of 100 become pregnant in one year.
The upside:
It's free and there are no devices to deal with. There are no side effects (except having to go without sex for several days before and after ovulation).
The downside:
Doesn't protect against STDs, including HIV. Predicting when a woman will ovulate is not easy, and sperm can live inside a woman's body for days. You have to keep careful track of your vaginal mucus, menstrual cycle, and/or body temperature to accurately track your fertility patterns, beginning several months before you start relying on this method. Because of the difficulty of using this method, there are a lot of accidental pregnancies.
How can I get it?
You will need good instruction - a class or health care provider - and several months of charting before you begin to rely on this method.

Withdrawal (Coitus Interruptus, Pulling out)
What is it?
The man pulls his penis out of the vagina before ejaculation.
Does it work?
With perfect use, four women in 100 will become pregnant in one year. With typical use, 27 women in 100 become pregnant in one year.
The upside:
It's better than not using any protection, but it's not a very effective method of birth control.
The downside:
Because sperm can live in pre-cum, even if a man withdraws early, there is a chance of pregnancy. It does not protect against STDs, including HIV. Also, it may be a stressful method to rely on-women have to rely on men to get it right, and men have to remember to withdraw prior to ejaculation.
How can I get it?
There is no cost to this method; however, you should discuss with your partner, in advance, to insure you are both aware of the risks and ineffectiveness of this approach.

What Doesn't Work At All

Having sex during your period
First of all, just because you see blood doesn't mean you can't get pregnant - some women bleed during ovulation, when they're most fertile. And it's often hard to predict when you'll ovulate. Sex during your period is also a riskier time for HIV transmission. Regardless of the time of the month, you should always use protection whenever you have sex.

Peeing after sex
A complete myth! Urinating after sex does nothing to protect against pregnancy because women do not urinate out of their vaginal opening. So although the urinary opening is near the vagina (just above it), urinating will not flush sperm out of the vaginal opening.

Douching
Instead of rinsing sperm out of the vagina, douching may actually help them swim upstream toward an egg. It also can increase the risk of infection. All in all, a bad idea!