The Guys' Guide To Birth Control

Be a gentleman and defray the cost of the co-pay.
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Be a gentleman and defray the cost of the co-pay.
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Sex is sexy, but birth control is, paradoxically, not. Sure, progesterone triggered the sexual revolution (Thanks Margaret Sanger!), but that doesn’t make female contraceptives any less expensive or confounding. Still, as a guy benefiting from the science of Plan A, you should take the time to know a little something about what stands between you and a maternity ward. Your partner will appreciate the effort and frank discussions about sex—no matter how outwardly unsexy—lead to better sex.

To help you sort things out and achieve carnal peace of mind, we’ve compiled a guide to the most common methods of birth control, from abstinence to IUDs. Keep this in mind: Just because you’re using a condom doesn’t mean it’s the primary means of birth control. Condoms are only the reservoir tip of the iceberg. And though you might have seen some well-produced Nuvaring commercials, odds are you’ve been too afraid to ask your female friends for more invasive details.

Think of this as a sex ed refresher.

The Barrier Methods

Female Condom

Unfortunately, the female condom is even less elegant than it’s brother – and considerably more cumbersome to use. While a male condom is worn on the penis, the female condom is inserted into the vagina before sex. It will look a bit like a woman’s vagina inhaled a grocery bag. It’s not the best.

Effectiveness: 95% percent when used perfectly, but honestly, who knows how to use a female condom?

Why Women Use It: Female condoms are relatively inexpensive, the outer rings can be stimulating, and they don't depend on the sometimes-fickle male erection to stay in place. They also can’t be surreptitiously slipped off…

Cervical Cap

Branded the Femcap, the cervical cap is a small silicone cup shaped like a sailor’s hat that, instead of capping a sailor, caps a cervix. If sperm can’t traverse the cervix, they can’t reach the egg. Think of her nether regions as Berlin circa 1961.

Effectiveness: 86% effective when used in conjunction with a spermicide; 71% if a woman has given birth. Unfortunately, cervical caps don’t protect against STDs.

Why Women Use It: Cervical caps can’t be felt by either partner, can be inserted up to six hours before, and don’t use hormones. An added bonus: Women can put some flair down there.

Diaphragm

Like a cervical cap, a diaphragm prevents pregnancy by blocking the cervix. Diaphragms come in many colors, including a horrifying beige “flesh tone.” As a man, you may never see one and you should feel pretty good about that because these are not attractive devices. The major downside is that if you have an especially substantial penis or undertake ambitious positions, you may accidentally pull the goalkeeper. 

Effectiveness: As typically used, the diaphragm is 88% effective.

Why Women Use It: Diaphragms appeal to the retro-minded, Mary Tyler Moore Show-loving nostalgist. There also portable and don’t limit sensation.

Sponge

The sponge is a more advanced version of a diaphragm: a small, cupped sponge suffused with spermicide that bars sperm from entering the uterus. Though they’ve returned to market, there was a time when supplies ran low, leading Seinfeld to introduce “spongeworthy” into the American lexicon.

Effectiveness: About 78% in typical use. Much higher when used in conjunction with a condom.

Why Women Use It: It’s small and convenient, can’t be felt, and can be worn long before and long after sex.

Tubal Ligation

Women who undergo sterilization have their fallopian tubes cut, tied, or cauterized, which prevents sperm from reaching the egg.

Effectiveness: The surgical procedure is 100 percent effective and can be reversed – with a lot of money and discomfort.

Why Women Use It: They’ve either been advised to do so for medical reasons or made a decision about their lifestyle.

The Hormone Manipulators

Patch

Birth control patches are available with a prescription and are (re)placed on a woman’s body weekly. If you’re trying to quit smoking and live with your girlfriend, let us give you a bit of advice: Organize your medicine cabinet meticulously.

Effectiveness: Almost perfect.

Why Women Use It: The full complement of birth control benefits (protection against acne, cysts, and heavy periods) plus once-weekly application.

Ring

Everyone has seen the Nuvaring commercials, which were apparently shot in a utopian land of women in their late twenties who love laughing together and getting brunch al fresco. The ring is just another means of delivery birth control hormones: inserting a ring every three weeks is little different – medically speaking – from take the pills.

Effectiveness: Almost perfect.

Why Women Use It: Nuvaring’s glossy ads presumably work. It’s also a good solution for women planning a pregnancy. It’s easier to get knocked up after removing the ring than after stopping birth control pills.

Pills

The OG. Just like the patch and the rings (and also shots, and insertables), the pill is just a way to introduce hormones into a woman’s body. Pills get points from us for coming in a package that looks like a UFO and looking completely innocuous. One of the side effects is also pretty great.

Effectiveness: Typically stellar in the way that hormonal treatments are.

Why Women Use It: It’s a proven technology, like the internal combustion engine. 

IUD

The intra-uterine device is a small, T-shaped object placed inside the uterus to irritate the lining and prevent fertilized eggs from attaching, and sperm from moving. IUDs are safe, effective, and can be implanted for years. IUDs got a bit of a bad name for a while because the Dalkon Corporation spent the early seventies torturing women with “shields,” but modern iterations actually work and don’t cause sepsis. Progress!

Effectiveness: Almost 100% and, if inserted up to five days after unprotected sex, can terminate a pregnancy.

Why Women Use It: IUDs are long-lasting and look incredibly non-threatening. Think of them as the VW Bugs of birth control.

The Sexual Strategies

Abstinence

Outside of Bethlehem, abstinence has a 100% success rate. It also means not having sex, which, for a lot people, is a deal-breaker. If this is your long-term SO’s stated strategy, you definitely don’t need to read the rest of this section.

Effectiveness: Works perfectly, but the side effects are miserable.

Why Women Use It: It’s free, relatively easy – at least in theory – and in line with most religious doctrines. It’s also hard to forget about.

Outercourse

This is a fancy name for any sexual activity excluding vaginal penetration. While intercourse is great, there’s much to be said for the rest of the sexual infield: no risk of pregnancy or STD’s, no male performance anxiety, and a chance to be intimate and erotic in creative ways. Taking frequent trips to the laundromat is cheaper than a nanny.

Effectiveness: Works perfectly, but often proves frustrating.

Why Women Use It: Condoms are expensive. They are in high school. They don’t want to have sex.

Withdrawal

The “pull-out” method is much derided – and for good reason. Yes, pulling out before ejaculation does prevent pregnancy – there is no sperm in pre-cum - but you actually have to do it. Withdrawal sounds promising during the early fumblings of a hook-up, but a lot of those experiences end with an apology.

Effectiveness: Depends on the guy, but not great.

Why Women Use It: Condom-free intercourse feels better for all concerned, but birth control and condoms exist for a reason. Use them.

Photos by Jonathan Knowles / Getty Images