Physical Method
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Barrier Methods
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Barrier methods place a physical impediment to the movement of sperm into the female reproductive tract.
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The most popular barrier method is the male condom, a latex or polyurethane sheath placed over the penis. The condom is also available in a female version, which is made of polyurethane. The female condom has a flexible ring at each end—one secures behind the pubic bone to hold the condom in place, while the other ring stays outside the vagina.
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Cervical barriers are devices that are contained completely within the vagina. The cervical cap is the smallest cervical barrier. It stays in place by suction to the cervix or to the vaginal walls. The Lea's shield is a larger cervical barrier, also held in place by suction. The diaphragm fits into place behind the woman's pubic bone and has a firm but flexible ring, which helps it press against the vaginal walls. The contraceptive sponge has a depression to hold it in place over the cervix.
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Hormonal Methods
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There are variety of delivery methods for hormonal contraception.
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Combinations of synthetic estrogens and progestin (synthetic progestogens) are commonly used. These include the combined oral contraceptive pill ("The Pill"), the Patch, and the contraceptive vaginal ring ("NuvaRing"). Not currently available for sale in the United States is Lunelle, a monthly injection.
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Other methods contain only a progestin (a synthetic progestogen). These include the progestin only pill (the POP or 'minipill'), the injectables Depo Provera (a depot formulation of medroxyprogesterone acetate given as an intramuscular injection every three months) and Noristerat (norethisterone acetate given as an intramuscular injection every 8 weeks), and contraceptive implants. The progestin-only pill must be taken at more precisely remembered times each day than combined pills. The first contraceptive implant, the original 6-capsule Norplant, was removed from the market in the United States in 1999, though a newer single-rod implant called Implanon was approved for sale in the United States on July 17, 2006. The various progestin-only methods may cause irregular bleeding while being used.
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Ormeloxifene (Centchroman)
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Ormeloxifene (Centchroman) is a Selective Estrogen Receptor Modulator, or SERM. It causes ovulation to occur asynchronously with the formation of the uterine lining, preventing implantation of a zygote. It has been widely available as a birth control method in India since the early 90s, marketed under the trade name Saheli®. Centchroman is legally available only in India .
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Intrauterine methods
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These are devices that are placed in the uterus. They are usually shaped like a "T"—the arms of the T hold the device in place inside the uterus. In the United States , all devices which are placed in the uterus to prevent pregnancy are referred to as IUDs. In the UK , a distinction is made between the IUDs and IUS. This is probably because there are seven different kinds of IUDs available in the UK , compared to two in the US .
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Intrauterine Devices ("IUDs") contain copper (which has a spermicidal effect).
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IntraUterine Systems ("IUS") release a progestogen (either progesterone or a progestin).
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Emergency contraception
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Some combined pills and POPs may be taken in high doses to prevent pregnancy after a birth control failure (such as a condom breaking) or after unprotected intercourse. Hormonal emergency contraception is also known as the "morning after pill," although it is licensed for use up to three days after intercourse.
Copper intrauterine devices may also be used as emergency contraception. For this use, they must be inserted within five days of the birth control failure or unprotected intercourse.
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Induced abortion
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Abortion can be done with surgical methods, usually suction-aspiration abortion (in the first trimester) or dilation and evacuation (in the second trimester). Medical abortion uses drugs to end a pregnancy and is approved for pregnancies of less than 8 weeks gestation.
Some herbs are believed to cause abortion (abortifacients). Peer-reviewed research has proven the efficacy of some of these substances, but the use of herbs to induce abortion is not recommended, due to the risk of serious side effects.
Abortion is subject to ethical debate.
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Sterilization
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Surgical sterilization is available in the form of tubal ligation for women and vasectomy for men.
A non-surgical sterilization procedure, Essure, is also available for women.
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Behavioral Methods
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Fertility awareness methods
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Fertility awareness (FA) methods involve a woman's observation and charting of one or more of her body's primary fertility signs, to determine the fertile and infertile phases of her cycle. Unprotected sex is restricted to the least fertile period. During the most fertile period, barrier methods may be availed, or she may abstain from intercourse. Different methods track one or more of the three primary fertility signs: basal body temperature, cervical mucus, and cervical position. Other bodily cues including mittelschmerz are considered secondary indicators. A woman may chart these events on paper or with software. FA is versatile and may also be practiced to achieve pregnancy, by identifying the fertile period and having intercourse prior to and during that time.
The term "natural family planning" (NFP) is sometimes used to refer to any use of FA methods. However, this term specifically refers to the birth control methods approved by the Roman Catholic Church -- breastfeeding infertility, and periodic abstinence during fertile times. FA methods may be used by NFP users to identify these fertile times.
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Statistical methods
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Statistical methods such as the Rhythm Method and Standard Days Method are dissimilar from observational fertility awareness methods, in that they do not involve the observation or recording of bodily cues of fertility. Instead, statistical methods estimate the likelihood of fertility based on the length of past menstrual cycles. Statistical methods are much less accurate than fertility awareness methods, and are considered by many fertility awareness teachers to have been obsolete for at least twenty years.
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Coitus interruptus
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Coitus interruptus (literally "interrupted sex"), also known as the withdrawal method, is the practice of ending sexual intercourse ("pulling out") before ejaculation. The main risk of coitus interruptus is that the man may not make the maneuver in time. Although concern has been raised about the risk of pregnancy from sperm in pre-ejaculate, several small studies have failed to find any viable sperm in the fluid.
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Avoiding vaginal intercourse
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The risk of pregnancy from non-vaginal sex, such as outercourse (sex without penetration) is low. However, with this method, discipline is required to prevent the progression to intercourse.
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Abstinence
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Sexual abstinence is the practice of refraining from all sexual activity. As with avoiding intercourse, the intention to remain abstinent may not prevent pregnancy, due to the level of discipline required.
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Lactational
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Most breastfeeding women have a period of infertility after the birth of their child. The Lactational Amenorrhea Method, or LAM, gives guidelines for determining the length of a woman's period of breastfeeding infertility.
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