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IN FOCUS: ARTICLE |
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At Your Cervix
by Kate Pavao and Jennifer Johnsen, 12.19.06
When considering a barrier method — and birth control choices in general — think about your personality. |
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When it comes to birth control, girls have a lot of choices. Hormonal birth control (the pill, the patch, the ring, the shot, and the implant) and condoms are popular — and highly effective — methods. But some teens are also considering prescription barrier methods like diaphragms, caps, and shields — options that are non-hormonal, easily reversible, and require no involvement from a partner. Other teens are choosing the IUD, which provides long-term protection from pregnancy.
Know Thyself
When considering a barrier method — and birth control choices in general — think about your personality. "Are you a person that needs very passive, not-think-about-it birth control, because otherwise you'll forget it?" asks Dr. Sujatha Reddy, a gynecologist at Atlanta's Premier Care for Women. "Or are you more responsible, and will you remember to insert a diaphragm if you need to, or make sure you take your pill every day?"
Also consider your lifestyle. Smoking cigarettes can make certain kinds of birth control — like hormonal methods — a bad fit. Think, too, about how comfortable you are with your body (barrier methods require you to insert something into your vagina). Finally, what is your sex life like? Is sex going to be a once-in-a-while kind of thing? Are you going to be having sex with one person or many people?
Before visiting a health care provider, do your homework. "You have to know your health history, like what medical problems do you have, what medications do you have," says Dr. Reddy. And don't forget about your family history. Knowing about certain family problems, like blood clotting disorders, can help you and your provider determine what birth control method is best for you.
Prescription Barrier Methods
Prescription barrier methods, like diaphragms, caps, and shields, are inserted into the vagina to cover the cervix so that sperm can't make contact with the egg. Barrier methods are ineffective without a spermicide, which kills sperm. Spermicides, which come in many forms including creams, foams, films, gels, and vaginal suppositories, are available at family planning clinics, drugstores, and some supermarkets. Read the directions carefully, because some must be used with certain prescription barrier methods, while others can be used with all kinds of barriers. The over-the-counter barrier method you should use every time you have sex is the condom. Latex condoms will increase your protection against pregnancy and sexually transmitted infections (STIs).
Prescription barriers are all fairly affordable: You'll spend from $50-$200 on an examination, $15-75 for your birth control, and $8-17 for spermicide jelly or cream. They may be cheaper at family planning health centers, so remember to ask up front.
Diaphragm
The diaphragm is a shallow, dome-shaped cup with a flexible rim. It fits securely in the vagina to cover the cervix.
Effectiveness
Sixteen out of 100 women who use the diaphragm will become pregnant during the first year of typical use. Six will become pregnant with perfect use.
Advantages
- no hormones
- easily reversible
- easy to carry with you
- can't be felt during sex
- inserted ahead of time — so doesn't interrupt sex
- can be reused for up to two years
Disadvantages
- doesn't prevent STIs
- needs to be fitted by a health care provider (and rechecked after significant changes to your body, such as childbirth)
- requires that you be comfortable touching your genitals
- can be difficult to insert
- can't be used during your period
- not recommended for women who have recently given birth, had an abortion after the first trimester, or had cervical surgery
- not suitable for women with allergies to latex or spermicide
- increases risk of urinary tract infections and toxic shock syndrome (TSS)
FemCap
The FemCap is a silicone cup shaped like a sailor's hat. It fits securely in the vagina to cover the cervix. It's available in three sizes: small, for women who have never been pregnant; medium, for women who have had an abortion or a cesarean delivery; and large, for women who have given birth vaginally.
Effectiveness
Fourteen out of 100 women who have never been pregnant or given birth vaginally and use FemCap will become pregnant during the first year of typical use. Of 100 women who have given birth vaginally and use FemCap, 29 will become pregnant during the first year of typical use. Effectiveness rates for perfect use are not available.
Advantages
- no hormones
- easily reversible
- easy to carry with you
- inserted ahead of time — so doesn't interrupt sex
- can be reused for up to a year
Disadvantages
- doesn't prevent STIs
- effectiveness greatly decreases for women who have given birth vaginally
- causes some women and their partners pain or discomfort
- needs to be fitted by a health care provider (and rechecked after significant changes to your body, such as childbirth)
- can be difficult to insert
- requires that you be comfortable touching your genitals
- can't be used during your period
- not recommended for women who have recently given birth, had an abortion, or undergone cervical surgery
- not suitable for women with allergies to latex or spermicide
The Shield
Lea's Shield is a silicone cup with an air valve and a loop to aid in removal. It fits snugly over the cervix.
Effectiveness
Fifteen out of 100 women who use the shield will become pregnant during the first year of typical use. Effectiveness rates for perfect use are not available.
Advantages
- no hormones
- easily reversible
- easy to carry with you
- inserted ahead of time — so doesn't interrupt sex
- only comes in one size, so doesn't require a fitting
- can be left in twice as long as a diaphragm (48 hours vs. 24 hours)
- can be reused for up to six months
- OK for women with latex allergies
Disadvantages
- doesn't prevent STIs
- causes some women and their partners pain or discomfort
- requires that you be comfortable touching your genitals
- can be difficult to insert
- can increase risk of urinary tract infections
- can't be used during your period
- not recommended for women who have recently given birth, had an abortion after the first trimester, or undergone cervical surgery
- not suitable for women with allergies to latex or spermicide
IUDs
An IUD, or Intrauterine Device, is a small, T-shaped contraceptive made of flexible plastic. There are two types of IUDs available in the U.S. — one releases copper, and one releases progestin. Both are placed in the uterus by a clinician. The IUD prevents pregnancy by preventing sperm from joining with an egg. IUDs cost between $250-$450 for the exam, insertion, and follow-up visit.
Effectiveness
One or fewer out of 1,000 women using IUDs will become pregnant during the first year of use. Fewer than one will become pregnant with perfect use.
Advantages
- don't have to think about it every time you have sex
- depending on which kind of IUD you use, can be left in place for five to 12 years
- highly effective in preventing pregnancy
- reversible
Disadvantages
- doesn't prevent STIs
- can cause cramping, heavier bleeding, and spotting, especially in the first few months
- can become dislodged — especially for women who have not given birth
- very rarely, the uterus is punctured during insertion, requiring surgery
Special Caution for Teens
A teen may not be able to use an IUD if her uterus is too small — a health care provider can tell you if an IUD is right for you.
It's All About You
In the end, the right birth control method is the one you feel comfortable with — and it might take some time to find it. "With all birth control, it tends to be a bit of trial and error. There's not one birth control that's going to be for everybody," says Dr. Reddy. "It's not a big deal if you have to try a few here and there to find the one that really works for you, because everybody's different."
To make an appointment to get birth control, please call 1-800-230-PLAN for the Planned Parenthood center nearest you. |
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