Contraception (birth control) methods are numerous, but basically, they include four groups: barriers, hormonal methods, spermicides, the timing of intercourse, and permanent surgical procedures. Barriers include diaphragms and condoms. Hormonal methods include the common birth control pill in numerous varieties, as well as devices impregnated with hormones. Gels, creams, and foams are available for spermicides, which kill sperm. The rhythm method and withdrawal before ejaculation are “natural” methods, both dependent on timing. Surgical procedures include tubal ligation and vasectomy.
With such a wide variety of options, “best” is really a matter of user preference and health issues. Only sterilization can be considered a permanent solution. Some women prefer birth control pills, while others would rather have a contraceptive injection every three months. Natural methods don’t have side effects, but forethought and self-control are critical, and these methods are more likely to result in pregnancy than other forms of contraception.
Even under the best of conditions, contraception can fail. The most secure methods are hormonal implants, intrauterine devices (IUDs) and female sterilization; these have the lowest unintended pregnancy rates. Using contraception consistently helps decrease the potential for failure. Another strategy to prevent unwanted pregnancy is to combine methods. For example, using a condom plus a diaphragm or combining either with a spermicide decreases the risk of contraceptive failure.
Like any medical treatment, contraception may have side effects. Spermicides may cause vaginal itching or irritation. An IUD may come out or cause heavy menstrual periods. Oral contraceptives may increase the chances of developing a blood clot for some women. Oral contraceptives may also increase the frequency or intensity of migraine headaches. Age, lifestyle, childbirth, smoking status and medical history all affect the risk of complications. The patient may need to try one or more methods before finding one that works well for her situation, or she may use different methods at different times in her life.
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