Treatment

There are numerous forms of hormonal contraception available. The decision for product selection should consider patient preference, contraindications to therapy, advantages, and disadvantages of particular forms, side effects, current medications, drug interactions, patient adherence factors, efficacy, out-of-pocket cost, and insurance coverage. It is imperative to review the safety profile and contraindications. It is also crucial to consider the failure rate, which varies depending on the method used. The failure rate, defined as the percentage of unwanted pregnancies during the first year of use, is lower for the long-acting contraceptives as they do not require daily dosing. Typically, formulations that do not require daily dosing have higher success rates as it minimizes patient action. Patients should be counseled that non-barrier methods of contraception do not prevent STIs. Short-acting or barrier methods may be preferred in women who want a more rapid return to fertility.

Table 3 – Birth Control Effectiveness17,18

Contraceptive MethodNumber of Pregnancies Expected (per 100 women during the first year of use)
Sterilization<1
IUD<1
Implantable rod<1
Shot/injection6
Oral contraceptives (combined hormonal and progestin-only pills)9
Patch9
Vaginal ring9
Diaphragm with spermicide12
Sponge with spermicide12-24
Cervical cap with spermicide17-23
Male condom18
Female condom21
Spermicide alone28

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