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Vasectomy Alternatives
Vasectomy, while highly effective, is also relatively final. The following chart is offered as a comparison of the alternatives.
Alternative Methods of Birth Control
| 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 |
| Essure® | Woman | Limited studies | ? | Early results show effectiveness similar to vasectomy. | Requires Hysteroscopy, Hysterosalpingogram and not rarely, repeat surgery. |
| 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 | Woman | .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.
