Birth control pills vs. condoms: What's the difference?

What are birth control pills? What are condoms?

Birth control pills (oral contraceptives) are a type of birth control that contains hormonal preparations and are used to prevent pregnancy. Birth control may contain combinations of the hormones estrogen and progestin or progestin alone. Combinations of these hormones prevent pregnancy by stopping the release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) from the pituitary gland in the brain. LH and FSH are key to the development of an egg and in the preparation of the lining of the uterus for implantation of the embryo. Progestin also causes the uterine mucus that surrounds the egg to become harder for sperm to penetrate which makes it more difficult for fertilization to take place. Progestin can also inhibit ovulation (release of an egg).

Condoms are a type of birth control that in addition to preventing pregnancy also prevent the spread of STDs. There are two types of condoms, the male condom and the female condom. The male condom, or "rubber," is a thin covering made of latex, plastic, or animal membrane that is rolled over an erect penis. The covering prevents semen, the fluid that contains sperm, from entering a woman's vagina. Latex condoms are the most effective condom at preventing STDs, while condoms made of animal membranes (lambskin) do not decrease the spread of many sexually transmitted diseases. The female condom is a lubricated polyurethane (plastic) tube that has a flexible ring at each end. One end of the tube is closed. Before sexual activity, a woman inserts the condom into the vagina so the closed end of the tube covers the cervix, and the other end slightly covers the labia. The condom blocks sperm from entering the womb.

QUESTION

Which of the following are methods for contraception? See Answer

What are the side effects of birth control pills and condoms?

Birth Control Pills

The most common side effects of the birth control pills include nausea, headache, breast tenderness, weight gain, irregular bleeding, and mood changes. These side effects often subside after a few months' use. Scanty menstrual periods or breakthrough bleeding may occur but are often temporary, and neither side effect is serious. Women with a history of migraines may notice an increase in migraine frequency. On the other hand, women whose migraines are triggered by fluctuations in their own hormone levels may notice improvement in migraines with oral contraceptive use because of the more uniform hormone levels during oral contraceptive use.

Uncommonly, oral contraceptives may contribute to increased blood pressure, blood clots, heart attack, and stroke. Women who smoke, especially those over 35, and women with certain medical conditions, such as a history of blood clots or breast or endometrial cancer, may be advised against taking oral contraceptives, as these conditions can increase the adverse risks of oral contraceptives.

Condoms

There are several reasons why a male condom would break:

  • Condoms too old. Modern condom wrappers have a date after which the condom should not be used.
  • Improper storage. Heat damages latex condoms, so they should not be kept in a hot place, such as a car glove compartment or wallet.
  • Not enough lubrication. Additional lubrication is always needed for rectal sex. It may also be needed for vaginal sex. The lubricant should be water-soluble, such as KY jelly.
  • The wrong kind of lubricant. Lubricants that contain oil -- such as Vaseline, baby oils and vegetable oils -- should not be used with latex condoms since they weaken the rubber.
  • Condom too small. Try a larger size.
  • Partner too tight. Use an extra strength condom and more lubricant.

A condom may come off during sex because:

  • Condom too large. Try a snug condom.
  • Loss of erection. Remove your penis, holding on to the rolled edge of the condom, as soon as you begin to lose your erection.

How do you use birth control pills vs. condoms?

Birth Control Pills

Many of the birth control pills come in easy-to-use dispensers in which the day of the week or a consecutive number (1, 2, 3, etc.) is written on the dispenser with a corresponding tablet for each day or number.

For example, some Ortho-Novum dispensers are labeled "Sunday" next to the first tablet. Thus, the first tablet is to be taken on the first Sunday after menstruation begins (the first Sunday following the first day of a woman's period). If her period begins on Sunday, the first tablet should be taken on that day.

For birth control pills that use consecutive numbers, the first tablet (#1) is taken on the first day of the menstrual period (the first day of bleeding). Tablet #2 is taken on the second day and so on.

Still other packages instruct women to begin on day five of the cycle. For such products, women count from day one of their menstrual cycle (day one is the first day of bleeding). On the fifth day, the first tablet is taken. Tablets then are taken daily.

Most birth control pills are packaged as 21-day or 28-day units. For 21-day packages, tablets are taken daily for 21 days. This is followed by a seven-day period during which no birth control pills are taken. Then the cycle repeats.

For the 28-day units, tablets containing medication are taken for 21 consecutive days, followed by a seven-day period during which placebo tablets (containing no medication) are taken.

Newer formulations with 24 days of hormone pills and only four days of placebo pills are now available, as are continuous or extended-cycle oral contraceptive regimens, in which only active hormone pills are taken. Extended-cycle preparations include seven-day intervals of placebo pills to be taken approximately every three months.

Women just starting to take birth control pills should use additional contraception for the first seven days of use because pregnancy may occur during this period.

If women forget to take tablets, pregnancy may result. If a single tablet is forgotten, it should be taken as soon as it is realized that it is forgotten. If more than one tablet is forgotten, the instructions that come with the packaging should be consulted, or a physician or pharmacist should be called.

Condoms

Take caution when opening the wrapper to avoid tearing the condom with your teeth, fingernails or rings. Gently pinch the air out of the tip of the condom before putting it on. The condom is rolled over the erect penis before sexual activity begins. If the condom does not have a built-in nipple, leave about 1/2-inch of the condom free at the tip of the penis so that semen has a place to collect.

A new condom must be used each time you have sex. The condom must be in place before the penis gets near the vagina. If you use lubricants with a condom, be sure to only use water-based lubricants, such as K-Y Jelly. Oil-based lubricants, such as Vaseline, massage oils and body lotions can cause condoms to leak or break. Certain vaginal medications used to treat yeast infections can also weaken condoms.

Initially it was felt that condoms lubricated with spermicidal agents offered more protection against STDs. Newer studies show that frequent use of condoms containing spermicides offers no additional protection and it may actually increase the risk of HIV and other STDs by irritating the vagina and penis. Spermicidal products do however remain useful in pregnancy prevention.

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What drugs interact with birth control pills and condoms?

Birth Control Pills

Estrogens can inhibit the metabolism (elimination) of cyclosporine, resulting in increased cyclosporine blood levels. Such increased blood levels can result in kidney and/or liver damage. If this combination cannot be avoided, cyclosporine concentrations can be monitored, and the dose of cyclosporine can be adjusted to assure that its blood levels do not become elevated.

Estrogens appear to increase the risk of liver disease in patients receiving dantrolene (Dantrium) through an unknown mechanism. Women over 35 years of age and those with a history of liver disease are especially at risk.

Estrogens increase the liver's ability to manufacture clotting factors. Because of this, patients receiving warfarin (Coumadin) need to be monitored for loss of anticoagulant (blood thinning) effect if an estrogen is begun.

A number of medications, including some antibiotics and antiseizure medications, can decrease the blood levels of oral contraceptive hormones, but an actual decrease in the effectiveness of the oral contraceptive has not been convincingly proven. Nonetheless, because of this theoretical possibility, some physicians recommend backup contraceptive methods during antibiotic use. Examples of medications that increase the elimination of estrogens include

Birth control pills with higher concentrations of estrogen or alternative forms of contraception may be necessary in women using those medications.

Condoms

If you use lubricants with a condom, be sure to only use water-based lubricants, such as K-Y Jelly. Oil-based lubricants, such as Vaseline, massage oils and body lotions can cause condoms to leak or break. Certain vaginal medications used to treat yeast infections can also weaken condoms.

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Are birth control pills and condoms safe to use while pregnant or breastfeeding?

Birth Control Pills

Use of birth control pills during lactation has been associated with decreased milk production, decreased infant weight gain, and decreased nitrogen and protein content of milk. The amount of estrogen consumed by an infant whose mother takes a standard dose of birth control pills is considered to be the same as from a lactating woman who is not taking birth control pills, and side effects have not been reported. Using a progestin-only product is most often recommended during lactation if birth control pills are to be used during this period. The American College of Obstetrics and Gynecology (ACOG) recommends delaying taking combined estrogen-progestin contraceptives until at least six weeks postpartum, while the World Health Organization (WHO) recommends delaying the initiation of combined contraceptives until six months.

Condoms

Condoms (both male and female) have no effect on fetuses or on the breast milk of nursing mothers.

Summary

Birth control pills (oral contraceptives) and condoms are methods of birth control used to prevent pregnancy. Birth control pills are taken orally and are used by women only. Condoms are worn externally and there are condoms for both males and females.

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Medically Reviewed on 5/31/2019
References
FDA Prescribing Information

Source for condom information is the American Social Health Association. The Female Health Company.

Martin, MD, Kathryn A and Pamela S Douglas, MD. Risks and side effects associated with combined estrogen-progestin oral contraceptives. 27 June 2018.
<https://www.uptodate.com/contents/risks-and-side-effects-associated-with-combined-estrogen-progestin-oral-contraceptives?search=birth%20control%20cause%20deep%20vein%20thrombosis&source=search_result&selectedTitle=3~150&usage_type=default&display_rank=3#H11>.

National Heart, Lung, and Blood Institute. Venous Thromboembolism. 2018. 31 July 2018
<https://www.nhlbi.nih.gov/health-topics/venous-thromboembolism>

National Women's Health Network. Hormonal Birth Control and Blood Clot Risk. 2018.
<https://nwhn.org/hormonal-birth-control-blood-clot-risk/>

NHS Choices. Deep vein thrombosis. 27 April 2016.
<https://www.nhs.uk/conditions/deep-vein-thrombosis-dvt/complications>

North American Thrombosis Forum. Birth Control: What You Need to Know. 31 July 2017.
<https://natfonline.org/2017/07/birth-control-need-know/>

<University of Colorado OB/GYN & Family Planning . Blood Clots & Birth Control. 2018.
<https://obgyn.coloradowomenshealth.com/health-info/birth-control/medical-conditions-birth-control/blood-clots>
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