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There are many contraceptive methods available to prevent unintended pregnancies. These methods can be surgical, oral medications, injectable forms, or long-acting devices. According to the American College of Obstetricians and Gynecologists (ACOG), long-acting reversible contraception (LARC) methods such as intrauterine devices (IUDs) and implants are up to 20 times more effective over time compared to pills, patches, or rings [1].
Contraception with Intrauterine Device (IUD)
Intrauterine devices (IUDs), commonly known as “coils,” are small T-shaped plastic devices inserted into the uterus. They are available in hormonal and copper types, both of which significantly reduce the risk of pregnancy. Less than 1% of users become pregnant during the first year of use [2].
- Copper IUD (Cu-IUD): Contains no hormones and can provide protection for up to 10 years. It may increase menstrual bleeding. It can also be used as the most effective emergency contraception method if inserted within 5 days after unprotected intercourse [1].
- Hormonal IUD (LNG-IUD): Releases progesterone, thickens cervical mucus, and prevents sperm from reaching the egg. It provides protection for 3–8 years depending on the type. It reduces bleeding and lowers the risk of infection [1].
Contraception with Tubal Ligation
Tubal ligation is a surgical procedure in which the fallopian tubes that carry the egg are tied or sealed. It is usually performed laparoscopically (minimally invasive) and takes about 30 minutes. This method is nearly 100% effective and does not affect sexual desire, hormonal balance, or body structure [2].
However, since it is difficult to reverse and the chances of a successful pregnancy after reversal are low, it is recommended for women who have completed their family planning.
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Contraception with Birth Control Pills
Birth control pills prevent ovulation and regulate hormonal balance. When used correctly, they provide nearly 99% protection; however, with typical use, the pregnancy rate is approximately 9% per year [2]. Pills are usually taken for 21 days starting from the first day of menstruation, followed by a 7-day break.
Contraception with Patch
The contraceptive patch is a small, skin-colored patch about 3–4 cm in size. It releases hormones that prevent ovulation and provide effective protection against pregnancy. It can be applied to the arm, leg, abdomen, or back (but not the breast). Each pack contains 3 patches, which are replaced weekly, followed by a 7-day break.
Contraception with Injection
Contraceptive injections contain estrogen and progesterone, which prevent ovulation and thicken cervical mucus, making it difficult for sperm to enter. The typical failure rate is around 4–6% per year [2]. They are administered intramuscularly either monthly or every 3 months. Rare side effects may include decreased libido or breast tenderness.
Contraception with Implants
The implant is a small, flexible rod about the size of a matchstick, inserted under the skin of the upper arm. It releases progesterone, prevents ovulation, thickens cervical mucus, and thins the endometrial lining. With a failure rate of less than 0.05% in the first year, it is one of the most effective contraceptive methods [2]. It remains effective for about 3 years, and fertility returns immediately after removal. The most common side effect is irregular menstruation.