| Contraceptive options | Risks | Benefits |
| IUDs | - Risk of expulsion and perforation
- Increased risk of ectopic pregnancy should pregnancy occur, which is rare
| - Most effective contraceptive category
- Long acting and reversible
- No evidence for increased risk of pelvic inflammatory disease
- No increased risk of hypertension, vascular disease, or venous thrombosis
|
| Copper IUD | - Change in menstrual bleeding pattern: heavier
| |
| IUD with progestin | - Change in menstrual bleeding pattern: lighter to amenorrhea
| - Contains levonorgestrel
- Lighter periods
|
| Combined estrogen-progestin hormonal methods | | - Highly effective contraceptive category
|
| Combined estrogen-progestin oral contraceptive pills (COC) | - Worsening of hypertension, worsening of proteinuria, and increased risk of venous thrombosis, stroke, and myocardial infraction
- Needs to be taken daily
| |
| Transdermal contraceptive patch (ethinyl estradiol and norelgestromin) | - Application site reactions
- Higher overall estrogen dose and risk of venous thrombosis compared with COC
| - Convenient weekly application
- No increased risk of hypertension or vascular disease, because it does not stimulate the RAAS
|
| Contraceptive vaginal ring (etonogestrel/ethinyl estradiol) | - Increased risk of venous thrombosis, stroke, and myocardial infraction similar to COC
| - Once a month self-administered use
|
| Progestin-only hormonal methods | | |
| Etonogestrel implant | - Change in bleeding pattern with unscheduled bleeding
- Possible increased risk of thrombotic events
| - Most effective contraceptive category
|
| Depot medroxyprogesterone acetate | - Change in bleeding pattern with unscheduled bleeding
- Decreased bone density
- Should not be used in patients with CV risk factors
| - Highly effective contraceptive category
- Administration every 3 months
|
| Progestin-only preparations | - Change in bleeding pattern with unscheduled bleeding
- Higher failure rate if not taken consistently within 3 hours each day
| - Highly effective contraceptive category
- No increased risk of hypertension, vascular disease, or venous thrombosis
|
| Pericoital methods | | - Least effective contraceptive method
- Contain no hormones
- Used only when needed
|
| Condoms with or without spermicides | - Least effective category of contraceptive methods
| |
| Diaphragms | - No protection against STIs
| |
| Spermicide and spermicidal sponge | - No protection against STIs
| |
| Sterilization procedures (male vasectomy and female tubal ligation) | | - Most effective contraceptive category
- Permanent
|
