What is the most reliable form of birth control?

One of the most reliable forms of birth control is Depo-Provera, an injection you receive every three months that is over 99 percent effective in preventing pregnancy. There are multiple other birth control methods. Condoms have a 10 to 12 percent failure rate but do afford some protection against sexually transmitted diseases (STD). Other options include spermicidal foam with a 10 to 12 percent failure rate, diaphragms with a five percent failure rate, birth control pills with around a half percent failure rate and intrauterine contraceptives (IUD) which are over 97 percent effective. All failure rates are approximate.

There is an advantage to using spermicidal foam and condoms which have only a one percent failure rate when used together, providing both reliable contraception and protection from STD. An advantage with diaphragms is there are no medications or other substances that may have potential for causing adverse reactions. However, a diaphragm can be quite labor intensive to use so many people will not use it.

IUDs are generally recommended for women who have had children, although they can be prescribed for women who have never given birth. An IUD is a T-shaped device placed inside the uterus and can be left in place for five to ten years, depending on the type of device. It can be removed by your health care provider at any time and most women return to normal fertility within a month or two. The IUD is expensive upfront; however, because it can last five to ten years, the cost is about the same over time as contraceptive pills or injections. Some women feel mild discomfort for a few weeks following IUD placement and IUDs can fall out and can be associated with irregular bleeding.

A common challenge with birth control pills is remembering to take it every day. Aside from this one drawback, birth control pills have very few side effects. A few women bleed irregularly. Birth control pills help to regulate periods by decreasing flow and secondarily decreasing cramps. When birth control pills were introduced in the 1950s, the dosage was very high. We used to be concerned with hypertension and headaches. Now dosages are very small and the occurrence of stroke or blood clot is extremely rare. However there is increased risk after age 35 in women who smoke. Newer low-dose pills don’t inhibit ovulation so most people become fertile right away after stopping the pill.

Depo-Provera has been associated with weight gain in some women but is convenient for people who can’t remember to take the pill every day. Some women may experience irregular bleeding for the first three to six months but over time it can stop periods altogether. The Depo-Provera injection has a very low failure rate and prevents pregnancy for three months. After stopping Depo-Provera, it may take several months to have ovulation return. Most women achieve pregnancy within 12 to 18 months after stopping the injections.

All of these methods of birth control have been around for many years – the diaphragm since around the turn of the 20th century, birth control pills and IUDs since the 1950s – and can be used effectively for family planning. Birth control pills can also be used to regulate periods and decrease menstrual cramps.