Talk:Comparison of birth control methods

Withdrawal

An edit was recently made, referring to this article as a "new study". While the article is highly informative (I'm going to go add it to the withdrawal article as soon as I'm done here), it is a review of previous studies, not a study in its own right. The citation it uses for the 18% typical-use failure rate is the 2002 National Survey of Family Growth.

The current consensus for the table is to use numbers from the most recent (current 19th, published in 2007) edition of Contraceptive Technology unless the method is not covered in that publication. This helps ensure that the numbers are comparable to each other, something that would be questionable if the numbers for each method came from different sources. With this in mind, I have reverted the changes. Lyrl^Talk _C 14:14, 23 July 2009 (UTC)

Sorry for writing that it was a new study, instead of a new analysis of studies. I understand the reasons for keeping the old numbers, but based on this new analysis, it seemed to me that they were seriously underestimating the efficacy of withdrawal. Also, since the analysis revealed that withdrawal is almost as effective as the male condom, I thought it would make the numbers more comparable and much more informative to include this updated information. I'm not really invested in this analysis, but it just seemed to be more accurate than Contraceptive Technology's numbers because of its examination of many different studies. So I'm just interested in what you think about this. --Ships at a Distance (talk) 20:04, 23 July 2009 (UTC)

The paper examines many studies on the prevalence of withdrawal as a birth control method. For effectiveness rates, it cites just one source (Contraceptive Technology - footnote 2 of the article) for the method failure rate, and a different single source (the 2002 National Survey of Family Growth - footnote 3 of the article) for the typical use failure rate. I don't know why the paper authors trusted Contraceptive Technology for the method failure rate but rejected its typical use failure rate. I also don't know why the Contraceptive Technology authors rejected the 2002 National Survey of Family Growth typical use figures (the current edition was published in 2007, so they had access to the NSFG data, they just chose not to use it).

Because the paper only uses one source for the typical effectiveness, I'm not inclined to use the paper to replace the Contraceptive Technology number. Lyrl^Talk _C 20:26, 23 July 2009 (UTC)

I thought I thought it was using estimates about the prevalence of withdrawal to conclude that its efficacy was being underestimated, but I see now that it is weird that it uses the typical use rate from Contraceptive Technology and perfect use rates from a different single source. Anyway thanks for discussing it with me --Ships at a Distance (talk) 20:39, 23 July 2009 (UTC)

Contradicting data

There is different Progestogen only pill perfect-use failure rate in the table and in the Progestogen only pill article. Which one of them is correct? --Irigi (talk) 16:42, 7 September 2009 (UTC)

I believe the data in the progestogen only pill table is from the 17th or 18th edition of Contraceptive Technology, while the data in this article is from the 19th edition. Neither one is incorrect per se, they are just from different sources. Lyrl^Talk _C 20:07, 7 September 2009 (UTC)

Table references

We should migrate these references into the table

in case you don't know, here's how:

cut-paste the {{cite blah blah blah}} bits inbetween <ref> tags next to the appropriate table entry, like this:

* '''So-and-so''': {{cite blah |blah=blah,etc}}

would become

|[[so-and-so]]<ref>{{cite blah |blah=blah,etc}}</ref>

--Arkelweis (talk) 02:37, 5 October 2009 (UTC)

The references for the table are listed separately from the references for the rest of the article. At the time the table was created, it was not possible to have more than one <ref></ref> lists in the same article, thus the manual coding of the table references.

I have updated the article code to enable clicking from the table to a separate list of table references. I have done the same thing for the table notes. In general, if a reference or note was cited more than once, I put the text of the ref or note in the code at the bottom of the table; otherwise I put the text next to the method. The only exceptions were the references for Lea's Shield (parous and nulliparous) and Prentif (parous and nulliparous): I figured if someone wanted to edit those references they would still be easy to find. Lyrl^Talk _C 01:51, 6 October 2009 (UTC)

5 October reversions

I have reversed several changes made recently:

• I removed abstinence from the table. While abstinence is sometimes included in lists of birth control methods, it does not lend itself to the kinds of comparisons being made in this article.
• I reverted the coloring of the "user action" column to the simpler version. Adding more colors to this column has been discussed before, at Talk:Comparison of birth control methods/Archive 1#Revert 20-June. The consensus at that time was to maintain the simpler coloring; I'd like to see discussion on the talk page before this change is implemented (I still support the simpler version). From the old discussion, a statement by Zodon:

The blue color was used to indicate items that were "non-user dependent" (from the user dependence section). As these methods for the most part correspond to the methods that have both perfect use and typical use failure rates of <1%, the same light blue color was used. (I think introducing more colors would make it more confusing.)

• I removed the references to emergency contraception. If a person needs emergency contraception, their only option is emergency contraception. It doesn't make sense to compare options for emergency situations to options for ongoing contraceptions.

Lyrl^Talk _C 02:18, 6 October 2009 (UTC)

I somewhat disagree with the removal of the "emergency" contraception information. It is perfectly logical that someone may want to see how the morning after pill, for example, compares to other birth control methods regarding their efficacy. I don't see any real reason to remove that information, and, unlike abstinence, comparing "emergency" methods is an apples to apples comparison with other birth control methods. I support the inclusion of that info in the article. The Seeker 4 Talk 12:06, 6 October 2009 (UTC)

I disagree with 'abstiencne doesn't lend itself to the kind of comparisons being made in this article'; abstinence can mean abstinence from vaginal intercourse (e.g., anal sex) or abstinence from sex altogether; the former has a perfect-use failure rate, and both have a typical-use failure rate, which is why I added them into the table. And it makes perfect sense to have both abstinence and unprotected sex in there to compare the other birth-control methods to.

reguarding the colour, I'd suggest picking a colour other than blue: blue is used for the best failure rate, so it looks like its high-lighting the best frequency of user interacition --Arkelweis (talk) 21:26, 6 October 2009 (UTC)

I have to agree with your point regarding abstinence; it does have a place in this article, especially if you include abstaining from vaginal sex, but engaging in other sexual activity, one type of abstinence. I stand corrected. The Seeker 4 Talk 23:10, 6 October 2009 (UTC)

Emergency birth control

Seeker had commented that it would be useful to see a comparison of effectiveness between emergency and ongoing birth control. I agree, that would be useful. However, it would be difficult to provide such a comparison. The failure rate of ongoing birth control is measured in pregnancies per year, a fairly simple concept to grasp. The failure rate of emergency contraception is measured very differently. Wikipedia's emergency contraception article explains it this way:

The effectiveness of emergency contraception is... expressed as a percentage reduction in pregnancy rate for a single use of EC. Different ECP regimens have different effectiveness levels, and even for a single regimen different studies may find varying rates of effectiveness. Using an example of "75% effective", an article in American Family Physician explains the effectiveness calculation thus:

... these numbers do not translate into a pregnancy rate of 25 percent. Rather, they mean that if 1,000 women have unprotected intercourse in the middle two weeks of their menstrual cycles, approximately 80 will become pregnant. Use of emergency contraceptive pills would reduce this number by 75 percent, to 20 women.

Because "75% effective" (or 89% effective, or 47% effective, depending on the type of ECP and whose calculations you trust more) means something drastically different for emergency contraception than for ongoing methods, it is not useful to put these numbers next to each other.

There have been estimates of theoretical per-year perfect-use failure rates for ECPs. Again from Wikipedia's emergency contraception article: perfect use of levonorgestrel ECPs would result in a 20% annual pregnancy rate; perfect use of Yuzpe regimen ECPs would result in a 40% annual pregnancy rate. I'm still hesitant about including these numbers, however, because they are theoretical calculations extrapolated from studies of people who used ECPs one time. Every method currently in the table has effectiveness numbers based on regular use of the method for at least six months. Lyrl^Talk _C 01:45, 7 October 2009 (UTC)

if fitted up to 5 days after sex, the coil has a success-rate near that as if it had been in place at the time of sex, hence the statistics for that are directly comparable to the statistics in the table (or we'd need to do some routine calculations/find a source to convert it into a measurement comparable with other emergency contraceptions); the pill, as you say, uses a different measurement, so it needs to be included out of the table (if included)

maybe there should just be a section on emergency contraception? --Arkelweis (talk) 17:10, 8 October 2009 (UTC)

EC pills (e.g. Plan B) can be used as an ongoing method. Since the pills tend to be priced higher than other OC, it may be more costly for those who have frequent intercourse. Will have to check my sources for details on effectiveness, etc. The bit about ongoing EC use in the EC article looks seriously out of date.

Also, commenting on some suggestions below, but in a similar vein. Probably better to not say postcoital. When used as a regular method it may make sense to take right before intercourse (depending on when is convenient for the users/so don't forget after, etc.)

I haven't looked at what was proposed for putting it in the table, so don't have comment on that yet. Zodon (talk) 05:46, 24 October 2009 (UTC)

If the table is going to include emergency contraception, Ulipristal acetate (Ella) should be added as it retains effectiveness for 5 days and is more effective for women with obesity. Lukascolashop (talk) 23:13, 17 August 2020 (UTC)

Abstinence

Adding abstinence (either total or only from vaginal intercourse) to the table adds very little information. Considering the columns of the table:

Brand/common name A number of methods in the table are known by multiple names. Listing them together can help readers not familiar with different terms learn that they actually refer to the same method. For abstinence, however, there are no other terms.

Effectiveness While it is known that abstinence has a typical-use failure rate, it is not known what that failure rate is. Similarly for the perfect-use failure rate of sexual activity that excludes vaginal intercourse.

Implementation For methods currently in the table, these columns provide additional information not obvious from the name of the method. For abstinence, the "implementation" column is completely uninformative: it just repeats the name of the method.

User action For abstinence, the correct entry into this column will vary widely from individual to individual. For some people, abstaining from sexual activity (or engaging in such activity while refraining from vaginal intercourse) is no big deal; they don't feel like they ever have to "take action." For other people, the temptation to have sex is strong and something they have to take frequent action to resist or avoid.

While the "type" column might provide some useful information (that abstinence shares similarities with breastfeeding, fertility monitoring, and withdrawal), I'm not convinced abstinence would be a net positive for the table.

I also like to point out that the table is not the entirety of this article. I think including abstinence in the discussions in the rest of the article (side effects, user dependence, and ease of use sections) would be an article improvement. Lyrl^Talk _C 01:45, 7 October 2009 (UTC)

OK, maybe abstinence would be better left off of the table, but elsewhere in the article, until more data is available; currently, the only 'data' as such is the (non-intuitive) observation that abstinence has a non-zero typical-use failure rate, and that 'anal' has a non-zero perfect use failure rate (actual failure rates unknown). --Arkelweis (talk) 17:06, 8 October 2009 (UTC)

Abstinence belongs in the table. I went to look for it and surprisingly it wasn't there. Since is certainly is a contraceptive method, and is widely used, people should see it there. --Marcwiki9 (talk) 16:11, 6 July 2012 (UTC)

Some suggestions for possible article improvement

1. combination section: expand entry on combining methods: it seems intuitive that if method 1 has a 50% failure rate, and method 2 has a 10% failure rate, then using both should grant a 5% failure rate (50*10), but I'm familiar enough with statistics to know that this is naiive: how do the various methods combine, and is it worth including information on this in the article? also, a better reference than scarleteen.com would be good.
2. STDs. I know that this is about birth-control, but I can't find an equivelent article comparing the success-rates in preventing STDs? At least one entry (iirc) in the table increases the severity of certain infections, if aquired (IUD): maybe some information on STD-prevention in the table? (or, starting an equivelent article for STDs)
3. 'See Also' section (links to safe sex, emergency contraception and abortion articles?).
4. abstinence and emergency contraception sections?

--Arkelweis (talk) 17:06, 8 October 2009 (UTC)

I once came across a Pubmed reference that discusses combining condoms and spermicide: PMID 1743276. Other than that, I am unfortunately not able to be very helpful in developing the entry on combined methods.

I think a section "Impact on sexual health" or similar would be a good addition to this article. Condoms (male and female) protect from STDs; IUD insertion can push STD infections from the vagina into the uterus and cause PID (I think it is no longer believed that IUDs cause an ongoing risk of PID; evidence seems to point to insertion being the main risk factor); hormonal contraceptives actually reduce the risk of STDs progressing to PID (this is discussed with references here). There is a speculated moderate amount of protection from diaphragm use, although study results have been disappointing (see Diaphragm (contraceptive)#Protection from sexually transmitted infections).

"See also" sections are generally used to link topics that should be discussed in the body of the article, but aren't because the article is underdeveloped (per Wikipedia:Guide to layout#See also section). Making such a section can be a good guide to future editors on what needs to be added to improve the article.

Abstinence and emergency contraception sections I'm not sure of: I'm afraid making sections for individual methods would tend to duplicate the sections from the birth control article. I guess it would depend on how they were done; I might come around to them.

Thanks for making such a good set of suggestions! Lyrl^Talk _C 01:54, 9 October 2009 (UTC)

---

Okeydokey, here's an 'alpha' version of some possible article additions, feel free to modify (obviously): --Arkelweis (talk) 17:57, 11 October 2009 (UTC)

Sections on specific methods
The following discussion has been closed. Please do not modify it.
Abstinence (main article, see abstinence/section in birth-control) Abstinence can be either thought of as vaginal abstinence (e.g., limiting sex to anal, oral, manual etc) or total abstinence from sex. It is worth noting that vaginal abstinence has a non-zero failure rate, due to, e.g., semen leaking from the anus onto the vagina, whilst total abstinence has a non-zero typical-use failure rate due to people spontaniously desciding to break their desizion to abstain. http://www.guttmacher.org/pubs/tgr/06/5/gr060504.html Post-coital contraceptives -- pill pills give a 75% (or 89% effective, or 47% effective, depending on the type of ECP and whose calculations you trust more) improvement in the chance of not becoming pregnant after unprotected sex, including where another form of contraception has failed. e.g., if there was a 4 in 100 chance of getting pregnent, taking the pill will, say, reduce this to 1 in 100, if taken within 72 hours of sex -- coil if implanted up to 5 days post-coitus, the copper IUD (coil) works with success rates as if it had been in place at the time of sex -- abortion (main article, see abortion) abortions generally have 100% success rates, tho (health considerations vs. other contraceptive methods)

Combining methods

Notes on method combinations (includes large table); ignore the 'do not modify' bit
The following discussion has been closed. Please do not modify it.
(are all of these combinable with morning-after pill? or, do some prevent it from working? e.g., can you not use MAP with so-and-so pill? at the least, you'd need to know when your method had failed, so e.g. condoms are at least partially combinable (if it breaks (or you don't have/use one) then you can take the MAP) whilst inplants presumably aren't, as you don't know if/when it's failed) Birth control method Implanon Jadelle Vasectomy Combined injectable Essure IntraUterine System Tubal ligation Copper intrauterine device LAM Depo Provera Lea's Shield and spermicide FemCap and spermicide Combined oral contraceptive pill Contraceptive patch NuvaRing Progestogen only pill Ormeloxifene Male latex condom Diaphragm and spermicide Prentif cervical cap and spermicide Today contraceptive sponge Female condom Symptoms-based fertility awareness Standard Days Method Knaus-Ogino method Coitus interruptus Spermicidal Implanon Jadelle Vasectomy Combined injectable Essure IntraUterine System Tubal ligation Copper intrauterine device LAM for 6 months only; not applicable if menstruation resumes Depo Provera Lea's Shield and spermicide FemCap and spermicide Combined oral contraceptive pill Contraceptive patch NuvaRing Progestogen only pill Ormeloxifene Male latex condom IIRC, should not combine (increased tearage) can combine with seperate spermicide, but pre-spermicided condoms no advantage, possible increase in STD transmissionref Diaphragm and spermicide Prentif cervical cap and spermicide Today contraceptive sponge Female condom IIRC, shouldn't combine (increased tearage) Symptoms-based fertility awareness cannot combine cannot combine Standard Days Method cannot combine cannot combine Knaus-Ogino method cannot combine cannot combine Coitus interruptus Spermicidal can combine with condoms, but pre-spermicided condoms no advantage, possible increase in STD transmissionref

Other topics with which this article could be expanded
The following discussion has been closed. Please do not modify it.
Other considerations (making anotehr table for now, anything else to chuck on here?) reversal -- how long and how full is recovery? bad reactions health consideratoins contraindictions? effect on STD transmission rate (how to measure? or just 'in/de-creases (a bit|lot)'? complications if it fails (i.e., pregnancy complications). anything else that's relevent and comparable across contraceptives? Implanon Subdermal implant Jadelle Vasectomy REVERSAL: reversable, but permanently drops fertility Combined injectable REVERSAL if bad reaction, how long's it take to wear off? Estrogen + progestogen Injection REVERSAL if bad reaction, how long's it take to wear off? Essure IntraUterine System REVERSAL requires doctor/nurse PREGNANCY increase in eptotic pregnancies; increase misscarriage/premature Intrauterine & progestogen Tubal ligation Copper intrauterine device STD in/de-creases likelyhood of PID LAM Depo Provera Lea's Shield and spermicide used by nulliparous FemCap and spermicide Combined oral contraceptive pill Contraceptive patch NuvaRing Progestogen only pill Ormeloxifene Male latex condom STD decreases likelyhood of transmission (barrier) Lea's Shield and spermicide used by parous Diaphragm and spermicide STD possible reduction due to blah... Prentif cervical cap and spermicide used by nulliparous Today contraceptive sponge used by nulliparous Female condom STD reduction in transmission (barrier) Symptoms-based fertility awareness Standard Days Method Knaus-Ogino method Coitus interruptus STD reduction in semen-borne STDs Spermicidal gel, foam, suppository, or film STD iirc, either in/de-creases STD transmission, forget which Today contraceptive sponge used by parous Prentif cervical cap and spermicide used by parous vaginal abstinence anal = increase in certain STDs abstinence None (unprotected intercourse) also: those requiring user-action every act of intercourse offer no protection against rape condoms and quick-withdrawl are the only male contraceptives, all others require action on the part of the female. iirc, at-least one (non-projesterone?) pill has a terratogenic (is it androstegonene (spelling almost certainly wrong)?) that mutates foetuses IF you do manage to get pregnant on them? --BAD REACTIONS 3-month injection can have a bad reaction, which cannot be reversed compare with condoms, which you can be allergic to, but which can be reversed by taking the condom off. -- PLAUSABLE DENIABILITY anything else?

The sections on specific methods (abstinence and postcoital) look, to me, like duplicates of those in the birth control article. I do not believe Wikipedia would gain anything by duplication that information in this article.

As far as more tables: I believe the effectiveness table largely works because there are published hard numbers for failure rates. Other characteristics have softer data that does not lend itself to table format: I believe the article would be much better off expanding the text sections instead of adding more tables. Lyrl^Talk _C 01:04, 14 October 2009 (UTC)

there are some published hard-science figures on combining methods. e.g., theres no benifit to the small amount of spermicide added to condoms, and it can actually increase risk of transmission of certain STDs (by causing micro-abrasions in the vagina, meaning if the condom breaks then there's an increaseed risk of STD spread), whereas (greater amounts of user-provided) spermacidal lubricant + condoms = decreased risk of pregnancy; otherwize, theres a lot of advice based on hard figures or (expert) common sense, such as not combining condoms + femidoms (increased friction == increased risk of breakage) and, presumably, not combining certain classes of methods, e.g. different hormonal pills, different 'rhythm' methods, etc.

as for wether to table or not: combining each method with every other method would be a huge number of combinations, which would lend itself to table form IF enough combinations have entries; elsewize, not. I just chucked the table up whilst it's being filled, if there's not enough data in the end then there's no reason for a table I suppose. --Arkelweis (talk) 13:00, 14 October 2009 (UTC)

You sound like you're on the right track. The only thing I have to add is about "latex grab". Two condoms that are both made of latex should not be combined because latex grab increases the risk of breakage. If one or both of the condoms are not made of latex, then they can be combined.

Latex grab is also a risk when combining a latex condom with a latex diaphragm; however, the smaller contact area between these two devices reduces the risk. I have not seen any sources for this information, but the women in the Yahoo! DiaphragmsAndCaps group say latex diaphragm and latex condoms are OK to combine as long as plenty of lubrication is added. Lyrl^Talk _C 13:45, 17 October 2009 (UTC)

So does non protected intercourse imply completion in the vagina? If so is it fair to assume that that act has a typical failure rate of 85%?

Hard to Believe

I find it hard to believe that a topic as pertinent as this, with the caliber of the article content being as high as it is, would be nominated for deletion. Maybe some Wikipedians should be vegging out with their TV more and doing less editing... solely for the benefit of the world... As they say in rmemwllsnpsee, if you can't play football, don't go to the game... It is a quality article... Kudos to the contributors. Stevenmitchell (talk) 11:46, 6 November 2009 (UTC)

On any given article, you will be able to find someone who thinks the article should be deleted. Doesn't surprise me that much, but I am glad the article was kept, and agree it is far from a how-to guide. The Seeker 4 Talk 12:59, 6 November 2009 (UTC)

Delete? Those people are crazy. This is a very useful and important article for comparing different types of birth control and easily helps readers know which birth control is best for them. So i say no to deletion. Please keep this article, it helped me alot. And thank you all for contributing this article.--67.65.160.129 (talk) 18:10, 22 April 2011 (UTC)

Outdated or Contradictory Data on Fertility Awareness-Based Methods

There's a conundrum here. The table lists symptoms-based fertility awareness methods being the basal body temperature and cervical mucus methods. (1) The 25% typical use failure rate, based on the references from Trussell, is an unexplained amalgamation of Standard Days, TwoDay and Ovulation methods. (2) There are newer references around, such as "Fertility awareness-based methods: another option for family planning" by Pallone and Bergus in the Journal of the American Board of Family Medicine 22(2), 2009, or "The effectiveness of a fertility awareness based method to avoid pregnancy in relation to a couple's sexual behaviour during the fertile time: a prospective longitudinal study" by Herrmann et al, Human Reproduction 22(5), 2007. They have more up to date data that treat these methods individually, and includes the newer methods such as the Symptothermal method with double checking, which they conclude to have a 0.2-1.8% failure rate for typical use. —Preceding unsigned comment added by Jefferson.tan (talk • contribs) 15:28, 14 May 2011 (UTC)

Since the purpose of the table is comparison, it is best to use sources that are clearly comparable wherever possible. Since Trussell/Contraceptive Tech is the authority in this area, the numbers from there are clearly comparable (and clearly not WP:OR).

I haven't looked at the articles you mention to see how they compare, whether they are review articles, etc.

A new edition of Contraceptive Tech will be coming out soon, which should facilitate updating the table. Zodon (talk) 07:14, 18 August 2011 (UTC)

I agree with the previous contributor on updating the table. Has the new edition of Contraceptive Tech come out yet? I also am curious as to why the listing of the symtoms-based fertility awareness category is an amalgamation of different methods, and not represented in a differentiated manner on the table. Even with the newer edition of Contraceptive Tech, I doubt that it would list these different methods individually, in which case it would probably be beneficial to resort to other sources on these methods (I would expect the American Board of Family Medicine to be quite reliable). In any case, the most up-to-date data in the table would be nice.

Noodles Addiction (talk) 04:14, 15 February 2012 (UTC)

The new edition (20th) of Contraceptive Tech is out. I have not had much time for Wikipedia lately, so have not had chance to check/update.

The main reason for the amalgam is that "typical use" is based on use in the National Survey of Family Growth, and I would guess (haven't checked) that it does not differentiate what particular fertility awareness method a couple may be intending to use. (Thus the mixture of methods used is presumably a sampling of the fertility awareness methods actually used in the United States in the populations sampled in that study in the relevant time period.)

The claim for a "typical use" failure rate for symptothermal of "0.2 to 1.4 %" seems highly doubtful (given that the perfect use failure rate in Trussell is 0.4%, and typically the difference between perfect and typical use failure rates is much larger for user dependent methods.) So it seems highly unlikely that Pallone and Bergus's figure is comparable to the figures from Trussell. (May have been based on a smaller population, research conditions, ...) Thus including it in a comparison table would be misleading.

Trussell continues to use the 25% typical use failure rate based on National Survey of Family Growth. I think the basic purpose of a table like this is to give an overview--lay out the big picture. The typical use and ideal use figures give an idea of the ranges of characteristics. The individual method articles is are probably more appropriate place for the details of different effectiveness estimates, etc. In general, both in theory and in practice, fertility awareness methods are very dependent on correct use (much less forgiving of user error than hormonal methods, for instance). Which is what the table shows. We would have to have extraordinarily good evidence in order to say something different. Zodon (talk) 07:55, 23 February 2012 (UTC)

The listed citation for fertility awareness required participants to submit daily reports on their family planning usage. This is not typical, and thus cannot be taken as an estimate of typical-use effectiveness. I strongly feel that we should use the quoted typical use in Contraceptive Tech at 24%. Jason Dick (talk) 16:29, 23 October 2013 (UTC)

trussell2007

This is heads up, in case people have missed the red error message. The article currently contains the reference <ref name="trussell2007" />, but there is no reference with this name. I assume it has been deleted. Could someone who is familiar with the literature please put it back. HairyWombat 03:05, 15 January 2012 (UTC)

I fixed the problem. Trussell2007 is the same reference as used extensively in the table. Citation bot 1 seems to have messed the item up in this edit. (Looks like the bot did not understand the group code used to make the table reference).

If the bot does the same thing again we should bring the problem to the attention of the bot maintainer and have them fix it, or find out how to tell the bot to leave this reference alone. Zodon (talk) 07:22, 29 February 2012 (UTC)

If the bot does the same thing again, we can restore the reference, and add this incantation to the article {{bots|deny=Citation bot}}. (We should also let the bot operator know about the bug.) Zodon (talk) 07:41, 29 February 2012 (UTC)

Uh, broken again? Refs 9 and 10 in the body do not show up on the Reflist, presumeably because the citation is captured by the Table Reflist. (I think 9 is Trussell2007). This level of detail is above my wiki-pay-grade - would appreciate if someone who understands the refs better would fix this. Perhaps by using separate labels 'Trussell2007b' to the same source... Ratagonia (talk) 22:36, 18 March 2012 (UTC)

Thanks for catching that. I figured out what was going on. It should be working now. Zodon (talk) 05:30, 19 March 2012 (UTC)

Addition of cost of birth control to table

It seems like it might be a good idea to include a general cost of each method to the table. It seems like it would be pertinent and useful, and would go well next to the user action required section. The problem would be how to integrate that into the table, as the methods differ greatly (one-time cost for surgery, or for each instance of sex with a barrier method, etc.) Noodles Addiction (talk) 13:58, 16 February 2012 (UTC)

I think that including cost has some merit, but do not think it belongs in the current table.

This has been discussed some (see Talk:Comparison of birth control methods/Archive 1#21 Comparison - cost, method use, and in the links.) There I suggested a reference.

I don't think the cost should go in the existing table in part because we don't want to overload the table with too much data. Cost varies considerably from country to country (not just with the currency, but based on the approach to health care, etc.), so the cost information may be of less use/interest in markets aside from the one(s) chosen.

Of course the major cost of contraceptives is the cost of (user and method) failures. So to be useful, any coverage of cost needs to include that aspect. What I would like to see is a listing including: direct method cost, cost of complications (side effects of the method), and cost to the user of contraceptive failures. (Consider that USDA estimates cost of raising a child is something on the order of $200,000.) Unfortunately the source listed above (and some older articles by Trussell and others) are the best sources I have, and they only cover medical costs to the insurer for method, complications and failures (but that just means cost of birth, and maybe some infant medical care - nothing close to the cost for the user).

I envision presentation in a second table, but textual coverage is also an option. I have a draft table that I started that I could dig up if people wanted it as a starting point. Zodon (talk) 08:27, 23 February 2012 (UTC)

Thank you 32cllou for starting a section on costs, I expanded some. I think it would be worth expanding on the risks aspect of costs a bit (at least maternal mortality) and comparison of risks in vasectomy vs. tubal ligation.

Another "cost" that might be nice to include is environmental. Again of course failure dominates everything, but there are some worthwhile items about the lack of environmental impact from hormonal contraceptives, etc. that would be worth covering. But that may be for another section. Zodon (talk) 08:01, 28 February 2012 (UTC)

I'm glad that the addition of the cost of birth control was seriously considered. Although it's very informative, it seems to obfuscate the issue by bringing up the whole point of raising a child into this. While it's later clarified that the costs up to the birth are more expensive than forms of birth control, it's a whole other issue to bring up the costs for raising a person, particularly when the aim of the article of a comparison of birth control methods. There are many assumptions in considering the cost of raising a child, and that doesn't even address the consideration whether adoption would be an option (costs of tests, natal care, birth, etc. covered by adopting parents). It seems for the purpose of this article this may be off-track. Also, I still think a table would be a great idea, because I was aiming more for a comparison of all the methods listed in the following table, instead of just a few; it just seems like a natural extension that if we were going to compare these methods we should compare them all in a concise manner. If you don't think that's still feasible in some way than I'll help add the costs of each method to this section. Again, thanks for seriously considering this section.Noodles Addiction (talk) 14:54, 28 February 2012 (UTC)

The cost of failure is central to the cost of contraception. Children are a huge investment. The point is the cost of contraceptive failure is several orders of magnitude greater than the cost of contraceptives. Not infrequently I see comparisons that only talk about the cost of the contraceptives themselves, which gives misleading impressions (e.g. making a to-do about the low up-front cost of withdrawal, without noting the much higher cost in contraceptive failures). You have to look at total cost, not just up front cost.

One suggestion I read is to consider contraception as treatment for the condition of "unwanted fertility." In general when considering treatments, one looks at the cost of the disease/condition being treated (vs. the cost of treatment).

Certainly in any particular case there are ways of managing costs (shift them onto somebody else, or on to society, get a higher paying job, etc.), but we probably don't need to go into the details in this article. (More apropos for article on pregnancy options counseling, or reproductive life planning, etc.)

I am not averse to tabular coverage (I started out with that idea in the discussion above). But in some ways tabular coverage may have even more potential to get bogged down in the numbers than does coverage in prose. Zodon (talk) 06:38, 29 February 2012 (UTC)

What do you envision as being in the table (I assume rows would be most of the contraceptive methods, as in effectiveness table), but what other columns should we have? (Might be worth doing a little planning before putting something together, especially since editing wikipedia tables is tedious.)

I will see about digging out the draft table I put together based on Trussell as a starting point. Zodon (talk) 09:08, 29 February 2012 (UTC)

The "costs" and "initial costs (per year)" columns in the table comparing birth control had "$0-" in each cell. The idea of birth control methods varying between countries has already been mentioned, but I also removed the columns for now because they did not provide comparable cost information. AlphanMangos (talk) 16:08, 2 December 2021 (UTC)

Calendar methods

The article currently has two links in the table to calendar-based methods Standard Days Method, CycleBeads & iCycleBeads and Knaus-Ogino method with differing statistics. Perhaps this should be clarified to be differing versions of the same type of method. Thoughs? --TeaDrinker (talk) 19:01, 18 February 2012 (UTC)

Although Standard Days and Knaus-Ogino methods are both covered in the same article, they appear to be different (use different calculations - see the linked article). I just fixed an error in the statistics here which should help clarify. Zodon (talk) 08:45, 29 February 2012 (UTC)

IUD

I'd like to add more information about IUD's, which seem to be lightly covered but not detailed in the Comparison page. I've research stating that it is the most economical and least compliance dependent method. Suggests optimal for the poor. Am I in the right place? How do I quickly create Wikikpedia standard reference text?32cllou (talk) 23:49, 26 February 2012 (UTC)

In answer to your question about references, Wikipedia:Citation templates may be helpful. (Find the template that corresponds to the type of reference you have, then fill in the fields).

You may also find a template filler, such as this tool User:Diberri/Template filler helpful. (For instance, see the web based interface.)

More coverage of IUD's seems reasonable. How economical they are does depend on IUD and time frame involved (e.g., hormonal may be less so than copper, vasectomy is also highly economical for long term (non-reversible) protection, may be less economical for very short term protection.) But those are refinements that you may already have in mind, or can be applied as the coverage is developed. Be bold, go ahead and write something, either add it to the article, or if you want additional input, put a draft here on the talk page. You might also find the references I mentioned under the addition of costs discussion interesting.

As to being optimal for the poor - IUD is one of the better methods regardless of economic status. Problem for poor can be high up-front costs. (Need to provide mechanisms to make initially affordable.) Zodon (talk) 01:17, 27 February 2012 (UTC)

I'd research papers to cite, but planned parenthood should suffice. I'll try to get the title to show first (before the hyperlink) in the reference tomorrow.32cllou (talk) 06:32, 27 February 2012 (UTC) I shouldn't have copied simplistic (and not recommended) examples. Using the template filling utility was a good recommendation. Thanks Zodon.32cllou (talk) 06:55, 27 February 2012 (UTC)

Your welcome, glad it helped.

I removed part of the material on US government subsidies (below) because it doesn't seem germane to the comparison. Wikipedia is worldwide, not US specific, so need to be clear when using examples what country dealing with, and to not assume that readers are in US. I think coverage of subsidies for particular methods more apropos in either the method article itself, or in articles about Family planning in the United States (no, as far as I know that doesn't exist, but some day.)

U.S. Department of Health and Human Services clinics may offer subsidized IUD birth control protection.

More apropos here might be more general observation that many governments and insurers subsidize costs. Zodon (talk) 06:27, 28 February 2012 (UTC)

Can I add that observation above to the subject, and cite the USHRCA as an example?32cllou (talk) 18:42, 28 February 2012 (UTC)

References

Electronic devices

There is no mention of these which have been available for more than 10 years ! http://www.persona.info/uk/how_does_work.php They're called Clearblue in the USA, we have them here in the UK, so why no mention? Has no-one heard of them? more info here http://uk.clearblue.com/persona They're officially called contraception monitors research link here http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3017256/ — Preceding unsigned comment added by Veryscarymary (talk • contribs) 19:00, 24 December 2015 (UTC)

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Placebo

What the hell is going on with the placebo statistic?

I can't access the full article, but just reading the abstract made no sense. It says that the women who were on this placebo *wanted* children, so I don't understand why they would be on the birth control in the first place. Furthermore, a value of 203.8 seems to mean that on average every woman got pregnant twice a year while on the placebo. That's just seems nonsensical to me. Am I misreading something? Can someone check out the full article and find out what's going on? It's published in a reputable place, but the article just seems to make no sense. — Preceding unsigned comment added by 2601:192:4800:5D77:8CC4:2567:56D0:C4A0 (talk) 21:07, 25 May 2018 (UTC)

I looked into this some more, and the 203.8 makes sense as a pearl index, because the study was run for about 3 months. I still don't understand the fact that the women being studied *wanted* to get pregnant. — Preceding unsigned comment added by 2601:192:4800:5D77:8CC4:2567:56D0:C4A0 (talk) 02:20, 27 May 2018 (UTC)

Agreed; this source completely fails verification. I would assume that the rate is actually closer to or equal to "no birth control". I've removed the entry as such. Casspedia (talk) 22:23, 1 July 2021 (UTC)

Coitus reservatus

Coitus reservatus should be added. Doyna Yar (talk) 23:44, 30 June 2021 (UTC)

I'm not sure if any sources exist containing failure rates for this method. If there is one, it could be used in order to add the information into the table. If not, it might be comparable to withdrawal (risk coming from pre-ejaculate fluid), but Wikipedia isn't a big fan of original research. Casspedia (talk) 02:48, 17 July 2021 (UTC)

The Effectiveness Section seems to be highly misleading to the general public despite being correct

Even though this Article is very correct in the way it presents the studies, the gist most people are taking from here seems to be that using a condom and pulling out carry the same risk of unwanted pregnancy. Which is not what it says, but nonetheless "failure rate" seems to suggest to the careless reader that it reflects the risk of using one method over another on a single case of intercourse. I see it on social media all the time and I don't think this is a topic where wikipedia should be careless about how it presents data that can change the life planning of a lot of people. Is there a way to make the limitations of what the %-value actually tells you about effectiveness more obvious to the careless skimmer of this acticle? Atanar (talk) 01:06, 5 February 2022 (UTC)

Added to Side Effect Section - Hormonal Side Effects

I decided to add 2 paragraphs about common hormonal side effects corresponding to different hormonal formulations to the "side effects" section. One paragraph for combined hormonal products and one for progestin only products just to give specific examples on what users may encounter while on the medication. AlphanMangos (talk) 05:43, 28 April 2022 (UTC)

Anyone else want to make a special request at GoCE? I'm maxed out.

The Guild of Copy Editors maintains a limit of two special requests per Wikipedian. I'm currently maxed out but I think this article clearly deserves priority attention due to the significance of its content. (It's also currently assessed as start class last I checked.) RadioactiveBoulevardier (talk) 12:08, 3 January 2023 (UTC)

Wiki Education assignment: PHMD 2040 Service - Learning Spring 2023

This article was the subject of a Wiki Education Foundation-supported course assignment, between 2 January 2023 and 30 June 2023. Further details are available on the course page. Student editor(s): Aharris13 (article contribs).

— Assignment last updated by JustinxLane (talk) 19:03, 2 June 2023 (UTC)