Overview of Contraception
Among contraceptive users in the US, the most commonly used methods are oral contraceptives (OCs—28%), female sterilization (27.1%), male condoms (16.1%), male sterilization (9.9%), intrauterine devices (IUDs—5.5%), withdrawal (coitus interruptus—5.2%), progestin injections (3.2%), vaginal contraceptive rings (2.4%), subdermal progestin implants (< 1%), contraceptive transdermal patches (< 1%), fertility awareness methods (periodic abstinence—< 1%), and female barrier methods (< 1%— Comparison of Common Contraceptive Methods).
In the first year of use, pregnancy rates with typical use are
< 1% with methods unrelated to coitus and not requiring user involvement (IUDs, subdermal progestin implants, sterilization)
About 6 to 9% with hormonal contraceptive methods unrelated to coitus and requiring user involvement (oral contraceptives, progestin injection, transdermal patch, vaginal ring)
> 10% with coitus-related methods (eg, condoms, diaphragms, fertility awareness methods, spermicides, withdrawal)
Pregnancy rates tend to be higher during the first year of use and decrease in subsequent years as users become more familiar with the contraceptive method they have chosen. Also, as women age, fertility declines. For fertile couples trying to conceive, the pregnancy rate is about 85% after 1 yr if no contraceptive method is used.
Despite the higher pregnancy rate associated with condom use, experts recommend that condoms always be worn during intercourse because they protect against sexually transmitted diseases (STDs). Most importantly, they help protect against HIV. For most effective contraception, other birth control methods should be used with condoms.
If contraception fails, emergency contraception may help prevent an unintended pregnancy. Emergency contraception should not be used as a regular form of contraception.