Birth Control Options

Birth control (also called contraception) helps prevent pregnancy. There are many different types of birth control. All methods have pros, cons and side effects. Birth control is only effective when it’s used correctly.

Pregnancy can happen any time you have sex without birth control. Using birth control can help prevent pregnancy if you’re not planning to have a baby. A healthcare provider can help you pick a type based on your lifestyle, health history and desire to have children in the future.

How does it work?

Different types of birth control work in different ways, including:

• Stopping sperm from reaching an egg
• Stopping your ovary from releasing an egg
• Damaging sperm so it can’t swim to an egg
• Thickening your cervical mucus so sperm can’t get through
• Changing the lining of your uterus so an egg can’t implant

How do I choose a type of birth control?

It's a personal decision, but your healthcare provider can help you. Think about these factors:

• Ease of use
• Effectiveness at preventing pregnancy (with correct use)
• Protection from sexually transmitted infections (STIs)
• Side effects or risks
• Plans for children
• How often you have sex
• Your age and overall health
• Privacy (if you want to keep it a secret)
• Other benefits, like lighter periods or less cramping

What are the main types of birth control?

The main birth control methods are:

• Barrier methods: These stop sperm from reaching an egg. You use them each time you have sex. Some also help protect against STIs.
• Hormonal medication and devices: These use hormones to prevent ovulation or make it hard for sperm to reach an egg.
• Intrauterine and implantable devices: Intrauterine devices (IUDs) and implants are long-acting birth control methods. They work for years without daily effort. They’re reversible.
• Sterilization: These methods involve surgery to prevent pregnancy. There are male and female sterilization methods. These are not meant to be reversible.
• Fertility awareness: Fertility awareness is a natural way to prevent pregnancy. It’s also called natural family planning.
• Withdrawal: This is sometimes called pulling out. It’s when a penis “pulls out” of a vagina before ejaculation.
• Emergency contraception: This is usually called the morning-after pill. You may use this type if your typical birth control method fails.
• Abstinence: This is not having sex at all to prevent pregnancy.

Talk to your partner and/or healthcare provider before you choose a method. Birth control is only effective if you use it the right way. No method is perfect. In most cases, you can change which type you use if you don’t like it.

Barrier methods

Barrier methods are better for protecting against STIs. But they’re usually easier to misuse. Examples of barrier methods are:

• Condoms: A condom is a latex sleeve you roll over an erect penis. It blocks sperm from entering the vagina. Condoms can break, rip and slip off. They’re about 85% effective when used correctly.
• Spermicide: This is a gel, cream or foam you put inside your vagina at least 15 to 30 minutes before sex. It contains chemicals that stop sperm from moving. People usually use it to make a barrier method more effective.
• Vaginal diaphragm: This is a small, flexible cup that you insert into your vagina before sex and remove afterward. You need a provider to fit it. It’s about 87% effective, and up to 94% effective when used with spermicide.
• Cervical cap: This is a thimble-shaped cup that fits over your cervix. A provider must fit you for one. It’s about 78% effective. But it can be 85% effective if you use it with spermicide.
• Internal condom: This type works like a regular external condom but goes inside the vagina. It’s about 80% effective.
• Sponge: A sponge is a small, donut-shaped device that contains spermicide. It’s between 76% and 91% effective at preventing pregnancy.

Hormonal medications and devices

These birth control methods use hormones to prevent pregnancy. They’re between 91% and 99% effective. Examples are:

• Birth control pills: Pills use hormones to prevent pregnancy. Most contain estrogen and progestin. Some only contain progestin (the minipill).
• Birth control shot: This is an injectable form of birth control. It’s a shot of progestin that you get every three months.
• Vaginal ring: This is a small, flexible ring that you insert into your vagina. It releases hormones to stop ovulation. You keep it in place for three weeks and remove it for one week.
• Birth control patch: This is a type of birth control that sticks to your skin. You wear it for three weeks and remove it for one week.

Intrauterine and implantable devices

These forms of birth control are typically most effective. This is mainly because they don’t require you to remember to use them. They're considered long-acting reversible contraception (LARC). Examples are:

• Birth control implant: This is a small, flexible rod that your provider places under the skin of your arm. It works for about three years.
• IUDs: An IUD is a small, flexible, T-shaped device that your provider puts in your uterus to prevent pregnancy. There are two types of IUDs: copper and progestin. They last between three and 12 years depending on the type.

Sterilization

Methods that involve sterilization are almost 100% effective in preventing pregnancy. But they’re mostly permanent. Options include:

• Salpingectomy: This is surgery to remove your fallopian tubes. This stops an egg from reaching your uterus.
• Tubal ligation: A tubal ligation blocks your fallopian tubes. A surgeon clamps, ties or blocks the tubes to prevent pregnancy.
• Vasectomy: This is a procedure to seal the vas deferens, the tubes that carry sperm. Pregnancy can’t occur without sperm.

Fertility awareness methods (natural family planning)

These methods don’t use medications or devices to prevent pregnancy. Instead, they rely on knowing your body and looking for signs of ovulation. You use this information to avoid sex on certain days. Natural family planning isn’t as effective at preventing pregnancy. Some examples are:

• Rhythm method: This form of birth control involves tracking your cycle on a calendar to predict ovulation.
• Cervical mucus method: This type involves looking for changes to the consistency of your cervical mucus. Thin, clear and stretchy vaginal discharge means you’re more likely to get pregnant.
• Basal body temperature: This involves taking your temperature before you get out of bed each morning. Your temperature rises after ovulation.

Pull-out method

Pulling out before ejaculation is hard to do and not very effective. Even a little bit of semen can cause pregnancy.

Emergency contraception

Morning-after pills can be up to 90% effective when taken within 72 hours (three days) after unprotected sex. Try to take them as soon as you can. The most effective morning-after pill contains ulipristal. It’s only available by prescription. Several over-the-counter brands are available and all contain levonorgestrel.

Abstinence

Abstinence is the only birth control that's 100% effective. It’s also the best way to protect yourself from infection. Don't let someone pressure you into having sex if you don't feel ready.

What are the most effective forms of birth control?

The most effective form of birth control is abstinence (not having sex at all). But this can be difficult.

Any form of birth control only works when you use it correctly. Methods that are easy to use and don’t need much effort are usually the most effective. For example, the birth control implant and intrauterine devices (IUDs) tend to be the most effective. Fertility awareness and pulling out are the least effective.

Using two types of birth control is often better than using only one — for example, using a condom and taking the pill. This helps prevent pregnancy and protects against STIs at the same time.

What is the best birth control with the least side effects?

Every method comes with its own side effects and risks. Condoms and diaphragms have fewer side effects. But they also aren’t super effective compared to other methods.

Don’t make a choice based on side effects alone. Choose a birth control based on effectiveness, risks and safety. Your healthcare provider can help you with this.

What is the best option to avoid weight gain?

The best birth control to avoid weight gain is usually a non-hormonal method, like condoms, a diaphragm or the copper IUD.

But most studies don’t show a definitive link between hormonal birth control and weight gain. The only exception is the birth control shot. On average, people gain around five pounds in the first year.

What is the healthiest option?

It depends on the person. Each type has its own side effects, risks and level of effectiveness. The healthiest type is the one that’s safe for you based on your health history and lifestyle. A healthcare provider can help you decide.

What are the least effective forms of birth control?

The least effective types are:

• Pull-out method
• Natural family planning (fertility awareness)
• Spermicide (when used alone)

Remember, all birth control methods can be ineffective when you don’t use them correctly.

Do the methods protect against sexually transmitted infections (STIs)?

The only form of birth control that protects against STIs are external (male) and internal (female) condoms.

Are there other good reasons to use birth control?

The main reason people use it is to prevent pregnancy. But there are also other reasons, including to:

• Help control or stop ovulation, including before IVF or other fertility treatments
• Improve symptoms of endometriosis and other hormone-related conditions
• Make periods lighter or less painful
• Help with certain health conditions, like acne or excess hair growth