Have questions about birth control? David Mellinger, associate director and chief physician in Student Health Services, has answers.

On the Washington University campus, Mellinger said that the three most effective birth control methods, as well as most popular, are the Depo Provera injection system, oral contraceptive pills and male condoms.

At the same time, there are other types of birth control that students do not know about and thus do not use as frequently, such as the diaphragm, NuvaRing and intrauterine devices (IUDs). Mellinger highlighted some common misconceptions about contraceptives and provided some tips about the use of contraceptives.

Of the three primary contraceptives on campus, the most effective is Depo Provera, which involves a series of muscular injections containing the hormone progestin given to women once every 10 weeks. The hormone, according to Mellinger, prevents women from ovulating and thus greatly reduces the likelihood of conception.

“It’s not possible to not use it properly; in other words, if you get the shot and have the shot on a regular basis, it will be very effective in preventing pregnancy,” said Mellinger.

Depo Provera carries a 0.3 percent perfect use failure rate, meaning that if used properly for a whole year, 0.3 percent of couples can expect an accidental pregnancy. Women students can receive these injections at the Habif Health and Wellness Center.

Like Depo Provera, oral contraceptive pills, which contain progestin and estrogen, also inhibit ovulation and are very effective, carrying a use failure rate between 0.1 and 0.5 percent.

Male condoms, on the other hand, carry a higher risk of pregnancy with a 3 percent failure rate, but women who wish to avoid the potential side effects of medical contraception find them to be an attractive option, even if that means sacrificing some pleasure.

However, Mellinger warned that these failure rates apply to situations in which the aforementioned contraceptives are used properly. Realistically, students may not always use them properly, meaning that in many cases the actual risk of accidental pregnancy is higher. Condoms, with a risk of rupturing or failing to adequately prevent the travel of sperm, carry a typical use failure rate of about 14 percent. Oral contraceptive pills have a typical use failure rate of 5 percent.

A relatively new form of contraception, known as the NuvaRing, has become somewhat known at the University as well. A small ring that is inserted into the vaginal canal, it uses a special timed release formula of estrogen and progestin.

“It releases the same sorts of hormones as you would get with a birth control pill, but it has a lower amount of estrogen, and you just replace it once a month,” said Mellinger. “And it’s a very popular option on campus.”

Other forms of effective contraception are less prevalent at the University because of slight inconveniences to the users. IUDs, though a viable alternative, are not popular at the University. In addition to requiring a visit to the doctor to implant the device within the uterus, it remains in the uterus for prolonged periods of time.

“There’s some hesitation in using it in a person who hasn’t been pregnant yet,” said Mellinger.

Diaphragms and cervical caps are devices that cover the opening of the cervix, preventing sperm from reaching the ovum. Despite being effective, Mellinger said that many students do not use them.

“A lot of people don’t like to use them because, for example, they have to be inserted and taken out within a certain time period, and you have to use them in combination with a spermicidal product,” he said. “Some of them, if you’ve had multiple sexual contacts within a few hours, even with the same person, you would have to inject more spermicide.”

Mellinger also noted that female condoms, though also very effective, are not popular, despite an added benefit that they carry. “The only two [contraceptives] that have significant effect on decreasing transmission of sexually transmitted infections are the barrier methods, which are the male condom and the female condom, because they stop the exchange of bodily fluids through which these organisms often times are transmitted,” he said.

At the same time, however, Mellinger warned about a popular misconception. Even condoms might not prevent all sexually transmitted infections (STI’s) from being transmitted, particularly skin infections. “If you have areas that are not covered by the condom, you can still transmit something like genital warts,” he said.

For students who try to avoid transmitting STI’s through intercourse by having oral sex, Mellinger also cautioned that oral genital contact can transfer STI’s, the most common of which is the herpes simplex virus one, the same virus that causes cold sores.

While many women may panic if they accidentally miss one dose of a birth control pill or fail to take the pill at the same time every day, Mellinger explains that one missed dose is not a cause for panic. “We actually know that if they miss a pill, it’s not that big of a deal,” said Mellinger. “We tell them to take two the next day.”

Mellinger also had some advice to give to sexually active students. He first warned students against relying too much on emergency contraception, because it carries a relatively high perfect use failure rate of 18 percent. “If you are using emergency contraception, it should not be your primary mode of contraception,” he said. “It’s certainly safe and is surely effective, but it is not to be used for the long term.”

Many female students are reluctant to use oral contraceptive pills because of the risk of weight gain. However, most women typically do not gain much weight when using the pills, and Mellinger said that keeping off a few extra pounds is not worth the added risk of pregnancy.

“There may be a small amount of weight gain that is associated with it, perhaps three pounds,” he said. “But I would not use that as a reason not to get started on the oral contraceptive.”

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