Spermicides are typically a gel that are used in conjunction with barrier methods. That is the condom, the cervical cup, the diaphragm, and the sponge. These are very effective in conjunction with these barrier methods. However, alone they are not very effective, so whenever using a spermicide, make sure that you're using a barrier method along with the spermicide. Oftentimes, if in a sample of a diaphragm, if you have used the spermicide and you have not had sexual relations, it is important to replace the spermicide within a 2 hour window.
The nice thing about condoms is that you can go to your local store and pick them up, which makes it very convenient. However, their effectiveness for pregnancy prevention is only approximately around 70% because they can break and/or people don't actually take them out and use them. In addition, the nice thing about condoms is that they actually are the only form of birth control that can help prevent and/or decrease your risk of sexually transmitted infections. I often tell my patients to practice the electrical fence rule: as you know, some people have electrical fences around their homes to prevent dogs from coming out. I say: have an electrical fence around your body. Use a condom to prevent the dogs from coming in.
We're going to break the different types of IUDs into categories. First, there are progesterone-only IUDs and the subset of progesterone-only IUDs is that they are specifically for nulliparous patients - meaning patients that have not had any children. They are a little bit smaller in width to accommodate the smaller uterus that has not bore children. That is the 3-year Syla and the 5-year Kyleena. Then another subset of progesterone IUDs is the Liletta (which is 4 years) and the Mirena (which is 5 years.) These are slightly larger but can also be used in nulliparous patients. There's also an IUD that has no hormones at all, and that's called the ParaGard. It lasts for 10 years.
The Nexplanon (or implantable subdermal device) is a type of birth control that lasts for 3 years. It is one of the long acting reversible contraceptions, meaning it lasts for an extended period of time. However, it's reversible because it can be removed. Once it's removed, your fertility resilience within 5 days. The nice thing about the Nexplanon is that it's done in the office and it is about the size of a matchstick. It goes right in between the inside of your arm - between the biceps and the triceps. It's right underneath the skin and you just get a local anesthetic and it's placed and it only takes a few moments.
When comparing LARCs versus other forms of birth control, one has to realize that you have to be honest with yourself. Most often when it requires a patient to actually do something themselves, they may be less compliant. The nice thing about LARCs is that they don't require a patient factor - meaning that once the doctor inserts the device, then that will be more effective and has a higher effective rate because it does not have the variable of requiring a patient to actually do something (i.e. Take a pill, put a condom on, put a patch on, place of NuvaRing in.)
The nice thing about emergency contraception is that now it is available over the counter. It is important that you use this emergency contraception in emergency situations where you have had unprotected intercourse and/or accidental episodes of, for example, a condom breaking. It's best to use it within the first 24 hours. However, it has been known to be actually effective up to 5 days. You may experience irregular bleeding when you have this and use this form of device. However, also understand that this is for emergency purposes and should not be used as you're maintaining or maintenance of contraception. For that, you should seek a gynecological provider to decide what form of contraception is best for you.
When one decides they want to have sterilization as their form of contraception, you should be 100% sure that you don't want any more children. There are several options of sterilization. There's the vasectomy from the male's perspective. Then from the female perspective, there's the Essure, which is done through the vagina, and then there are laparoscopic approaches as well as a postpartum tubal, which is done in the immediate postpartum period.