Beyond pregnancy prevention

The options:
IUD
pros

• Easy to use
• Long-term protection
• Hidden
• Lightens period 
• Few or no side effects
• Choice of products
• Reversible

cons

• Medical visit
• No STI protection
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
99 %

Implant
pros

• Easy to use
• Long-term protection
• Hidden
• Lightens period for some
• Choice of products
• Reversible

cons

• Medical visit
• No STI protection
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
99%

"Not right now":
pros

• STI protection
• Few or no side effects
• No hormones

cons

• Harder to use

effectiveness at preventing pregnancy with typical use
100% if consistently done right

other options

• Withdrawal
• Sterilization
• The Patch
• The Pill

The options:
Hormonal IUD
pros

• Easy to use
• Long-term protection
• Hidden
• Lightens period 
• Few or no side effects
• Choice of products
• Reversible

cons

• Medical visit
• No STI protection
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
99 %

The Pill
pros

• Lightens period
• Hidden
• Choice of products
• Reversible

cons

• Medical visit
• No STI protection
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
91%

The Ring
pros

• Easy to use
• Medium-term protection
• Lightens period
• Reversible

cons

• Medical visit
• No STI protection
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
91%

other options

• The Patch
• The Shot
• Implant

The options:
Male condom
pros

• STI protection
• Widely available
• No medical visit
• Easy to use
• No hormones
• Few or no side effects*

* Unless latex allergy, but non-latex versions available

cons

• Limited pregnancy prevention
• Use one every time
• Best with a backup method

effectiveness at preventing pregnancy with typical use
82%

Female condom
pros

• STI protection
• No medical visit
• More control for women
• Easy to use
• No hormones
• Few or no side effects
• Safe with latex allergies
• Sexual pleasure for women

cons

• Limited pregnancy prevention
• Use one every time
• Not widely available
• Best with a backup method

effectiveness at preventing pregnancy with typical use
79%

"Not right now":
pros

• STI protection
• Few or no side effects
• No hormones

cons

• Harder to use

effectiveness at preventing pregnancy with typical use
100% if consistently done right

The options:
Male condom
pros

• STI protection
• Widely available
• No medical visit
• Easy to use
• No hormones
• Few or no side effects*

* Unless latex allergy, but non-latex versions available

cons

• Limited pregnancy prevention
• Use one every time
• Best with a backup method

effectiveness at preventing pregnancy with typical use
82%

Female condom
pros

• STI protection
• No medical visit
• More control for women
• Easy to use
• No hormones
• Few or no side effects
• Safe with latex allergies
• Sexual pleasure for women

cons

• Limited pregnancy prevention
• Use one every time
• Not widely available
• Best with a backup method

effectiveness at preventing pregnancy with typical use
79%

Sponge
pros

• No hormones
• Few or no side effects
• More control for women
• Can be inserted in advance

cons

• No STI protection
• Limited protection against pregnancy
• Not widely available
• Harder to use
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
76-88%

other options

• Spermicide
• Withdrawal
• “Not right now”
• Fertility awareness

The options:
Copper IUD
pros

• Long-term protection
• Hidden
• Lightens period 
• Few or no side effects
• Reversible
• Very effective in emergencies

cons

• Medical visit
• No STI protection
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
99%

Male condom
pros

• STI protection
• Widely available
• No medical visit
• Easy to use
• No hormones
• Few or no side effects*

* Unless latex allergy, but non-latex versions available

cons

• Limited pregnancy prevention
• Use one every time
• Best with a backup method

effectiveness at preventing pregnancy with typical use
82%

Female condom
pros

• STI protection
• No medical visit
• More control for women
• Easy to use
• No hormones
• Few or no side effects
• Safe with latex allergies
• Sexual pleasure for women

cons

• Limited pregnancy prevention
• Use one every time
• Not widely available
• Best with a backup method

effectiveness at preventing pregnancy with typical use
79%

other options

• Withdrawal
• Sponge
• Spermicide
• Diaphragm

The options:
IUD
pros

• Easy to use
• Long-term protection
• Hidden
• Lightens period 
• Few or no side effects
• Choice of products
• Reversible

cons

• Medical visit
• No STI protection
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
99 %

Implant
pros

• Easy to use
• Long-term protection
• Hidden
• Lightens period for some
• Choice of products
• Reversible

cons

• Medical visit
• No STI protection
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
99%

The Shot
pros

• Easy to use
• Medium-term protection
• Hidden
• Lightens period

cons

• Medical visit
• No STI protection
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
94%

other options

• Sterilization

The options:
IUD
pros

• Easy to use
• Long-term protection
• Hidden
• Lightens period 
• Few or no side effects
• Choice of products
• Reversible

cons

• Medical visit
• No STI protection
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
99 %

Implant
pros

• Easy to use
• Long-term protection
• Hidden
• Lightens period for some
• Choice of products
• Reversible

cons

• Medical visit
• No STI protection
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
99%

The Ring
pros

• Easy to use
• Medium-term protection
• Lightens period
• Reversible

cons

• Medical visit
• No STI protection
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
91%

other options

• The Patch
• Sterilization
• The Shot

The options:
Copper IUD
pros

• Long-term protection
• Hidden
• Lightens period  
• Few or no side effects
• Reversible
• Very effective in emergencies

cons

• Medical visit
• No STI protection
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
99%

EC Pill (Ella)
pros

• Very effective in emergencies

cons

• Protection after the fact
• Medical visit
• Most pharmacies need to order it
• Not effective as a regular method
• No STI protection
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
95% up to 5 days after sex

EC Pills (Levonorgestrel-based)
pros

• Very effective in emergencies
• Choice of products

cons

• Protection after the fact
• Medical visit
• Not effective as a regular method
• No STI protection
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
95% first 24 hours then declines slightly

The Bedsider guide to the male condom.

Found it!
“I was with a girl and we were having sex. When I was about to finish, I pulled out and didn’t realize the condom I was wearing broke. She found the condom when she went to the restroom.”
—Justin N., Metropolitan State University of Denver in Colorado

What it is & how it works Male condoms are one of the most popular forms of birth control out there. They slip over a guy’s penis to prevent pregnancy and lower the risk of STIs by keeping the guy’s sperm inside the condom.

Use condoms for STI protection with other methods of birth control. Condoms aren’t the most effective method for birth control. But unlike most forms of contraception, they can often prevent transmission of STIs.

Find the best fit in advance Condoms are not one-size-fits-all. The wrong size condom might not be as effective or comfortable. It’s important for men to explore their options ahead of time.

Choose lubricated condoms or add lubrication to make the experience more comfortable and pleasurable for both parties. For comfort, pick a lubricant that is water-based, unscented, and isn’t “warming” or “cooling.”

Don’t forget perseverance and humor Sometimes, condoms don’t cooperate. But it’s important to persevere and learn how to “suit up” for present and future encounters. An understanding and patient partner can take some of the pressure off (you’ll be having more fun eventually). And don’t be afraid to laugh.

Women are responsible for condoms too Dr. K.: “Women should feel empowered to buy male or female condoms. It’s not always the guy’s responsibility. If you want to have sex, you should have a condom too.”

The Bedsider guide to the female condom.

Develop your insertion skills
“Young women: Be the one to protect yourself. Using female condoms lets you be in control. Practice putting one in at home. Don’t wait till the heat of the moment then get aggravated because you can’t get it in right. Practice, practice, practice!”
– Jennifer W., Tulsa Community College, Oklahoma

What it is & how it works The female condom is a pouch you insert into your vagina. It keeps the guy’s sperm inside the condom and out of your vagina. Unlike most male condoms, it doesn’t contain latex.

Practice in advance Dr. K.: “If you’re feeling apprehensive or intimidated, practice inserting it ahead of time. Be sure to read the instructions! Also, don’t be shy with using lubrication. With a bit of practice, you’ll be a pro.”

Use condoms for STI protection with other methods of birth control. Male and female condoms aren’t the most effective method for birth control. But unlike most forms of contraception, they’re great for STI prevention.

Women are responsible for condoms too Dr. K.: “Women should feel empowered to buy male or female condoms. It’s not always the guy’s responsibility. Unfortunately the female condom is not widely available in drug stores, but is available at Amazon.com and Walgreens.com.”

Choose lubricated condoms or add lubrication to make the experience more comfortable and pleasurable for both parties. For comfort, pick a lubricant that is water-based, unscented, and isn’t “warming” or “cooling.”

The Bedsider guide to “Not right now.”

Somebody to love
I believe sex is a special and meaningful act that should be saved for someone you love. I haven’t found that person yet.”
—Matt A., College of Southern Idaho in Twin Falls

Is anyone worth it?
“I chose not to be sexually active because I have not yet found someone worth all the risks. I haven’t met someone that I know would love and support me through an STI or pregnancy, so therefore I have not found anyone worth losing my virginity to.”
—Caroline G., Indiana University Southeast, New Albany

What it is & how it works  Here, we’re using “not right now” to mean “no vaginal sex.” You can still be sexual in other ways—but be mindful that those other ways might introduce the risk of STIs.

You can always say “no” or “not right now”—for any reason. If you are feeling apprehensive or intimidated, this may not be the right time or partner.

Make conversation, not assumptions Dr. K.: “If your partner observes a particular religion, don’t assume that you don’t need to talk about birth control, sexuality, boundaries, or other topics. Conversations, not assumptions, are key to healthy relationships.”

The Bedsider guide to the IUD.

Relief from anxiety and phone alarms
“I was nervous at first to get an IUD. But reassurance from the nurse helped. I am so happy I did it because now I don’t have an embarrassing alarm going off on my phone. And I never have to worry about remembering the pills.”
—Liz P., Ohlone College in Fremont, California

What it is & how it works  This small, T-shaped piece of plastic sits in your uterus to mess with the way sperm can move and prevent them from fertilizing an egg. Sounds odd, but it works like a charm.

Insertion is okay Dr. K.: “Lots of people hear stories about IUD insertion being scary. Everybody’s experience is different. The scariness will go away, but your birth control stays in place. Most patients that I place the IUD in say, ‘Oh, that wasn’t nearly as bad as I thought!’”

Your IUD options:

• Mirena and Skyla last for three to five years. They contain hormones. These IUDs can make your periods much lighter or stop completely.
• ParaGard lasts for up to 12 years and does not contain hormones. Some women may experience increased blood flow or cramping while using this type of IUD.

Long acting and reversible contraception (LARC)
LARC methods are very low maintenance and can provide protection from pregnancy for years.

Also use condoms for protection from STIs.

The Bedsider guide to The Ring.

Birth control talk still shocks
“I discuss my birth control options openly with people. Whenever I tell anyone that I’m on the vaginal ring, I receive a shocked look. I don’t blame them; it’s not a popular option. Most people only know about the Pill. Then they say, ‘Wait, you mean, you stick it up there?’”
—Rebecca J., Brock University, Ontario, Canada

What it is & how it works  The NuvaRing is a small, flexible ring that you insert into your vagina. It contains hormones that stop your ovaries from releasing eggs. It works in a similar way to the Pill, but is much lower maintenance.

Don’t knock it till you try it Dr. K.: “All methods work for some women and not others. In a study of satisfied Pill users randomly assigned to the Patch or the Ring, 71 percent of women in the Ring group planned to continue using it after the study was completed.”

Three weeks in, one week out The Ring stays in place for three weeks. You take it out for the fourth week, which is usually when you get your period. After the fourth week you put a new ring in and start over.

Insertion diversion If you’re not okay with putting your fingers inside yourself, the Ring probably isn’t for you. It’s a lot like putting in a tampon: If you can do that, you’re good to go.

Also use condoms for protection from STIs.

About Rebecca’s experience Dr. K.: “It’s problematic that people feel okay asking women about their birth control choices, but then as soon as a woman mentions her vagina, they get grossed out.”

Sign up for reminders when it’s time to put it in and take it out.

For the Bedsider guide to the Pill.

“I started having sex when I was young, and I had just started taking birth control pills. My mother was fully aware of my taking them. However, my father was absolutely not aware that I was on this contraceptive pill. But, one day, he and I were eating dinner together, and I decided it would be a good time to take my pill. I tried to sneakily rummage through my purse and take it without him seeing, but instead I dropped the pill case on the ground. It broke apart right at his feet.”
—Jenna C., John Jay College of Criminal Justice in New York City, New York

“I’d been with a guy for many months and he finally stayed over one night. The next morning I woke up and took my pill, and he thought I was taking the ‘morning after pill.’ I informed him, ‘Just because I am on the Pill doesn’t mean I’m safe from your STDs,’ so I continued to make him use a condom.”
—Name and college withheld

What it is & how it works  You take the Pill once a day, at the same time every day. The Pill releases hormones that keep your ovaries from releasing eggs. The hormones also thicken your cervical mucus, which helps to block sperm from getting to the egg in the first place. 

Sign up for a daily reminder.

Period drama  The Pill comes in 21-day or 28-day packs. Some types give you a regular period every month. Others let you have your period more rarely.

Keep emergency contraception in your cabinet—in case you forget your pill and then have sex without a condom or other barrier method.

Also use condoms for protection from STIs.

The Bedsider guide to emergency contraception.

Pulling an all-nighter
“The one time a condom broke, my boyfriend and I had a panic attack immediately. We literally stayed up all night just so we could walk into a CVS just to get the ‘morning after pill.’ I don’t think I have ever been so nervous in my life.”
—Heather B., University of Miami in Coral Gables, Florida

What it is & how it works Emergency contraception (EC) pills, such as Plan B One-Step and Ella, stop a pregnancy before it starts. This means they are not the same as the abortion pill.

Copper IUD  ParaGard is the most effective EC. Have a provider insert it within five days of a misstep and lower your chance of pregnancy by 99.9 percent.

Buy emergency contraception in advance Dr. K.: “A common theme in students’ stories is that everyone had to rush out to get Plan B in the morning. There’s no reason not to just buy it and stick it in your cabinet. In a stressful time, things would have been easier if these students had it on hand.”

Over-the-counter EC pills These are available without a prescription at pharmacies and online. They include
Plan B One-Step, Next Choice One Dose, Next Choice, My Way, and Levonorgestrel.

Prescription EC pill Ella is a new EC pill that is available only by prescription. It works for up to five days after unprotected sex, and does not decrease in effectiveness over those five days.

An emergency contraception locator.

The Bedsider guide to withdrawal.

Withdrawal symptoms
“I was not using protection but attempted the withdrawal method. A few months later a friend told me my former partner was pregnant. I had to quickly search on Facebook to find her. I didn’t have to ask her ‘Is the baby mine?’ because she was only a few months along, which didn’t match up to when we were last together. However, it was a wake-up call to always use protection.”
—Paul J., Rutgers University Newark, New Jersey

No pressure, please
“We used condoms but sometimes he would complain it’s too expensive, then later there wasn’t time or we forgot. So we would use withdrawal. I felt like he was making excuses to not use condoms. Girls shouldn’t feel pressured into using withdrawal.”
—Name withheld, University of Kansas in Lawrence

What it is & how it works  The guy pulls out before he ejaculates. The key thing to remember is this: You’ve got to do it right—every single time—for withdrawal to be effective. And how many guys do you know with that kind of total control?

Higher risk of pregnancy Dr. K.: “Withdrawal, the diaphragm, and the sponge are less effective than some other methods, so as primary pregnancy prevention they’re not acceptable to many couples. Everyone is different, though, and effectiveness isn’t always the number-one concern. It’s important to have a good understanding of the risks and benefits.”

The Bedsider guide to the sponge.

Advance planning
“We maintained a long-distance relationship, and I didn’t want to use the Pill daily. I boarded the plane with the sponge in place. My boyfriend met me at the airport. We had a luxurious meal at a Greek cafe, a few glasses of wine, went back to his apartment, joyously threw our clothes off, and celebrated our union. The disadvantage: My boyfriend reports the foam masks my natural aroma and taste. Also, wear a panty liner so it doesn’t mark your panties.”
—Solange S., St. Mary’s University, Nova Scotia, Canada

What it is & how it works  The sponge is a small round piece of white plastic foam, which you insert into your vagina before you have sex. It blocks your cervix to keep sperm from getting into your uterus, and continuously releases spermicide. Think of it like a bouncer at the nightclub door to your uterus.

No foreplay interruptus  Here’s the handy thing about the sponge—you can insert it up to 24 hours before you get busy. So there’s no need to fumble in the dark right before the big moment. But it does take a bit of practice getting it in.

Higher risk of pregnancy Dr. K.: “The sponge is less effective than some other methods. It’s great if you combine a sponge with a condom, but it’s very difficult to rely on this method as your primary method.”

Also use condoms for protection against STIs.

The Bedsider guide to the diaphragm.

Puts the woman in control
“My partner says she likes the diaphragm because there’s no stopping and putting on the condom and no hormones that can mess up her cycle. She says that it is easy to put in, easy to remove and clean up, and this way she is 100 percent certain that contraception is used and used correctly. She had an ex that routinely lied to her and was attempting to get her pregnant to force a marriage. No babies so far and it’s a lot cheaper than buying condoms all the time.”
—Spencer M., College of Southern Idaho, Twin Falls

How it works  A diaphragm is a shallow, dome-shaped cup made of latex or silicone. You insert it into your vagina, so it covers your cervix and keeps sperm out of your uterus.

Use it with a spermicide—or the diaphragm will not work effectively.

Higher risk of pregnancy Dr. K.: “The diaphragm is not very effective as primary birth control and doesn’t protect against STIs.”

No foreplay interruptus Dr. K.: “Diaphragms are another method that allows women to take control of their birth control, since it can be inserted before sexual activity has begun.”

Also use condoms for protection from STIs.

For the Bedsider guide to the implant.

Three stress-free years
“I started out with the Depo shot, but I was too busy to remember every three months. My doctor said the implant was convenient and a one-time insertion and would last for three years, worry free. Why not? It was very effective and very convenient. You don’t need reminders or alarms to take a pill or change a patch or switch a ring. You also don’t have to worry about it being misplaced or getting ‘lost.’”
—Ka Y., University of Wisconsin at Manitowoc  

What it is & how it works  The implant is a teeny-tiny rod inserted under the skin of your upper arm. The implant releases hormones that keep your ovaries from releasing eggs and thicken your cervical mucus, which helps to block sperm from getting to the egg in the first place. It prevents pregnancy for three years. 

The most effective method  The implant is more effective than the IUD or any other method, with a failure rate of five out of 10,000.

Period drama  Dr. K.: “The effect on bleeding is unpredictable. My patients who love the implant say, ‘I don’t mind what happens with my period: I want to know I’m not pregnant.’”

Love it or hate it Dr. K.: “Just like with the Ring, the women who love it love it, and the women who hate it hate it. If you think this method will work for you, then by all means try it out. Some women are comfortable getting the implant inserted in their arm, because it’s familiar, like a tattoo or piercing.”

Also use condoms for protection from STIs.

The Bedsider guide to The Patch.

Trial and error
“I had previously been on the Pill and kept forgetting to take it. Then I tried the Shot, but after six months my period was still not regulated and I was spotting almost every day and became anemic. Then my gyno recommended the Patch, which has worked the best for me. What I like about this method is the easy application and the fact that my period is so well regulated that I know exactly when it will start and end.”
—Taylor U., University of Wisconsin-Madison

What it is & how it works The Patch is a thin, beige piece of plastic that looks like a square Band-Aid. You stick the Patch on your skin and it gives off hormones that prevent your ovaries from releasing eggs. The hormones also thicken your cervical mucus, which helps to block sperm from getting to the egg in the first place. Its medical name is Ortho Evra.

Less effective against pregnancy  Dr. K.: “It’s great that this patient found a method that works for her, and addresses her priority of regular bleeding.  It’s important to keep in mind that the typical failure rate is about 1 in 10, so adding barrier protection (i.e., a condom) is a good idea as well.”

Also use condoms for protection from STIs.

Sign up for a reminder to keep you and your patch on track.