Talk:Comparison of birth control methods

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Contents 1 Scope of article 1.1 Lea's shield 2 Delete for now? 3 Effectiveness calculation 4 Never mind sex frequency

[edit] Scope of article

Is this page intended only to show effectiveness of various methods? Or is it envisioned to expand to compare other things such as side effects, convenience, etc.? Lyrl ^Talk _Contrib 01:29, 17 July 2006 (UTC)

I've no idea. Certainly original wording was of being a comaprison of risks, yet in fact only shows failure rates.

• In favour of more info would be that it becomes a quick ready-comprison chart (difficult to do if having to read through lots of separate full articles). But it needs to be brief, else will never fit on a page. Perhaps just using summarised info as currently found in the BirthControl infobox templates ? This articles title is about "comparison", not "relative contraceptive effectiveness rates".
• Against - It will end up duplicating info included already in each article (via the infobox template and the rest of the article's description). Unless extraordinary care is taken, the necessary crude summarisation (eg for COCP risks "DVTs") is so brief as to be lacking in balance (eg when the DVT scare came out about 3rd generation COCPs having higher rates of DVTs of 25-20 per 100,000 - those who immediately stopped, against media advice, and subsequently became pregnant through other-methods failures were at even higher risk rates of DVT of 60 in 100,000) - yet fuller explanations may end up getting too long to fit onto a single table in this page.

As the article/table stands at the moment, it would be a candidate for merger suggestion with Pearl index... David Ruben ^Talk 02:18, 17 July 2006 (UTC)

I have several concerns on the article in its current state.

• It only discusses Pearl Index method for calculating pregnancy rates. While a majority of studies use Pearl Index, many studies use life table rates that do not have some of the problems PI does.
• It makes birth control recommendations (via the color-coding).
  • An encyclopedia should not give medical advice.
  • The recommendations do not take into account individual characteristics (e.g. a person who can remember to use condoms at every act of intercourse, but can't remember to take a pill daily, could have a lower actual failure rate with condoms vs. pill - even though the perfect use rate of the pill is lower than that of condoms).
• It groups together a number of only very loosely related methods under Natural Family Planning. Observational and lactational methods should be broken apart from the Rhythm Method.

I also share David's concerns on duplicate information and summaries not giving the topic a good coverage. However, there did seem to be support for an article similar to this in the following discussing: Talk:Birth control#Effectiveness of birth control section Lyrl ^Talk _Contribs 22:16, 18 July 2006 (UTC)

[edit] Lea's shield

I have serious doubts about the failure rates associated with Lea's shield. I've read the FDA Summary of Safety and Effectiveness (http://www.fda.gov/cdrh/pdf/P010043b.pdf) and they talk about 9% and 14% rates (with and without spermicide). In fact, the low indexes I have found are at http://www.contraceptiononline.org/contrareport/article01.cfm?art=210, and they talk about 4 and 6%, but correcting the statistics because of a supposed bias associated with few nulliparous users. Anyway, it seems that till now the data is scarce, so if we choose to say 4% I would add a note about low sample used. --213.194.135.44 15:21, 5 August 2006 (UTC)saragc

[edit] Delete for now?

There seems to be very little interest in working on this page. I propose deleting it for now and concentrating on improving the birth control article. When that article has sufficient information to need a spin-off, I think we could re-create a much better version of this page. Lyrl ^Talk _Contribs 01:33, 25 July 2006 (UTC)

No - I really like the list for allowing comparison of effectiveness rates and banding into highj/medium/low effectiveness rates (agree "not recomended" is poor phrasing in an encyclopedia), just not sure if article title correctly reflects the current content (vs perhaps Comparison of birth control effeciveness or better Birth control (effectiveness)) or whether table should be expanded to meet full meaning of article title (i.e. other comparisons than just effectiveness - various approaches as previously discussed but no consensus on). Likewise table as it currently stands best here or in Pearl index article. If we can get a few more editors to suggest where we go from here than perhaps can tag article, vote/consensus and make a change. But work-in-progress, even if goal not entirely clear is not a reason for deletion; well perhaps it is if one is a deletionist, but I'm more a weak inclusionist :-) David Ruben ^Talk 02:06, 25 July 2006 (UTC)

Comment - I'm the original author of the page, so I won't take a stance here :-) . I'd just like to clarify that I compiled it simply because I wished to see an overview of birth control methods by using some information from the "fact boxes" on most of the birth control method articles here as a base. That way, I figured me and others could avoid navigating through dozens of articles if just being on the look after basic facts and references. I now understand the problem with heavily summarizing the subject, but if it helps to include other measures for efficiencies and other important properties, I'm all for including such here. My intended scope was anyway just that; a side-by-side overview of the "fact" boxes on most of the birth control articles. If another article covers such a summary, I admit this may not fill much use. If not, I believe it does, but feel free to vote it away if you feel like. ;-) I'd hope for people to do consider fixing it up if merely finding it to be lacking, though. I am in no way an expert on sexuality matters, so maybe I had no clear view of what's important, and you do. -- Northgrove 21:31, 9 August 2006 (UTC)

One more thing, the Pearl Index used was simply chosen because it seemed to be most prevalent and easiest to find agreeing figures on from various sites, as well as being formerly documented well on Wikipedia. I applied no thought to the PI itself and its accuracy when using it. -- Northgrove 21:40, 9 August 2006 (UTC)

Merge - I would suggest merging it with Birth Control. Also, I think that maybe it's ok to stick with colors and ranges, but not with labels "high/low", because I think that is quite subjective, isn't it? It strikes me as odd to have withdrawal as a low risk method, together with condoms, for instance. And I would suggest also to use the same source for all the failure rates of the different methods, for instance the ones given by FDA. In this way, it doesn't matter so much the accuracy of the data, because you can always make a comparison between them. If we use different sources, this can be seriously distorted. 81.32.8.78 20:10, 12 August 2006 (UTC)saragc

i vote for a merge with pearl index, as it's stubby and this article is only a comparison of effectiveness of different forms of birth control. i think there is no way to concisely summarize the comparative risks of bc in tables/boxes in an informative way. all the risks are too complicated, too enmeshed in controversy and opinionated risk-benefit calculations. plus, the categories bear comparison to each other, and then methods within categories bear comparison to each other--bc doesn't lend itself to a handy pocket guide/simple comparisons or decisions, i don't think... Cindery 22:13, 6 September 2006 (UTC)

[edit] Effectiveness calculation

The stats are presented as "chance of getting pregnant in a year". As well as being dependant on the method, this obviously depends on how many times you have sex during the year. Is there a standard assumed in these stats? Any allowance for variance of frequency around the menstrual cycle? It would be nice to be able to say, if you have sex once, using method X, at point Y in the cycle, the chance of pregnancy is 1 in n. The small amount of info about "Effectiveness calculation" suggests the stats are not that precise and simply based on a sample of couples in a marriage-like relationship who reported back at the end of the year. I might hazard a guess that such couples average 2 or 3 times a week. Clearly, your mileage will vary if you're at it twice a day, or twice a year for that matter. However, sociologically, the numbers for a per-copulation rate would be so small people could be misled into thinking them negligible. Suppose a method has a 10% annual failure, based on say 120 copulations per annum. Some arithmetic leads me to a per-copulation failure rate of under 1-in-a-thousand. A lot more people would take those odds. jnestorius^(talk) 07:55, 27 January 2007 (UTC)

Pregnancy rates based on where a woman is in her menstrual cycle are discussed at fertility awareness. During the least fertile portions of the menstrual cycle, couples could go twice a day or more and have a less than 1% chance of pregnancy per year. On the most fertile day, a single act of intercourse results in pregnancy about 2/3 of the time. This is a huge variation in fertility. Combined with the fact that most women do not track their fertility signals, I believe that makes any "sex per year" stats completely useless for birth control purposes. I think we're stuck with the "couples reporting back at the end of the year" method (though note actual studies typically have followup at least monthly). Lyrl ^Talk _C 15:50, 27 January 2007 (UTC)

[edit] Never mind sex frequency

The failure rates reported here don't take sex frequency into account. They are based on how many women (in real life) become pregnant during a year, when using certain forms of contraception. They therefore don't represent absolute truths about the chance of getting pregnant. Instead, these failure rates indicate the chance of getting pregnant during 'typical use', compared to all the women in the studies that were taken into consideration. If your sex life resembles the 'typical sex life' of these women, your chance of getting pregnant during one year's use of a particular method will be the same as reported here.

NB Recent Dutch research showed about 60% of people in a steady relationship had sex once a week or less. 'Typical use' is therefore probably not based on 120 occurrences of intercourse. Not in the Netherlands anyway... —The preceding unsigned comment was added by 193.67.185.234 (talk) 16:06, 23 February 2007 (UTC).