Women’s Health: birth-control basics
Feb 16,2007 00:00 by Douglas W. Laube, MD, MEd

More than 38 million women in the US—about 64% of women of childbearing age—practice some form of contraception.  All women should know what their contraceptive options are, how they work, and how they meet different lifestyle needs.


Dr. Laube is President of The American College of Obstetricians and Gynecologists. 

Birth control falls into five main categories—hormonal contraception, barrier methods, intrauterine device (IUD), sterilization, and natural family planning.  For maxium effectiveness, hormonal, barrier, and natural family planning methods all must be used consistently and correctly every time, while IUDs and sterilization do not require further action from the patient.  Here’s some basic information on each method:

Birth control pills, injections, vaginal rings, skin patches, and implants are all types of hormonal contraception, which rely on hormones to prevent ovulation.  These hormones also cause changes in the cervical mucus and uterus to help prevent pregnancy. 

Barrier methods, such as male and female condoms, spermicides, diaphragms, sponges, and cervical caps, provide either a physical or chemical barrier to the sperm reaching the egg. 

The IUD is a small T-shaped device that is inserted into the uterus by a physician.  Both copper and hormonal IUDs cause a reaction inside the uterus and fallopian tubes that makes it difficult for the egg to be fertilized and also reduces sperm’s ability to fertilize the egg.  Additionally, hormonal IUDs cause changes in the cervical mucus and uterus, much like other hormonal methods. 

Tubal sterilization in women and vasectomy in men permanently block the pathways of egg and sperm.  These are usually surgical procedures, but women can talk to their ob-gyns about a newer, non-surgical tubal sterilization method. 

Natural family planning uses a variety of methods that do not rely on drugs or devices.  A woman’s menstrual cycle is used to plan sex around times when the likelihood of pregnancy is lowest. 

Women should talk to their ob-gyn about risks and benefits, effectiveness, and convenience of their current birth control method at least annually, and reevaluate contraceptive options at times of major life changes, such as right after the birth of a child or during perimenopause.

For more information, the Patient Education Pamphlet “Birth Control” is available at www.acog.org/publications/patient_ education/bp005.cfm

About the author:  Dr. Laube is President of The American College of Obstetricians and Gynecologists.