All about pregnancy prevention with pills, patches, implants, and other types of birth control, plus information on effectiveness, potential side effects, and more.
It’s a fact: As a woman, if you have sex with a man, it’s possible to get pregnant. But if you don’t want to get pregnant, there are many forms of birth control to help prevent pregnancy.
Birth Control: A Definition and Overview
Also called contraception, birth control has several different options. While abstinence, or refraining from intercourse, is the only way to prevent pregnancy with 100 percent certainty, there are both nonhormonal and hormonal methods of contraception.
Nonhormonal methods generally create a physical barrier between the sperm and the egg. There are also two permanent methods requiring surgery: sterilization, or tubal ligation, for women, and vasectomy for men.
Hormonal methods generally make it less likely that a woman will release an egg, that an embryo will form, or that an embryo will be implanted.
What’s the Best Birth Control Method?
“It varies, and it depends on you and your lifestyle,” says Keosha T. Bond, doctor of education, an assistant professor of epidemiology at New York Medical College in Valhalla, New York. “I try to explain there’s no 'one size fits all.' It’s more, ‘What can I do, and how does my body react?’ There are so many contraceptive methods out there, but every one won’t fit every person.”
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Emergency Contraception and Next-Day Birth Control
In addition to the many methods detailed in the list of contraception options, today women have access to emergency contraception (EC). Sometimes called next-day birth control or the morning-after pill, EC is a safe way to prevent pregnancy up to five days after unprotected sex.
Choosing the Right Birth Control Method for You
Birth control methods are measured based on perfect use — meaning when they are used correctly every single time — and actual use, which is a more typical basis. For example, if birth control pills are supposed to be taken at the same time every single day, perfect use means the person is taking those pills exactly as directed. Typical use would mean that the pills were perhaps taken most of the time, but not every single day, or not at the same time every single day.
Available Birth Control Methods: All Your Contraception Options
Here’s a look at every kind of birth control available today:
Type of Contraception: Hormonal Birth Control
Contraception based on hormones help alter how your body works to get and stay pregnant. These range from daily use options, such as birth control pills, to long-term use approaches, such as hormone-based IUDs, which stay in place for several years, says Dr. Bond.
Hormonal Contraception Option: Birth Control Pills
There are many different kinds of birth control pills available, including high and low doses of hormones, some that change dosages based on a woman’s cycle, and others that give the same amount all month long, says Bond.
Some important facts:
- Pills need to be taken every day, typically at the same time each day.
- How effective are they? Perfect use: 99 percent; typical use: 91 percent.
- Depending on health insurance coverage, birth control pills may cost nothing or up to $113 per month, according to Bedsider. (1)
Hormonal Birth Control Side Effects
Some people don’t do well on hormonal contraception, which typically includes either estrogen, a form of progesterone called progestin, or a combination of the two. “Each woman is different, and you have to understand your body,” says Bond. If you notice one or more of these side effects, let your doctor know:
- Nausea
- Weight gain
- Changed menstrual cycles, including spotting
Who Shouldn’t Take Hormonal Birth Control?
For some people, using hormones is not recommended. “The pill is easy and awesome, but if you have migraines with aura (vision changes during a bad headache), or have a history of deep vein thrombosis, stroke, or other cardiac changes,” talk to your doctor to learn if you should consider another birth control option, says Christine Carlan Greves, MD, an ob-gyn based in Orlando, Florida. “If you have a blood clotting disorder, or breast cancer, you don’t want to take progesterone,” she added. Smokers, and those considered overweight or obese, should talk to their doctors about which contraceptives are recommended for them.
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Before the Birth Control Pill Existed
When the birth control pill was first introduced in 1960, it changed everything, especially for women.
Reliable contraception was scarce a hundred years ago. For women, having sexual intercourse meant risking pregnancy. Prior to the arrival of the pill, withdrawal and abstinence were the main birth control methods available. And there were other risks and obstacles related to using birth control to space or prevent pregnancies. One big obstacle was the Comstock Act of 1873, which made birth control illegal.
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According to Planned Parenthood, fully one-third of the wage gains made by American women since the 1960s can be traced back to oral contraceptives. Between 1970 and 1990, hormonal birth control accounted for some 30 percent of the increase in the rate of women entering skilled careers like medicine and law. The birth control pill has also been the most influential factor enabling women to stay in college.
Hormonal Contraception Option: The Shot, Depo, or Depo-Provera
Known by the above names, an injection of Depo-Provera can help prevent pregnancy for three months. It’s a shot of progestin, which works by keeping your ovaries from releasing eggs, as well as thickening the cervical mucous so sperm can’t travel effectively.
- Getting injections is private and done at your doctor’s office regularly every quarter. It also doesn’t require a monthly prescription or regular pharmacy trips.
- How effective is it? With perfect use: 99 percent; typical use: 94 percent
- It can cost nothing or up to $100, according to Planned Parenthood. ( 2 )
Hormonal Contraception Option: Arm Implant, Nexplanon, or Implanon
This is a small rod about the size of a matchstick that is placed into the upper arm. It releases progestin, which prevents your body from releasing eggs, and makes it tougher for sperm to move. It’s good for up to four years of pregnancy protection.
- It needs to be inserted in a healthcare provider’s office.
- It is 99 percent effective for both perfect and typical use.
- Most of the time it is covered for free but it can be expensive if not. Still, over the course of four years, it will end up costing about $10 per month, per Bedsider. ( 3 )
Hormonal Birth Control Option: Vaginal Ring or NuvaRing
Like many birth control pills, the vaginal ring contains both progestin and estrogen. Unlike oral pills, a woman inserts the ring into her vagina (similar to inserting a tampon) and the hormones work to prevent ovulation and pregnancy. It is worn each month and needs to be changed on a specific schedule, typically after three weeks, with a week off for a period. Then a new ring is inserted for the next cycle.
- You can use the ring to skip your period every month if you want, which is considered safe to do.
- How effective is it? Perfect use: 99 percent; typical use: 91 perfect.
- It can cost between $0 and $200. ( 4 )
Hormonal Birth Control Option: The Patch
Resembling a small square Band-Aid, the beige contraceptive patch is worn on the skin and infuses estrogen and progestin so that ovulation doesn’t happen. It needs to be changed out every week and is available in generic form known as Xulane. ( 5 )
- How effective is it? Perfect use: 99 percent; typical use: 91 percent.
- It can cost between $0 and $150. ( 6 )
Type of Contraception: Intrauterine device, or the IUD
IUDs (short for intrauterine device) are one of the most effective forms of birth control — they're more than 99 percent effective against pregnancy. Once recommended only for women who've already had children, experts now say that women who haven’t had children can effectively use an IUD.
IUDs are inserted into the uterus by a healthcare professional, and can work for 3 to 12 years, depending on which one you choose. They can also be removed any time if a woman wants to try to get pregnant.
Different IUDs on the Market
There are five kinds of IUDs available in the United States. Four of these work with a small amount of pregestin, which thickens cervical mucous and prevents sperm from reaching an egg. Known by the brand names Mirena, Kyleena, Liletta, and Skyla, these IUDs can be inserted for a period of three to six years. They can also make your period lighter or disappear altogether. Talk to your doctor about which one might be right for you.
The fifth kind of IUD is made with plastic and a small amount of copper and is called the ParaGard. It prevents sperm from reaching an egg because sperm dislike copper. It does not affect your period and can be worn for up to 12 years.
- While many health insurances plans cover IUDs in full, for those women that pay out of pocket, IUDs can cost up to $1,300, though amortized over several years, the cost per week or month of use is low. ( 7 )
- How effective is it? All IUDs are 99 percent effective both for perfect and typical use.
Type of Contraception: Barrier Methods
Barrier Method Options: Diaphragm, Sponge, and Cervical Cap
These are older methods of contraception that are still available, but aren’t as effective or as easy to use as other methods. “Sponges or a diaphragm? I don’t want to say they are outdated, but they aren’t talked about as much today by healthcare providers,” says Bond. All three methods need to be inserted into the vagina before having sex, so “they took away from the romance and the whole aspect of engaging in sex,” she says.
Similarly, “a diaphragm doesn’t work that great,” says Greves. “It’s better than nothing, but I don’t remember the last time I recommended it for someone.”
The Quick Diaphragm Details
- Diaphragms are a small silicone saucer that fits over the cervix and acts as a barrier for sperm to reach an egg.
- It’s inserted manually.
- How effective is it? Perfect use: 94 percent when coated in spermicide (a lubricant that kills sperm); typical use: 88 percent.
- Costs vary from $0 to $90. ( 8 )
The Quick Sponge Details
- Sponges are available over the counter at drugstores and look like a white foam circle with a nylon handle. It’s inserted into the vagina up to three hours before sex.
- It works by blocking the cervix as well as continuously releasing spermicide while it is inserted.
- It costs from $0 to $15.
- How effective is it? Perfect use: 80 to 91 percent. Typical use: 76 to 88 percent effective. ( 9 )
The Quick Cervical Cap Details
- Like a diaphragm, the cervical cap is a silicone circle inserted into the vagina up to six hours before intercourse to cover the cervix and prevent sperm from reaching an egg in the uterus. It’s also more effective when used with spermicide.
- It can be left in for up to 48 hours.
- Effectiveness at preventing pregnancy is between 71 and 86 percent. There are no stats available for perfect use.
- It costs between $0 and $200 to be fitted in a healthcare provider’s office, then from $0 to $89 for the cap itself, plus ongoing costs for spermicide. ( 10 )
Barrier Method Contraception Option: Condoms
There are condoms available for men to use as a sheath over the penis as well as for women to use internally in the vagina or anus. Both are used to avoid pregnancy as well as to reduce the transmission of sexually transmitted infections (STIs) from person to person. While male condoms are made from latex, plastic, or lambskin, female condoms are made only from plastic, which helps people with a latex allergy.
- Male condoms are available in most drugstores, grocery stores, and health clinics. They can be $0 to $2 apiece and are not typically covered by health insurance.
- Female condoms are also found in many drugstores, grocery stores, and health clinics, costing from $0 to $5 apiece. When used with spermicide, they are most effective.
- Male condom effectiveness rates are around 98 percent for perfect use and 85 percent with typical use; female condoms are about 95 percent effective for perfect use, 79 percent effective for typical use. ( 11 , 12 )