Birth control is any medicine, device or method people use to prevent pregnancy. Types of birth control can include pills, intrauterine devices (IUD), vasectomy and condoms. Some forms of birth control work better than others.
What is birth control?
Birth control (also called contraception) is how you prevent pregnancy. There are many different types of birth control. Birth control only works when you use it correctly. Take the time to understand how each type of birth control works and how you use it.
If you're sexually active and don't want a baby, use birth control. A pregnancy can happen any time you have unprotected sex.
What birth control is best?
By learning more about birth control options, you can decide which method is best for you and your partner. Consider the following factors when making your decision:
- Ease of use or comfort level using the method.
- Effectiveness at preventing pregnancy (with correct use).
- Protection against sexually transmitted infections (STIs).
- Your age and overall health.
- Plans for pregnancy.
- Side effects or risks.
- How frequently you have sex or how many partners you have.
- Privacy (how important it is to keep your birth control method a secret).
- Other benefits like lighter periods or more predictable menstrual cycles.
How does birth control work?
Each form of birth control works slightly different. Some of the ways it works include:
- Preventing sperm from reaching an egg.
- Preventing your ovary from releasing an egg.
- Damaging sperm so it can’t swim to an egg.
- Thickening your cervical mucus so sperm can’t swim through it.
- Changing the thickness of your uterine lining so an egg can’t implant.
What are the most effective forms of birth control?
The most effective form of birth control is to not have sexual intercourse (abstinence). Even for the most motivated couples, this can be difficult to maintain. So, it’s important to have a backup form of birth control in mind.
Birth control only works when you use it correctly and consistently. Forms of birth control that are more convenient and don’t require much maintenance are usually most effective. These forms include the birth control implant, intrauterine devices (IUDs) and sterilization.
Methods of birth control like fertility awareness or pulling out are least effective at preventing pregnancy.
Doubling-up on birth control is typically best — like using a condom and a birth control pill. That’s because you’re protecting against STIs, using a barrier method, and taking hormonal medication all at the same time.
What are the types of birth control?
Before you choose a method, you should discuss birth control with your partner and your healthcare provider. Birth control methods are only effective if you use them properly. Make sure that you understand how to use the method you choose.
Birth control methods include:
- Barrier methods: Barrier methods block sperm from getting into your uterus. You use a barrier method each time you have sex.
- Hormonal medication and devices: These methods use hormones to prevent ovulation or change the conditions in your uterus and cervix. There are some hormonal medications that require daily use (short-acting) and others that your provider inserts into your arm or your uterus (long-acting).
- Sterilization: Surgery to permanently prevent pregnancy is sterilization. There are male and female sterilization methods.
- Fertility awareness: Fertility awareness uses natural methods to prevent pregnancy. This is also called natural family planning.
- Emergency contraception: Emergency contraception provides protection against pregnancy if your birth control fails. You can think of this like your last “safety net” against pregnancy.
- Abstinence: Refraining from sexual intercourse to prevent pregnancy.
There are many types of birth control and each form works a little different. Some types work better than others in preventing pregnancy.
Barrier methods
Condoms
What is it?
A condom is a thin covering made of latex, plastic or lambskin that is rolled over an erect penis. The covering prevents semen, the fluid that contains sperm, from entering your vagina. Condoms may tear or rip easily, making them less effective than other birth control methods.
How is it used?
A condom is rolled over an erect penis before sexual intercourse. Use a new condom every time you have sex.
How can I get it?
You can purchase condoms at most drug or grocery stores.
How effective is it?
Condoms are about 85% effective if they’re worn before intercourse begins and don’t rip.
What else should I know?
Even though they don’t provide 100% protection, condoms are one of the best options for protection against STIs. Use only water-based lubricants, such as K-Y Jelly® or Astroglide® with condoms. Oil-based lubricants (Vaseline® or baby oil) can cause condoms to break. If a condom breaks, you should consider emergency contraception.
Spermicide
What is it?
Spermicide is a gel, cream or suppository that prevents sperm from reaching an egg. It contains chemicals that damage sperm, so they can’t swim up to an egg. You must use spermicide exactly as directed for it to be effective. There’s also a prescription-only vaginal gel that works like a spermicide. It works by lowering the pH in your vagina, which makes it hard for sperm to swim.
How is it used?
You place spermicide and vaginal gels inside your vagina at least 15 to 30 minutes before sexual intercourse. Most spermicides work for about an hour before you need to reapply it. Reapply spermicide every time you have sex and don’t wash it out after sex.
How can I get it?
Spermicides are available at most drug or grocery stores. The vaginal gel that reduces pH (Phexxi®) is available with a prescription.
How effective is it?
If you use spermicide by itself, it’s only 70% effective in preventing pregnancy. If you use spermicide with another barrier method of birth control, it can be 94% effective. A vaginal gel (prescription only) is about 85% to 93% effective.
What else should I know?
Spermicide offers no protection against STIs. In fact, it may actually increase your risk. That’s because the chemicals in spermicide irritate your vagina and make it easier for infection to enter your body.
Diaphragm
What is it?
A vaginal diaphragm is a flexible, reusable dome-shaped cup that you place inside your vagina to prevent pregnancy. It stops sperm from getting into your uterus by blocking your cervix. You must use a water-based spermicide or contraceptive gel with a diaphragm.
How is it used?
A diaphragm looks like a small hat or cup. You bend it in half and slide it up into your vagina so it covers your cervix. Insert your diaphragm approximately one to two hours before sex. Remove it six to 24 hours after having sex. Add spermicide around the rim of the diaphragm before intercourse for maximum protection.
How can I get it?
Some diaphragms come in different sizes. It requires a visit to a healthcare provider for a pelvic exam so they can fit you for a diaphragm. Getting a properly-fitting diaphragm is important. If you lose or gain more than 10 to 15 pounds, a provider may need to refit your diaphragm. Other diaphragms, however, like the Caya® is a “one-size-fits-most” diaphragm and doesn’t require a fitting.
How effective is it?
Vaginal diaphragms are about 87% effective, but it can be as high as 94% effective when you use it correctly (with spermicide) and consistently.
What else should I know?
Using a diaphragm and spermicide doesn’t protect against some STIs, including HIV (the virus that causes AIDS).
Cervical cap
What is it?
A cervical cap is a thimble-shaped cup made out of silicone or soft rubber that fits snugly over your cervix.
How is it used?
First, coat the cap in spermicide. Then, insert the cap into your vagina and up against your cervix. The cap blocks your cervix, and the spermicide paralyzes the sperm. You can insert the cervical cap up to six hours before sexual intercourse. Don’t remove your cervical cap for at least eight hours after sex. The cap can be kept in place for up to 48 hours. Make sure to use spermicide exactly as directed.
How can I get it?
You must visit your healthcare provider and get a pelvic exam so that you can be fitted for a cervical cap. Like a diaphragm, it’s only effective when it fits properly.
How effective is it?
A cervical cap is about 78% effective at preventing pregnancy, but it can be 85% effective if you use it with a spermicide.
What else should I know?
Using a cervical cap and spermicide doesn’t offer as much protection against STIs as condoms.
Female condom
What is it?
A female condom is a lubricated plastic tube that has a flexible ring at each end. One end of the tube is closed.
How is it used?
Before sexual activity begins, insert the condom into your vagina so that the closed end of the tube covers your cervix, and the other end slightly covers your labia (the lips on the outside of your vagina). The condom blocks sperm from entering your uterus. You remove the condom immediately after sex.
How can I get it?
A female condom is available at drug and grocery stores without a prescription.
How effective is it?
About 21% of people get pregnant each year despite using a female condom.
What else should I know?
Female condoms provide some protection against STIs, but a male condom provides the best protection.
Sponge
What is it?
A vaginal sponge is a small, donut-shaped device that contains spermicide. It acts as a barrier between sperm and your cervix.
How does it work?
You wet the sponge with water, then place it into your vagina so it covers your cervix. Once it’s moist, it releases spermicide. The sponge contains enough spermicide to last about 24 hours. This means you can put it in up to 24 hours before you have sex. Always leave it in place for six hours after sex. You shouldn't leave a sponge inside your vagina for more than 30 hours.
How is it available?
The sponge is available without a prescription at most drug and grocery stores.
How effective is it?
A birth control sponge is between 76% and 91% effective at preventing pregnancy (depending on if you use it correctly). The sponge is also more effective if you've never given birth.
What else should I know?
The sponge is associated with higher rates of vaginal infections and doesn’t protect against STIs.
Hormonal devices
Birth control implant
What is it?
Nexplanon® is a small rod (the size of a matchstick) that your provider places under the skin of your upper arm. It delivers a steady stream of the hormone progestin and lasts about three years before it needs removed or replaced. Some people like the convenience of an implant because it requires little to no maintenance, doesn’t interfere with the spontaneity of having sex and can be kept secret.
How do doctors insert a birth control implant?
A healthcare provider inserts the implant in their office. First, they numb an area in the inside of your upper arm so you don’t feel pain. Then, they use an applicator to place the implant just underneath your skin. They cover the area with a bandage. A healthcare provider must remove your birth control implant (you can’t do it yourself).
How can I get it?
A healthcare provider must prescribe a birth control implant.
How effective is it?
Birth control implants are almost 100% effective. It’s the most effective form of reversible contraception available.
What else should I know?
Contraceptive implants come with risks and may not be right for you. The most common side effect of an implant is irregular bleeding, though the bleeding tends to be light. This typically improves after six to 12 months, but some people completely stop getting their periods. Other side effects include sore breasts and headaches.
Intrauterine device (IUD)
What is it?
An intrauterine device (IUD) is a small, flexible, T-shaped device you put in your uterus to prevent pregnancy. There are two types of IUDs:
- An IUD made of copper.
- An IUD made of plastic containing hormones (progestin).
The copper ParaGard T380A®, can be kept in place for 10 years. The copper stops sperm from making it through your vagina and uterus to reach an egg.
The progestin IUDs include:
- Mirena® (lasts seven years).
- Liletta® (lasts six years)
- Kyleena® (lasts five years).
- Skyla® (lasts three years).
These IUDs work by causing your cervical mucus to become thicker so sperm can’t reach an egg. The hormone also thins the lining of your uterus, so menstrual bleeding becomes lighter.
How is it used?
IUDs are one of the “get it and forget it” forms of birth control. This means once you get it, you can forget it because there is no daily or monthly maintenance.
How is it available?
After a pelvic exam, a healthcare provider places the IUD into your uterus. It’s only available with a prescription.
How effective is it?
The IUD is close to 100% effective.
Does an IUD hurt?
No, an IUD shouldn’t hurt. You may feel uncomfortable or have light cramping after your provider puts it in. The same goes for getting your IUD out — there may be brief discomfort.
What else should I know?
Side effects are different depending on the type of IUD you have. Copper IUDs may cause more painful and heavy periods. Some people prefer copper IUDs because it doesn’t contain hormones. The most common side effect of progestin IUDs is irregular bleeding. This typically improves after six to 12 months. Some people may also stop getting their periods completely. A provider must remove your IUD. In the very rare chance pregnancy occurs while having an IUD, there is a greater chance that the pregnancy is an ectopic pregnancy.
IUDs can also be used for emergency contraception within 120 hours (five days) of having unprotected sex. It’s actually more effective as an emergency contraception than the morning after pill.
Hormonal contraception
Includes estrogen containing birth control pills, the contraceptive vaginal ring (NuvaRing®) and patch (Xulane®).
What is it?
The pill, patch and ring are medications that you take to prevent pregnancy. You take the pill daily, insert the vaginal ring once a month and change the patch weekly. Most hormonal contraception contains two different hormones (estrogen and progestin). All of these forms of birth control work by preventing ovulation.
How is it used?
You take a pill at the same time every day. There are several different types of pills. Some are designed to allow for a monthly period, while others allow for a longer time between periods or no period at all. You replace a vaginal ring every month to allow for your period. A birth control patch releases hormones through your skin. You replace your patch once per week. All of these methods require regular, consistent use. If you forget to use it, irregular menstrual cycles are common and you can get pregnant.
How can I get it?
Hormonal birth control is available by prescription only.
How effective is it?
Combined hormonal contraceptives have the potential to be 99% effective if you use it correctly. However, most people don’t use it correctly, so the effectiveness is around 91%. While not as effective as an IUD or implant, hormonal contraception like the pill is much more effective than barrier methods like condoms.
What else should I know?
The pill can cause minor side effects in the first several months of use, including:
- Breast tenderness/pain.
- Nausea.
- Headaches.
- Irregular periods.
Contraception that contains estrogen increases your risk of blood clots. Talk to a healthcare provider to make sure estrogen-containing contraception is right for you. There are benefits to hormonal contraception like lighter, more regular periods and less menstrual cramping. Birth control pill users may also notice an improvement in acne and PMS.
Progestin only pills (mini pills)
What is it?
These are birth control pills that contain only one hormone (progestin).
How do they work?
Minipills work by thickening your cervical mucus so sperm can’t reach an egg. The hormone in the pills also thins the lining of your uterus, so menstrual bleeding is lighter. For the minipill to be most effective, it’s very important you take a mini pill at the same time each day. Progestin-only “minipills” are available with a prescription.
How effective is it?
Like combination birth control pills, progestin-only pills can be 99% effective. In reality, they’re about 91% effective because most people don’t use them correctly.
What else should I know?
The most common side effect of a progestin-only pill is irregular bleeding, though the bleeding tends to be light. This typically improves after six to 12 months. The minipill is a good alternative for people who are breastfeeding (chestfeeding) or who can’t take estrogen.
Depo-provera® (birth control shot or Depo)
What is it?
Depo-Provera® is a form of the hormone progestin. It stops you from ovulating and thickens your cervical mucus to prevent sperm from reaching an egg.
How is it used?
The birth control shot is an injection. Your provider injects it into your upper thigh or arm. Each injection provides protection against pregnancy for about 12 weeks (or three months). Some providers allow you to inject yourself at home with a low-dose version (Depo-Subq Provera 104®).
How is it available?
Depo-Provera® must be prescribed by a healthcare provider. They’ll inject you with the hormone in their office. You may be able to inject yourself at home if you use the lower dose version of the shot.
How effective is it?
The Depo-Provera® shot has the potential to be 99% effective. However, 6% of people get pregnant each year on the shot because they don’t get the injections on time.
What else should I know?
Depo-Provera® may cause irregular bleeding. People who use it for more than one year stop getting their period while on the medication. This is the only contraceptive that may cause weight gain. It may be slightly harder to predict when your fertility will return once you stop Depo-Provera® (compared to other birth control methods).
Fertility awareness methods (natural family planning)
Rhythm method
What is it?
The rhythm method (or calendar method) teaches you to recognize when you’ll ovulate. This allows you to determine your fertile days, or the days you’re most likely to get pregnant. You avoid having sex on the days you’re fertile.
How is it done?
You use a calendar to chart and predict ovulation. It involves tracking and recording your cycle for several months until you’re able to predict your menstrual cycle.
How effective is it?
It’s one of the least effective forms of birth control. Even when it’s done correctly, it’s only effective about 75% to 88% of the time.
What else should I know?
The rhythm method doesn’t work if you have irregular menstrual cycles. The benefits are that it has no side effects and is inexpensive.
Cervical mucus method
What is it?
The cervical mucus method of birth control involves analyzing your vaginal discharge to identify when you’re most fertile. You avoid sexual intercourse during your fertile time.
How is it done?
You can check your cervical mucus using your finger or by looking in your underwear. Fertile cervical mucus is slippery, clear and has the texture of egg whites. Thick, pasty discharge means you aren’t fertile. Learning the stages your cervical mucus goes through each menstrual cycle helps you predict ovulation.
How effective is it?
The cervical mucus method can be up to 88% effective. In most cases, it’s about 75% effective.
What else should I know?
Tracking your cervical mucus is time consuming and requires dedication. It involves avoiding intercourse on the days you’re fertile, which may be up to two weeks. It can sometimes be hard to pinpoint which days are safe for intercourse.
Basal body temperature
What is it?
Taking your basal body temperature is a way to identify ovulation. You must have a thermometer that measures temperatures to at least one-tenth of a degree for it to work.
How is it done?
Record your temperature every morning before getting out of bed (before you even stand up). Basal body temperature typically rises less than one-half of a degree after you ovulate. Once your temperature increases, you’re safe to have unprotected sex for up to three days. It may take a few cycles to determine when this rise occurs each month.
How effective is it?
It’s not effective when used alone because it only tells you that ovulation has occurred, not that it’s about to. Since you can get pregnant up to five days before ovulation, it’s very unreliable.
What else should I know?
Recording your temperature at rest each morning takes a lot of dedication. While inexpensive to use, it doesn’t offer as much protection against pregnancy as barrier methods or hormonal birth control.
Abstinence
What is abstinence?
Abstinence is the only birth control that is 100% effective. It means you never have sexual intercourse. It’s also the only way to protect yourself from STDs.
Don't let someone pressure you into having sex if you don't feel ready. It’s an important decision with serious emotional and physical consequences.
Emergency contraception
What is the morning after pill?
Emergency contraception is a form of birth control that you can use within 120 hours (five days) of having unprotected sex. It’s most effective in preventing pregnancy if you use it within three days of unprotected intercourse.
The most effective morning after pill contains ulipristal (brand name: ella®). It’s only available by prescription. Several over-the-counter options are available and all contain levonorgestrel (many generic names including Plan B One-Step®, Take Action®, etc.).
How does it work?
The pills prevent pregnancy by temporarily blocking eggs from being produced (delaying ovulation).
How is it available?
You can purchase levonorgestrel pills over-the-counter (without a prescription) at your local drug store. Ulipristal (ella®) is available by prescription only.
How effective is it?
Emergency contraceptive pills can be up to 90% effective when taken within 72 hours of unprotected intercourse. However, no pills will work if you have already ovulated. This is why it’s important to take it as soon as possible after intercourse.
Can you use IUDs for emergency contraception?
Yes, both copper-containing IUDs (Paragard®) and progestin-containing IUDs (Mirena® or Liletta®) can be used as a form of emergency contraception when used within 120 hours (five days) of having unprotected sex. This is the most effective form of emergency contraception. The benefit of using IUDs for emergency contraception is that you’re seeking a method of birth control and you’re preventing future unwanted pregnancies.
Progestin-containing IUDs work by causing your cervical mucus to become thicker so sperm can’t reach an egg. The hormone also thins the lining of your uterus, so menstrual bleeding becomes lighter. The copper-containing IUD works by stopping the sperm from reaching the egg.
How is it available?
A healthcare provider prescribes and inserts IUDs.
How effective is it?
IUDs can be close to 100% effective at preventing pregnancy when inserted within five days of having unprotected sex.
What else should I know about emergency contraception?
Menstrual irregularities are common after you take emergency contraception. However, if you don’t get your period within a few weeks of taking emergency contraception, you should take a pregnancy test. It's important to use condoms or abstain from intercourse for the next five days after taking emergency contraception, otherwise you can get pregnant. If you find yourself taking emergency contraceptive pills frequently, speak to a healthcare provider about more effective ways to prevent pregnancy. The benefit of using IUDs as a form of emergency contraception is that you are taking proactive steps to protect yourself from future unwanted pregnancies.
Sterilization
Salpingectomy
What is it?
Salpingectomy is a surgical procedure to permanently remove your fallopian tubes. This prevents an egg from reaching your uterus. It also blocks sperm from your fallopian tube, where fertilization typically occurs. Provider often perform this surgery over tubal ligation (where the fallopian tubes are tied off but not completely removed), because in the very rare chance you do get pregnant with a tubal ligation, there's a higher chance of having an ectopic pregnancy.
How is it done?
Your healthcare provider performs salpingectomy while you’re asleep. They make two to three small incisions (cuts) in your abdomen, then insert a tool called a laparoscope. They are able to seal and completely remove your fallopian tubes through the laparoscope.
How effective is it?
This procedure is almost 100% effective.
What else should I know?
Female sterilization is permanent. You should not get permanent sterilization if you feel you may change your mind about wanting to get pregnant in the future. While in very rare cases it can be reversed, this operation is not without risk, and can be very expensive. It doesn’t protect against STDs.
Tubal ligation
What is a tubal ligation?
A tubal ligation is a procedure to block your fallopian tubes. A surgeon clamps, ties or blocks your fallopian tubes to prevent pregnancy. The procedure is similar to a salpingectomy, but your fallopian tubes aren’t completely removed. In the rare chance you’d get pregnant after a tubal ligation, you’re at higher risk for an ectopic pregnancy.
How effective is it?
Tubal ligation is about 100% effective.
Vasectomy
What is it?
A vasectomy is a procedure to seal the vas deferens, the tubes in the male reproductive system that carry sperm. Without sperm, pregnancy can’t occur.
How is it done?
Healthcare providers typically perform a vasectomy in an office or surgical center under a local anesthesia (numbing the area). Your surgeon makes a small incision in your scrotum to access the vas deferens tubes. Then, they tie off or cut the tubes.
How effective is it?
Vasectomies are almost 100% effective, but failure is possible. It is important to know that it does not provide immediate protection against pregnancy. You will need to use an additional form of birth control for a few months after the procedure, until your provider confirms there are no sperm left in your semen.
What else should I know?
Sterilization doesn’t protect against STDs. In some cases, your provider can reverse a vasectomy. There are fewer risks of complications with a vasectomy than a laparoscopic salpingectomy.
Frequently Asked Questions About Birth Control
How effective is pulling out?
The pull out method (or withdrawal method) is when a person’s penis “pulls out” of a person’s vagina before ejaculation (or cumming). Removing your penis before sperm comes out is one way to prevent pregnancy, but it’s very ineffective. That’s because it’s hard to do. Even a tiny amount of semen (cum) can get a person pregnant. About 1 in 5 (or 20%) of people will get pregnant each year if pulling out is their only method of birth control.
What method is best to prevent sexually transmitted infections (STIs)?
Condoms are the best way to prevent STIs. However, condoms aren’t the most effective at preventing pregnancy. Condoms work best when they’re used with another type of birth control.
A note from Cleveland Clinic
By learning more about the different forms of birth control, you can decide what method is best for you. Some things you should consider include how often you have sex, your overall health and your future plans for children. Another important factor is convenience. Certain birth control options require daily upkeep (like a pill) to be effective, while other methods (like an IUD) are “get it and forget it” because they last for years. Some birth control methods are easier to keep hidden from others, and some are better at preserving sexual spontaneity than others. Discuss your options for birth control with a healthcare provider. They can help you understand how each form of contraception works as well as the risks and benefits of each.
Comments