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The Two Approaches to Birth Control (Hormonal and Barrier)

Sex is a normal and healthy part of life, but you don’t always want it to lead to pregnancy. Fortunately, there are effective methods a woman can use to prevent an unwanted birth.

At the OB/GYN practice of Dr. Hany H Ahmed in Houston, Texas, we’re pleased to offer our patients a variety of birth control options. Not everyone is familiar with what’s available, so we’ve put together this guide to help familiarize you with your choices.

No birth control method works 100% of the time. Talk to Dr. Ahmed about the advantages and disadvantages of each option to decide which is best for you.

There are two major types of birth control:

1. Hormonal birth control

There are a number of hormonal treatments, including:

Oral contraceptives

Collectively known as "the pill," most oral contraceptives contain a combination of estrogen and progestin. The hormones reduce the risk of pregnancy by:

Taken properly, birth control pills are highly effective. However, if you skip pills or forget to restart them following the week of your period, their efficacy decreases. About 9 in 100 women taking oral contraceptives for a year have unintended pregnancies, most because of missed pills.

For women unable to take estrogen, some newer pills (called the “mini pill”) contain only progestin. However, dosage timing is much more restricted than for combination pills.

Intrauterine devices (IUDs)

IUDs are T-shaped devices made of molded plastic, with a string that lies in the vagina but doesn’t extend outside the body. Your doctor inserts the device through the vagina and cervix into the uterus. 

They’re a good choice for long-term contraception, but they can be removed at any time should you wish to become pregnant.

There are two types of IUDs approved for use in the US:

1. Copper-containing IUD

This IUD prevents pregnancy by blocking sperm from reaching the fallopian tubes. The IUD can remain in place for at least 10 years, and the pregnancy rate is below 1% in the first year of use.

2. Levonorgestrel (progestin)-containing IUD

This IUD prevents pregnancy by thickening the cervical mucus and thinning the uterine lining. They also decrease menstrual bleeding and pain. Depending on the brand, the IUD can last 3-6 years. As with the copper IUDs, the pregnancy rate is below 1% in the first year of use.

Other hormonal options include the vaginal ring and skin patch, both of which contain estrogen and progestin; implants, which are small progestin-containing rods inserted under the skin in the upper inner arm, effective for up to three years; and a deep muscle injectable that uses depot medroxyprogesterone acetate (DMPA), administered every three months.

2. Barrier birth control

Barrier contraceptives erect a physical wall between sperm and egg cells to prevent fertilization. Spermicides, chemicals that kill sperm, are often used with barriers to increase effectiveness.

Barrier options may be preferable to some women, as they generally don’t have the side effects that hormonal contraceptives do. In addition, some forms of barrier contraception don’t require a prescription and are readily available at pharmacies.

On the downside, though, barrier contraceptives, with the exception of the male condom, don’t prevent sexually transmitted diseases (STDs).

Again, there are several options:

Male and female condoms

A male condom is a thin latex or polyurethane sheath worn over the man's penis during sex. The condom collects sperm so it doesn’t penetrate the vagina. Condoms can tear, but their estimated effectiveness is still 87%-90%.

The female condom isn’t widely used in the US, but it's been found about 85% effective.

Contraceptive sponge

This doughnut-shaped ring of polyurethane foam is impregnated with the spermicide Nonoxynol-9, which confers its efficacy. The woman inserts the sponge high in the vagina, as if inserting a tampon. The sponge then prevents sperm from getting to the cervix.


The woman inserts this soft, flexible, dome-shaped latex cup, with a metal coil to hold it in place, into her vagina prior to sex, covering it on both sides and around the rim with a spermacide to form a tight seal. The diaphragm blocks access to the cervix so sperm can’t penetrate.

Are you looking for an effective birth control method but aren’t certain which type or method is right for you? Dr. Ahmed can help you decide based on your lifestyle, health, and future pregnancy plans. Give our office a call or schedule an appointment online today.

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