What is the Most Effective OTC Birth Control Method?

Effectiveness of Condoms and OTC Birth Control Against Pregnancy

Effectiveness of Condoms Against Pregnancy
Effectiveness of Condoms Against Pregnancy. Cultura Science/Rafe Swan/Getty Images

When it comes to birth control, some methods are more effective than others. This is especially the case with over-the-counter (OTC) methods. For example, the effectiveness of condoms against pregnancy is higher than the effectiveness of spermicides. Plus, to be most effective, OTC birth control needs to be used correctly every time you have sex. So even though condoms can be an effective way to prevent against pregnancy, if your boyfriend refuses to wear condoms, or he does not properly puts one on, the condom losses some of its effectiveness.

When we talk about the effectiveness of any kind of birth control (including condoms and other OTC methods), we look at perfect user rates as well as typical user rates.

  • Perfect use refers to the effectiveness of a birth control method when it is used consistently (meaning, every time you have sex) and always used correctly.
  • Typical user rates usually apply to the average person. These tell us how effective a birth control method is when it may not always be used, or if it is used, it may not be used correctly. These rates tend to be the ones we pay attention to because, the truth is, it can be difficult to always and reliably use birth control the correct way.

One last piece of information to keep in mind, both perfect rates and typical rates are based on looking at 100 couples who use that OTC birth control method for one year and determining how many will become pregnant within a year. This is where things can become tricky, so I will try to break this down for you:

  1. No one method is 100% effective in perfect or typical use over time (except for abstinence).
  2. These effectiveness rates are based on using a birth control method for one year. They don’t take into account how often during that year you are having sex. For example, in typical use, the effectiveness of condoms against pregnancy is 82%. This is the case whether this is your first time having sex or your 300th time. This does not mean that if you have sex 100 times, that you will get pregnant on your 82nd time (or any time after that). It also does not mean that you have an 82% chance of not getting pregnant.
  1. It also doesn’t mean that condoms can’t be 100% effective. When you look at a single time that you had sex, you either became pregnant or you didn’t (after all, you can’t be 15% pregnant!). If you used a condom for contraception when you had sex that time, and you did not become pregnant, you can say that the effectiveness of that condom against pregnancy was 100%.

So, How Effective are OTC Birth Control Methods?

Well, first, it may be helpful to know that you can buy OTC birth control at the store or online without a doctor’s prescription. These methods typically act as a barrier to keep sperm from joining and fertilizing an egg. So now let's compare the effectiveness of OTC birth control.

Condoms (Male):

Male condoms are made of latex, polyurethane, polyisoprene, or natural membrane. One of the things that factor into the effectiveness of condoms is that you are using the correct size condom. Condoms do not typically break or have holes and are one of the only birth control methods that are also effective at preventing sexually transmitted infections.

  • Perfect use: male condoms are 98% effective.
  • Typical use: male condoms are 82% effective.
  • This means that out of every 100 women whose partners use condoms for one year, 2 will become pregnant (with perfect use) and 18 will become pregnant (with typical use).

Female Condoms:

A female condom is sort of like a pre-lubricated pouch and is made from polyurethane or synthetic latex. Like male condoms, female condoms can also offer you protection from sexually transmitted infections. To make sure that it is most effective, you may want to practice inserting the female condom a couple of times before having sex. Use a new female condom for each act of sexual intercourse and never use a female condom with a male condom.

  • Perfect use: female condoms are 95% effective.
  • Typical use: female condoms are 79% effective.
  • This means that out of every 100 women who use female condoms for one year, 5 will become pregnant (with perfect use) and 21 will become pregnant (with typical use).

Spermicide:

Spermicide kill sperm. It can come in many forms and tends to be more effective when used with an additional birth control method, like a condom or a diaphragm.

  • Perfect use: spermicide is 82% effective.
  • Typical use: spermicide is 72% effective.
  • This means that out of every 100 women who use foam, cream, jelly, film, or suppository spermicide for one year, 18 will become pregnant (with perfect use) and 28 will become pregnant (with typical use).

The Sponge:

The sponge is made of polyurethane foam and is coated with the spermicide, nonoxynol-9. It can offer continuous pregnancy protection for up to 24 hours. The sponge is most effective if it is left in place for at least 6 hours after having sex. As with the female condom, it may be helpful to practice to make sure you are inserting the sponge correctly.

Effectiveness rates for the sponge range between 76% to 91%.

For women who have not given birth:

  • Perfect use: the sponge is 91% effective.
  • Typical use: the sponge is 88% effective.
  • This means that out of every 100 women who have never given birth and use the sponge for one year, 9 will become pregnant (with perfect use) and 12 will become pregnant (with typical use).

For women who have given birth:

  • Perfect use: the sponge is 80% effective.
  • Typical use: the sponge is 76% effective.
  • This means that out of every 100 women who have previously given birth and use the sponge for one year, 20 will become pregnant (with perfect use) and 24 will become pregnant (with typical use).

Research suggests that the effectiveness rates for the sponge may increase during the second year of use -- perhaps this is due to women having become more comfortable using this method.

Source:

Zieman M. "Overview of contraception." Jul 22, 2015; UptoDate. Accessed via private subscription.

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