Contraception Survey: Most US Women Try 3 or More Methods

Yael Waknine

February 14, 2013

Nearly 30% of American women have tried 5 or more methods of contraception, and they are increasingly using condoms and emergency contraception, according to 2 new reports published online February 14 by the National Center for Health Statistics, a division of the Centers for Disease Control and Prevention.

The findings are based on an analysis of data collected from 12,279 women aged 15 to 44 years during the 2006 to 2010 National Survey of Family Growth, which revealed that virtually all (99.1%) sexually experienced women have used some form of contraception in their lifetimes. Popular methods currently include the male condom (93.4%), the pill (81.9%), withdrawal (59.6%), and 3-month injectable contraception (23.2%), according to the first report.

Although women reported having tried a median of 3 methods over the years, 29% of those surveyed had tried 5 or more approaches to contraception.

The hormonal pill in its varied forms, although remaining popular among 82% of women since 1995, has been discontinued by 30% of users at some point because of adverse effects and related concerns (63% and 12%), menstrual cycle changes (12%), and method failure resulting in pregnancy (11%).

New hormonal alternatives were embraced as they became available: Use of injectable contraception, introduced in 1992, increased in popularity from 4.5% in 1995 to 23.2% in 2006 to 2010 and has been used 3 times more commonly in women lacking a high school diploma/general equivalency degree than those with a bachelor's degree. Top reasons for discontinuation have included adverse events (74.0%) and a dissatisfaction with menstrual cycle changes (30.5%).

Use of the contraceptive patch increased from 0.9% in 2002 to 10% in 2006 to 2010, and the contraceptive ring (first included in the 2006 - 2010 poll), has been used by 6.3% of women. Although reasons for discontinuation mimic those associated with the pill (adverse effects, 44.7%; related concerns, 8.6%), difficulty with use (11.1%), efficacy concerns (9.3%), and method failure (9.3%) are also common.

Intrauterine device (IUD) use has varied over time, declining from 1982 (18.4%) through 2002 (5.8%) and then increasing from 2002 to 2010 (7.7%), when the hormonal IUD became an option. IUDs have been particularly popular among foreign-born Hispanic women, who are up to 3 times more likely to use this method of contraception than all other groups (20% vs 7.6% for US-born Hispanic women; white, 6.8%; black, 5.5%; Asian, 4.6%).

Spermicidal and interim methods such as the diaphragm, cervical cap, sponge, female condom, and foams/jellies/suppositories have either declined in popularity or remained infrequently used.

Survey results also revealed an increase in condom use from 52% in 1982 to 82% in 1995 and then 93.4% in 2006 to 2010, perhaps reflecting an increased awareness of the risk for transmission of HIV/AIDS and other viruses and a willingness to use this method despite the increasing availability of different hormonal options and common objections such as decreased sexual pleasure (43.0%), partner dislike (41.1%), and fear of method failure (16.9%).

Interestingly, use of condoms and withdrawal methods increased in tandem: 60% of partners who used a condom within the survey interview month had also used withdrawal, which was least popular among partners of foreign-born Hispanic women (44% vs 60% for US-born Hispanic; white, 64%; and black, 55%).

Since it became available in 1998, the popularity of emergency contraception has increased, going from 4.2% in 2002 to 10.8% in 2006 to 2010, at which point roughly 11% (5.8 million) of sexually experienced women aged 15 to 44 years reported having used the method.

Emergency contraception has been particularly popular among young adults aged 20 to 24 years, according to the second publication: 23% vs 16% for age 25 to 29 years, 14% for age 15 to 19 years, and 5.0% for age 30 to 44 years. It is also popular among those who have never been married or have a live-in partner (19% and 14% vs 5.7% for those currently/formerly married) and among white and Hispanic women (both 11% vs 7.9% for black women).

Most women used the emergency measure once (59%) or twice (24%) vs 17% for 3 or more times, and did so because they feared that their primary contraceptive method had failed (45%) or because they had unprotected sex (49%). Fear of failure varied with age, remaining stable from age 15 to 29 years (34%, 41%) and then increasing from age 30 to 44 years (52%).

Other factors for emergency contraceptive use included race/ethnicity (white, 53%; black, 27%; Hispanic, 33%) and education: Emergency contraception was more than twice as popular among women with a bachelor's degree or more compared with those lacking a high school education/general equivalency degree (58% vs 26%).

"Contraceptive Methods Women Have Ever Used: United States, 1982–2010." National Health Statistics Reports. Centers for Disease Control and Prevention. Full text

"Use of Emergency Contraception Among Women Aged 15–44: United States, 2006–2010." National Center for Health Statistics Data Brief. Centers for Disease Control and Prevention. Full text