Broken Condom? Birth Control Options and Failure Rates Explained

DrSugar Answers: OMG! Am I Pregnant?

DrSugar is in the house! And she's answering your health-related questions.

OK FitSugar readers, this week’s column is not based on a single reader’s question. Instead it is going to be a broad, general answer to the vast amount of questions regarding sex, contraception, and pregnancy we here at Sugar get on a rather routine basis. Most questions that we receive are along the lines of: "I'm not on birth control and had unprotected sex, am I pregnant?" or "We used a condom, but it broke . . . am I pregnant?" This column deals with sex, common types of contraception and their failure rates, and how to avoid unplanned pregnancies. If you have ever ended up in a tricky situation after having sex, keep on reading.

Unprotected sex or sex without any type of contraceptive can lead to pregnancy. The only surefire way to not get pregnant is abstinence. For those who choose not to abstain from sex, the only way to decrease your chances of getting pregnant is to choose a form of contraception. According to the US Department of Health and Human Services, there are two primary types of contraception: hormonal (prevents females from releasing eggs) and barrier (keeps sperm from reaching the egg). A third and less common type of contraception is chemical and this type creates a reaction in the body that reduces the chance that a sperm will connect with an egg.

The most common types of hormone contraceptives are the birth control pill, DepoProvera injections, emergency contraceptives (i.e. morning-after pill), the birth control patch, and the birth control vaginal ring. Barrier methods of contraceptives include: male condom, female condom, cervical cap, diaphragm, spermicides, and contraceptive sponge. The only type of chemical contraceptive is the intrauterine device (IUD). There are other forms of "contraception," but these fall into the category of "other" as they do not involve any form of barrier or hormone. The "other" contraceptive methods are the withdrawal method (male removes penis from vagina before ejaculation) and natural family planning (also known as the rhythm method), which involves avoiding sex near the time of ovulation.

Clearly, there is a vast array of choices when it comes to contraception. One of the things that sets the different types of contraception apart is their failure rates. The American Congress of Obstetricians and Gynecologists has a fantastic table and website dedicated to the types of contraceptives and their respective failure rates. The failure rates listed are the annual rates for pregnancy for each type of contraceptive and are representative of "typical use." Typical-use failure rates are based on how the contraceptive is usually used, not on perfect use. This means that the method was not always used correctly or not used with every act of sexual intercourse, or was used correctly but failed anyway. Here are some of the common contraceptives and their typical-use annual failure rates: male condom (15 percent), IUD (0.2-0.8 percent), birth control pills/patch/ring (eight percent), morning-after pill (11-25 percent) DepoProvera (three percent), spermicides (29 percent), diaphragm (16 percent), withdrawal method (27 percent), and rhythm method (25 percent). Without using any method at all for one year, 85 percent of women would get pregnant.

I must say, the typical-use failure rates were pretty alarming the first time I saw them! But you have to realize that they do not account for perfect or correct use (which would lead to a much lower failure rate), or if one uses multiple forms of contraceptives (which would also lead to a lower failure rate depending on which forms are used). When it comes down to it, the best way to prevent unplanned pregnancy is to use at least one form of contraceptive each and every time you have sex. But this is not enough . . . you have to use the contraceptive the correct way every time you use it. For birth control pills, this means taking it at the same time every day and not missing any doses. For condoms, it means putting it on correctly every single time.

Unfortunately, even when taken or used perfectly, there is still a chance of becoming pregnant if you are having sex! I have no way of knowing if all of our readers are pregnant based on all the questions and messages we get. It’s simple: ANY act of unprotected sex (meaning without barrier, hormone, or chemical contraception) can lead to pregnancy. Even if you are using contraception, you can still get pregnant. The only way to make sure you do not get pregnant is to not have sex. If you fall into the first two categories above and you do not get your period, have pregnancy symptoms or signs, or think you could be pregnant, take a pregnancy test or call your primary care provider. As much as I would love to reassure each and every one of the people who message us about failed contraception or lack of contraception, I simply cannot. Hopefully the information I’ve provided will help readers to make smart and proactive choices regarding contraception, thus decreasing the risk of unplanned pregnancies through education!

Have a question for DrSugar? You can send it to me via private message here, and I will forward it to the good doctor.

DrSugar's posts are for informational purposes only and should not be considered medical advice, diagnosis, or treatment recommendations. Click here for more details.

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