Table 1.
Contraceptive Options Currently Available in the United States
| Number of pregnancies expected in first year of use per 100 women using method24 | ||||||
|---|---|---|---|---|---|---|
| Class | Examples | Issues for cancer survivors | Pros | Cons | Typical use | Perfect use |
| Sterilization | Tubal ligation | Decreases ovarian cancer | Coitally independent | Irreversible | 0.5 | 0.5 |
| Essure | Long-term efficacy | 0.5 | 0.5 | |||
| Vasectomy | 0.15 | 0.10 | ||||
| Intrauterine | Copper 380A (Paragard) | Decreases endometrial cancer | Coitally independent | Insertion by a trained provider | 0.8 | 0.6 |
| Hormone free | Reversible | Heavier menses | ||||
| Effective for 10–20 years | May have more cramps | |||||
| Levonorgestrel (Mirena) | Decreases endometrial cancer | Coitally independent | Insertion by a trained provider | 0.2 | 0.2 | |
| Used with caution if concern of breast cancer | Reversible | |||||
| Effective for 5–7 years | ||||||
| Decreases vaginal bleeding | Irregular vaginal bleeding | |||||
| Progestin-only | Implant (Implanon) | Decreases ovarian cancer | Effective for 3 years | Insertion/removal by a trained provider requires small incision | 0.05 | 0.05 |
| Irregular vaginal bleeding | ||||||
| Progestin-only | Injection (Depo-Provera) | Decreases ovarian cancer | Effective for 3 months | Requires prescription and injection | 3 | 0.3 |
| Transient decrease in bone mineral density | Irregular vaginal bleeding | |||||
| Return to fertility may be delayed | ||||||
| Mini-pill (Micronor, Nor-QD, Camilla, Errin) | Decrease ovarian cancer | Taken daily | 8 | 0.3 | ||
| Irregular vaginal bleeding | ||||||
| Estrogen-containing | Pill | Decreases ovarian cancer May increase breast cancer | Coitally independent | Requires prescription | 8 | 0.3 |
| Increases thromboembolism | Regular withdrawal bleed | |||||
| Generics available | ||||||
| Patch (Ortho Evra) | Decreases ovarian cancer May increase breast cancer | Used weekly | Requires prescription | 8 | 0.3 | |
| Increases thromboembolism | Regular withdrawal bleed | |||||
| Ring (Nuvaring) | Decreases ovarian cancer May increase breast cancer | Used monthly | Requires prescription | 8 | 0.3 | |
| Increases thromboembolism | Regular withdrawal bleed | |||||
| Barrier Methods | Male/female condoms | Protection from HPV and cervical cancer | No prescription needed | Coitally dependent | 15 | 2 |
| Protection from infection | 21 | 5 | ||||
| Diaphragm | Requires prescription | 16 | 6 | |||
| Coitally dependent | ||||||
| Sponge | No prescription needed | Coitally dependent | 16–32 | 9–20 | ||
| Emergency contraception | Plan B | No increased risk of thrombosis | No prescription needed if >17 years of age | ? | Use <72 hours after intercourse reduces risk by ≥75% | |
| Behavioral | Withdrawal | No prescription needed | Coitally dependent | 27 | 4 | |
| Fertility awareness | 25 | 3–5 | ||||
| No method | 85 | 85 | ||||