Believe it or not, everything you know about sex may not be right on target. This is especially true when it comes to birth control; a lot of those "alternative" birth control methods you've picked up from friends, siblings, Gandhi, and the guy at the gas station just won't do the trick.

The taking of proper birth control precautions is VERY SERIOUS. When you have sex, you're messing with bringing a life into this world, and if that's not your goal, you might have to make some very difficult decisions that no one should ever be forced to make. So please, we beg that you be responsible and use your brain. Unless you are actively trying to have a baby, ALWAYS use birth control, or just cross your legs and don't engage in sexual relations until you're ready for baby-making.

One extra-important note: birth control is just as important for boys as for girls. If a man doesn't understand the basics of birth control, he won't be able to act responsibly. So while most of these methods do focus on female biology, it is essential for males to be just as much in the know. But also keep in mind that the woman is the one who will be using most of these methods, so she must be comfortable with her decision. Yeah, it sounds like we're contradicting ourselves, but whoever said that a loving relationship was easy?

1. CONSIDER BARRIER METHODS

Barrier methods are exactly what they sound like: they involve putting something between the sperm and the egg.

The condom

The condom is the one birth control method with which men will have to engage in the protective action (it usually doesn't affect men whether their partners use the pill, the shot, the diaphragm, etc). We probably don't have to tell you what a condom is. You probably learned plenty about them on a very special Beverly Hills 90210. But we must tell you that a latex condom is the best protection out there (next to not having sex) against STIs (Sexually Transmitted Infections). Also, condoms with spermicide provide better pregnancy protection.

Condoms are best for people who want to protect themselves against STIs, STDs (Sexually Transmitted Diseases), or those who are lazy (they don't involve taking pills or getting shots). They're cheap (about a buck each), and they're often free at clinics (go to the CondomUSA page for free condoms). The bonus of pregnancy protection is great, but keep in mind that during the first year of typical use, 14 out of 100 women will get pregnant. So it's a good idea to supplement any birth control method with condom use.

Both men and women should know how to properly put a condom on. Here are the basic steps:

  1. Store your condoms in a cool, dry place.

  2. Put a drop or two of lubricant inside the condom.

  3. If the penis is not circumcised, pull back the foreskin before rolling on the condom.

  4. Place the rolled condom over the tip of the hard penis, leaving a half-inch space at the tip to collect the semen.

  5. Pinch the air out of the tip of the condom, as air bubbles may cause the condom to break.

  6. Unroll the condom over the penis with the other hand all the way down to the base.

  7. Smooth out any air bubbles.

You can find funny illustrations, as well as more condom info, at the Planned Parenthood site.

The female condom

The female condom is useful for women whose partner who doesn't like wearing a male condom (many wimpy men complain about discomfort). The female condom basically works the same way as a male condom, except that it's larger and fits into a woman's vagina and over the vulva, capturing the semen. The female condom also interferes with sexual sensation less than the male condom.

However, the female condom is not as effective as the male condom (against either STIs or pregnancy), and they cost more (about $2.50 each). So it's up to you to decide whether the woes of Mr. "I-Just-Can't-Feel-It" are worth the extra dough and worry.

From this point on, the birth control methods we list in this SYW DO NOT provide protection against STIs or STDs (except for abstinence). Therefore, the rest of the methods are either for women in committed relationships (your partner has been tested and you are 101% sure that he will not cheat on you) or for women who want added pregnancy protection when using a condom.

The diaphragm

A diaphragm is a soft, rubber dome that fits over the cervix, and it MUST be used with spermicide each time you have intercourse (even if you have sex two, three, or 100 times in an evening). You'll have to have to be fitted for a diaphragm by a gynecologist and shown how to insert/extract it. Diaphragms can be really hard to insert properly, especially because they're greased with spermicide. Practice makes perfect, so practice popping it in and out while you're watching Friends (just make sure your friends aren't over watching it too).

Diaphragms must be inserted at least 6 hours before sex, and should stay in place 6 to 8 hours after intercourse. 18 out of 100 women get pregnant using diaphragms during the first year of use. They cost about $20 (plus the cost of the examination and the spermicide - $10 a tube).

2. CONSIDER HORMONAL METHODS

All of the hormonal methods have different possible side effects, ranging from weight gain to blood clots in the legs, heart, or brain. Needless to say, you must see a doctor before beginning any of these methods so that you can be aware the side effects. Hormonal methods are all 99% effective in preventing pregnancy if used correctly. Ironically, these methods can tend to mess with your libido, making you… shall we say… frigid or frisky. We'll cross our fingers for you (and your partner) and hope that the latter happens.

The pill

There are many different brands of birth control pills, but there are essentially two types of oral contraception: progestin-only pills and combination pills (which use both estrogen and progestin). Depending on your medical makeup and needs, your doctor will recommend one or the other. The basic function of the pill is to trick your body into thinking that you're pregnant. As you know, when a woman is pregnant, the body sends out signals (that is, progestin) to tell the reproductive system not to allow more pregnancy to occur. That's why women don't become pregnant with a brand new baby when they already have a 6-month-old fetus cooking.

Most pills are in the $20-per-month range. Also, you have to take the pill the same time every day, so it's important to get yourself into the habit of establishing a pill routine (e.g., "I'll always take a pill first thing when I wake up in the morning"). The only time that you shouldn't take the pill is when you're scheduled to menstruate, but many pill kits have harmless sugar pills for you to take on those days so that you don't break the habit. Some brands of birth control pills help clear up your skin, but others cause mild weight gain. That's the price of messing with your hormones.

Depo-provera

Needle-phobes beware! With Depo-provera treatment, you will get an injection in the rear end every three months with a needle that releases a hormone similar to progesterone. This hormone keeps your ovaries from releasing eggs, so it's basically impossible to get pregnant. Yes, they hurt, but here's the good news: most women on Depo-Provera no longer have their periods. So burn those bulky pads and buy some condoms with the money you'll save on tampons. Each shot costs about $40.

Norplant

Norplant is a commitment. Six thin plastic implants are put under the skin of your arm, and hormones are released constantly for 5 years to keep your ovaries from releasing eggs. The insertion is painless (except for the prick of the numbing needle), and it costs around $600. Norplant can be removed early, but removal costs about $150, and therefore, this method isn't worth it unless you plan on leaving the implants in for the full 5 years.

3. CONSIDER NATURAL METHODS

Unless your religious beliefs preclude you from using one of our already discussed methods, we highly suggest that you reserve using "natural methods" for a time when you WANT to get pregnant; they are really useful in predicting when you are fertile (feel like a plot of farmland?). Using natural methods can be time-consuming, and they are also extremely unreliable. But they're also free, so you might as well educate yourself.

The rhythm method

The rhythm method involves figuring out when your body is most likely to get pregnant and then avoiding sex during those times. You can do this by taking your temperature in the morning (your temperature goes up during ovulation), examining your cervical mucus (sorry, we had to list it), and charting your periods on a calendar (learn how to at the Planned Parenthood site). Although the rhythm method is a good predictor of ovulation, "good" does not equal "great," especially for women whose menstrual cycles aren't predictable. Furthermore, sperm can live in the body for up to 7 days, and therefore, practicing a natural method perfectly means that you will have to abstain from sex for 10 days or more during every menstrual cycle. The benefit of the rhythm method, however, is that if you're trying to get pregnant, you'll know exactly when you should do the deed.

Withdrawal

Withdrawal is exactly what it sounds like: when the man feels that he is about to ejaculate, he pulls himself out of the woman, so that the semen doesn't enter the vagina. Withdrawal is fine and dandy if you're using it with another form of birth control for added protection, but it should NEVER be your sole form of birth control. First of all, withdrawal requires more vigorous self-control than most men possess (and let's not forget those one-minute wonders out there who hardly know themselves when the big moment arrives). Second of all, even if your partner does pull out before he ejaculates, there is enough sperm in pre-ejaculate to cause pregnancy. So even if you trust him, his early swimmers can still cause you problems.

Abstinence

Abstinence is the only form of natural birth control that works 100% (unless your name is Mary and the year is 0). It basically involves not having sex. Tough, huh?

4. LEARN ABOUT EMERGENCY CONTRACEPTION

We hope that you will never need to use this knowledge, but emergency contraception is something that you should be familiar with just in case a mistake occurs (the condom broke, you forgot your pill, etc.). The panic will inevitably set in, but you'll feel slightly better if you know what your options are beforehand.

Also called "morning after" contraception, emergency contraception prevents pregnancy after unprotected intercourse through one of two ways: oral contraception or the insertion of an IUD (intrauterine device).

Emergency oral contraception

"Morning after" pills originally came to light in the form of RU-486. We're not going to go into the medical terms, but suffice it to say that when you take emergency oral contraception, the body makes it so that if by chance you did become pregnant within the last 3 days, you will no longer be pregnant. You must go to a doctor to get this treatment. As with regular birth control pills, emergency pills come in several forms, and the doctor will decide which pills and dosage are best for you. You must take the first dose of pills no later than 72 hours after the "mistake" occurs.

We will be crystal clear: emergency oral contraception should not be used as your regular form of birth control. First of all, even if you begin treatment right away, it's slightly less reliable than the other hormonal methods listed earlier. Second, you have to consume about 40 pills in a 24-hour time frame, and this shock to your body may cause vomiting, headaches, and irregular periods. The cost varies, depending on the cost of the doctor's visit and the type of pills he/she prescribes, but plan on dropping at least $50.

Emergency IUD insertion

An IUD is a small, flexible plastic device that contains either copper or a hormone, and it is inserted into the uterus, preventing an egg from attaching to the uterine wall. There are a few kinds available, and different brands can be left in the uterus for up to ten years to prevent pregnancy. Therefore, using an IUD as emergency contraception only makes sense if you plan on using it as your method of birth control from that point on. For emergency situations, the IUD must be inserted within 5 days of unprotected intercourse. The insertion costs about $600.

Although IUD's are extremely reliable (99.7% effective), there are strong reasons against using an IUD as a method of birth control, emergency or regular. First, the IUD can be squeezed out of the uterus or actually puncture the uterus. Furthermore, the side effects range from heavy menstrual flow to severe cramping to infertility. The threat of infertility causes most doctors to warn young women who plan on having children someday against using an IUD. Besides, with the many new birth control methods slowly emerging, you now have a lot more options available to you.

5. GO TO A DOCTOR

It's amazing how many women make uninformed decisions and are later amazed when they realize that they didn't get all of the information they needed. Thus, we recommend that all women get a gynecologist if (1) you want to change your current method of birth control or (2) you are thinking about having sex for the first time. Anyone over the age of 16 should be visiting the gynecologist yearly for her regular gyno exam and pap smear anyway. You should try to visit the same doctor/nurse practitioner every time you go; this way, you will feel comfortable asking him/her questions about sex and birth control, and he/she will know your medical history (which will help him/her better prescribe and monitor your birth control methods).

Make sure you read up on the birth control method you are considering before you visit the doctor. You'll be more prepared to go over your questions/concerns with your gynecologist. You can also pick up pamphlets on various methods from your local clinic or doctor's office before you go in for your appointment. And reading this SYW was a good start too.

Most importantly, remember NOT to be embarrassed. If you're concerned about losing your sex drive, ask your doctor about it. Your gynecologist needs to know all of your needs so that he/she can help you pick the right method of birth control. You're not in fifth grade anymore, so giggling over words like "penis" and "intercourse" should be out of your system. Be open and honest, and remember that your doctor's instructions aren't bendable like the rules of Monopoly. So check in with your doctor throughout the year, make sure that all of your questions/concerns are answered, and follow those instructions.

And please be safe.