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So Many Choices
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So you like sex, but aren’t exactly interested in cankles nine months from now? With all the different medications, devices, and methods out there, how to choose the right birth control for you (and your partner) can become quite the daunting task. Here’s some information—including reviews from my colleagues and acquaintances—to help narrow down the field.
Remember, though, if you’re not in a monogamous relationship, it’s best to always use a male condom.
Female condom
Male condom
Lubricants
Spermicides
Diaphragm
Cervical cap
IUDs
Combination pill
Progestin-only “mini pill“
Ortho Evra patch
Depo-Provera injection
Implanon implant
Emergency contraception pill
Withdrawal
Abstinence
The female condom is currently sold over-the-counter under the brand name Reality. They are pricier than regular male latex condoms but have at least one advantage: unlike its latex counterparts, the female condom’s polyurethane doesn’t deteriorate in high temperatures or humidity, so they don’t require special storage conditions.
Effectiveness: Polyurethane condoms have not been well studied for preventing sexually transmitted infections (STIs), but they’re believed to offer as much, or even more, protection against pregnancy than latex condoms.
Bonus Points: If you don’t mind making squishy sounds when you walk, the female condom can be inserted up to eight hours before having intercourse. Plus a man doesn't have to be fully erect when his partner uses the female condom so it doesn’t necessarily interrupt sexual spontaneity.
What users say:
Suzie: “It scared the crap out of me. It was so big, I felt as though it was going to rip me apart; its uncanny resemblance to the future of Ziplocks might have had something to do with it. Definitely a bit of a mood kill… Even though it comes pre-packaged with a silicone-based lubricant, we still added some extra water-based lube (polyurethane can handle both types of lube) cause we heard it might decrease the noise. Did I mention that yet? It’s very noisy. We weren’t exactly sure where to put the extra lube and ended up putting too much on the outer ring. Read: too much lube makes vagina very hungry. Swallowed it up like a guppy fish.”
Rob: “Note to all the guys out there who think double bagging it is a ‘good thing’: it’s not. And that goes two fold for teaming up male and female condoms, which my girlfriend and I regrettably discovered. The friction between the two caused my (male) condom to slip off every now and then. But the worst part was that since we kept going, the female condom ended up getting lodged inside my girlfriend’s vagina. And we all know how embarrassing those hospital visits can be.”
Condoms are made from three different materials—latex, lambskin, and now polyurethane. Latex condoms are by far the most widely available and least expensive. Best of all, you don’t have to be of voting age or drinking age to get your hands on them. They’re available at supermarkets, convenience stores, gas stations, even restroom vending machines.
Effectiveness: All three male condom types offer the same statistical effectiveness against pregnancy, although lambskin offers no protection against STIs. When used correctly, condoms are just about 98 percent effective in preventing pregnancy. Of course, that implies not opening the package with your teeth.
Bonus Points: For the tree huggers out there, biodegradable latex condoms are available from some manufacturers. Also, in recent condom news, TheyFit brand condoms apparently come in fifty-five different sizes varying in length and circumference!
What users say:
Extra thin latex condoms:
Mark: “Extra thin kimonos are my favorite. That would be because they’re extra thin. I think it’s probably psychological, but I still think using them feels closer to nothing at all. Apart from having to use one, there weren’t any other downsides.”
Suzie: “I think I can tell the difference between the ultra thins and regular condoms. The normal ones just feel like more of a barrier and create an awkward friction inside my special place. Although, if I had to participate in a 20/20-type blind penis test, I might not pass.”
Studded/flavored/textured/novelty condoms:
[Note: Be careful about using novelty condoms; many of them do not protect against pregnancy or STDs.]
Pamela: “My boyfriend and I recently bought a variety pack called ‘Durex Play Sensations Thin Condoms’ that came with four condoms slathered in different types of lube. The first one we tested out, ‘Play Warmer’, was nice and warm at first but then got too warm, and not in a good way. More like ‘Am I getting a rash?’ kind of way. In the end it got real sticky. The second one, ‘Play Tingling’, felt like I was rubbing Colgate on my vagina (not that I would know or anything…). The third one, ‘Play Brand’, was no different from any other regular condom. And finally, ‘Play Flavor’ was okay, so long as you don’t mind funky smells and eventual gooiness.”
Mike: “I like the ones that come with extra room on the top. It creates extra sensation for the guy (and I think for the girl too). And when you’re wearing a rubber, every little bit counts!”
Marie: “Be careful about using flavored or glow in the dark condoms for actual intercourse. I found out the hard way that the chemicals used to coat them can really irritate the vagina. It took a whole lot of Monistat to clear up that snafu.”
Polyurethane Condoms:
Dave: “I use Avanti condoms which are made from polyurethane rather than latex. I prefer them because they’re thinner, clearer in color, have a less constricting fit and transmit heat better than latex. I can use water-based, oil-based, and silicone-based lube with them. The only drawback is that since they’re not as stretchy as latex, it’s sometimes harder to find the right size or fit. But if you got the girth, they’ll probably fit just right.”
Melissa: “According to The Centers for Disease Control, the estimated risk of an allergic reaction to latex is 0.08%. I always knew I was special, but never thought I was that special. Now I only use polyurethane condoms, which, thank the lord, I can handle and afford. (They’re slightly more expensive than latex condoms.)”
Lambskin Condoms:
Heather: “I didn’t know it was a lambskin condom at the time; I just saw my boyfriend put one on and assumed everything was cool. But afterwards when he pulled it off, I looked down, noticed it looked different from other condoms and said, ‘Hey, what the hell is this? This is lambskin!” He replied, ‘Oh, it’s okay. It prevents pregnancy.’ I freaked out cause I knew that lambskin, while feeling most natural for him, offered me zero protection against STIs. I called my friend right away and asked her if she thought I should get tested for whatever infections the schmuck might have given me. Never mind the ugch factor of having had a sheep’s intestine inside me.”
Lubes come in three basic types—water-based, oil-based, and silicone-based—all of which have different properties and can inhibit sperm from reaching the end zone.
Effectiveness: It’s hard to say exactly how much lube is needed when it comes to hindering conception because even a lil’ dab of water-based lube, olive oil, baby oil, or even saliva can cause “diminished head movement” of the sperm. However, using any lubricant as your primary or only source of contraception is not recommended. They can, however, be added to increase condom effectiveness. Remember, they offer no protection against STIs, but are otherwise tons of fun.
Bonus Points: Adding a drop of water- or silicone-based lube on the inside of a condom increases penile sensation. But beware, too much can cause the condom to slip off, so save the dousing for the outside. And for guys and gals on the go, certain brands come in cute, portable, mini pouches. Very Polly Pocket.
What users say:
Rachel: “I use all types, but usually water-based cause it’s the most available; you don’t have to go to any specialty stores to get it or anything. I did discover that I’m especially sensitive to glycerin, which is an ingredient in certain brands. So now I’m careful to check the ingredients before buying. It’s cheaper than stocking up on yogurt.”
Matt: “Word to the wise: anything you might find in your kitchen or bathroom cupboards are automatic no-no’s. At least if you’re using condoms. Keep the Vaseline and Jergens for solo time.”
Courtney: “I really love silicone lube. I find that it lasts way longer than water-based lube, so you don’t have to constantly reapply during particularly lengthy ‘sessions’. And it can be used with all condoms, even latex ones.”
Semen killers, or spermicides for short, come in many forms—foams, creams, jellies, suppositories. Some spermicides are made specifically for use with diaphragms, cervical caps, and IUDs, while others have been adapted for use alone or with condoms. Sort of like a slip and slide that burns a bit.
Effectiveness: Used alone, spermicides have the highest failure rates of all methods of birth control—even higher than withdrawal (in other words, more than a 20% failure rate!) What’s more, they offer no protection against STIs.
Bonus Points: Combined with other forms of contraception, spermicides can be a great back up method. For instance, if a condom breaks, the foam/jelly makes for a great wing man, taking care of the leftovers and picking up the tab you accidentally forgot to pay.
What users say:
Maggie: “It stings, especially if you’re having rough sex. Even though I had no open cuts or soars, the ‘rough sex’ made me slightly tender and the foam really irritated me. It hurt kind of like a paper cut, bearable, but not totally awful. I used it for about six months. Or was it one? Maybe two? Then again, maybe I only used it twice.”
Elaine: “I used when I was really young and didn’t like it. It was annoying, messy, a moment killer. Plus, it had to be planned (in advance) and I was really put off by that.”
The diaphragm works by physically blocking the sperm from entering the cervical opening. It’s made of rubber and is shaped like a shallow cup, kind of like those suction bubbles that were big in the ’ 80s. Diaphragms can only be obtained from a healthcare provider since users must be fitted with the proper size; the size of the diaphragm depends on the vagina’s shape and contour, as well as the muscle strength of the surrounding vaginal walls.
Effectiveness: When fitted correctly and used with spermicidal jelly or cream, the success rate is fairly high, around 90%. This is best for those in monogamous relationships, since the diaphragm does not protect against STIs.
Bonus Points: You can insert a diaphragm up to two hours before sex, which means you can at least pretend you’re being spontaneous.
What users say:
Claire: “It spares you the side effects of nasty hormones and the need to remember to take a micro-sized pill everyday, but does come along with a host of other annoyances. You have to use it with spermicidal lubricant for the protection to be dependable. The jelly is messy (gets all over your hands and vagina), and makes it’s kinda gross for a guy to go down on you after you’ve inserted it. You also HAVE TO keep it in place for six to eight hours after intercourse, which some people find annoying/gross, as did I. Oh yeah, and if you decide to go for a round two, you have to add more cream or jelly with an applicator (without removing the diaphragm). Almost like putting in a tampon, only this time in front of your boyfriend.”
Like the diaphragm, the cervical cap works by physically blocking sperm from entering the cervical opening but is designed to provide an almost airtight seal around the cervical opening à la Glad Press’n Seal Wrap. Made of rubber, it’s smaller than a diaphragm and shaped like a thimble. The cervical cap, which must be fitted by a health care provider, comes in limited sizes.
Effectiveness: When fitted correctly and used properly by those yet to experience the pleasures of child birth, the cap’s success rate is high: 84-91 percent effective. However, if you have procreated in the past, you might want to look elsewhere for your contraceptive needs: the cap’s only 68-74 percent effective for women who’ve given birth. Unlike the diaphragm, it’s not absolutely necessary to use a spermicidal cream or jelly with the cap. But we certainly recommend it. It doesn’t offer any protection against STIs.
Bonus Points: The cervical cap can be put in on a Friday night and left in for the weekend. Perfect for those last minute jaunts to the Hamptons. You know, the ones that will never happen.
What users say:
(Note from writer: I tried guys. I really tried on this one. Even went as far as calling my mother and the rest of her perimenopausal girlfriends. But alas, not a one of them had ever used a rubber thimble outside of a 1970s sewing class.)
Intrauterine devices (IUD) are small contraceptive devices inserted by healthcare providers. They sit in a woman’s uterus, just past the cervix. Today, two types of IUDs—Copper IUDs and Hormonal IUDs (Mirena)—are available. Depending on which type a woman uses (and how much your mother complains about your wasted womb), IUDs can remain in place from one to ten years and can be removed at any time by a health care provider.
Effectiveness: Both types of IUDs are over 99% effective. Though specialists are still uncertain as to precisely how they work, they do know that the device changes the uterine lining, preventing implantation if an egg is fertilized. Once again, no protection from STIs.
Bonus Points: The copper IUD can be inserted for emergency contraception within five days after unprotected sex. As emergency contraception, the Copper-T IUD is more effective than emergency contraceptive pills (or “morning after pills”), reducing your risk of pregnancy to less than 1%.
What users say:
Copper IUD:
Christine: “I used the Copper IUD from the age of twenty-five all the way to fifty. I put it in for the first time after having my first child and have nothing really bad to say about it. I had crampy periods with it, but I had crampy periods before that too, so who really knows. Putting it in was always pretty simple, not too painful, just like a little pinch. Then again, I also find bikini waxes relaxing.”
Rebecca: “I’ve had a copper IUD ever since my first pregnancy. I was looking for an easy form of birth control and it seemed to fit the bill. Unfortunately, having them removed every couple of years has proven to be somewhat challenging; often, they’d have to go fishing, or better yet, deep sea diving for it cause my pelvic is retro-tilted (i.e. my uterus tilts backwards). And that was definitely painful to the point where once my OBGYN had to use a local anesthetic to remove it, and another time it was so bad that I had to have it removed at a hospital, again using some type of local anesthetic. But for the three or four times it was a problem, the other ten times it wasn’t.”
Beth: “Before you get one, you should know that you’ll have two visible plastic strings hanging from your vagina at all times. The strings never bothered me; I can’t feel them or really even see them, but then again, I’m not the one going down on me.”
Hormonal IUDs (Mirena):
Sasha: “I am so glad that I chose the Mirena! After hearing that Mirena could be used in women who haven’t had children yet, I felt like an IUD was my best option, especially since I wanted a long-term contraceptive. Plus, I had some girlfriends already using it and they stopped getting their periods (due to the progesterone in the device) something I was definitely interested in. Unfortunately, that wasn’t the case for me; I still get my period, it’s just not as overwhelmingly heavy as before. Nonetheless, I like knowing that I am protected against unwanted pregnancy and that I do not have to think about contraception everyday.”
An oral contraceptive (OC), the combination pill is available in numerous incarnations, including a chewable mint (Femcon Fe). And we all know how important fresh breath is when it comes to needing to prevent pregnancy in the first place. Whatever the brand or type, each comes with varying doses of synthetic estrogen and progesterone.
Effectiveness: When taken properly, approximately the same time every day, the pill is 98% to 99% in preventing pregnancy. Obviously, no protections against STIs here.
Bonus Points: Women who have used OCs have a 40% reduction in the risk of developing endometrial and ovarian cancer, when compared to women who have never used OCs. In fact, women who have used OCs for ten years or longer have an 80% reduction in risk. This protective effect lasts for twenty years after discontinuing OCs. In your face, Ortho Evra!
What users say:
Regular combination pills/Ortho Tri-Cyclen 28:
Betty: “It didn’t take away my PMS; it just made it one solid predictable week of insanity. It did make my cramps less painful, though. I never experienced nausea except when I had to double or triple my dose after forgetting to take it for one or two days, a consequence of my less popular moments otherwise known as ‘dry spells’). And, of course, when I did use it properly, I got pregnant, so I guess I’m that .001 percent of the damned. After I became pregnant (and got an abortion) I started using the Patch cause I obviously no longer trusted the Pill. Then I stopped using the Patch when I went gay.
Karen: “Before I went on it, I was as flat as a wall. I decided to start taking it during a semester abroad in Spain, and when I got back the following summer, my boobs had gone from an A cup to a C/small D cup! Going back to school that fall was extremely embarrassing cause everyone, including my boyfriend at the time, thought I’d spent the summer recovering from a boob job (and had lied about being in Spain).”
Joanna: “I’ve been using Ortho Tri-Cyclen 28 continuously since the age of eighteen, (I’m currently twenty-seven.) I’ve never switched pills and have been popping since day one. I never gained a lot of weight, I always get my period on the twenty-eighth day without fail, I don't get any cramps or swelling during my period, and if my memory serves me correctly, it made my boobs a little bigger. All in all, I would recommend this pill to anyone!”
Regular combination pills/OrthoNovum, 7-7-7 28:
Carol: “I’ve been on it for almost twenty years now. Why, might you ask, is a big old dyke on birth control? That would be because I started out having sex with men. And my mom always taught me that if I ever started having sex to go straight to Planned Parenthood and get myself the Pill. I tried to go off of it several times, considering the whole lesbian thing and all, but my period never came back, which is why I’m still on it. I never really felt as though it gave me any side effects, but I know some other women who got really bad side effects from taking it, like nausea and weight gain.”
Lower dose estrogen pills/Loestrin:
Veronica: “I’ve been taking Loestrin for many years now and though generally mild, have experienced some side effects, including weight gain and going up an extra cup size (good for some, not for me). At one point it diminished my sex drive and made me moodier than usual, but my staggering relationship might have had something to do with that.”
Lower dose estrogen pills/Alesse:
Lynn: “I started having hot flashes and felt like I was going through menopause at one point. Did I mention I’m only twenty-six? It also made me slightly disoriented. On more than one occasion, I was like ‘where the fuck am I?’ Once I was in my own room and the room started spinning, and I wasn’t even drunk or high. I honestly thought I was going nuts and had to call my mother for help! It also made me super nauseous, which didn’t help much with the whole insanity thing. I switched to the new three day period pill, Loestrin3, and am proud to say that I am no longer crazy.”
Lower dose estrogen pills/Yasmin:
Grace: “It’s wonderful! I’ve been on it for the past two years at least, and ever since (I started taking it) my skin has totally cleared up. Plus, my periods went from seven days to five days. Yasmin’s carrying case is also way cute and portable instead of ugly and bulky like Ortho Tri-Cyclen’s carrying case, so I look really hip pulling it out at bars. It’s kind of pricey though, definitely more expensive than other pills. But I now I get it for free. God bless Planned Parenthood.”
Lisa: “It gave me a rash. I picked up some free samples at my OBGYN’s clinic, and after two days, my face looked like rosacea on steroids.”
Lower dose estrogen pills/Femcon Fe:
Deidra: “I just started using the ‘chewable’ pill this past month. I thought it would be more convenient, or at least that what the commercials led me to believe. The truth is Femcon is just as annoying and inconvenient as any other pill; you still have to take it every day at approximately the same time, only now there’s the added stress of having to carry around a bottle of water where ever I go. You see, Femcon doesn’t work unless you drink eight ounces of water immediately after chewing it. You don’t need the water if you just swallow it, but then it’s just like any other pill, minus the minty after taste. Absolutely pointless.”
No Period Pills/Seasonale:
Beth: I just started taking Seasonale. I go on lots of trips and didn’t want to deal with running from cabana to cabana looking for tampons anymore. You take the pills for eighty-three days (twelve weeks) straight and then placebo pills during the thirteenth week, which is when you get your period. Once every three months is good enough for me. I have started hearing about another type of pill (currently awaiting FDA approval) called Lybrel, which is supposed to stave of your period for an entire year!”
No Period Pills/Seasonique:
Judy: My doctor recommended that I switch to Seasonique since I get really bad periods. I’m not a fan of all the detergents in tampons and maxi pads. And yes, I know there are ‘natural’ ones out there, but who has the time to hunt them down? I’ve been on it for about six months and so far so good.”
The mini-pill is a progestin-only oral contraceptive, usually prescribed for women unhappy with huge breasts, an extra ten pounds, and other estrogen-induced side effects associated with combination pills. Like regular OCs, it runs on a twenty-eight day cycle, is prescribed by a health care provider, and should be taken at approximately the same time every day.
Effectiveness: Mini-Pills are 87% to 99.7% effective, slightly less than that of regular birth control pills. Again, there’s no protection against STIs here.
Bonus Points: Since there’s no estrogen in the mini-pill, women who need to breast-feed but are uninterested in getting knocked up again can use them.
What users say:
Wendy: “It caused a lot of irregular bleeding in the beginning, but over time that stopped. As did my period.”
NuvaRing, a new contraceptive available by prescription only, is a clear, flexible, and thin polymer ring (2&frac;12; inches in diameter and an 1/8 of an inch thick) that provides a continuous low dose of a progestin and estrogen to prevent pregnancy. The ring is inserted into the vagina, an experience akin to using an OB tampon, and is kept up there for three weeks. At the beginning of the fourth week, the ring is removed, allowing for menstruation. And the cycle goes on and on…
Effectiveness: NuvaRing is 98% to 99% effective in preventing pregnancies when used correctly. It offers no protection against STIs.
Bonus Points: Oral sex needn’t be an issue for ring wearers. The continuous low dose of hormones released by NuvaRing means those watering your lawn have minimal contact with hormones. And just in case you didn’t believe me, Organon, the ring’s manufacturer agrees.
What users say:
Cindy: “The NuvaRing ROCKS MY WORLD. It's an easy, no muss, no fuss once a month birth control. I mark my insert and remove dates on my calendar and don’t think about it again for the rest of the month. Sure, you can feel it if you stick your hand in your vagina, but I’ve never known a penis that could detect it. I love that if it happens to come out (never happened except once during drunken sex) you can just wash it off and put it back in! No birth-control coverage lost! Also, the hormone dosage is a little lower, which agrees with my body. I love it, love it, love it!!!”
Valerie: “I was on NuvaRing for three months, and asides from getting pregnant, didn’t notice any other side effects. I was using the method as directed by my doctor; in for three weeks, out for one. I even used a back up method for the first two months. The one time I didn’t use a condom I got pregnant, but that’s not actually why I got pregnant: I had kept my Nuva supply in my bathroom cabinet with all my other medications. Big mistake. Mine had become ineffective due to the high temperature in my cabinet. So here’s a little piece of advice for all you ring users out there: store them in the fridge.”
A glorified band-aid, Ortho Evra, or the patch for those “in the know,” prevents a woman from becoming pregnant by slowly and continually supplying the bloodstream with progestin and estrogen. These hormones are embedded in the sticky layer of the thin beige adhesive square patch (1&frac;34; inches wide). The patch is to be worn for three consecutive weeks, a new one each week. The fourth week nothing is worn, and shockingly, enables menstruation.
Effectiveness: The contraceptive patch is 99% effective in preventing pregnancy when it’s used correctly. Obviously, this doesn’t protect anyone from STIs.
Bonus Points: For those with skin colors other than taupe or fawn, a clear version is currently being researched and developed.
What users say:
Sandra: “My breasts grew to about two times there regular size so rapidly that one morning I actually woke up in fear of being suffocated by my own breasts. I used it for four months and stopped because I wasn’t willing to be obese. It literally got to the point where I didn’t want to have sex anymore because my body had changed so quickly. It also made me slightly bitchy, thus allowing me to blame my pseudo obesity on my sex starved boyfriend.”
Hannah: The outer edges gather little debris and dirt; it gets all brown around the sticky edges like a bad band-aid that’s been on too long. And I can’t speak for everyone else, but it’s definitely not “flesh” color. Oh yeah, and it gave me a rash.”
An injected form of progesterone, Depo is given at three-month intervals by a healthcare provider. So it’s kind of like getting your booster shots, only you’re not five anymore and crying isn’t as acceptable.
Effectiveness: According to the World Health Organization, Depo is almost 100% effective in preventing pregnancy when received every three months. If a shot is missed, the chances of becoming pregnant increase and continue to increase. Depo doesn’t protect against STIs.
Bonus Points: With continued use, many women stop getting their periods. But only for as long as they continue to shoot up.
What users say:
Marisol: “Worry-free birth control in the form of a small shot in my tush every three months? Who wouldn’t love it! For the first six months I had some spotting, meaning I skipped some periods, randomly bled a lot for a day, and had brownish secretions (and lots of ruined panties) for weeks at a time. After about six months, my periods stopped entirely. No periods? Rock on!”
Grace: “Some women report mood swings and weight gain. I just lost my hair. Thank the lord it grew back once that poison was out of my system. Which I should mention, takes months!”
What this is, is a rod about the size of a matchstick made of a biodegradable synthetic material that slowly releases a type of progesterone over the course of three years. It’s inserted relatively painlessly into the underside of the upper arm after local anesthetic is used to numb the area, the whole procedure taking about a minute. And unless you’re on the same diet as Nicole Richie's, you won’t be able to see the rod (although you can feel it with your fingers).
Effectiveness: Implanon seems to be highly effective. (Some studies have shown a less than 1% failure rate.) In studies of over 2000 women, not one became pregnant during the three year period. Interestingly, the makers of Implanon purposefully advertise that no method of contraception can be 100 percent effective, which makes me kind of nervous. But not in an “I’m a doctor, trust me” kind of way. More like a “If you’re my friend, use a condom instead” kind of way. (Once again, zero protection against STIs.)
Bonus Points: If you’re the sort that finds scars sexy, removing the rod sometimes results in a two millimeter wound of glory.
What users say:
(Note from writer: Again, I tried but Implanon users seem to be very rare indeed. It only gained FDA approval in 2006. I did manage to speak with some doctors about its lengthy list of potential side effects: irregular (or missed) periods, weight gain, acne, headaches, breast tenderness, hair loss, changes in mood and/or libido, abdominal pain, and painful periods. As if that weren’t enough, during clinical trials, about 30% of women had it removed within the first two years, primarily due to complaints about irregular bleeding.)
Emergency contraception, often called the “morning-after pill”, is birth control that prevents pregnancy after you’ve already messed up. Prescribed by a healthcare provider, they can be taken right away or up to five days after “the incident”. In the United States the only type of emergency contraception currently available is the progesterone-only Plan B.
Effectiveness: Plan B reduces your risk of getting pregnant by 89%. The sooner you take it, the better it works, making pregnancy that much less likely. Whatever the time frame, emergency contraceptives are not as effective as birth control that’s used before or during sex, like the pill or condoms. In other words, it shouldn’t make your contraceptive top ten.
Bonus Points: In the United States, Plan B is available without prescription to women and men eighteen years and older, but younger women still need a prescription. In some states (Alaska, California, Hawaii, Maine, Massachusetts, Montana, New Hampshire, New Mexico, Washington State, and Vermont) women seventeen years and younger can get a hold of them directly from pharmacists without a prescription.
What users say:
Heidi: “I took it a day after having unprotected sex, or more appropriately, a day after my boyfriend’s condom slipped off inside of me. I was a little nauseous, but it could have been in my head. Whatever the case, I’m not pregnant. Yay.”
Withdrawal, or “pulling out” as I like to call it, is not the most reliable or forgiving form of contraception. In that vein, neither is reinserting a penis after ejaculation; the urethra is kind of like an after hours club for sperm, and even though the amount left behind is nowhere near the amount of sperm in a typical ejaculate, it still presents a risk.
Effectiveness: As a primary means of contraception, pulling out poses many problems that may decrease its effectiveness. First off, pulling out doesn’t pay proper homage to “pre-cum”, that pesky pre-ejaculate fluid released well before ejaculation. And then you have to consider that to be effective, you have to consistently practice the method, which, let's face it, is pretty hard to do every time. Statistically speaking, five to twenty women out of every one hundred who use withdrawal as a contraceptive method get pregnant. Feeling lucky?
Bonus Points: It’s free and readily available. And aside from pregnancy, there are no other side effects. (Dirty sheets not included.)
What practitioners say:
Jeff: “It was thrilling but disappointing because I couldn’t keep it in till the end. And the end is what it’s all about! In terms of it working, so far so good. I don’t see any little Jeffies running around anywhere yet!”
With abstinence you don’t have sex. Except with yourself.
Effectiveness: It is 100% effective.
Bonus point: If you stick with a virgin pledge, your dad will buy you a really nice ring.
What most people say:
Good luck with that one!
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