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Family Planning: A Global Handbook for Providers

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Family Planning

A GLOBAL HANDBOOK FOR PROVIDERS

Comparing Contraceptives

Comparing Combined Methods

Characteristic Combined Oral Contraceptives Monthly Injectables Combined Patch Combined Vaginal Ring
How it is used Pill taken orally. Intramuscular injection. Patch worn on upper outer arm, back, abdomen or buttocks. Not on breasts. Ring inserted in the vagina.
Frequency of use Daily. Monthly: Injection every 4 weeks. Weekly: Patch is changed every week for 3 weeks. No patch worn 4th week. Monthly: Ring kept in place for 3 weeks and taken out during 4th week.
Effectiveness Depends on user's ability to take a pill every day. Least dependent on the user. User must return to clinic every 4 weeks (plus or minus 7 days). Requires user's attention once a week. Depends on user keeping the ring in place all day, not leaving it out for more than 3 hours at a time.
Bleeding patterns Typically, irregular bleeding for the first few months and then lighter and more regular bleeding. Irregular bleeding or no monthly bleeding is more common than with COCs. Some also have prolonged bleeding in the first few months. Similar to COCs, but irregular bleeding is more common in the first few cycles than with COCs. Similar to COCs, but irregular bleeding is less common than with COCs.
Privacy No physical signs of use but others may find the pills. No physical signs of use. Patch may be seen by partner or others. Some partners may be able to feel the ring.