Pros, cons of fertility control

Preventing pregnancy is important for many people, both men and women.

You may want to have a child in the future, but feel you are not yet ready to make such a commitment. You may want to have children now, but would like to control the frequency of pregnancies or have only a certain number of children. You may have decided to not have any more or to not have children at all.

Regardless of the motivation, the decision to control fertility or prepare for a pregnancy is a personal one and it is good to plan with your partner, if you have one.

Remember, the only 100 percent effective method for preventing pregnancy is to not have sex at all. Since that is not the choice most people make, every person who is sexually active should know about the many effective methods of birth control available and the differences between them in order to make an informed choice that suits him or her best.

Controlling fertility is not a new concept. There is documented evidence of attempts to do this as far back as the ancient Egyptians. Over the past 100 years, the types and methods of birth control have increased greatly. Among them: natural family planning, barrier methods, spermicides, surgical methods, hormones and intrauterine devices.

All types of contraception have pros and cons. When any type is used or performed incorrectly the chance of an accidental pregnancy increases.

Natural family planning, sometimes called the rhythm method, is not an option I would recommend for anyone who is not OK with becoming pregnant because it has the highest failure rate of all birth control methods.

Barrier methods include male and female condoms, cervical caps, diaphragms and cervical shields. You can increase the effectiveness of the barrier method by using spermicide with it. Latex is a common material used in barrier contraception. If you are sensitive to it, look for barriers made of polyurethane. If you use a lubricant with a latex barrier, use one that is water-based, because oil-based lubricants weaken latex and increase the chance of breakage.

Barrier methods typically have fewer side effects than hormonal methods and IUDs, but they are not as effective at preventing pregnancy. However, male and female condoms have the added benefit of preventing the transmission of most sexually transmitted infections.

Spermicides kill sperm and are more dependable when used with a barrier method. Some people are sensitive to nonoxynol-9, a common active ingredient in spermicides. Spermicides with other active ingredients are now difficult to find, so if you are sensitive to nonoxynol-9, I suggest using a barrier method without nonoxynol-9 and an additional form of birth control, such as a second barrier. If your skin is sensitive, some spermicides can irritate and even damage the skin, making it easier to transmit an infection. This is another reason to use a barrier method when you choose to use spermicides.

Vasectomies are currently the only dependable choice of birth control for men other than condoms. Many men shy away from this option, but it is a fairly simple procedure done in the office with a short recovery time. Tubal ligation for women was once an invasive surgery, but today it is sometimes an office procedure. Tubal implant, also for women, is usually performed in the office.

These options should only be considered by those who are certain they do not want to have children or have more children. The procedures to reverse them do not have high rates of success.

In the next column, I will cover hormonal contraceptive methods, IUDs and emergency contraception.