Advantages

• Highly effective contraception ^{10. Berek, p. 250A}
• May increase menstrual cycle regularity ^{10. Berek, p. 259A}
• May decrease iron deficiencies and anemia due to blood loss ^{10. Berek, p. 259}
• May reduce the chance of developing ovarian and endometrial cancers ^{Berek-10, p. 259A}
• May help protect against noncancerous breast tumors and pelvic inflammatory disease ^{Berek-10, p. 259A}
• May decrease the risk of ovarian cysts and ectopic pregnancies ^{Berek-10, p. 259A}

Limitations

• Increased risk of developing heart attacks, strokes, and blood clots, particularly in women who smoke ^{Berek-10, pp. 251A, B, 253A, 254A, 255A}
• Irregular bleeding or breakthrough bleeding ^{Carlson, p. 283A}
• Adverse effects may include headaches, breast tenderness, weight changes, excess hair growth or hair loss, nausea, and depression ^{Carlson, pp. 283A, 284A}
• Daily action required^{44. Ortho Tri-Cyclen Lo PI, p 1 (Indication & Usage)}
• No protection against STDs^{49. FDA Birth Control p. 3}

Advantages

• Provides effective contraception, with typical failure rates between 15% and 32% ^{Trussell, p. 90A}
• Some methods may help reduce the risk of contracting some sexually transmitted diseases, and possibly cervical cancer ^{Carlson, p. 81A}
• Among the safest methods ^{Carlson, p. 81A}
• Among the least expensive methods ^{Carlson, p. 81A}
• May help reduce the risk of acquiring pelvic inflammatory disease ^{Berek-10, p. 238A}

Limitations

• Decreased effectiveness if not used consistently and correctly ^{Carlson, p. 81B}
• Require a fair amount of regular effort ^{Carlson, p. 81B}
• Often inconsistently used ^{Carlson, p. 81B}
• Methods such as the cervical cap require fitting by a health care professional ^{Carlson, p. 81C}
• Highest failure rate of contraceptive options other than "no method" ^{Berek-10, p. 236A}

Advantages

• Provides highly effective contraception ^{Carlson, p. 318A}
• Can be used long term ^{Carlson, p. 318B}
• No daily or coital action required ^{Carlson, p. 319A}

Limitations

• Increases risk of developing pelvic inflammatory disease ^{Mirena PI, p. 1F}
• May perforate the uterine wall ^{Mirena PI, p. 1H}
• May cause some rare but serious complications that can render a women infertile ^{Mirena PI, p. 1F}
• May cause menstrual cramps and excessive menstrual bleeding ^{Mirena PI, p. 1I}
• Must be inserted by a medical professional ^{Mirena PI, p. 1B}
• No protection against STDs^{49. FDA Birth Control p. 3}

Advantages

• Provides highly effective contraception, with 0.15% (male sterilization) to 0.5% (female sterilization) of women experiencing an unintended pregnancy within the first year ^{Trussell, p. 90A}
• Causes permanent infertility ^{Carlson, p. 82A}
• No need for any other form of birth control ^{Carlson, p. 82B}

Limitations

• Exposes individual to risks of surgery ^{Speroff-21, p. 847A}
• Is generally irreversible ^{Carlson, p. 82A}

Advantages

• Most economical forms of contraception

Limitations

• Effectiveness is highly dependent on the methods being used consistently and correctly^{4. Danforth’s Obstetrics & Gynecology, p. 554}
• No protection against STDs^{42. Nakajima, p. 141}
• Lack of reliability in estimating the fertile window ^{4. Danforth’s Obstetrics & Gynecology, p. 554-555; 42. Nakajima, p. 141}

Advantages

• Possible improved compliance due to the elimination of a daily regimen ^{Speroff- pp. 23, 943A}
• Less fluctuation in estrogen and progestin levels with weekly change of patch than consuming a daily oral medication ^{REF Nakajima-4, p. 70A}
• Avoidance of first-pass effect through the liver, with fewer adverse effects on liver parameters ^{Nakajima-4, p. 70A; Ortho Evra PI, p. 1F}

Limitations

• Visibility of the patch ^{Nakajima-4, p. 70A}
• Application site reactions ^{Nakajima-4, 70A; Ortho Evra PI, p. 4B}
• Decreased contraceptive efficacy with increased body weight ^{Ortho Evra PI, p. 4A}
• Increased estrogen exposure relative to OCs ^{Ortho Evra PI, pp. 1A, B, 2B}
• Insufficient drug delivery if the patch becomes partially or completely detached and remains detached ^{Ortho Evra PI, p. 5B}
• No protection against STDs^{49. FDA Birth Control p. 3}

Advantages

• Highly effective
• No daily or coital action required ^{NuvaRing PI, p. 18A}
• Avoids first-pass effect through the liver with less disruption of lipoproteins and less alteration of hepatic function ^{Nakajima-4, p. 76B}
• Concentrates hormones in the uterus, which allows for use of lower doses of medication and potentially less frequent administration ^{Nakajima-4, p. 76B}
• Hormones are rapidly absorbed, with the estrogen having a bioavailability of approximately 56%, which is comparable to oral administration, and the progestin having a bioavailability of approximately 100% ^{NuvaRing PI, p. 2A}
• Compared with oral medication, causes less nausea and gastrointestinal disturbance, and less susceptibility to inadequate absorption if diarrhea occurs ^{Nakajima-4, p. 76B}
• Compared with transdermal route, is more easily absorbed into bloodstream and is not stored in fat tissue ^{Nakajima-4, p. 76C}
• Provides steady-state hormone levels that are easily achieved and less dependent upon patient compliance with daily or weekly medication administration ^{Nakajima-4, p. 76D; NuvaRing PI, p. 2B}

Limitations

• Young patients may be unwilling to insert ring and leave in place for 3 weeks ^{Nakajima-4, p. 76D}
• Woman and/or partner may feel ring during sexual intercourse ^{NuvaRing PI, p. 15A}
• Occasional spontaneous expulsion can occur ^{NuvaRing PI, p. 16A}
• No protection against STDs^{49. FDA Birth Control p. 3}

Advantages

• No daily or coital action required ^{Implanon PI, p. 1A}
• Provide highly effective contraception ^{Speroff-24, p. 954A}
• Provide long-term, rapidly reversible contraception ^{Speroff-24, p. 953B}
• Can be used by women who have contraindications for the use of estrogen-containing
  contraceptives ^{Speroff-24, p. 953B}

Limitations

• Cause unpredictable bleeding patterns; endometrium sheds at unpredictable intervals ^{Implanon PI, p. 3A; Speroff-24, p. 953C}
• Require invasive procedure for insertion and removal, increasing costs ^{Implanon PI, p. 7A; Speroff-24, pp. 953D, 954B}
• Visible under the skin ^{Speroff-24, p. 953D}
• No protection against STDs^{49. FDA Birth Control p. 3}

Advantages

• Easy to use; no daily or coital action required ^{Speroff-24, p. 964A}
• Comparable efficacy to sterilization, intrauterine contraception, and implant contraception ^{Speroff-24, p. 964A; Depo-PI, p. 6A}
• Free from estrogen-related effects ^{Speroff-24, p. 964A}
• Not associated with compliance problems during the 3 months it is effective ^{Speroff-24, p. 963C; Depo-PI, pp. 12A, 16A}

Limitations

• Contraceptive effect lasts 12 to 14 weeks; method not immediately reversible ^{Depo-PI, p. 2A}
• May cause: ^{Speroff-24, p. 964B}
  – Irregular menstrual bleeding ^{Depo-PI, p. 12A}
  – Breast tenderness ^{Depo-PI, p. 20B}
  – Weight gain ^{Depo-PI, p. 17A}
  – Depression ^{Depo-PI, p. 18A}
  – Loss of bone mineral density ^{Speroff-24, p. 966A; Depo-PI, pp. 1A, 9A}
• No protection against STDs^{49. FDA Birth Control p. 3}