7/20/2014 Overview of contraceptive methods

OfficialreprintfromUpToDate
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Overviewofcontraceptivemethods

Contraceptive
Copper Levonorgestrel Etonogestrel Male
Characteristics pill,patch,or DMPA Diaphragm
IUD releasingIUD implant condom
ring
Pregnancyratein <1 <1 9 <1 6 18 12
thefirstyearofuse
inatypicalpatient

Durationofefficacy 10years 3to5years Usedaily(pill), 3years 12weeks Singleuseat Reusable.Must

(dependingontype) weekly(patch), thetimeof beinserted
monthly(ring) eachcoital beforecoitus
act andusedwith
aspermicidal
cream/gel.

Hormonalexposure None Progestin Estrogenand Progestin Progestin None None

progestin

Effectonmenses Maybe Lighter,irregular Lighter,regular Lighter,irregular Lighter, None None

heavier especiallyinfirst3to predictable irregular
6months withdrawal
bleedingwith
cyclicuse

Unscheduled Yes Yes Yes Yes Yes No No

bleeding/spotting

Notagoodchoice Heavyor Severedistortionof Contraindications Poortoleranceof Poortolerance Sensitivityor Sensitivityor

forotherwise painful uterinecavity,active tousing amenorrheaor ofamenorrhea allergyto allergytolatex
healthywomen* periods,iron pelvicinfection,poor exogenous unscheduled orunscheduled latex(non (nonlatex
with: deficiency toleranceof estrogenorwho bleeding bleedingor latex diaphragmsare
anemia, amenorrheaor aresensitiveto known condomsare available),

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7/20/2014 Overview of contraceptive methods

severe unscheduled estrogenrelated preexistinglow available), pelvic

distortionof bleeding,sensitiveto sideeffects(eg, bonemineral malepartner relaxation,
uterine hormonalsideeffects nausea,breast density,orwho whowon't difficultywith
cavity, tenderness, wanttoget usethe insertionor
copper headache,etc). pregnant method careofthe
allergyor Womenover35 quicklyupon diaphragm
Wilson yearswhosmoke. discontinuation
disease,
activepelvic
infection

Access Mustbe Mustbeinsertedand Prescription Mustbeinserted Injectionbya Overthe Prescription

insertedand removedbya andremoved clinician counter
removedby clinician throughatiny
aclinician skinincisionbya
clinicianwith
specialtraining

Selectedadverse Uterine Uterineperforation, Increasedriskof Infectionor Maycause Condommay Mayincrease

events perforation, expulsion,increased venous scarringat weightgain break riskofurinary
expulsion, riskofpelvicinfection thrombosis, insertion/removal andmood tractinfection
increased inthefirst20days hepaticadenoma site,difficult changes
riskofpelvic afterinsertion removal
infectionin
thefirst20
daysafter
insertion

Selected Highly Highlyeffectivelong Benefitsof Highlyeffective Effective Best Nosystemicor

advantages effectivelong actingmethodthat estrogenmay longacting prolonged protection mensesrelated
acting resultsinfavorable includereduction methodthatcan contraception against sideeffects
methodthat progestininduced inacneand beusedby thatcanbe sexually
canbeused endometrialchanges hirsutism,and womenwho usedbywomen transmitted
bywomen withnoorlow reduced mustorchoose whomustor infections
whomustor systemicprogestin vasomotor toavoidestrogen choosetoavoid
chooseto relatedsideeffects symptomsin estrogen
avoid perimenopausal
exogenous women
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7/20/2014 Overview of contraceptive methods

hormones

*Forwomenwithcurrentorpriormedicaldisorders,refertoaresourcesuchasUnitedStatesMedicalEligibilityCriteriaforContraceptiveUse[USMEC]
(availableatwww.cdc.gov).

Graphic89046Version2.0

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