For a healthy, sexually active woman with normal periods of fertility, the chances of becoming pregnant are quite high. But there are times when a healthy, sexually active woman does not wish to become pregnant. At these times, a woman may choose to actively prevent pregnancy using birth control.

The first question a woman has to ask herself about pregnancy is if there will be a right time in the future. For some women the answer may be that the time will be right in a few months, or a few years. Other women may have made the decision for any number of reasons that pregnancy has no place in their future at any time. An examination of this question, together with discussions with her partner when appropriate, can help a woman make her birth control choice.

Birth control has almost as many names as there are methods, family planning, contraception, pregnancy prevention, and fertility control, to name a few. Essentially all birth control methods are the same at their core level: they prevent a woman’s egg from becoming fertilized by a man’s sperm. Some birth control methods are an ideal choice for the “not now” answer to pregnancy, while there are a few methods that are only suited to the “not ever” answer. These methods are reversible, and permanent, respectively. A reversible method does not permanently affect fertility, and can be stopped any time a woman desires to try to conceive. A permanent method is just what the name implies: it usually is non-reversible and generally fertility removed by these methods cannot be restored.

There are several times of reversible birth control methods: barrier methods (condoms, for example), hormonal methods (birth control pills), mechanical methods (IUDs), and natural methods (rhythm methods, for example). It is important to note that most forms of birth control do not protect against diseases which are transmitted by sexual activity; that concern must be addressed separately.

Permanent Surgical Sterilization

Permanent methods of birth control are revered to as sterilization. Men who are certain they do not wish to father children have the option of choosing a vasectomy. A vasectomy involves the surgical closing of the spermatic duct through which sperm travels out of the man’s body during orgasm; this is done by cutting the duct and closing each of the resulting ends of the vessel. This surgery is usually performed under local anesthesia by a urologist or specialty surgeon. After a vasectomy has been performed, a man’s sperm do not exit his penis during orgasm, and therefore he cannot fertilize the woman’s egg. A vasectomy does not affect a man’s ability to achieve an erection, perform sexually, and it does not noticeably affect his semen except on a microscopic level.

Permanent surgical sterilization for women generally takes the form of tubal ligation. In this method, a woman receives general anesthesia. The surgeon then identifies the Fallopian tubes (the vessel in which the eggs travel from the woman’s ovaries to her uterus) and closes it by clipping or cutting it, and then tying, cauterizing or otherwise sealing the ends. This is often done as an outpatient procedure and typically takes from one-half hour to 45 minutes. Tubal ligation carries some risks, including bleeding, infection, and the other risks related to receiving general anesthesia. However, it has a high rate of pregnancy prevention (98%) and is more likely to be successfully reversed than a vasectomy.

Mechanical Methods: Intrauterine Devices

Intrauterine devices, or IUDs are a type of birth control classified as mechanical, though the exact method in which they work is not fully understood. It is though that the presence of an IUD in a woman’s uterus causes a brief inflammation response localized to the uterus, while also affecting cervical mucus in a way that inhibits the passage of sperm into the uterus. An IUD is a small “T” shaped polyethylene plastic device that is inserted into the uterus. A small string protrudes through the cervix into the vaginal canal; this helps the woman and doctor know when the device is properly inserted and allows the woman to verify that it has not been expelled from the body. Some IUDs are made of and emit small amounts of copper, while some release small amounts of the hormone progesterone to further help prevent pregnancy.

“On The Pill”

Hormonal birth control, such as the oral contraceptive pill, are one of the most popular forms of contraception. Hormonal forms of birth control include oral pills, injectables, the contraceptive patch, the vaginal ring, etc. All are based on delivering hormones into a woman’s body. Birth control pills may contain one or more synthetic hormones and are typically called combination or mini pills. Side effects of using hormonal methods of birth control include breast tenderness, nausea while the body is adapting to the hormonal changes, vaginal bleeding, etc.

Preventing Pregnancy Nature’s Way

Natural methods of preventing pregnancy rely not on surgery, medication, or other devices, but rather instead on knowing how a woman’s body works and timing sexual activity for a time when fertilization is very unlikely to occur. Natural methods are safe methods in that they are free from the side effects possible with surgery and drugs. However, they must be followed stringently to be reliable. All methods involve determining when a woman is fertile. The Calendar method uses a calendar to track a woman’s menstrual cycle to make this determination. The Basal Body Temperature (BBT) method tracks the changes that occur in a woman’s body temperature when ovulation takes place. The Family Awareness Method (FAM) involves looking for other signs and symptoms of ovulation. Some methods use more than one way to determine fertile periods.