Contraceptive options in the U.S. examined

The New York Times on Tuesday examined contraceptive options in the U.S., where 60% of unplanned pregnancies occur among women who use contraception.

Some contraceptive devices -- such as cervical caps, condoms, diaphragms, sponges, and spermicidal jellies and creams -- often are not effective because they need to be applied at times of sexual activity, the Times reports.

A wide range of hormonal contraceptives and intrauterine devices provide effective methods of contraception, according to the Times.

Most available oral contraceptives now have lower doses of progestin, which allows for lower doses of estrogen without disruption of the menstrual cycle.

There also are types of oral contraceptives that can reduce or eliminate monthly menstrual periods and often are taken for 21 consecutive days followed by seven days of placebo pills.

Other contraceptive options include injections, transdermal patches, vaginal rings, implantable devices and IUDs.

According to the Times, IUDs -- which are 99.7% effective in preventing pregnancy -- are "about as effective as female sterilization but completely reversible."

However, "[a]s effective and safe as IUDs are, they have never caught on with American women," the Times reports (Brody, New York Times, 10/17).

Currently, two types of IUDs are available in the U.S. -- Mirena, which slowly releases the hormone progesterone, and ParaGard, which is hormone-free.

About 2% of women who use contraception use IUDs (Kaiser Daily Women's Health Policy Report, 6/14/05).

Hormone-free contraceptives -- such as the ParaGard Copper T 380A, which is a copper-containing IUD that is 99% effective in preventing pregnancy -- also are available and used by 75 million women worldwide, according to the Times (New York Times, 10/17).