SIDEBAR: How FDA-approved contraceptive methods work

January 28, 2014

WASHINGTON — The Affordable Care Act’s contraception mandate specifies women should be offered insurance coverage with no co-payment for all contraceptive methods approved by the Food and Drug Administration.

An FDA web site explains the four major methods of contraception and how they work.

Barrier methods

Prevent fertilization by blocking sperm before it can reach the egg. Examples: Condoms, sponges, spermicides used with a diaphragm or a cervical cap.

Hormonal methods

Work by “interfering with ovulation and possibly fertilization.” Examples include a skin patch, the vaginal ring, two types of pills and a shot:

* The “combined pill,” the patch and the ring each have two hormones (estrogen and progestin) that combine to prevent ovulation, and may also prevent sperm from reaching the egg.

* A progestin-only “mini pill” acts to keep sperm from getting to the egg. Less often, it stops ovulation.

* A progestin shot stops ovulation or prevents sperm from reaching the egg.

Implanted Devices

Inserted in the body, an intrauterine device (known as an IUD) or a contraceptive rod with progestin, work by preventing sperm from reaching or fertilizing the egg, and may prevent implantation.

Emergency contraception

Used within three days of unprotected sex, they come in two major forms:

* Plan B, Plan B One-Step and Next Choice (levonorgestrel) work mainly by preventing ovulation, preventing fertilization, or by preventing implantation.

* Ella (ulipristal acetate) works primarily by stopping or delaying ovulation. It may also prevent implantation.

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