Contraception include barrier methods, such as condoms or diaphragm, injectable contraceptives, and hormonal contraception, also known as oral contraception. The most common methods of hormonal contraception include the combined oral contraceptive pill and the minipill. Hormonal emergency contraception can be both contraceptive and contragestive.
Contragestion
Main article: Contragestion
Contragestives include intrauterine devices placed inside the uterus and some forms of hormonal "emergency contraception".
Surgical sterilization is available in the form of tubal ligation for women and vasectomy for men. Although sterilization is considered a permanent procedure due to the uncertainty of reversal possibility, it is possible to attempt a tubal reversal to reconnect the Fallopian tubes in females or a vasectomy reversal to reconnect the vasa deferentia in males. The rate of success depends on the type of sterilization that was originally performed and damage done to the tubes as well as the patient's age.Sterilization
Vasectomy
A Vasectomy is a minor surgical procedure for male sterilization and/or birth control. During the procedure, the vasa deferentia of a man are severed, and then tied/sealed in a manner which prevents sperm from entering into the seminal stream (ejaculate). Vasectomy should not be confused with castration, which is the surgical removal of the testicle(s).
Behavioral methods
Behavioral methods involve regulating the timing or methods of intercourse to prevent the introduction of sperm into the female reproductive tract, either altogether or when an egg may be present.
Lactational
Main article: Lactational amenorrhea method
From ancient times women tried to extend breastfeeding in order to avoid a new pregnancy. The lactational amenorrhea method, or LAM, gives guidelines for determining the length of a woman's period of breastfeeding infertility.
Fertility awareness
Symptoms-based methods of fertility awareness involve a woman's observation and charting of her body's fertility signs, to determine the fertile and infertile phases of her cycle. Charting may be done by hand or with the assistance of fertility monitors. Most methods track one or more of the three primary fertility signs: changes in basal body temperature, in cervical mucus, and in cervical position. If a woman tracks both basal body temperature and another primary sign, the method is referred to as symptothermal. Other bodily cues such as mittelschmerz are considered secondary indicators.
Calendar-based methods such as the rhythm method and Standard Days Method estimate the likelihood of fertility based on the length of past menstrual cycles. To avoid pregnancy with fertility awareness, unprotected sex is restricted to the least fertile period. During the most fertile period, barrier methods may be availed, or she may abstain from intercourse.
The term natural family planning (NFP) is sometimes used to refer to any use of fertility awareness methods. However, this term specifically refers to the practices that are permitted by the Roman Catholic Church — breastfeeding infertility for example. FA methods may be used by NFP users to identify these fertile times.
Coitus interruptus
Coitus interruptus (literally "interrupted sexual intercourse"), also known as the withdrawal or pull-out method, is the practice of ending sexual intercourse ("pulling out") before ejaculation. The main risk of coitus interruptus is that the man may not perform the maneuver correctly, or may not perform the maneuver in a timely manner. Although concern has been raised about the risk of pregnancy from sperm in pre-ejaculate, several small studies have failed to find any viable sperm in the fluid.
Avoiding semen near vagina
Non-penetrative sex is used to avoid pregnancy, but pregnancy can still occur with Intercrural sex and other forms of penis-near-vagina sex (genital rubbing, and the penis exiting from anal intercourse) where semen can be deposited near the entrance to the vagina and can itself travel along the vagina's lubricating fluids.
Total abstinence
Different groups define the term sexual abstinence in different ways. When used in discussions of birth control, usually the avoidance of all sexual activity—total sexual abstinence—is the intended meaning. Sometimes people choose to be sexually abstinent to eliminate their risk of pregnancy, and abstinence may be included in lists of birth control methods. Those who are sexually abstinent do not have unplanned pregnancies. Other sources instead classify abstinence as not being a form of birth control.
Abstinence is 100% effective in preventing pregnancy; however, not everyone who intends to be abstinent refrains from all sexual activity, and in many populations there is a significant risk of pregnancy from nonconsensual sex. As a public health measure, it is estimated that the protection provided by abstinence may be similar to that of condoms. Some authorities recommend that those using abstinence as a primary method have backup method(s) available (such as condoms or emergency contraceptive pills).
Induced abortion
Main article: abortion
Surgical abortion methods include suction-aspiration abortion (used in the first trimester) or dilation and evacuation (used in the second trimester). Medical abortion methods involve the use of medication that is swallowed or inserted vaginally to induce abortion. Medical abortion can be used if the length of gestation has not exceeded 8 weeks.
Some herbs are considered abortifacient, and some animal studies have found various herbs to be effective in inducing abortion in non-human animal species. Humans generally do not use herbs when other methods are available, due to the unknown efficacy and due to risks of toxicity.
Methods in development
For females
- Praneem is a polyherbal vaginal tablet being studied in India as a spermicide, and a microbicide active against HIV.
- BufferGel is a spermicidal gel being studied as a microbicide active against HIV.
- Duet is a disposable diaphragm in development that will be pre-filled with BufferGel. It is designed to deliver microbicide to both the cervix and vagina. Unlike currently available diaphragms, the Duet will be manufactured in only one size and will not require a prescription, fitting, or a visit to a doctor.
- The SILCS diaphragm is a silicone barrier that is still in clinical testing. It has a finger cup molded on one end for easy removal. Unlike currently available diaphragms, the SILCS diaphragm will be available in only one size.
- A longer acting vaginal ring is being developed that releases both estrogen and progesterone, and is effective for over 12 months.
- Two types of progestogen-only vaginal rings are being developed. Progestogen-only products may be particularly useful for women who are breastfeeding. The rings may be used for four months at a time.
- A progesterone-only contraceptive is being developed that would be sprayed onto the skin once a day.
- Quinacrine sterilization (non-surgical) and the Adiana procedure (similar to Essure) are two permanent methods of birth control being developed.
For males
Main article: Male contraceptive
Other than condoms and withdrawal, there is currently only one method of birth control available. This option is undergoing a vasectomy, a minor surgical procedure wherein the vasa deferentia of a man are severed, and then tied/sealed in a manner which prevents sperm from entering the seminal stream (ejaculate). Several methods are in research and development:
- As of 2007, a chemical called Adjudin was in Phase II human trials as a male oral contraceptive.
- RISUG (Reversible Inhibition of Sperm Under Guidance), is an experimental injection into the vas deferens that coats the walls of the vas with a spermicidal substance. The method can potentially be reversed by washing out the vas deferens with a second injection.
- Experiments in vas-occlusive contraception involve an implant placed in the vasa deferentia.
- Experiments in heat-based contraception involve heating the testicles to a high temperature for a short period of time.