CHOOSING A CONTRACEPTIVE

A Reprint from FDA Consumer Magazine Printed December 1993. PUBLICATION NO. (FDA) 94-1213 (This article originally appeared in the September 1993 FDA Consumer.)

Choosing a method of birth control is a highly personal decision, based on individual preferences, medical history, lifestyle, and other factors. Each method carries with it a number of risks and benefits of which the user should be aware.

Each method of birth control has a failure rate--an inability to prevent pregnancy over a one-year period. Sometimes the failure rate is due to the method and sometimes it is due to human error, such as incorrect use or not using it at all. Each method has possible side effects, some minor and some serious. Some methods require lifestyle modifications, such as remembering to use the method with each and every sexual intercourse. Some cannot be used by individuals with certain medical problems.

Spermicides Used Alone

Spermicides. which come in many forms--foams, jellies, gels, and suppositories-work by forming a physical and chemical barrier to sperm. They should be inserted into the vagina within an hour before intercourse. If intercourse is repeated. more spermicide should be inserted. The active ingredient in most spermicides is the chemical nonoxynol-9. The failure rate for spermicides in preventing pregnancy when used alone is from 20 to 30 percent.

Spermicides are available without a prescription. People who experience burning or irritation with these products should not use them.

Barrier Methods

There are five barrier methods of contraception: male condoms, female condoms, diaphragm, sponge, and cervical cap. In each instance, the method works by keeping the sperm and egg apart. Usually, these methods have only minor side effects. The main possible side effect is an allergic reaction either to the material of the barrier or the spermicides that should be used with them. Using the methods correctly for each and every sexual intercourse gives the best protection. For many people, the prevention of sexually transmitted diseases (STDs), including HIV (human immunodeficiency virus), which leads to AIDS, is a factor in choosing a contraceptive. Only one form of birth control currently available--the latex condom, worn by the man--is considered highly effective in helping protect against HIV and other STDs. FDA has approved the marketing of male condoms made from polyurethane as also effective in preventing STDs, including HIV. However, at press time, they were not yet being sold in this country. Reality Female Condom, made from polyurethane, may give limited protection against STDs but has not been proven as effective as male latex condoms. People who use another form of birth control but who also want a highly effective way to reduce their STD risks, should also use a latex condom for every sex act, from start to finish.
 

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