How “safe” is “safe”?

There are various methods for contraception. Every woman, every couple has to figure out which method is best for her, for them. In general:

You should always be using a condom. It prevents genital diseases that can be transferred through having sex. Especially AIDS is prevented through a condom.

You can combine the condom with every other method of contraception. To lower the risk of a pregnancy – especially in younger years, when a pregnancy is not an option and the condom is sometimes misused – the following can be a good idea:

Birth control + condom = prevention of a pregnancy + protection against AIDS

In the following you will find other options for contraception.

Welche Verhütungsmethode passt zu mir?

Which method is best for me?

Before you decide on one of the options, you should think about how high you want the level of protection to be and weigh the various methods over against each other.

How much protection do I need?

When you think about contraception, you should also think of your wish now or in the future of having a child:

  • Do I want children (in general)?
  • Do I want to become pregnant in the foreseeable future?
  • Or do I want some more time without having a child?
  • Is there a specific time frame in which I would like to become pregnant?

Those are the kind of questions we should talk about.

If you have decided to use contraception, the pearl index will help you to choose the correct method. The pearl index enables you to compare the various options:

Pearl index = number of unwanted pregnancies among a thousand women per year

Among women, who don’t use contraception, the pearl index is at 600 (600 to 800 out of 1000 women get pregnant if they are not using a method of contraception for one year).

Contraception with a high rate of protection
Birth control pill 0,2–0,5 2–5 out of 1000 women got pregnant using that birth control for one year
Contraceptive patch or vaginal ring 0,3–0,9
3–9 out of 1000 women got pregnant using that birth control for one year
Birth control pill (Estrogen pill)/Injection for three months 0,3–3
3–30 out of 1000 women got pregnant using that birth control for one year
Intrauterine device (copper)
0,3–3
3–30 out of 1000 women got pregnant using that birth control for one year
Contraception with a very high protection-rate
Implantation 0,0–0,3 0–3 out of 1000 women got pregnant using that birth control for one year
Intrauterine device with hormones "Mirena" 0,1–0,3 1–3 out of 1000 women got pregnant using that birth control for one year
Intrauterine device with hormones "Jaydess" 0,1–0,3 1–3 out of 1000 women got pregnant using that birth control for one year
Sterilization 0,01–0,1 0–1 out of 1000 women got pregnant using that birth control for one year
Contraception with a lower protection-rate
only condom 3–3,6 30–36 out of 1000 women got pregnant using that birth control for one year
Temperature-method 1–3
10–30 out of 1000 women got pregnant using that birth control for one year
Natural family planning with calculating of the fertile days 15–20
150–200 out of 1000 women got pregnant using that birth control for one year
Knaus-Ogino technique 15–20 150–200 out of 1000 women got pregnant using that birth control for one year
Diaphragm 2–6 20–60 out of 1000 women got pregnant using that birth control for one year
Spermicidal method 2–6 20–60 out of 1000 women got pregnant using that birth control for one year
Contraception-Computer 1–3 10–30 out of 1000 women got pregnant using that birth control for one year
Cyclotest (using urine test systems to find the fertile days) 1–3 10–30 out of 1000 women got pregnant using that birth control for one year
Long-term Contraception
Sterilization final decision (re-fertilization is only successful in 30–50% of all cases)
Contraception including hormones "Mirena"/"Kyleena" lasts up to 5 years
Contraception including hormones "Jaydess" lasts up to 3 years
Contraception made of copper lasts up to 5 years
Implantation lasts up to 3 years
Injection for three months lasts for 3 months
Flexible Contraception

For women, who don’t wish to be bound to one method of contraception for a longer period of time, hormonal contraception is a good option. The level of protection is very high. One of the hormonal contraception methods is the birth control pill which you can stop taking at anytime. Therefore, you are flexible with your decisions concerning a pregnancy or change of contraception method.

For women who feel that it is annoying to remember to take the birth control pill every day, other options exist. The vaginal ring is used for three weeks in a row, then there is a break of one week. The contraceptive patch is changed every week, after three weeks there is a break of one week as well. The application to the skin, or insertion in the vagina, also has other advantages. The hormones do not burden the liver and the dose of hormones is lower in total than the pill.

Pro and contra of contraception with an intrauterine device

Pro arguments

The two regular checkups a year are sufficient. You don’t have to think or take care of your contraception every day. If you choose one made of copper, no hormones are included; therefore, it has no effect on your body. Even if you decide for one that includes hormones the effects on your body will be minimal.

Contra arguments

Complications can occur, such as a bleeding disorder and an infection of the uterus. Moreover, inserting the device can be uncomfortable.

Pro and contra of the hormonal contraception

Pro arguments

You have control over your menstruation. It is predictable; you always know when and will be able to shift the date of the menstruation. Also it is usually pain-free and weaker through the taking hormones. Acne can be improved and the growth of hair optimized. Hair loss and disturbing hair (for example, in the face) is minimized.

Contra arguments

Contra-indications do exist. Women above the age of 35 who are smokers should be cautious about taking hormones which increase the risk of developing a blood clot (thrombosis). Therefore, your blood pressure has to be checked regularly. For women who don’t need protection on regular basis might want to consider other options.

"Morning-after pill" – birth control after intercourse

Taking medication after intercourse to prevent getting pregnant should be a rare exception and not repeated on regular basis. The tablet must be taken within 72 hours after the intercourse. The ovulation is then blocked by two very strong hormone doses. That only has an effect for that singular time. It does not protect you against a pregnancy for the rest of month.

Side effects can occur; among them are nausea and bleeding disorders. Not in every case it is necessary to take that medication. There are days that are not fertile. For women that cannot take hormones for health reasons, there is the option to insert an intrauterine device after the unprotected intercourse.