Choosing Birth Control

If you're having a difficult time choosing among the variety of options for contraception, you are not alone. Several new products are on the market, along with improved versions of old standards, and the choices for birth control devices have improved, reports CBS News Health Correspondent Dr. Emily Senay.

More than 60 percent of all pregnancies in the United States are unintended, and although no single contraceptive method exists that is best for all women, there are devices that offer good options.

Almost 86 percent of all Americans choose one of three methods of birth control: sterilization, the Pill, or the condom. Only seven percent choose other readily available contraceptive devices including hormonal injections, diaphragms, implants, and I.U.Ds.

Here are the lesser-known birth control products:

Depo-Provera
This is an attractive option for women who want short-term protection. Available in the U.S. since 1992, Depo-Provera is a hormonal injection that inhibits ovulation for up to three months at a time. It's popular with younger women and is as effective as the Pill without requiring that a capsule be taken every day. However, like other hormones, there are possible side effects, including weight gain, depression, headaches, and irregular bleeding. Not everyone is able to take hormonal birth control, and Depo-Provera takes up to eight months to leave your system. The hormone costs about $140 a year.


A Depo-Provera injection.

Norplant
This contraceptive provides long-term protection. Six match-like sticks of hormones are implanted by a single incision into a woman's arm for birth control that lasts up to five years. The method can be reversed by a doctor making another incision to remove the sticks. It's highly effective, but the possible side effects are the same as for any hormonal contraceptive. Norplant is also more costly than Depo-Provera, at $500 to $700 for the initial procedure.

IUD
The IUD had a bad reputation in the '70s and '80s when a product called the Dalkon Shield was associated with infections, infertility, and 18 deaths in women who used it. Today's IUDs are said to be 100 percent safe and highly effective. For women who have already had children and want to use long-term birth control, this is a good choice to consider. However, it's not a good device for women who are vulnerable to infection or who have multiple sex partners. There are two versions: a copper device that is inserted into the vaginal wall and is effective for up to ten years, and a hormonal version that works for one year. IUDs cost about $150 to $200.


The IUD.

Diaphragm
This is one of the more familiar barrier methods, and a particularly good choice for women who can't or don't want to take any kind of hormone. Diaphragms work like other barrier methods such as the female condom or the cervical cap - they cover the cervix and prevent sperm from getting to the egg. While women won't be susceptible to the side effects of hormones, the diaphragm requires planning and proper insertion by the user.

When considering any of these birth control products, it is important to understand that none of them help protect against contracting sexually-transmitted diseases such as AIDS or genital herpes. Only condoms or abstinence can protect against infection.

Several other birth control options are being researched for use in the near future:

  • Vaginal Ring
    This device is made of flexible silicon that releases a steady dose of hormones. Women can insert it themselves after their menstrual cycle, then take it out a month later before their next period begins. Researchers expect this option to be on the market in three years.
  • Gel
    Another hormone-based contraceptive still in the testing stages. The gel, which also may be sold as a patch, works directly through the skin. It's applied on the abdomen, and the hormones are absorbed. Doctors don't expect this product to be available for at least five years.
  • Fem Cap
    A new variation of cervical barrier devices, this may be available by the end of next year. Researchers say they are a little less messy than diaphragms, easier to insert, and less likely to dislodge. It can be worn for up to 48 hours, and doesn't use hormones. Doctors expect the Fem Cap to be available by the end of 1999.
  • Unipath
    This is an electronic device available in Europe and currently being tested in the U.S. It is the only natural planning device being studied now. It relies on information that the user enters about her menstrual cycle, and then by measuring hormone levels through her urine. It indicates what days she is most likely to conceive and what days she is not. It is only about 94 percent accurate, and there's a high risk of user error.
  • Contraceptives For Men
    Hormonally-based injections, pills, and patches for men are all in the testing stages. New non-latex condoms are expected by the end of next year, and they will come in three different sizes. Study participants say the new condoms have increased sensitivity.

    Reported by Dr. Emily Senay