NurseAsk Nurse Lisa

Birth Control

“Txin achigalix anĝaĝigumin anuxtanatxin ax̂saasaduukux̂tin. / Huzugaan txin achigax̂agacha mada ama txin sakaaĝatada.”

“Always learn and maintain a balance.”

– Unangan/Unangas value

Remember, sex is meant to be a mutual decision – meaning two people who agree they want to have sex. Communicating or talking with your partner about safe sex can be challenging. But just because you’re faced with a challenge, don’t give up. There are different birth control methods available and you can decide which is best for you.

The only 100%, proven method of protecting yourself from unplanned pregnancy and Sexually Transmitted Diseases (STDs) is by not having sex (abstinence) or waiting to have sex.

If two people decide to have sex, there many ways to have safe sex. The level of protection from unplanned pregnancy and STDs is different for each type or method. Some methods of birth control, also called contraception, are proven better than others or are more effective.

To learn more about how to access these methods, ask your local health care provider. To read more about how to use these methods or compare their pros and cons, read up at Planned Parenthood.

The Most Effective Methods

We’ll say it again, abstinence or waiting to have sex are the only, 100% effective ways of not getting pregnant or getting an STD. There is a risk of getting STDs if you have oral or anal sex.

This method requires no doctor or pharmacy and is free! Some people make the decision to wait to have sex until they have a steady partner or marriage. Some couples wait to have sex until they have the protection they need…like a condom. Choosing to wait to have sex takes away the worry of unplanned pregnancy, Sexually Transmitted Diseases (STDs), and all the emotional consequences from choosing to have sex.

The birth control pill or “the pill” is 91%* effective at avoiding pregnancy. For the pill to work you need to remember to take the pill EVERY DAY at the same time. The pill does not protect against STDs or HIV/AIDs. It may regulate or lighten periods, reduce cramps, and lessen acne.

TIP: It can be difficult remembering to take the pill every day. Try setting an alarm on your phone to remind you!

The pill works by releasing hormones (progestin or a combination of progestin and estrogen) to stop ovulation or releasing of fertile eggs. At end of each month you’ll still get a period before starting the next pack of pills. The pill requires a prescription from a doctor or provider. Some side effects are possible – remember to talk with your health care provider or pharmacists before beginning a birth control method.

The patch, sometimes called “Ortho Evra”, is 91%* effective at avoiding pregnancy if used correctly. However, the patch does not protect against STDs or HIV/AIDs.

The patch is a thin square plastic “sticker” with hormones on one side which get absorbed into the body. A woman can stick and wear the patch almost anywhere – the butt, belly, arm, or upper torso but NOT on the breasts. The patch can be worn under clothes, hidden, and stays on while showering, bathing, or exercising. After one week, the patch is replaced and during the fourth week no patch is worn and a woman gets her period and the cycle begins again. The patch requires a prescription from a doctor or provider. Some side effects are possible – remember to talk with your health care provider or pharmacists before beginning a birth control method.

The ring, sometimes called “NuvaRing”, is 91%* effective at avoiding pregnancy if used correctly. However, the ring does not protect against STDs or HIV/AIDs.

The ring is a thin flexible ring which contains hormones (progestin or a combination of progestin and estrogen). A woman inserts the ring herself into her vagina, where the ring is held in place by the vaginal walls. The ring stays in for a month releasing hormones, after a month a woman will have her period and the cycle begins again. To be effective, you have to remember to insert a new ring each month. The ring does not interrupt sexual activity and the woman or her partner can’t feel it. The ring requires a prescription from a doctor or provider.

This method of contraception is 99%* effective at avoiding pregnancy. However, implanon does not protect against STDs or HIV/AIDs. Great method because you don’t have to remember something everyday like “the pill”.

An implantable contraceptive, sometimes known by the name “implanon”, is exactly what it sounds like: a small, flexible, plastic tube with hormones which is put under the skin of the upper arm (implanted).

This method requires a doctor or provider to put (implant) the rod under the skin and will work up to three years or until you decide to remove it. Quick and easy! Implanon works by releasing the hormone progestin. Progestin prevents a woman’s eggs from being released and thickens cervical mucus – preventing sperm from entering the cervix and getting to the eggs. Some side effects are possible – remember to talk with your health care provider or pharmacists before beginning a birth control method.

This method of contraception is 99%* effective at avoiding pregnancy. However, IUDs do not protect against STDs or HIV/AIDS. Great method because you don’t have to remember something everyday like “the pill”.

An Intrauterine Device or IUD is directly inserted into the uterus. IUDs are small, flexible, plastic “T”-shaped devices. There are two different types of IUDs available in the U.S.: Mirena and Copper T (ParaGard).

An IUD requires a prescription and doctor or provider. This method can last anywhere from 5 to 10 years depending on the type of IUD or until you decide to remove it. Some side effects are possible – remember to talk with your health care provider or pharmacists before beginning a birth control method.

This contraceptive shot, sometimes called “Depo”, is nearly 94%* effective at avoiding pregnancy. However, “Depo” does not protect against STDs or HIV/AIDs. Great method because you don’t have to remember something everyday like “the pill” and it doesn’t interrupt sexual activity. It may reduce periods, cramping, or PMS.

Depo is a hormone (progestin) injection given to a woman every three months. Remember, the shot is only effective if you get it on time. The shot requires a prescription from a doctor or provider. Some side effects are possible – remember to talk with your health care provider or pharmacists before beginning a birth control method.

Barrier Methods – No doctor visit required

External condoms are thin latex or plastic (polyurethane – latex free) which are placed and rolled on over the penis before any sexual contact (vaginal intercourse, anal, or oral sex).

If used every time, condoms are 85%* effective at avoiding pregnancy. Most STIs, including HIV/AIDS, have a greater percentage of non-transmission than 85%. There is an exception for STIs that may be transmitted via skin contact alone (herpes, syphilis and chancroid) outside of the genital region, like the inner thigh, but they do still help reduce the risk.

With perfect use (proper fit, useage of lubricant, and correct method of application) the number increases to 98%* of women preventing pregnancy in a year. With no contraceptive use, only 15% of women were not pregnant at the end of the study!

Condoms are the ONLY method that gives protection for both STDs and HIV/AIDs.

REMEMBER: You must use and put on condoms correctly for them to work.

Review the CDC guidelines of how to put on condoms here.

Some people choose to use the dual method of using condoms with birth control pills or patch to be more safe.

You might think that using both an internal and an external condom would mean more protection, but this is not true! Use only one internal or external condom at a time – not both together; double-bagging makes the condoms more likely to tear.

Plan ahead! If it’s possible you might have sex, be prepared with a condom and make sure to check the expiration date on the wrapper. Be sure to carry your condom in a place without high heat and where no wear and tear is possible –not in wallets or glove compartments – where friction and heat can cause micro-tears in the condom.

External condoms are inexpensive and easy to use! You can find condoms at drugstores, online (like through us!), health clinics or family planning centers without prescriptions.

*Source, Advocates for Youth

The diaphragm is a round flexible circle cup that is inserted into the vagina up to two hours before having sex! After sex, the diaphragm must stay in place for at least six hours, but for no more than 24 hours. The diaphragm stops sperm from entering the cervix and works best if used in combination with spermicide to kill sperm. For diaphragms to work best, you need to learn how to use them correctly. There are different “sizes” so see your doctor or provider to get the right size for you. Each diaphragm can be used up to ten years and are available at a low cost. To get a diaphragm, you need to see a doctor or provider.

The diaphragm is 88%* effective at avoiding pregnancy and are less effective with women who have given birth already. However, the diaphragm does not protect against STDs or HIV/AIDs.

Internal condoms are thin latex or plastic (polyurethane – latex free) which are placed in the vagina and line the inside walls of vagina, so sperm are unable to fertilize the eggs. Female condoms can be inserted up to 8 hours before sexual contact – so you can plan way ahead of time before the heat of the moment!

Internal condoms, if used every time, correctly and consistently, are 79%* effective at avoiding pregnancy AND most STDs and HIV/AIDs. This method offers some protection from STDs and HIV/AIDs – external condoms are more effective.

REMEMBER: Just like external condoms, you must use and put on condoms correctly for them to work. Read the instructions that come with your internal condoms carefully to make sure you have it in right!

Plan ahead! Be prepared with a condom and make sure to check the expiration date on the wrapper. Be sure to carry your condom in a place without high heat and where no wear and tear is possible –not in wallets or glove compartments – where friction and heat can cause micro-tears in the condom.

Internal condoms are more expensive than external condoms and can be more difficult to use. Places where you can find female condoms: drugstores, online, health clinics or family planning centers without prescriptions.

Some people choose to use the dual method of using condoms with birth control pills or patch to be more safe.

You might think that using both an internal and an external condom would mean more protection, but this is not true! Use only one internal or external condom at a time – not both together; double-bagging makes the condoms more likely to tear.

There are different types of spermicides: creams, gels, foams, film, and suppositories. Spermicides when used alone are less effective at avoiding pregnancy and do not protect against STDs or HIV/AIDs. When spermicides are used with another type of birth control, they are more effective, like with condoms or birth control pills.

Spermicides are inserted into the vagina before having sex – there are instructions of how long before sex they must be applied, usually 15 minutes before sex. Spermicides work by immobilizing (stopping) sperm from entering the cervix and kills sperm with spermicide. There is the possibility of allergic reactions to certain brands or vaginal irritation and risk of getting STDs if used twice in one day. You can buy spermicides at drugstores or online.

The sponge is 76-88%* effective at avoiding pregnancy. However, the sponge does not protect against STDs or HIV/AIDs.

The sponge is a round foam circle that is inserted into the vagina before having sex – one size fits all. The sponge stops sperm from entering the cervix and kills sperm with spermicide. Each sponge can be used only once. You can buy sponges at drugstores or online.

Other Methods

Exclusively breastfeeding a child will only protect against pregnancy until the child is six months old, the first menstrual period after birth, or the amount of breastfeeding is reduced.

After ovulation (the menstrual period) returns after birth, the breastfeeding method will not protect against pregnancy. This method does not protect against STDs or HIV/AIDs.

This method is very effective but, does not protect against STDs or HIV/AIDs. This method is intended as a back up for other birth control methods and is often called “Plan B.” This method is called the “emergency” birth control pill because it must be taken as soon as possible after vaginal intercourse. If taken within 72 hours (3 days) after intercourse, the chance of pregnancy is greatly reduced.

Emergency contraception is a hormone pill that works the same way regular birth control pills do: they stop an egg from being released (ovulation), or interfere with the implantation of the egg in the uterus.

People younger than 18 can only get Plan B from a doctor or provider. Older people can buy Plan B at drugstores, over the counter.

This method is helpful for people who forgot to use birth control, used failed methods (like a broken condom), as well as those who may have experienced rape and need to prevent pregnancy. Emergency contraception is safe and just about anyone at risk for pregnancy can take it.

REMEMBER: you must take Plan B within 3 days of vaginal intercourse to prevent pregnancy!

This method is least effective at avoiding pregnancy and does not protect against STDs or HIV/AIDs.

Sometimes it is called fertility awareness based (FAB) method. All these big words boil down to: a person knowing their cycle during menstruation (“period”) and when they are fertile or not. When a person is fertile, their egg(s) move through the Fallopian tubes to meet with sperm (fertilized) and embed in the lining of the uterus or become “flushed out” with the uterus lining during their period.

The rhythm method can be used for couples who may be planning on have a child and family in the future but are not ready right now. There is no cost, health risk, or side effects. However, this method requires that the person keep a careful record of their menstruation cycle and practice commitment, calculation and planning with their partner.

Sterilization is a permanent and effective surgical procedure to prevent pregnancy. However, sterilization does not protect against STDs or HIV/AIDs. Sterilization does not affect erections or sexual pleasure.

Vasectomy – when the tubes which carry sperm to the penis (vas deferens) are cut and sealed.

Tubal ligation – when the Fallopian tubes are cut and sealed so eggs are unable to reach the uterus. This is sometimes called “getting your tubes tied.”

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