Non-hormonal birth control?

Dear Lucy: I want to know more about effective, non-hormonal birth control methods. I’m concerned about my partner and having additional protection besides condoms—in case there is ever a mistake or breakage—and I would strongly prefer a non-hormonal method. I’ve heard that copper IUDs are 99 percent effective; is this true? Are there other effective, non-hormonal methods out there?  —Better Safe Than Sorry

Dear Better Safe: Lucy is so glad you asked this question, as information about effective birth control methods is something that benefits many women in the MIT community. For answers to your questions, Lucy knew just where to turn: Medical Director and Gynecologist Cecilia Stuopis.
According to Stuopis, there are two categories of non-hormonal contraception available in the US. The first, “barrier methods,” includes condoms, diaphragms, cervical caps, and the sponge. The second is “long-acting reversible contraception”—or “LARC” for short—which includes injections, intrauterine devices (IUDs), and subdermal implants.
As the name suggests, barrier methods work by blocking sperm from entering the female reproductive system. “Typically, these methods are paired with a spermicide to create an additional layer of protection,” Stuopis explains. “Barrier methods are very safe and reversible and typically have few side effects. They can be fairly inexpensive as well, as you only use them when you need them.” But if effectiveness is your primary criteria, these methods should not be your first choice. “With typical use,” Stuopis notes, “somewhere between 12 and 21 of every 100 women using these methods for a year will become pregnant.”
LARC methods are more effective than barrier methods, Stuopis tells Lucy, and the most reliable is the one you mention: the copper intrauterine device (IUD), marketed in the US as the Paragard IUD. “The Paragard IUD is placed in the uterus during an office visit,” Stuopis explains. “Once in place, it provides excellent contraception for 10 years. It works by creating an intrauterine environment that is toxic to sperm and ova, preventing fertilization.” 
While it is one of the most reliable forms of birth control available—fewer than one in 100 women using this IUD for a year will become pregnant—it sometimes causes a woman to have heavier, longer, or more uncomfortable menstrual periods, especially at first. “However,” Stuopis says, “Using nonsteroidal anti-inflammatory medications, like ibuprofen or naproxen, during your period can effectively control these side effects, and most women are very happy with their choice of the Paragard IUD.” Like all LARCs, once the IUD is removed, a woman’s fertility will return quickly, allowing her to become pregnant if she desires.
To compare all available contraceptive methods, Stuopis recommends this chart at Lots of other useful information about birth control is also available at this terrific website. 
Of course, Lucy reminds you, you shouldn’t hesitate to make an appointment to discuss these questions in person with one of our primary care or OB/Gyn providers at MIT Medical. They’re ready and willing to help you choose the method that will work best in your particular situation. —Lucy

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