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Ask the Medical Expert Archives 2000-2004

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Birth Control
March 2000

Q. What is the best form of birth control?

A. This is a common question and one for which there is a simple answer: the best form of birth control is the one the couple will use! There are many options (see http://www.universityobgyn.com/birth.htm and http://www.plannedparenthood.com/)

Naturally, the most powerful form of birth control is abstinence. For couples that desire intercourse, there are several options.

Currently, most forms of birth control depend on the woman more than the man. The birth control pill is quite popular, but it requires taking a pill each day. For women who have a hard time remembering to do this, the pill may not be a good option. Also, side effects sometimes get in the way, but most women can find a pill that minimizes side effects. The pill can also have other benefits, such as helping to control acne and reducing painful menstruation.

The IUD is another popular option, but it is often not used in women who are not finished with their family. This is because the IUD is associated with an infection that cause infertility. It must be emphasized that this complication is rare.

The diaphragm is effective, but it requires placement before intercourse. Many women find this intrusive, while others do not. Again, if the method is not acceptable, it is not likely to be used. If it is not used, it can't work.

DepoProvera and Norplant are progesterone-based (progesterone is a hormone that forms 1/2 of the standard birth control pill) forms of contraception. They are also effective, but some women don't like the side effects. (Side effects can be reviewed at the above web sites.) DepoProvera is administered as an injection once every 3 months; Norplant is a small device placed into the arm.

Condoms and foam are also effective, and they carry the additional benefit not offered by any of the other methods (except abstinence) of helping to reduce sexually transmitted diseases, including HIV. They also have the advantage of more greatly involving the male partner.

Another method that is often used is the rhythm method. While it is effective, the other forms offer more protection against pregnancy. It is also difficult to do and requires great discipline.

Finally, if a woman (or a couple) is not interested in having more children, a form of permanent sterilization (e.g., tubal ligation or vasectomy) can be considered.

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