Table 1.
Effectiveness of contraceptive methods
| Method | Perfect use efficacy (%)** | Typical use efficacy (%)*** | 1-year continuation rate (%) | Benefits | Disadvantages |
|---|---|---|---|---|---|
| Long-term methods | |||||
| Male sterilization | >99 | >99 | 100 | Permanent; superior effectiveness; quick recovery; no partner reliance; does not interrupt sex | Requires time for procedure; expertise of provider; risk of infection or surgical complications; potential of regret; does not protect against STIs |
| Female sterilization | >99 | >99 | 100 | Permanent; superior effectiveness; quick recovery; no partner reliance; does not interrupt sex; safe while breastfeeding | Requires time for procedure; expertise of provider; risk of infection or surgical complications; potential of regret; does not protect against STIs |
| Hormonal implant | >99 | >99 | 83–92 | Lasts for up to 3 years; easily reversible; easy to use (do not have to do anything); discreet; can be used while breastfeeding; does not interrupt sex | Provider needs to place and remove it; may cause changes in menstrual flow, headaches, or acne; increased risk of ectopic pregnancy; does not protect against STIs |
| IUDs | >99 | >99 | 74–88 | Can last from 3 to 12 years depending on the IUD chosen; easy to use; hormonal IUD may make periods lighter and shorter; copper IUD has no hormones; discreet; can be used while breastfeeding; does not interrupt sex | Provider needs to place and remove it; may cause changes in menstrual flow; IUD may come out on its own; increased risk of ectopic pregnancy; does not protect against STIs |
| Short-term methods | |||||
| Contraceptive injection | >99 | 94 | 23–57 | Easy to use; lasts for 3 months; discreet; may make periods lighter/shorter or cause amenorrhea; may be used while breastfeeding | Provider needs to give it every 3 months; may cause irregular bleeding, change in appetite, weight gain |
| Vaginal ring | >99 | 91 | 54 | Monthly method (instead of daily/weekly); discreet; may make periods lighter/shorter and regular; may clear up acne; may reduce menstrual cramps | Need to change it every month; its use needs prescription from provider; not recommended for those with contraindications to estrogen use; may cause breast tenderness, spotting, or nausea in the beginning; women need to be comfortable placing it |
| Patch | >99 | 91 | 49 | Easy to use (weekly method); does not interrupt sex; may make periods lighter/shorter and regular; may clear up acne; may reduce menstrual cramps | Need to change it every month; its use needs prescription from provider; not recommended for those with contraindications to estrogen use; may cause breast tenderness, spotting, or nausea in the beginning |
| Oral contraceptive pills | >99 | 91 | 55 | Easy to use; does not interrupt sex; may make periods lighter; may clear up acne; may reduce menstrual cramps | Need to take it every day; need prescription from provider; not recommended for those with contraindications to estrogen use; may cause breast tenderness, spotting, or nausea in the beginning |
| Other methods | |||||
| Male condom | 98 | 82 | N/A | Protects against STIs; no prescription required; available in latex and nonlatex forms and with or without spermicide | Must be used every time; may reduce sensitivity |
| Female condom | 95 | 79 | N/A | Protects against STIs; no prescription required; can be used even if allergic to latex | Must be used every time; must feel comfortable placing it into vagina |
| Diaphragm | 94 | 88 | N/A | Can be placed hours before sex; does not have any hormones; can be used while breastfeeding | Some diaphragms need fitting; needs to be used every time; may cause vaginal irritation; needs to be used with spermicide |
| Cervical cap | N/A | 71–86 | N/A | Can be placed hours before sex; does not have any hormones; can be used while breastfeeding; does not require prescription | Must be used every time; some women may have a hard time placing it into the vagina; may cause vaginal irritation; needs to be used with spermicide |
| Sponge | 80–91 | 76–82 | N/A | Can be placed hours before sex; does not have hormones; does not require prescription; can be used while breastfeeding | Must be used every time; some women may have a hard time placing it into the vagina; may cause vaginal irritation; needs to be used with spermicide |
| Withdrawal | 96 | 78 | N/A | No prescription necessary; no costs | Difficult to perform perfectly every time; relies on male knowing when he will ejaculate |
| Fertility awareness methods | 95–99 | 76–88 | N/A | No prescription necessary; does not contain hormones; no side effects; helps women to learn about their body | Requires a lot of effort, record-keeping, and self-control; requires abstinence; some methods do not work for women with irregular periods |
| Spermicide | 82 | 72 | N/A | Easy to use; no prescription necessary (available over the counter); does not affect hormones; can be used while breastfeeding | May cause allergic reactions; needs to be used every time; may be messy |
**
Pregnancy rates during perfect use show how effective methods can be, where perfect use is defined as following the directions for use.
***
Pregnancy rates during typical use show how effective the different methods are during actual use (including inconsistent or incorrect use).
Abbreviations: CDC, Centers for Disease Control and Prevention; IUDs, intrauterine devices; N/A, not applicable; STIs, sexually transmitted infections.