Table 1.
Birth control methods and considerations for women with SCI
| Method | What is the risk for pregnancy? | How do you use this method? | How often is this used? | What are menstrual side effects? | Other possible side effects? | Other things to consider? | |
|---|---|---|---|---|---|---|---|
| Most effective | Female sterilization (tubal ligation) | 0.5 out of 100 | Surgical procedure | Once | No menstrual side effects | Pain, bleeding, risk of infection | Permanent |
| Male sterilization (vasectomy) | 0.15 out of 100 | ||||||
| Hormonal IUD | 0.2 out of 100 | Placed inside uterus | Up to 7 years | Spotting, lighter or no periods | Discomfort with placement; may trigger AD; expulsion may go undetected if sensation is impaired | No estrogen; may reduce cramps | |
| Copper IUD | 0.8 out of 100 | Up to 10 years | May cause heavier, longer periods | No hormones; may cause cramps | |||
| Implant | 0.05 out of 100 | Placed in upper arm | Up to 3 years | Spotting, lighter or no periods | Discomfort with placement; may trigger AD | No estrogen; may reduce cramps | |
| Moderately effective | Injectables | 4 out of 100 | Shot in arm, hip, or under the skin | Every 3 months | Spotting, lighter, or no periods | May cause weight gain | No estrogen; may reduce cramps |
| Pill | 8 out of 100 | Take by mouth | Every day at the same time | Can cause spotting for the first few months; periods may become lighter | Nausea, breast tenderness; risk for blood clots | Progestin-only pill formulations may be preferable; may improve acne; may reduce menstrual cramps; lowers ovarian and uterine cancer risk | |
| Patch | 9 out of 100 | Put on skin | Weekly | ||||
| Ring | 9 out of 100 | Put in vagina | Monthly | ||||
| Diaphragm | 12 out of 100 | Put in vagina with spermicide | Every time you have sex | No menstrual side effects | Allergic reaction, irritation | No hormones | |
| Least effective | External condom | 13 out of 100 | Put over penis | Every time you have sex | No menstrual side effects | Allergic reaction, irritation | No hormones; no prescription |
| Vaginal gel | 14 out of 100 | Put in vagina | Allergic reaction, irritation | No hormones; may require assistance to apply | |||
| Withdrawal | 20 out of 100 | Pull penis out of vagina before ejaculation | No side effects | No hormones; nothing to buy | |||
| Internal condom | 21 out of 100 | Put in vagina | Allergic reaction, irritation | No hormones; no prescription; may require assistance to position | |||
| Cervical sponge | 24 out of 100 | Put in vagina | Allergic reaction, irritation | ||||
| Fertility awareness-based methods | 24 out of 100 | Monitor fertility signs and abstain or use condoms on fertile days | Every day | No side effects | No hormones; increased awareness of fertility signs; basal body temperature tracking may be less reliable | ||
| Spermicides | 28 out of 100 | Put in vagina | Every time you have sex | Allergic reaction, irritation | No hormones; no prescription; may require assistance to apply |
Note: Adapted from the National Reproductive Health Training Center's “Birth Control Method Options,” 2022. AD = autonomic dysreflexia; IUD = intrauterine device.