# Sexual Health/Other Birth Control Methods

There are a number of other birth control methods besides hormonal and barrier methods. We will discuss some of them here.

## IUD

An IUD, or "Intrauterine Device" is a small hard object, typically made of metal or plastic, that is inserted into the uterus. The IUD causes the body to release substances that are hostile to both sperm and eggs. Copper enhances this spermicidal effect.
Some IUDs contain a hormone-releasing cylinder instead of copper. These are known as IntraUterine Systems (IUS). The hormones in an IUS reduce the frequency of ovulation (by 10-50%), cause changes in cervical mucus that prevent sperm from entering the uterus, and also cause changes in the endometrium that may prevent embryos from implanting.
Copper IUDs can be used as an emergency contraceptive. Emergency contraceptives are birth control methods that are designed to prevent pregnancy after unprotected sex, or sex where the primary contraception (usually a broken condom) fails. Inserting an IUD within 5 days of unprotected sex has a 99% chance of preventing pregnancy.
IUDs do not protect against STDs.

## Morning-After Pill

The morning after pill, also known as the emergency contraceptive pill, is a high-dose hormonal contraceptive that can be taken after unprotected sex, or sex where the primary contraceptive has failed. The morning after pill causes the uterus to shed its lining, effectively prompting an immediate menstruation that washes the fertilized egg out of the uterus. There is some risk involved with the emergency contraceptive pill, and there have been a handful of deaths reported among women who have used the pill. It is unknown in these cases whether the emergency contraceptive itself caused those deaths. Regardless, care should be taken when using an emergency contraceptive, and you should consult your doctor.
The morning after pill does not prevent against STDs.

## Fertility Awareness Methods

Fertility awareness methods teach women to observe one or more of their primary fertility signs: basal body temperature, cervical mucus, and cervical position. From these signs, the woman can known when she is fertile (approximately 8-10 days of each menstrual cycle), and when she is not fertile. To avoid pregnancy, the woman will not have intercourse, or will use some other method of birth control, on days she is fertile.
Fertility awareness is best learned in a class. A good fertility awareness teacher will provide individualized instruction based on a woman's own observations. A class in fertility awareness should also provide suggestions on how to make abstinence during fertile times easier, or on how to remember to use other methods of birth control on those days. Most fertility awareness teachers are associated with the Roman Catholic Church; inquiring at the local Catholic diocese is a good way of finding a teacher. Catholic teachers usually call the method natural family planning, or NFP. Local women's health clinics may be aware of non-religious fertility awareness teachers in their area.
In addition to these observational methods, there are statistical methods that estimate when a woman is fertile. They are the Rhythm Method (a formula based on menstrual cycle length) and the Standard Days Method (can only be used by women whose menstrual cycles are always between 26 and 32 days). While easier to learn, these statistical methods are not as accurate as the observational methods.
Fertility awareness methods do not protect against STDs.

## Withdrawal

Before ejaculation, a man may remove his penis from the woman's vagina, and ejaculate away from her genital area. The fluid that comes out of a man's penis prior to ejaculation, known as Cowper's fluid or pre-ejaculate fluid, is not believed to contain viable sperm. (An exception is if the man has ejaculated recently - there may be sperm left from the previous ejaculation in the urethra.)
Precisely predicting the time of ejaculation is very difficult. Getting even a small amount of semen in a woman's vagina or on her vulva results in a very high risk of pregnancy, and it is not recommended that couples rely only on withdrawal as birth control. However, withdrawal may be used to increase the effectiveness of other methods. Using withdrawal in combination with a hormonal method or barrier method will lower the risk of pregnancy.
If a couple is using withdrawal, the man should urinate after ejaculation and before any other sexual contact. This is to clear any remaining sperm out of the urethra.
Withdrawal does not protect against STDs: infectious microorganisms can be present in pre-ejaculate fluid.