By B. Nejad, MD, Obstetrician & Gynecologist

Every guy anticipates the time when he will no longer have to use a condom. There are many forms of birth control out there so that every couple can find one to match their needs. It is important to keep in mind that barrier contraception (i.e. condoms) are the only way to prevent sexually transmitted diseases (STDs). So, before you have sex without a condom with any new partner, make sure you get tested for STDs such as HIV, Syphyllis, and Hepatitis at a routine check up with your physician. You can also ask your physician about testing for Gonorrhea and Chlamydia.

One easy way to look at contraception, otherwise known as birth control, is by timing. Almost all non-barrier methods include hormones such as estrogen, progesterone, or both. They can be timed daily, weekly, monthly, every three months, or every 5 to 10 years. There are different forms such as pills, patches, shots, barrier methods, and intrauterine devices. For more detailed information, please contact your physician. The following are some of the common forms of birth control.

Your future wife should also get tested for sexually transmitted diseases and see her physician before you get married. This is a sensitive topic to bring up with your fiancé. You are essentially transferring the burden of birth control from the “guy using a condom” to the “woman using some method of birth control.” So, you may use an icebreaker like flowers, chocolate, or some other form of bribery to prompt the conversation. Then you can say things like “I think we should discuss different forms of birth control…” “Let’s make a decision about birth control together…”

Male Condoms:
Condoms act as a mechanical barrier to prevent pregnancy by blocking the passage of sperm. They also reduce the risk of transmission of sexually transmitted diseases including HIV. Non-spermicidal condoms last up to 5 years and spermicide-coated condoms only last up to 2 years. Failure rates range from 3-14%. Most condoms are latex, but if there is a latex allergy, there are condoms made of polyurethane.

Diaphragms:
Rubber dome-shaped device filled with spermicide to cover the cercix that are placed within 6 hours prior to intercourse, and are left in place for up to 6-8 hours after intercourse. Failure rates of 6-20%. Not effective if used without spermicide. This is a non-hormonal device which has fewer side effects, but is less effective and less convenient for some.

Intrauterine Devices (IUD):
There are a copper IUD and a progesterone IUD. The copper IUD will work for up to ten years and is a non-hormonal device. The progesterone IUD will work for up to 5 years and has a local hormonal effect. IUDs have .6-2.8% failure rates. They do not protect against sexually transmitted diseases. These are great for long-term contraception but easier to insert after a woman has had a child.

Emergency Contraception:
Any method after intercourse to prevent pregnancy. These methods include combined oral contraceptive pills, progestin-only contraceptive pills, IUD insertion.

Progestin-Only Pills:
Taken daily, failure rate of .5-5%. Requires very punctual dosing daily. Decreases menstrual pain and blood loss. Does not prevent against transmission of sexually transmitted diseases. Not always as effective as combined pills but a good option if estrogen is contraindicated.

Combined Oral Contraceptives:
Each pill contains an estrogen and a progestin. 21 days have active hormones and 7 days are placebo when menstruation occurs. Failure rate of .1-5%. Decreases menstrual blood loss and menstrual pain. To be taken within a 2-hour time frame daily. Decreases risk of ovarian cancer. Does not protect against sexually transmitted diseases. Not recommended if smoking or blood clotting are a problem.

Depo-Provera:
One injection every three months into the arm or buttock muscle. Failure rate of .3%. Decreases menstrual blood loss but may cause fewer episodes of menstruation overall and/or complete loss of menstruation while on the medication. No protection against sexually transmitted diseases. May cause weight gain and/or hair loss as a possible side effect.

Nuva Ring:
Plastic band placed in vagina, that secretes local hormones. Device placed once a month and removed every three weeks during the menstrual week. Does not protect against sexually transmitted diseases. Device not felt by woman or partner during intercourse. If the device falls out, can be rinsed off and replaced within 3 hours

Ortho Evra:
Patch placed on the skin once a week and removed during week of menstruation. Hormones secreted through patch. Patch is the color of skin and hardly noticeable. Patch may be placed on the buttocks, abdomen, upper arm, or upper torso. Benefits and risks are similar to combined oral contraceptives.