How effective is contraception at preventing pregnancy?

How effective your contraception is depends on the type you use and whether you use it correctly.

Some methods are more effective than others. You need to follow the instructions and use your contraception correctly for it to be as effective as possible.

With some methods, such as the implant, there’s no need to remember to take or use them. These are known as methods with “no user failure”.

No contraceptive is 100% reliable, and some can have side effects. Find out about all the methods available so you can decide which contraceptive is right for you.

Perfect use or typical use

All the methods are listed here, showing how effective they are with “perfect use”. This is when the method is always used correctly.

Some methods are less effective with “typical use”. This is when the method is not always used correctly – for example, missing a pill or getting the injection later than you need to. Some methods do not have typical use rates because they have no user failure.

Contraception is less effective at preventing pregnancy if not used correctly.

Long-active reversible contraceptive (LARC) methods

You do not have to remember to take or use these methods. They have no user failure, so are not less effective with typical use.

• Contraceptive implant: more than 99% effective with perfect use. They work for 3 years, but can be taken out earlier. Fewer than 1 in 100 women using the implant will get pregnant in a year.
• Intrauterine system (IUS): more than 99% effective. An IUS normally works for 3 to 5 years depending on the type, but can be taken out earlier. Fewer than 1 in 100 women will get pregnant over the 3 to 5 years when using an IUS.
• Intrauterine device (IUD): more than 99% effective. An IUD can stay in place for 5 or 10 years depending on the type but can be taken out at any time. Fewer than 1 in 100 women will get pregnant in a year, depending on the type of IUD. Older types are less effective.

Contraceptive injection

Contraceptive injection 

• Perfect use: more than 99% effective. Fewer than 1 in 100 women will get pregnant in a year when using contraceptive injections regularly.
• Typical use: around 94% effective. Around 6 in 100 women will get pregnant in a year.

The injection lasts for 8 or 13 weeks, depending on the type.

Patch and ring

Contraceptive patch

• Perfect use: more than 99% effective.  Fewer than 1 in 100 women will get pregnant in a year when using the contraceptive patch correctly.
• Typical use: around 91% effective. Around 9 in 100 women who use the patch will get pregnant in a year.

Vaginal ring

• Perfect use: more than 99% effective. Fewer than 1 in 100 women will get pregnant in a year when using the vaginal ring correctly.
• Typical use: around 91% effective. Around 9 in 100 women using the ring will get pregnant in a year.

Contraceptive pill

Combined contraceptive pill

• Perfect use: more than 99% effective. Fewer than 1 in 100 women will get pregnant in a year when using the combined pill correctly.
• Typical use: around 91% effective. Around 9 in 100 women using the combined pill will get pregnant in a year.

Progestogen-only pill

• Perfect use: 99% effective. Around 1 in 100 women will get pregnant in a year when using the progestogen-only pill correctly.
• Typical use: around 91% effective. Around 9 in 100 women will get pregnant in a year.

Sterilisation (permanent contraception)

• Female sterilisation: more than 99% effective. Around 1 in 200 women will become pregnant in their lifetime after being sterilised.
• Male sterilisation or vasectomy: around 1 in 2,000 men can become fertile again in their lifetime after a vasectomy.

Male and female condoms

Male condoms

• Perfect use: 98% effective. This means that 2 in 100 women whose partners use a condom will get pregnant in a year.
• Typical use: around 82% effective. This means around 18 in 100 women will get pregnant in a year.

Female condoms

• Perfect use: 95% effective. About 5 in 100 women who use a female condom will get pregnant in a year.
• Typical use: around 79% effective. Around 21 in 100 women will get pregnant in a year.

Diaphragms and caps

Diaphragms and caps

• Perfect use: 92 to 96% effective. Between 4 and 8 women in 100 who use a diaphragm or cap with spermicide will get pregnant in a year.
• Typical use: around 71 to 88% effective. Between 12 and 29 women in 100 using a diaphragm or cap will get pregnant in a year.

Natural family planning

Natural family planning 

• Perfect use: can be up to 99% effective if the natural family planning methods are followed precisely. These include monitoring cervical secretions and your basal body temperature. It’s more effective if more than 1 method is used and it’s taught by specialist teachers. Up to 1 in 100 women will get pregnant in a year when using this method perfectly.
• Typical use: around 76% effective. Around 24 in 100 women using natural family planning will get pregnant in a year.

Page last reviewed: 17 April 2020

Next review due: 17 April 2023

Contraceptive Options and Effectiveness – Most or Moderately Effective Contraception

The chart describes types of contraception from the most to the least effective.

In this chart, the most or moderately effective contraceptive options have been highlighted.

Contraception resulting in less than 1 pregnancy per 100 women in a year

• Reversible contraception
  • Implant: 0.05% of women using an implant experienced an unintended pregnancy.
  • Intrauterine device (IUD): 0.2% of women using an LNG intrauterine device experienced an unintended pregnancy, and 0.8% of women using a Copper T intrauterine device experienced an unintended pregnancy.

• Permanent contraception
  • Male sterilization (vasectomy): 0.15% of women whose partners had male sterilization experienced an unintended pregnancy.
  • Female sterilization (abdominal, laparoscopic, or hysteroscopic): 0.5% of women who have had female sterilization experienced an unintended pregnancy.

How to make your method most effective

After the procedure there is little or nothing to do or remember. For vasectomy or hysteroscopic sterilization, use another method of the first 3 months.

Contraception resulting in 6-12 pregnancies per 100 women in a year

• Injectable: 6% of women using injectable contraception experienced an unintended pregnancy within the first year of typical use.
• Pill: 9% of women using a pill experienced an unintended pregnancy within the first year of typical use.
• Patch: 9% of women using a patch experienced an unintended pregnancy within the first year of typical use.
• Ring: 9% of women using a ring experienced an unintended pregnancy within the first year of typical use.
• Diaphragm: 12% of women using a diaphragm experienced an unintended pregnancy within the first year of typical use.

How to make your method most effective

• Injectable: Get repeat injections on time.
• Pills: Take a pill each day.
• Patch, ring: Keep in place, change on time.
• Diaphragm: Use correctly every time you have sex.

Contraception resulting in 18 or more pregnancies per 100 women in a year

• Male condom: 18% of women whose partners used a male condom experienced an unintended pregnancy within the first year of typical use.
• Female condom: 21% of women who used a female condom experienced an unintended pregnancy within the first year of typical use.
• Withdrawal: 22% of women who used withdrawal experienced an unintended pregnancy within the first year of typical use.
• Sponge: 24% of parous women and 12% of nulliparous women using a sponge experienced an unintended pregnancy within the first year of typical use.
• Fertility-Awareness Based Methods: 24% of women using fertility-awareness based methods experienced an unintended pregnancy within the first year of typical use.
• Spermicide: 28% of women using spermicide experienced an unintended pregnancy within the first year of typical use.

How to make your method most effective

• Condoms, sponge, withdrawal, spermicides: Use correctly every time you have sex.
• Fertility-awareness based methods: Abstain or use condoms on fertile days. The newest methods (Standard Days Method and TwoDay Method) may be the easiest to use and, consequently, more effective.

Other methods of contraception

• Lactational amenorrhea method: LAM is a highly effective, temporary method of contraception.
• Emergency contraception: Emergency contraceptive pills or a copper IUD after unprotected intercourse substantially reduces risk of pregnancy.

Condoms should always be used to reduce the risk of sexually transmitted infections.

Adapted from WHO’s Family Planning: A Global Handbook for Providers (2001) and Trussell et al (2011).

Modern methods of contraception Medical On Group Khabarovsk

When choosing a method of contraception, it is very important to consider its effectiveness.
Low efficiency:

• calendar method;
• temperature method;
• interrupted intercourse.

Medium effective:

• condoms;
• spermicides.

High Efficiency:

• sterilization;
• hormonal contraception;
• intrauterine device.

Currently, the most common method of preventing unwanted pregnancy is hormonal contraception.

Hormonal contraceptives have been used for over 55 years. They have won the trust and respect of many women because they provide a high and effective level of protection against unwanted conception.

Hormonal contraceptives include:

• birth control pills;
• vaginal ring;
• plasters;
• injection;
• implants;
• hormonal coils.

The menstrual cycle is the time from the first day of the previous period to the first day of the next period. Its duration is normally from 25 to 35 days, but most often 28 days.

And when a woman takes hormonal contraceptives, there are no fluctuations in hormone levels. This prevents the growth of follicles and ovulation, and hence pregnancy. However, this does not mean that the woman’s hormonal system is completely turned off: hormones that come from outside (from the contraceptive) even out the woman’s hormonal background and make it monotonous throughout the entire menstrual cycle. This absence of monthly fluctuations in hormone levels is beneficial for the body.

Hormonal contraception acts in such a way that the hormones that are part of the contraceptive (in pills, in an implant, in a patch, in a ring) prevent the growth and maturation of the follicle in the ovary. The egg does not come out, which means that fertilization is impossible. That is, hormonal contraception is the most reliable method of preventing unwanted pregnancy.

To date, more than 3,000 studies have been conducted on the therapeutic possibilities of hormonal contraception, the results of which can be summarized as follows:

• Regulates the menstrual cycle has a curative effect on disorders associated with the menstrual cycle: heavy menstrual bleeding, PMS, menstrual migraine.
• They prevent the development of benign diseases of the reproductive system: endometrial hyperplasia, endometriosis, inflammatory diseases of the pelvic organs, uterine fibroids, fibrocystic disease of the mammary glands.
• Relieve pelvic pain of inflammatory origin or associated with existing endometriosis.
• Reduce the risk of certain cancers, such as endometrial cancer, ovarian cancer, colon cancer.
• They prevent symptoms caused by estrogen deficiency: loss of bone mineral density, behavioral disorders, vasomotor symptoms (flushing of the face, hot flashes to the head, sweating).
• They do not allow the development or progression of such diseases as iron deficiency anemia, rheumatoid arthritis.

In general, the therapeutic potential of hormonal contraceptives is so pronounced that the question of expanding indications for their use is constantly being raised, and many drugs have already registered additional indications, such as acne, PMS, very heavy menstruation.

At the same time, prejudices dominate the minds of not only adolescents, but also of some medical workers.
Misconception 1. Weight gain.
Misconception 2. Provocation of acne and hirsutism\skin manifestations\.
Misconception 3. Lack of menstruation after the abolition of hormonal contraception.
Misconception 4. Problems with conception in the future.
Misconception 5. The risk of ectopic pregnancy.
Misconception 6. Danger of thrombotic complications.
Misconception 7. The need for breaks in admission.

One of the most persistent and harmful delusions. To date, there is no evidence of benefit from “contraceptive holidays”. Competent contraceptive counseling makes it possible to dispel these misconceptions, which can artificially limit the choice of method for preventing unwanted pregnancy.

Sometimes the doctor may recommend prolonged use (long-term, 3-4 months without a break) of contraceptives. Does our contemporary woman need monthly menstruation?

In recent years, more and more evidence has appeared that is only for complacency: regular “critical days” are a sign that her reproductive system is functioning normally. However, they are sometimes uncomfortable for the woman herself, and endless menstruation, without a periodic break during pregnancy, is not provided for by evolution. In this regard, researchers are inclined to conclude that the prolonged regimen has advantages. Flexible extended mode allows you to reduce the number of periods from 13 to three during the year, as well as choose the timing of menstruation.

Obviously, contraception improves a woman’s health by preventing abortions and unwanted childbearing, providing an opportunity to plan the future of young patients, reduce the risk of gynecological diseases that affect the ability to have a pregnancy, and with it the risk of obstetric complications.

Understanding the types of contraception, their pros and cons with an obstetrician gynecologist

Every woman is concerned about how to prevent unwanted pregnancy and protect herself from sexually transmitted infections.

The questions of how to prevent unwanted pregnancy and protect against sexually transmitted infections are of concern to every woman. Choosing reliable contraception is not an easy task, and this issue should be discussed with your doctor. Obstetrician-gynecologist of the clinic “Euromed” Marina Pavlovna GLUSHENKOVA talks about the existing methods of contraception, their pros and cons.

Contraception is barrier, hormonal and intrauterine. Methods such as coitus interruptus and calendar methods cannot be considered reliable and effective. Fortunately, in the XXI century there are many ways and means of protection from unwanted pregnancy and unpleasant diseases.

Barrier methods

Condoms

Pluses

• reliable protection against sexually transmitted diseases (STDs) and unwanted pregnancies (when used correctly)

• affordable price

• no systemic effect on the body

• ideal for those who have an irregular sex life

• do not require preliminary examinations for selection

Cons

Spermicides

Spermicides are substances that immobilize spermatozoa, due to which they do not penetrate into the uterine cavity.

Pluses

• partial protection against sexually transmitted infections (some viruses do not work)

• suitable for those who cannot use hormonal and intrauterine contraception

Cons

• low efficiency (60–70%), this method cannot be used as a standalone method

• requires very strict enforcement of the rules of use

• Possible irritation, allergic reactions of the skin of the genital organs

Intrauterine methods

Copper intrauterine system (coil)

The coil thickens cervical mucus and forms a barrier to spermatozoa. Copper acts toxically on spermatozoa, immobilizing them, and also suppresses ovulation.

Pros

• prolonged action, allowing you to forget about contraception for several years

• no systemic effect on the body

• can be used during lactation

Cons

• it is impossible to put nulliparous, because against the background of the spiral there is a risk of the formation of intrauterine synechia, adhesions, which can lead to infertility; Also, nulliparous due to anatomical features have a narrower cervical canal, which makes it difficult to install the spiral.

• the spiral does not protect against STDs, respectively, it is only suitable for women who have one permanent healthy sexual partner;

• against the background of the use of a copper-containing spiral, the risk of inflammatory diseases of the uterus and appendages increases by 5-6 times compared with women who do not have spirals;

• the spiral can provoke longer and more painful periods;

• if a woman has a history of multiple abortions, invasive interventions, curettage, there is a risk of developing cervical insufficiency, i.e. failure of the cervix, which can lead to expulsion (falling out) of the spiral.

Protected hormonal coils

The hormones contained in the system act in the uterine cavity, make the mucous membrane thinner, and immobilize spermatozoa. All this makes fertilization and implantation of the fetal egg impossible.

Pluses

• Reliable contraceptive action for five years

• No systemic action

• has a therapeutic effect: it is indicated for patients with a history of endometrial hyperplastic processes, uterine myoma

• can be used during lactation

Cons

Hormonal contraception

This is perhaps the most effective method of all existing today.

Hormonal preparations differ in dosage (mini-dose – estrogen content no more than 30 mcg, micro-dose – no more than 20 mcg, large doses are not currently used), components, and the method of entry into the body.

There are two types of drugs: combined and the “mini-drank” group. Combined contraceptives contain estrogens (ethinyl estradiol) and gestagens, “mini-drank” – only gestagens.

Preparations from the “mini-drank” group are indicated for lactating women who should not take estrogens, but only gestagens. Also, “mini-pills” can be taken by women who do not tolerate the estrogen component.

Types of drugs: tablets (taken orally), vaginal ring (hormones penetrate the vaginal mucosa) and patch (transdermal route – hormones enter through the skin).

Reception methods. Tablets should be taken daily, at the same time. It is especially important to take at the same time for drugs from the “mini-drank” group. Tablets are generally taken for 21 days, after which they take a break for 7 days.

The vaginal ring is inserted into the vagina for 21 days, after which there is a break for a week.

The patch is changed every 7 days.

The advantage of alternative routes of administration (ring, patch) is that you do not need to remember to take the pill every day and there is no primary passage through the liver and gastrointestinal tract, which reduces the load on them. This is especially important if a woman has problems with the gastrointestinal tract or chronic cholecystitis.

Pluses

• reliable contraceptive effect (if a woman does not miss taking pills, the guarantee is almost 100%)

• active protection of the ovaries and endometrium (mucosa) of the uterus from cancer

• regulation of the menstrual cycle

• reduction of pain during menstruation

• cosmetic effect (some OK help to cope with acne, normalize skin condition)

• therapeutic effect (the doctor will help you choose hormonal contraceptives, which are indicated for patients with uterine fibroids, with endometriosis).

Cons

• the need for strict discipline, control of taking drugs at the same time (especially important for “mini-pill”)

• do not protect against STDs

• any hormonal drugs affect metabolism (metabolism), which can lead to fluctuations in body weight, although in modern drugs this effect is minimal;

• there is an effect on the vascular link, on the blood coagulation system, therefore, when taking contraceptives, constant monitoring of hemostasis is necessary. If a woman has a predisposition to varicose veins, to hypertension, or in the family there were cases of diseases of the cardiovascular system, accompanied by thrombosis, heart attacks, strokes, then the patient needs a comprehensive examination of the hemostasis system before taking hormonal contraceptives;

• there is a period of adaptation to hormones. Within 2-3 months, nausea, headaches and pains in the mammary glands can sometimes be observed, there may be slight spotting in the middle of the cycle, changes in libido, mood swings. Therefore, mandatory medical supervision of the use of drugs during the first months of admission.

• hormonal contraceptives have a number of contraindications: active smoking (more than 5 cigarettes per day), severe somatic diseases, severe decompensated diabetes mellitus, thrombosis, varicose veins, heart attacks, strokes, arterial hypertension, frequent migraines, etc.

Sterilization

Medical sterilization is a surgical technique that can be used by both men and women. This is a reliable method of 100% protection against pregnancy, a good choice for people who are definitely not planning more children.

After the operation, the ability to conceive can no longer be restored for women, in men there is a small (less than 30%) chance of restoring reproductive function by re-operation within five years after the intervention.

Female sterilization is a laparoscopic operation during which the fallopian tubes are cut, which reliably prevents the possibility of pregnancy.

Male sterilization (vasectomy) is a simple operation that takes about 20 minutes. During surgery, the vas deferens are tied up and crossed. Sterilization does not affect the erection, the amount of seminal fluid and the ability to experience an orgasm.

Pluses

Cons

• irreversibility of the operation

• the need for surgery

• there are legal restrictions on this operation

Medical sterilization as a special medical intervention in order to deprive a person of the ability to reproduce offspring or as a method of contraception can only be carried out upon a written application of a citizen over the age of thirty-five or a citizen with at least two children, and if there are medical indications and informed voluntary consent citizen – regardless of age and the presence of children.

Article 57

emergency contraception

In case of unprotected intercourse, you can use the so-called emergency contraception. These drugs are aimed at protection, this is not an abortion. The tablet contains a large dose of progestin preparations that cause rejection of the endometrial mucosa.

Pluses

Cons

When choosing contraception, be sure to contact a gynecologist. Before prescribing this or that drug, the doctor will conduct an examination, which includes an examination on a chair, taking a smear for oncocytology. Also, if there are signs of endocrinopathy (increased hair growth, acne), it is necessary to investigate the hormonal background. Since hormones thicken the blood, affect hemostasis (blood coagulation system), it makes sense to conduct a comprehensive examination of the state of the hemostasis system. In addition, it is recommended to do an ultrasound examination of the pelvic organs (uterus and appendages) and mammary glands. All these procedures are minimally invasive, painless, they are not difficult to pass, and they will help to avoid possible complications against the background of long-term use of contraceptives.