There are a variety of ways to decrease the risk of unwanted pregnancies without using a condom. You can speak to your family doctor to discuss (and receive prescriptions for) various medical options, or you can opt for natural methods. Keep in mind, however, that there are benefits to a condom beyond contraception – namely, the prevention of STIs (sexually transmitted infections). Also, the only 100% guaranteed way to prevent pregnancy is to abstain from sex; all other options significantly decrease your risk of pregnancy, but they are not guaranteed to prevent it.
1. Take hormonal birth control pills. If you are a woman seeking to prevent pregnancy without using a condom, one of the most common options is to take hormonal birth control pills. These are available from your family doctor; the pills are composed of either a blend of estrogen and progesterone, or just progesterone. You normally take one per day for 21 days followed by seven days of “sugar pills” (during which your body experiences a “withdrawal bleed” in place of a period).
There are a variety of different birth control formulations, and you can speak to your family doctor about the different options to determine which one is best for you.
The advantage of taking birth control pills is that they are 91% effective in preventing pregnancy (and even more effective when used at exactly the same time every day without missing any doses).
If you are a man having sex with a woman and not wanting to get her pregnant, you can ask her if she is regularly taking birth control pills. The downside of this method of contraception for men, however, is that you are relying on taking the woman’s word for it, and also trusting that she has been taking them daily and not accidentally missing doses.
2. Have an IUD (intrauterine device) inserted.
An IUD is a small, T-shaped device that is inserted through your vagina into your uterus (where it sits for the next number of years and functions as birth control). They are over 99% effective at preventing pregnancy.
IUDs available include: the Mirena, Skyla, and Lilletta IUDs, and the Copper IUD.
The Mirena IUD is hormone-based. It is more expensive and lasts up to five years; however, the benefit is that it decreases menstrual cramps and bleeding. Skyla, and Lilletta IUDs are also hormone based and these last up to three years.
The Copper IUD is not hormone-based. The pros are that it is cheaper and lasts up to 10 years; however, the downside is that your menstrual cramps and monthly bleeding may be increased.
You may receive a prescription for an IUD from your family doctor. Your doctor can then set up an appointment to have it inserted, which usually only takes a couple of minutes.
Having the IUD inserted may be painful for a brief moment as it passes through the narrow opening of your cervix; however, after it has been inserted, you should no longer feel any pain.
3. Try other hormonal birth control options.
Other hormonal options include a vaginal ring, Depo-Provera injections, and contraceptive patches. They are available via a prescription from your family doctor.
A vaginal ring (called the NuvaRing) is something you place in your vagina and leave there for three weeks at a time (and then remove it for one week for a withdrawal bleed). It suppresses ovulation by releasing hormones (a mixture of estrogen and progesterone) during the time that it is in your vagina. It is rare for the ring to cause any problems with sexual intercourse, and it is normally not felt by either the user or the user’s partner. The failure rate is 9% with typical use, and 0.3% with perfect use. The ring can be removed for up to three hours, so if you are more comfortable having sex without it, then this is an option.
Depo-Provera injections are administered by your family doctor once every three months, so the advantage is that, as long as you go every three months, you do not need to remember to take birth control pills (or to use another method) on a regular basis. The failure rate is less than 1% for those who follow through with injections every three months.
Contraceptive patches are about 5cm x 5cm in size, and are placed on your skin. Each patch lasts for one week, and then must be replaced – therefore, you need to use three in a row, followed by one week off to allow for a withdrawal bleed. The patches contain the same hormones as the birth control pill, and, when used correctly (and replaced diligently every week), the failure rate is less than 1%.
Ask about the implantable birth control called Implanon. This birth control method is inserted into your arm and it will last for up to four years.
4. Opt for a spermicide.
Spermicides are gels or foams that are inserted into the vagina, which trap and subsequently kill sperm through the use of chemicals that are toxic to sperm. They can be purchased at your local drugstore or pharmacy. The failure rate for spermicides is around 22%.
5. Use a barrier method such as a cervical cap or a diaphragm.
Both a cervical cap and a diaphragm are devices that a woman inserts into her vagina to cover the cervix. This blocks sperm from entering the uterus. The cervical cap or diaphragm also normally contains chemicals that kill sperm, further reducing the risk of becoming pregnant. The failure rate is about 14% in women who have never been pregnant, and 29% in women who have previously been pregnant.
You can get fitted for a cervical cap or diaphragm at your doctor’s office.
6. Opt for sterilization.
One of the surest ways to prevent pregnancy is for either the man or the woman (or both) to be sterilized. However, it is key to know that this is a permanent procedure. It should not be undertaken unless you are absolutely sure that you do not want biological children of your own in the future.
For a man, the procedure is called a “vasectomy.” In this procedure, his “vas deferens,” the tube that carries sperm, is cut. This prevents the man’s ability to contribute to a pregnancy.
For a woman, the procedure is called “tubal ligation.” The woman’s fallopian tubes (which carry unfertilized eggs from the ovaries to the uterus) are severed. This prevents eggs from being fertilized and thus prevents pregnancy.