Alternatives
Vasectomy, while highly effective, is also relatively final. The following chart is offered as a
comparison of the alternatives.
Contraceptive And Sterilization Options:
| Method | Used by | Theoretical* Failure Rate | Actual** Failure Rate | Advantages | Disadvantages |
|---|---|---|---|---|---|
| Vasectomy | Man | .02-0.1% | .02-0.2% | Very high effectiveness; no cumbersome methods to use before or during intercourse | Should be considered permanent; some risk of infection |
| Tubal Ligation (“tying off tubes”) | Woman | 0.2% | 0.2-0.4% | Comparable in effectiveness to vasectomy | More expensive and complicated than vasectomy with higher surgical risk |
| Birth Control Pill (combination) | Woman | 0.1% | .16-3% | High success rate; no loss of sensation; other established health benefits | Side effects can be significant |
| Method | Used by | Theoretical* Failure Rate | Actual** Failure Rate | Advantages | Disadvantages |
|---|---|---|---|---|---|
| Condom | Man | 1-3% | 1-33% | No side effects; adds protection from sexually transmitted diseases | Reduced sensation; risk of pregnancy if not used correctly; application cumbersome |
| Diaphragm | Woman | 1-6% | 1-21% | No loss of sensation | Prescription required; application cumbersome |
| Spermicidal jelly, foam, cream or suppositories | Woman | 3% | 13-28% | No serious side effects or loss of sensation; prescription not required | Cumbersome; lower effectiveness |
| Method | Used by | Theoretical* Failure Rate | Actual** Failure Rate | Advantages | Disadvantages |
|---|---|---|---|---|---|
| Hormonal Implants | Man | .2% | .2% | High effectiveness; one implant lasts up to 5 years | Requires surgical insertion and removal; irregular vaginal bleeding |
| Intrauterine device (IUD) | Woman | 0.6-1.5% | 0.5-3% | One-time application; high success rate; no loss of sensation | Prescription required; some side effects |
| Natural family planning (“rhythm method”) | Both partners | 1-3% | 14-47% | Nothing to buy or apply | Requires abstention for 5-15 days per month; high risk of pregnancy |
| Withdrawal | Man | 4% | 19% | Nothing to buy or apply | Reduced satisfaction; high risk of pregnancy |
| No Method | Both partners | 85% | 85% | Nothing to buy or apply | Play now, pay later |
*Theoretical Rate
signifies rate when method is
used correctly over a one year period.
*Actual Rate
signifies rate when method is used
routinely over a one year period.
Adapted from
Trussell J, Hatcher RA, Cates W, Stewart FH, Kost K. A Guide to Interpreting Contraceptive Efficacy Studies. Obstetrics and Gynecology 1990; 76:558-67.
Mishell DR, Jr. Contraception. New England Journal of Medicine 1989; 320: 777-787.