Quiz: How Much Do You Know About Birth Control?

Birth control, also called contraception, are methods, medications, and devices used to prevent pregnancy.

The only 100% reliable method that can prevent pregnancy is abstinence, which means avoiding penile-vaginal intercourse and any sexual activity in which sperm can get near or into the vagina.

After abstinence, the next best form of birth control in terms of effectiveness is surgical sterilization, either a tubal ligation (“tubes tied”), sterilization implant, or hysterectomy (removal of the uterus) in women, or a vasectomy in men.

Surgical methods of birth control are not usually reversible. The most effective reversible form of birth control is long-acting reversible contraception such as an intrauterine device (IUD) or implant plus a condom. IUDs and implants work the best to prevent pregnancy.

Hormonal birth control methods such as birth control pills are also very effective in preventing pregnancy when used perfectly, but many people do not use them perfectly, which can result in pregnancy.

Types of contraception include:

• Long-acting reversible contraception (LARC)
• Hormonal birth control
• Barrier methods
• Emergency contraception
• Sterilization
• "Natural" birth control

Long-acting reversible contraception (LARC) is considered the most effective form of reversible contraception. Examples of LARC include:

• Intrauterine devices (IUDs) (also called an intrauterine system, or IUS)
• Small, T-shaped devices inserted into the uterus by a health care provider that remain in place to prevent pregnancy for years
• Hormonal IUDs release the hormone progestin (levonorgestrel) into the uterus, to help prevent sperm from reaching or fertilizing the egg and possibly preventing the ovaries from releasing eggs
• Copper IUDs prevent sperm from reaching and fertilizing the egg, and prevent an egg from attaching in the uterus

• Implants
• Implantable rods surgically inserted by a physician under the skin of the upper arm
• Release a form of the female hormone progestin and can stay in place for up to 5 years

Hormonal methods of birth control use hormones to regulate or stop ovulation in order to prevent pregnancy.

Types of short-acting hormonal methods include:

• Injectable birth control
• Progestin-only pills (POPs)
• Combined oral contraceptives (also called COCs or “the pill”) are taken
• Contraceptive patches
• Vaginal ring

Barrier methods of birth control are those that prevent sperm from entering the uterus and are meant to be used each time you have sex.

Male condoms and female condoms are the only types of barrier birth control that can protect against sexually transmitted diseases (STDs). Condoms are not the most effective form of birth control and are best used along with another form of birth control such as an IUD, implant, or shot.

Other types of barrier methods of birth control that do not protect against STDs include:

• Contraceptive sponges
• Diaphragms
• Cervical caps
• Spermicides may be used alone or in combination with a diaphragm or cervical cap

Male and female condoms, contraceptive sponges, and spermicides are available without a prescription. Diaphragms and cervical caps require a doctor visit.

Emergency contraception is used after unprotected intercourse or if a condom breaks.

Emergency contraceptive pills (ECPs, or “morning after pills”) are hormonal pills such as Plan B One-Step and generic versions that are available in drugstores and some supermarkets, taken either as a single dose or two doses 12 hours apart, used in the event of unprotected intercourse. They should be taken as soon as possible after unprotected sex and are not intended to be used as a regular method of contraception. Emergency contraception is not the same as "the abortion pill."

Copper IUDs can also be inserted as a method of emergency contraception within 5 days (120 hours) of unprotected intercourse and are a very effective method of contraception for as long as the device remains in place.

Sterilization refers to surgical procedures that are permanent forms of birth control that are used to either prevent pregnancy or prevent the release of sperm.

Sterilization procedures for women include:

• Implant: a nonsurgical method used to permanently block the fallopian tubes
• Tubal ligation ("tubes tied"): a surgical procedure in which the fallopian tubes are cut, tied, or sealed so sperm cannot reach an egg to fertilize it, and an egg cannot reach the uterus
• Hysterectomy: surgical removal of the uterus, usually performed for reasons other than contraception, though it makes pregnancy impossible

A vasectomy is a surgical procedure performed on males to cut, close, or block the vas deferens, so sperm cannot leave the testes and cannot reach the egg.

"Natural" birth control does not require use of medication, devices, or surgery. Natural birth control methods are the least effective.

Examples of natural birth control include:

• Withdrawal: a man takes his penis out of a woman's vagina ("pulls out") before ejaculating
  • Sperm can be released before a man pulls out
• Natural family planning (rhythm method): involves tracking the days a woman is most fertile such as by body temperature or cervical mucus and avoiding sex or using back-up birth control during those times
  • It can be difficult to determine the most fertile days
• Breastfeeding (lactational amenorrhea method, or LAM): used by women who are breastfeeding who have not resumed menstrual periods, who breastfeed on demand day and night, and whose babies are less than 6 months old
  • The method can only be used short-term when all of the above criteria are met and there are no underlying health conditions where it would not be recommended