Providing women with access to effective contraception is a critical element of women’s health. Enabling women to make choices about their fertility is empowering and offers women better economic and social opportunities. When it comes to birth control, a woman should be aware of her options so she can make choices that are best for her.
THE PILL
> More than
>99% EFFECTIVE WITH PERFECT USE1
>93% EFFECTIVE WITH COMMON USE*
TAKEN ONCE-DAILY2,3
Pills containing oestrogen and progestogen
- hormone-containing tablets (also called COCs – Combined Oral Contraceptives)
Works primarily by preventing the release of eggs from the ovaries (ovulation), thickening cervical mucus and inducing changes in the endometrium2,4
Pills containing only progestogen
- hormone-containing tablets (also called POPs – Progesterone Only Pills)
Works primarily by thickening cervical mucous which prevents sperm from meeting an egg and disrupting the menstrual cycle, including preventing the release of eggs from the ovaries 3,4
There are COC pills available which contain hormones that are structurally similar or identical to a woman’s own, naturally occurring hormones5
VAGINAL RING
> More than
>99% EFFECTIVE WITH PERFECT USE1
>93% EFFECTIVE WITH COMMON USE*
INSERTED ONCE-MONTHLY6
- a flexible ring placed in the vagina6
- continuously releases oestrogen and a progestogen6
- the ring is kept in place for 3 weeks followed by a week long ring-free period6
Works by preventing the release of the egg from the ovary, thickens the cervical mucus and induces changes in the endometrial lining 4
IMPLANT
>99% EFFECTIVE1
REPLACED EVERY 3-5 YEARS 7
- small, flexible rod7
- placed under the skin in the upper arm by a physician7
- releases progestogen7
Works by preventing sperm from entering the womb and meeting the egg (by thickening the cervical mucosa) 1,4,7
Prevents the release of the egg from the ovary and induces changes in the endometrium4,7
INTRAUTERINE DEVICES (IUDS)
>99% EFFECTIVE1
COPPER IUD: Can remain in for 12 years
HORMONAL IUD: Can remain in for 5 years
5 OR 12 YEARS8,9
Copper IUDs
- small plastic device with copper wire/sleeves that is inserted into the uterus8
Hormonal IUD:
- plastic T-shaped device inserted in the uterus 9
- releases small amounts of the progestogen hormone9
Works by causing a chemical change that damages sperm and egg before they meet8 Works by thickening cervical mucous to block sperm and egg from meeting1,9
PATCH
>99% EFFECTIVE WITH PERFECT USE1,10
>93% EFFECTIVE WITH COMMON USE*
A NEW PATCH IS APPLIED ONCE-WEEKLY 10
- small, thin, square of flexible plastic worn on the body 10
- continuously releases oestrogen and a progestogen into the bloodstream, through the skin 10
- a patch is worn every week for 3 weeks, then no patch for the 4th week 10
Works by preventing the release of the egg from the ovary, thickens the cervical mucus and induces changes in the endometrial lining 4,10
EMERGENCY METHOD
UP TO 95% EFFECTIVE IF TAKEN WITHIN 5 DAYS17
SHORT-TERM USE ONLY15
Emergency contraceptive pill
- pill containing progestogen only 15
- taken within 5 days after unprotected sex 15
Copper IUDs and combined oral contraceptives can also be used as emergency
contraceptives 15
Emergency contraceptives will not induce an abortion if you are already pregnant. They only work to prevent pregnancy before it occurs.
INJECTION (PROGESTOGEN-ONLY)
>96% EFFECTIVE WITH PERFECT USE1
ADMINISTERED ONCE EVERY 2-3 MONTHS 11
- injections containing progestogen-like hormones 11
- injected once every 2-3 months 11
Works by preventing the release of eggs from the ovaries, thickens the cervical mucus and suppresses the endometrial lining 4,11
CONDOMS
FEMALE
>95% EFFECTIVE WITH PERFECT USE1
>79% EFFECTIVE WITH COMMON USE*
- a loosely fitting sheath, made of thin, transparent, soft plastic film13
- placed inside the vagina13
MALE
>98% EFFECTIVE WITH PERFECT USE1
>87% EFFECTIVE WITH COMMON USE*
SINGLE-USE ONLY12,13
- a thin sheath or latex covering 12
- forms a barrier between the male and female sexual organs 12
The barrier prevents sperm from entering the vagina12,13
FEMALE STERILIZATION
>99% EFFECTIVE1
LIFE LONG14
The tubes (fallopian tubes) that help transfer eggs to the uterus are blocked or cut, therefore the eggs do not enter the tube to meet the sperm14
MALE STERILIZATION
>99% EFFECTIVE WITH PERFECT USE1,16
VASECTOMY IS NOT FULLY EFFECTIVE FOR THE FIRST 3 MONTHS. PREGNANCIES DO OCCUR IF THE COUPLE DOES NOT USE ANOTHER METHOD DURING THIS PERIOD.
The tubes (vas deferens) that carry sperm are blocked or cut, therefore the ejaculated semen does not contain sperm 16
THE RELIABILITY OF VARIOUS CONTRACEPTIVE METHODS TO PROTECT AGAINST UNWANTED PREGNANCY
*Common use includes actual, real-world use of the contraceptive method, including inconsistent or incorrect use.18,20
- WHO. Family planning/contraception methods. Available at: https://www.who.int/en/news-room/fact-sheets/detail/family-planning contraception. Accessed February 2023.
- Combined Oral Contraceptives. WHO/RHR and Johns Hopkins Bloomberg School of Public Health/CCP, Knowledge for Health Project. Family Planning: A Global Handbook for Providers (2018 update), p1–28.
- Progestogen-Only Pills. WHO/RHR and Johns Hopkins Bloomberg School of Public Health/CCP, Knowledge for Health Project. Family Planning: A Global Handbook for Providers (2018 update), p29–48.
- Apgar BS, Greenberg G. Using Progestogens in Clinical Practice. Am Fam Physician. 2000;62(8):1839–1846.
- Mansour D, Verhoeven C, Sommer W. et al. Efficacy and tolerability of a monophasic combined oral contraceptive containing nomegestrol acetate and 17ß-oestradiol in a 24/4 regimen, in comparison to an oral contraceptive containing ethinylestradiol and drospirenone in a 21/7 regimen. Eur J Contracept Reprod Health Care. 2011;16(6):430–443.
- Combined Vaginal Ring. WHO/RHR and Johns Hopkins Bloomberg School of Public Health/CCP, Knowledge for Health Project. Family Planning: A Global Handbook for Providers (2018 update), p123–126.
- Implants. WHO/RHR and Johns Hopkins Bloomberg School of Public Health/CCP, Knowledge for Health Project. Family Planning: A Global Handbook for Providers (2018 update), p131–154.
- Copper-Bearing Intrauterine Device. WHO/RHR and Johns Hopkins Bloomberg School of Public Health/CCP, Knowledge for Health Project. Family Planning: A Global Handbook for Providers (2018 update), p155–180.
- Levonorgestrel Intrauterine Device. WHO/RHR and Johns Hopkins Bloomberg School of Public Health/CCP, Knowledge for Health Project. Family Planning: A Global Handbook for Providers (2018 update), p181–210.
- Combined Patch. WHO/RHR and Johns Hopkins Bloomberg School of Public Health/CCP, Knowledge for Health Project. Family Planning: A Global Handbook for Providers (2018 update), p119–122.
- Progestogen-Only Injectables. WHO/RHR and Johns Hopkins Bloomberg School of Public Health/CCP, Knowledge for Health Project. Family Planning: A Global Handbook for Providers (2018 update), p65–96.
- Male Condoms. WHO/RHR and Johns Hopkins Bloomberg School of Public Health/CCP, Knowledge for Health Project. Family Planning: A Global Handbook for Providers (2018 update), p247–260.
- Female Condoms. WHO/RHR and Johns Hopkins Bloomberg School of Public Health/CCP, Knowledge for Health Project. Family Planning: A Global Handbook for Providers (2018 update), p261–270.
- Female Sterilization. WHO/RHR and Johns Hopkins Bloomberg School of Public Health/CCP, Knowledge for Health Project. Family Planning: A Global Handbook for Providers (2018 update), p211–230.
- Emergency Contraceptive Pills. WHO/RHR and Johns Hopkins Bloomberg School of Public Health/CCP, Knowledge for Health Project. Family Planning: A Global Handbook for Providers (2018 update), p49–64.
- Vasectomy. WHO/RHR and Johns Hopkins Bloomberg School of Public Health/CCP, Knowledge for Health Project. Family Planning: A Global Handbook for Providers (2018 update), p231–246.
- WHO. Emergency Contraception. Available at: https://www.who.int/en/news-room/fact-sheets/detail/emergency-contraception. Accessed February 2023.
- Appendix A. WHO/RHR and Johns Hopkins Bloomberg School of Public Health/CCP, Knowledge for Health Project. Family Planning: A Global Handbook for Providers (2018 update), p383.
- WHO. Western Pacific Region. What is the Best Way to Protect from Unintended Pregnancy?. Available at: https://apps.who.int/iris/handle/10665/208327. Accessed February 2023.
- Trussell J, Aiken A, Micks E, et al. Chapter 3: Efficacy, Safety, and Personal Considerations. Contraceptive Technology. 21st Edition. 2018. Ayer Company Publishers, Inc., New York. NY.
- Mayo Clinic. Birth control options: Things to consider. https://www.mayoclinic.org/healthy-lifestyle/birth-control/in-depth/birth-control-options/art-20045571. Accessed on 22 July 2022.
- Organon. Which contraceptive is right for me? http://cpages.idecide.co.za/microsite#Home. Accessed on 22 Jully 2022. ZA-NON-110173
- World Health Organization. Western Pacific. Region. What is the Best Way to Protect from Unintended Pregnancy? Available at: https://apps.who.int/iris/handle/10665/208327. Accessed June 2022.
- World Health Organization (WHO). Selected practice recommendations for contraceptive use. 3rd edition, 2016. Available at: https://apps.who.int/iris/bitstream/handle/10665/252267/9789241565400-eng.pdf;jsessionid=5587A3665972B72C284C81FA2E8BF59A?sequence=1. Accessed: June 2022.
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