birth control methods

The Basics

• Effectiveness FABMs are not the most effective methods. It is typical for 12- 24 women out of 100 to get pregnant using this method in one year.
• Cost Up to $30 for thermometer and CycleBeads
• Side effects None
• Effort Daily tracking is required to use FABMs correctly
• Easy to get Supplies can be purchased online or at some drug stores. Online apps can help you track your cycle. Some clinics and churches offer classes.

How FABM Works:

Women learn to track the days they can get pregnant and don’t have sex during that time. You have to pay close attention to the changes in your body and its patterns. There are several ways you can track your cycle over several months to predict your fertile days:

• Use a calendar to track your menstrual cycle;
• When your temperature goes up slightly, 1- 2 degrees higher than normal, you’re probably ovulating;
• Check your cervical mucus for changes in color, texture, and amount;
• If your menstrual cycle is really regular and between 26 and 32 days long, use can use CycleBeads to learn your fertile days. https://www.cyclebeads.com/shop/CB

Avoid having sex or use a condom during your fertile days.

Are FABMs right for me?

FABMs are safe, inexpensive, and have no hormones. They can be inconvenient and require a woman to closely track her cycle, however, so they aren’t as effective as other birth control methods.

FABMs can help women learn more about their bodies and know when to have sex if they want to get pregnant.

FABMs might not be right for you if your periods are irregular or if you can’t keep daily track of your fertility signs.

If you do have unprotected sex during your fertile time, emergency contraception (brand name- Plan B) can help prevent pregnancy after sex.

Access Esperanza Clinics can provide more information about FABMs. Call us at 956-688-3700 for an appointment to any of our clinics.

The Basics

• Effectiveness Withdrawal has below average effectiveness. With typical use, about 27 women out of 100 will get pregnant using this method over a year

• Cost $0

• Side effects None

• Effort The man has to pull out in time every time. Always.

• Easy to get There’s nothing to get. You just need cooperation between partners.

• STD Protection? No

How Withdrawal Works:

This method is dependent on the man and his self-control. In order for this method to work, the man needs to pull-out before any semen comes out, every time you have vaginal sex.

Is withdrawal right for me?

Typical use with withdrawal has a high failure rate. If you wouldn’t mind getting pregnant, withdrawal might be OK. But if getting pregnant at this time is not what you want, consider another method.

In order for withdrawal to work, the man must be committed to pulling out before any semen comes out- every single time they have vaginal sex. This can be hard to remember if he’s had too much to drink or is using drugs.

Condoms can be combined with the pulling out method, both to help prevent pregnancy and STDs.

If you have an accident using the withdrawal method, emergency contraception (brand name- Plan B) can help prevent pregnancy after sex.

LAM Works Only If
• You breastfeed your baby and do not give baby any other food, formula or drinks.
• You breastfeed your baby every 4 to 6 hours day and night, no exceptions. LAM may not work as well if you give your baby a pacifier.
• You have not started your monthly period since your baby was born.
• Your baby is younger than 6 months.

LAM Does Not Work If:
• You pump the milk instead of breastfeeding.
• Your baby is older than 6 months.
• You have started your period since your baby was born.
• You give your baby any other food, formula or drinks.

Benefits:
• Do not have to visit clinic for birth control.
• Does not interrupt sex.
• Breastfeeding is good for mother and baby. Helps keep baby healthy.
• Can be used with some other methods including condoms, spermicides, IUD, Depo-provera, mini-pills, Norplant, natural family planning, and sterilization.

Possible Problems or Disadvantages:
• No protection from STls and HIV/AIDS.
• May not work if you have sudden schedule changes.
• May not work if mother and baby are separated a lot.
• Must be ready to use another method when LAM will not work.
• Cervical caps and sponges do not work as well as they did before baby was born.
• Mother may have less milk if using birth control methods that have estrogen.

How Well Does It Prevent Pregnancy?
If used perfectly, 2 out of 100 women get pregnant in a year while using the LAM method.

The Basics

• Effectiveness With perfect use, condoms are very effective, but with typical use, they are just so-so.  With typical use, about 18 women out of 100 will get pregnant using condoms during one year.
• Cost Ranges from $0.25 to $1 each (sometimes higher) or free at Access Esperanza Clinics.
• Side effects No side effects unless you are sensitive to latex or are allergic to the spermicide. In that case, you can use plastic condoms.
• Effort Use a new condom each time you have sex. Every single time. Easy to carry, use, and buy.
• Easy to get Condoms are available at most drug stores and supermarkets. You can get a pack of 10 free condoms at any Access Esperanza Clinics site. No appointment is necessary. Here are our locations and hours.
• STI Protection? Yes. Protects against many STIs, including HIV.

How the Condom Works:

• Condom covers an erect (hard) penis to keep sperm from entering vagina.
• Some brands of condoms have spermicide that kills sperm.
• Store in cool, dry area away from sharp objects and sunlight. Don’t keep in pockets, cars, or bathrooms for over a month as heat and moisture can damage condoms,
• Always check the expiration date and throw away outdated condoms.
• Before opening, check the package for holes- you should feel a little air bubble. If condom is torn, dry, or sticky, throw it away.
• Carefully open the package. Don’t use your teeth!
• You can add a drop or two of water-based or silicon lube to make condoms feel better and keep from breaking. Don’t use anything with oil for lube- no baby oil, Vaseline, lotion, butter, or cooking oil.
• Use a new condom each time you have sex.
• Make putting on a condom fun and sexy with your partner.
• Handy tip! Practice putting on a condom before you need it.
• Throw away used condoms. Do not flush!
• If the condom breaks or slips off during sex, emergency contraception (brand name- Plan B) can help prevent pregnancy.

• Pouch placed inside a vagina to keep sperm from reaching the egg; also covers part of the outside of a woman’s genital area.

How to Use The Female Condom:

Before Sex

• Use a new condom every time you have sex.
• Store female condoms in cool dry place.
• Have several condoms ready to use.
• Check the expiration date- don’t use expired condoms.
• Carefully open the condom package- don’t use your teeth.
• Can insert up to 8 hours before sex
  • Slide inner ring up into the vagina as far as it will go.
  • Make sure outer ring stays outside vagina to cover labia (lips) and base of the man’s penis.

During Sex- Penis goes inside female condom.

After Sex

• Remove right after male ejaculation (coming), before standing up.
• Squeeze and twist outer ring to keep semen/sperm from leaking out while removing.
• Throw away in trash- do not flush.

Pros:

• Helps protect against HIV and other STIs, infertility, and other serious medical problems
• Female condoms offer some protection against STIs that are transmitted through skin-to-skin contact like herpes and HPV.
• Easy to buy and carry
• No prescription necessary
• May insert up to 8 hours before having sex.
• May use while breastfeeding

Cons:

• Some STIs can infect the body through places the condom does not cover.
• May break or slip out during sex.
• Outer ring left outside of vagina may not feel comfortable.
• Putting female condom on may seem like an interruption.

How Well Does It Prevent Pregnancy?

• Effectiveness depends on using the condom correctly
• With typical use, 21 out of 100 women get pregnant in a year while using female condoms.

Reminders

• Use a new condom:
  • Each and every time you have sex,
  • If outer ring gets pushed inside,
  • If condom comes out of the vagina during sex
• Can add lubricant to inside of female condom or to penis
• May use with spermicides.
• Do not use with male condom as condoms may stick together.

• Contains the hormone progestin like those a women naturally produces
• Stops egg from leaving the ovary so no egg can be fertilized
• Thickens the liquid at the cervix (opening to the uterus) to prevent sperm from getting into the uterus

How The Shot Is Used:

• A qualified health care provider gives you a shot every 3 months.
• Use a back-up method if you are a week late for a shot.

Advantages:

• Do not have to interrupt sex.
• May decrease menstrual bleeding and cramping
• May be used while breastfeeding.

Possible Side Effects

• The shot can cause changes in your periods- irregular bleeding, heavier periods, lighter periods, or no periods. If this bothers you, see your clinician.
• Possibility of bone loss if used more than 2 years; no long-term effects on bones after stopping the shot
• May have breast tenderness, increased appetite, weight gain, or mood changes
• Has no estrogen; women who have migraines can use it
• Can make existing depression worse; women with severe postpartum depression should talk to a health care provider about using this method
• Lowers the risk of uterine cancer and anemia
• Side effects may continue 6-8 months after last shot.
• May take 6-12 months or longer to get pregnant after last shot.

How Well Does It Prevent Pregnancy?

• Effectiveness depends on getting the shot on time
• With typical use, 6 out of 100 women get pregnant in a year while using it

Reminders

• Be sure to get enough calcium in your diet (seeds, cheese, yogurt, etc.) while using the shot
• See your clinician if you often have very bad headaches, on-going heavy bleeding, or severe abdominal pain.
• No protection against STIs and HIV/AIDS
• Must return to clinic every 3 months for an injection

• Small (one size fits all) flexible ring that is placed in the vagina.
• Slowly releases low dose hormones (estrogen and progestin) that are similar to the ones a women’s body naturally makes
  • Stops eggs from leaving the ovary no egg can be fertilized
  • Thickens the liquid at the cervix (opening to the uterus) to prevent sperm from getting into the uterus

How The Ring is Used:

• Requires a prescription from a qualified health care provider
• Woman places it in her vagina for 3 weeks, then after 1 week, puts in a new one
• If the ring is accidentally left in for more than 4 weeks and you’ve had sex, pregnancy can happen
• If the ring slips out of the vagina, and it has been out less than 3 hours, rinse it with cool water and put it back in. If it is out of the vagina more than 3 hours, a new ring is needed.
• Some women say they are aware that the ring is in their vagina, but it should not be felt by the woman or her partner once it is in place.

Advantages:

• No need to do or remember anything every day; easy to use and very effective.
• No need to interrupt sex
• Ability to get pregnant again starts right after you stop using the ring.
• Periods are usually lighter, more regular and with less cramping.
• Helps protect against ovarian cancer, uterine cancer, and iron deficiency
• May improve acne.

Possible Problems or Disadvantages:

• Does not protect against STls, including HIV
• May delay or prevent breastfeeding.
• Can cause spotting between periods (especially in the first few months)
• May cause mood changes, increased vaginal discharge, headaches, and/or nausea
• Most healthy women can use the ring with no problems, but serious possible side effects include: blood clots, heart attacks, and stroke. Cigarette smoking can increase this risk, so women using the ring are encouraged not to smoke.
• Some women who have had certain cardiovascular problems or who have migraines with auras should not use the ring.

How Well Does It Prevent Pregnancy?

• Effectiveness depends on using the ring correctly
• With typical use 9 out of 100 women will become pregnant in a year while using the ring.

Reminders

• Store the ring in a cool place until ready to use.
• Do not flush used rings down the toilet
• Call your health care provider right away if you have: pain in the chest, calf, stomach or head, shortness of breath, vomiting dizziness, problems with vision or speech, yellowing of the skin or whites of the eyes, heavy bleeding, swelling, or depression

• A thin patch is placed on the skin that releases hormones that prevent pregnancy.
• Stops egg from leaving the ovary.
• Changes uterus lining so that a fertilized egg may not implant.
• Prevents sperm from reaching the egg.

How The Patch Is Used:

• See your health care provider for a prescription.
• Be careful not to damage the patch when you remove it from the package.
• If you apply the patch within the first 24 hours of your period, no back-up method is needed.
• If you apply the patch on a Sunday after the first 24 hours of your period, use a back-up method of birth control for the first seven days after you start using the patch.
• Clean and dry an area of skin on your buttocks, stomach, back or upper outer arm where you will place the patch. Apply each new patch to a different place on your skin. Never apply the patch to your breasts or to skin that is red, irritated, or cut.
• Do not apply the patch on top of make-up, lotions, creams, powders, or anything else but clean skin.
• Press firmly on the patch with the palm of your hand for 10 seconds and run your fingers around the edge of the patch to make sure the edges stick well. Check your patch every day to make sure all the edges are sticking.
• Wear the patch for seven days. On the eighth day, take off the patch and put on a new one.
• Do not decorate or write on the patch; doing so may damage it so that it will not work as well.
• When removing the old patch, fold it in half so that the medicine side is covered up before you throw it away. Do not flush it down the toilet.
• Apply a new patch once a week for three weeks, and then do not wear a patch on the fourth week.
• Begin your next four week cycle by applying a new patch on your normal ‘patch change day’, no matter when your period begins or ends.
• If your patch comes loose or falls off for less than one day, try to re-apply it or apply new patch immediately. No back up method is needed.
• If you forget to change your patch during the first week or if your patch comes loose or falls off for more than one day, or if you aren’t sure how long, put on new patch immediately. This will begin a new week. Use a back-up method of birth control for seven days
• Do not try to reapply a patch if it’s no longer sticky or if it has been stuck to something besides your skin
• Store the patch in its package, at room temperature, until you are ready to use it.
• If you are scheduled for any lab tests or need to take other medicine, let your health care provider know you use the patch. Be aware that your patch may interact with over-the-counter or alternative medicines.
• Call your health care provider right away if you miss your period or if you have pain in the chest, calf, stomach, or head; shortness of breath, vomiting, dizziness, coughing of blood, problems with vision or speech, breast lumps, yellowing of the skin or whites of the eyes, or depression.

Advantages:

• No need to do or remember anything every day.
• No need to interrupt sex.
• Easy to use and very effective.
• It is ok to bathe, swim, exercise, and be where it is humid while wearing the patch.
• May improve acne.

Possible Problems or Disadvantages:

• There may be a higher risk of side effects, such as blood clots with the patch.
• Does not protect against STIs or HIV/AIDS.
• May not work well on women who weigh more than 198 pounds.
• Skin under the patch may get irritated.
• May have irregular vaginal bleeding or spotting. This may stop after a few months.
• If the bleeding lasts more than a few days or happens every month, contact your health care provider
• Contact your health care provider if your fingers or ankles start swelling or if you start having problems wearing your contact lenses.
• Skin on the face may darken.
• The patch should not be used while breast feeding.
• May not be able to use the patch, depending on your health history.
• The most common side effects include nausea, mood changes, headache, breast tenderness, and skin irritation where the patch is worn. Less common side effects include: menstrual cramps, appetite changes, loss of scalp hair, rash, vaginal infections, and dizziness.
• Serious side effects will be more likely to happen if you smoke; these include: blood clots, heart attacks, strokes, and breast cancer. Other serious side effects include gall bladder disease, and liver tumors.

How Well Does It Prevent Pregnancy?

• With typical use, 8 out of 100 women might get pregnant in a year while using the patch.

How The Pill Is Used:
• A pill is taken every day at the same time each day.
• See your clinician if you have severe abdominal pain, chest pain, headache, shortness of breath, changes in vision, or severe leg pain.

Advantages:
• Easy to use and very effective.
• Do not have to interrupt sex.
• No loss in fertility after pills are stopped.
• Periods are usually lighter, more regular and have less cramping.
• May improve acne.
• Some pills, when used as directed, can allow you not to have a period for several months.

Possible Problems or Disadvantages:
• No protection against STIs and HIV/AIDS
• Must get pills from a clinician.
• Not all women can take the pill.
• Must remember to take a pill every day.
• May have nausea at first.
• May have weight gain, headaches, breast discomfort, depression, or loss in sex.
• May miss periods or have irregular bleeding.
• Skin on face may darken (like sometimes in pregnancy).
• May not produce as much milk if breastfeeding.
• May get high blood pressure or blood clots (Rare).
• May not be a good choice for women who have had breast cancer, liver disease, stroke, diabetes or blood clots.
• Heart attack (Rare)
• Liver tumors (Rare)

What are the side effects?
• You may have headaches or symptoms that usually clear up in 2 or 3 months:
o Nausea
o Sore breasts
o Spotting between periods
o Some women take the pill every day to avoid periods. Spotting or bleeding the first 6 months between periods is normal. It may lessen or completely stop over time.

How Well Does It Prevent Pregnancy?
With typical use, 8 out of 100 women will get pregnant in a year while using the pill.

How the Implantable Contraceptive Is Used:
• It can be removed at any time by a clinician in a clinic or doctor’s office, after which time the woman returns to her pre-existing fertility level.
• Prevents sperm from reaching the egg.
• The thin, match-sized, rod implant is placed in the inner side of a woman’s upper arm by a clinician in a clinic or doctor’s office.

Advantages:
• No need to remember to do anything on a schedule.
• The implant works for 3 years.
• It works great.
• Do not have to interrupt sex.
• Protects against bad cramps and pregnancy in the tubes.

Possible Problems or Disadvantages:
• No protection against STIs, including HIV/AIDs.
• May have redness, swelling, and pain at the spot where the rod was implanted and there may be some scarring at insertion site.
• May have headaches and mood swings.
• May have irregular bleeding and spotting or no monthly periods at all.
• May not be a good choice for women who have had breast cancer, liver disease, stroke, diabetes or blood clots.
• Serious side effects will be more likely if you smoke. These include blood clots, heart attacks, and stroke.

What are possible side effects of the Implant?
• Nausea (feeling sick to your stomach) — usually clears up in 2 or 3 months
• Sore breasts — usually clears up in 2 or 3 months
• Headache
• Irregular bleeding — including early or late periods, spotting between periods, or no periods
• Weight gain

How Well Does it Prevent Pregnancy:
• With typical use, less than 1 in 100 women get pregnant in a year when using the implantable contraceptive rod.
• This method may be less effective in women who are very overweight or are taking certain types of medications

How The IUD Is Used:
• An IUD is placed in the uterus by clinician.
• Woman checks IUD strings after each menstrual period.
• Must be replaced as needed (5-12 years) depending on type of IUD.
• Do not attempt to remove IUD yourself.
• See your clinician if you have fever, abdominal pain, pain when having sex, bleeding, discharge, missed period, any STI, or if the strings are missing, longer or shorter.

Advantages:
• Works for a long time
• Do not have to interrupt sex.
• Can be used while breastfeeding.
• Copper-releasing IUD may prevent pregnancy when inserted up to 5 days after unprotected sex.
• Copper-releasing IUD contains no hormones

Possible Problems or Disadvantages:
• No protection against STls including HIV/AIDs.
• If you get an STI, the infection may be much worse and more damaging.
• IUD may fall out without the woman knowing it.
• Not a good method for women with more than one partner.
• Not a good method for women with partners who have other partners.
• If you become pregnant, there is a higher risk of having a tubal pregnancy.
• Irregular periods or spotting between periods in the first 3 –6 months.
• Heavier periods and worse menstrual cramps — with Copper IUD

How Well Does It Prevent Pregnancy?
• With typical use, less than 1 out of 100 women get pregnant in a year while using an IUD

How EC Is Used:
• EC pills (ECPs) should not be used as your regular method of birth control, because other methods work better.
• A pill to prevent nausea is taken one hour before taking first ECP.
• The woman takes emergency contraceptive pills. The pills work best if she takes them within 72 hours after having sex, but they may also work if she takes them within 120 hours after having sex
• Twelve hours later, she may need to take ECP(s) again, depending on the instructions given by the health care provider
• Do not take any extra pills.
• Do not have unprotected sex after you have taken ECPs.
• See your clinician for a pregnancy test if your menstrual period does not start within 3 weeks

Advantages:
• Can be used to prevent pregnancy after sex has occurred.
• ECPs will not harm a pregnancy or cause a miscarriage.

Possible Problems or Disadvantages:
• No protection against STIs and HIV/AIDS.
• ECPs do not work as well as some other methods of birth control.
• May cause nausea/vomiting, fatigue, headache, abdominal pain, or breast tenderness.
• No protection against pregnancy if unprotected sex happens after ECPs have been taken

How Well Does It Prevent Pregnancy?
• When no birth control is used, 85 out of 100 women get pregnant in a year.
• If 100 women had unprotected intercourse, about eight would become pregnant; following treatment with ECPs within 72 hours after having sex, only two would become pregnant.
• If 100 women had unprotected intercourse and were treated with progestin-only ECPS within 72 hours after having sex, one woman would become pregnant.
• The longer you wait after having sex, the less likely the pills are to prevent pregnancy.

Another EC Option
• Another option is to have a copper-releasing IUD placed in the uterus within having unprotected sex. If you are interested in this option, discuss it with your care provider.
• With typical use, 1 out of 100 women get pregnant in a year while using the copper IUD.

• Don’t have sex without using a birth control method (unless you want to be pregnant).
• Don’t forget to use your birth control method.
• Don’t let your friends choose your method of birth control.
• Don’t believe that it is possible to tell if a person has an STI or HIV by looking.
• Don’t share your prescription method with a friend.
• Don’t wait until you run out of your method before calling the clinic for a refill.
• Don’t douche. Douching increases the risk of getting a vaginal infection.
• Don’t think you can’t get an STI or HIV/AIDS from having unprotected oral or anal sex. You can!