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Home , Coitus interruptus, Contraceptive sponge, Vasectomy

Cornell Non-hormonal Methods Health of Contraception

Live Well to What they are Learn Well A non-hormonal method of Web: protects against pregnancy, without influencing health.cornell.edu a woman’s natural hormones. You may wish to consider a non-hormonal Phone (24/7): method of birth control if you: 607-255-5155 • want to“back-up” your hormonal method Fax: (e.g., use to further protect against 607-255-0269 pregnancy and reduce risk of exposure to sexually transmitted ) Appointments: • experience undesired side effects from, or Monday–Saturday have medical contraindications to, hormones Check web for hours, • have infrequent intercourse and do not feel services, providers, you need ongoing contraception and appointment • do not want to alter body’s natural rhythms (i.e., your natural menstrual cycle) for information spiritual or other reasons Several non-hormonal birth control methods are available to students. 110 Ho Plaza, Below are brief descriptions of available non- Ithaca, NY hormonal methods of contraception. Additional are easily obtained and relatively easy to use. 14853-3101 information can be obtained from topic-specific Condoms also are the only method, aside from fact sheets available at health.cornell.edu, or from abstinence, that can provide some protection a Cornell Health care provider. against STI. (They are one of few contraceptives Abstinence a man can use to help prevent unintended pregnancies). Complete abstinence from penile-vaginal sexual contact is, of course, the only 100% effective Disadvantages may include (for some) an allergy method of preventing pregnancy. Some couples to or irritation from the latex or used choose abstinence due to religious or cultural in the . If condoms are irritating, be sure considerations, some due to medical conditions, to use types that are not spermicidally-lubricated. and some because it is truly the most effective Use water-based lube instead. Other disadvantages way to prevent pregnancy and reduce exposure to include decreased sensation, and the need to sexually-transmitted infections. interrupt sexual activity to put on a condom. If you choose abstinence, remember that any Proper use is the key to effectiveness of condoms, contact with on or near a woman’s which can vary from 80% to 98% depending on external genitals (e.g., labia, vulva) or inner the user. Cornell Health’s fact sheet on condoms thighs can potentially result in pregnancy. and lubricants outlines instructions for proper Be sure to keep any ejaculate or pre-ejaculate use. Consider meeting with a sexual health nurse away from these areas. to further discuss selection, as well as correct usage. [Search “condom” at health.cornell.edu]. (IUD) The Paragard (copper) IUD can be placed into the -Awareness-Based during an in-office procedure. It is highly methods effective, and can be left in place for long-term There are several different Fertility-Awareness- contraception without affecting future fertility. Based (FAB) methods of contraception. Each Some IUDs in the past were linked to pelvic involves tracking a woman’s menstrual cycle to infections. The IUDs used today have been proven predict which times of the month are “fertile” safe and effective. Both hormonal and non- periods, during which she is at higher risk of hormonal IUDs are available at Cornell Health. pregnancy due to ovulation, and which times of Please refer to our IUD fact sheet for more detailed the month are “safe.” information. [Search “IUD” at health.cornell.edu]. Some women women choose FABchoose methods F becauseAB me theythods allow them bec toause be very the in y Condoms tuneallo withw theirthem body t ando be its rhythms. very inThey tune are also with very helpfultheir for body couples who areand trying its to rh becomeythms. pregnant, The asy they ar ehelp also them vmaximizeery help theirful opportunities for Condoms are one of the most popular non- to conceive. For some couples, however, it is too difficult either to keep track of couples who are trying to become pregnant, as

hormonal methods of contraception, for they the necessary data or to abstain from intercourse during fertile times (as many asthe 10–14y help days per them month). maximize their opportunities to conceive. For some couples, however, The it is too difficult either to keep track of Vaginal spermicides are widely available, The contraceptive sponge is a small, pillow- the necessary data or to abstain from and many women choose them. However shaped polyurethane sponge containing intercourse during fertile times (as many they are the least effective form of nonoxynol-9, a common spermicide. as 10–14 days per month). contraception va ailable when used alone, It is moistened with water prior to use and • These methods are most effective with a perfect use effectiveness of 82% and then inserted far up into the so that when a couple is completely abstinent a typical use effectiveness of 71%. They the concave side covers the . during the fertile times. are available as gels, foams, jelly, Vaginal • They are not very effective for Once in place, the sponge protects for 24 Contraceptive Film (VCF), creams, and women who have irregular or hours, and must be left in place for at least unpredictable menstrual periods, suppositories. 6 hours after the last act of intercourse. are currently breast-feeding or Spermicide works by disrupting the Afterwards, the sponge is removed by recently post-childbirth, or have membrane to kill them. They are not highly pulling the small attached loop and recently discontinued a hormonal effective, however, because it is difficult for discarded. It cannot be reused. contraceptive method. all of the millions of sperm to be exposed Perfect use effectiveness for the sponge is • Most require daily monitoring of to the spermicide before they enter the 91%, but typical use effectiveness is only signs of fertility, such as cycle day, cervical canal. 80%. The sponge cannot be used during a , and cervical Some men and women may also find the menstrual period. secretions. spermicides irritating, and higher rates of As these methods can be difficult to use, urinary tract infections have been reported the effectiveness varies widely, from 75% among women using spermicides. Method (LAM) to 94%, depending on the user. Spermicides are an important adjunct to When a woman has had a baby and If you are interested in using a FAB diaphragms (see below), but their presence is breast-feeding, the hormones that method, visit arhp.org and search in conjunction with condoms has not been regulate the production of milk also “fertility fact sheet”, or please schedule shown to improve contraceptive efficacy. inhibit ovulation, thereby preventing the an appointment with a Cornell Health Overall, spermicides are certainly better possibility of another pregnancy. clinician to discuss which method would than no method at all, but they are the During this time, women do not have work best for you and how to use it, as least effective solo form of contraception menstrual periods. Therefore, women proper understanding of the method is available. who are exclusively breast-feeding (i.e., the crucial to its success. infant has NO source of food or fluids other Withdrawal Diaphragm than the mother’s breast milk), have a low The diaphragm is a dome-shaped latex — — Technically termed “,” risk of pregnancy about 2% in the first six barrier that is inserted vaginally to cover and more commonly “pulling out,” this months following the baby’s birth. the cervix and prevent sperm from method refers to removing the The risk is somewhat higher in working entering the uterus. Diaphragms come from the vagina prior to to mothers—about 5%—as breast pumping in different sizes, and therefore require prevent the deposit of sperm in or near does not as reliably produce the same a clinician visit for fitting and instruction. the vagina. hormonal signals as nursing. Once an infant Perfect use effectiveness for diaphragms, In theory, this method should be quite starts to receive other food sources used in conjunction with spermicide, is — generally at six months— this method of effective (best possible efficacy estimated 94%, but typical use is 84%. at 96%), but in practice it is quite difficult birth control becomes ineffective. A diaphragm is inserted prior to intercourse to do. Typical use effectiveness is only and must be left in place for a minimum of Surgical 73%, due to the difficulty involved in six hours afterward. It can be left in place For those who desire permanent interrupting intercourse at just the right for a total of 24 hours at a time. After use, contraception, with no future possibility of time, and ensuring that no semen is a diaphragm should be removed, rinsed having a child, surgery can be performed deposited near the woman’s genitals or clean, and stored in a cool, dry place. In to make such an event highly unlikely. inner thighs. some women, a diaphragm can increase While highly effective, these methods For this reason, withdrawal is not the risk of urinary tract infections, so it are not 100%. Also remember that they recommended as a first choice for is not recommended for women with are intended to be permanent and are contraception, but it can be used if no a history of multiple UTI’s. Oil-based therefore often extraordinarily difficult, if other method is available and the couple lubricants and vaginal creams (Monistat, not impossible, to reverse. is unable to refrain from intercourse. Vagisil, and others) should not be used ForFor men, men, vasect is a omsimpley isoffice a simpleprocedure officerequiring either Withdrawal does not protect against with diaphragms, as they can cause latex to nopr sedativeocedur or eonly requiring a mild one, alongeither with nolocal sedaanesthesiative or STIs, as infectious organisms can be deteriorate. (numbingonly a medicine).mild one The, alongprocedure with does notloc impactal anes abilitythesia to present on the genital skin and in the Diaphragms are not stocked by any retail achieve(numbing or maintain me erectionsdicine or). toThe ejaculate. procedur As it takese doestime to pre-ejaculate. pharmacy. The Cornell Health pharmacy clearnot anyimpact remaining ability sperm outto ofachie the system,ve or the main couple tisain not protected for several months, until the absence of sperm has been can assist you in ordering one once you documentederections on twoor consecutiveot ejacula sampleste. As by it the t akphysician.es time The have been fitted. effectivenessto clear an is abouty remaining 99.9%. sperm out of the system, the couple is not protected for several months, until the absence of sperm has been documented on two consecutive samples by the physician. The effectiveness is about 99.9%. For women, female sterilization effectiveness is lower than for vasectomy at 99.5%. There are a variety of options available for female sterilization. The best choice for you can be discussed with your health care provider. If you are considering sterilization, contact Cornell Health, and we will refer you to a local surgeon for consultation. If pregnancy is undesired and you are using a non-hormonal method as your primary form of birth control, consider keeping a supply of Emergency Contraception on hand. This hormone pill can serve as a back-up method to reduce the chance of pregnancy in the event of contraceptive failure. It is best used soon after unprotected sex, but may be effective up to 5 days later. More information about EC can be found on our fact sheet, and online at health.cornell.edu. More Information The sexual health nurses at Cornell Health can talk with you about any questions you have about birth control methods, reducing your risk of exposure to STIs, and/or testing for pregnancy or . These consultations are free to students. You may schedule an appointment via myCornellHealth or by calling 607-255-5155. The pharmacy at Cornell Health carries a wide range of prescription and non- prescription contraceptives, safer sex supplies, and other sexual health products at reasonable and sometimes no osc t. For more information about the pharmacy, please visit: health.cornell.edu/pharmacy

health.cornell.edu 10/18/19