Contraception, also called birth control, is any method taken to help prevent pregnancy while sexually active. No contraceptive method is 100% effective, but by using one or more type correctly, women have more choice about if and when they become pregnant. When no method of birth control is used, the likelihood of a fertile couple becoming pregnant within one year is on average 85%.
What Types of Contraception Are There?
There are many different types of contraception. Most require a visit to the doctor, but others (such as condoms) are widely available over-the-counter or from sexual health clinics. Some methods can last for months or even years, while others need to be used every time a person has heterosexual vaginal sex. Other than sterilization, all methods are birth control are designed to be reversible. Using a method inconsistently or incorrectly can reduce or eliminate its effectiveness, so it’s important to follow instructions.
Understanding the different types of contraception available can help you to decide what’s best for you and your partner. This page provides an overview of the most common methods of birth control. For more information about any method, speak to your doctor.
Reversible Methods of Birth Control
All of the following methods of birth control are temporary and can be undone, though some may be more difficult to reverse than others.
Intrauterine devices (IUDs) are a long-lasting birth control method inserted into the uterus by a doctor or nurse. According to the CDC, they are more than 99% effective. Once inserted, they can prevent against pregnancy for years before needing to be replaced. If you and your partner decide to conceive while using an IUD, your doctor will remove the device in a simple procedure that typically takes just a few minutes.
There are two types of IUD:
- Copper T IUD. This T-shaped device can often be used for up to 10 years. If inserted within five days, it can also protect against pregnancy from an unprotected sexual encounter.
- Levonorgestrel intrauterine system (LNG IUD). LNG IUDs are also T-shaped. Unlike the Copper T IUD, this device releases progestin. Some brands remain effective for as long as five years.
The Mirena IUD manufactured by Bayer HealthCare Pharmaceuticals has been known to cause severe side effects in some women. Always speak to your doctor about the potential risks before having an IUD inserted.
Birth Control Pill
The birth control pill, often referred to simply as “the pill,” is an oral contraceptive taken daily. According to the CDC, 16% of American women of reproductive age (15-44 years) use the pill. Unintended pregnancy occurs in about 9% of users. Forgetting to take the daily pill or having it expelled from the system (such as during vomiting or diarrhea) can reduce its effectiveness. Ideally, the pill should be taken at the same time every day.
In addition to protecting against pregnancy, many women take birth control pills for other reasons, like regulating periods and reducing menstrual pain. The pill is an easy method of birth control than can be stopped at any time. There are two main types, both of which require a prescription from the doctor:
- Combined oral contraceptives (COCs). COC pills contain synthetic estrogen and a progestin (a synthetic steroid hormone).
- Progestin-only pills (POPs). Often call the mini-pill, POPs only contain the hormone progestin. Since some women cannot take estrogen, POPs can be a viable alternative.
While generally safe, emerging evidence suggests that long-term use of the birth control pill can increase the risk of developing cervical cancer. If you already have some cervical cancer risk factors, it may be worth considering an alternative birth control method.
Birth Control Shot
A progestin can also be injected into the arm or buttock once every three months to protect against pregnancy. Unintended pregnancy with this method occurs in about 6% of women. Forgetting to get a new shot on time can increase the risk of pregnancy.
A doctor or nurse will administer the shot. Self-injectable birth control is currently available in the UK and some other countries, and is expected to be approved for use in the US soon.
Birth Control Implant
Implants provide long-term protection against pregnancy, often lasting between three and five years. A small rod (about the size of a matchstick) is inserted beneath the skin in the upper arm and releases progestin into the bloodstream. This is performed under local anesthetic, and leaves a small scar.
Contraceptive implants are the most effective method of birth control besides abstinence, resulting in unintended pregnancy for only 0.05% of women within their first year (and 0.5% overall).
Birth Control Patch
A birth control patch is worn on the skin and releases hormones (estrogen and progestin) into the bloodstream. The patch is made of thin plastic and is replaced weekly for three weeks. During the fourth week, no patch is worn while you menstruate. It is effective in about 91% of cases, when replaced on time.
Women wear the patch on the buttocks, lower abdomen, upper body, or outer arm. It should not be worn on the breasts.
A vaginal ring is a thin and flexible plastic ring placed inside the vagina that can be removed at any time. When inserted, the ring releases estrogen and progestin to prevent pregnancy. Around 9% of women experience unwanted pregnancy while using a vaginal ring.
Like the birth control patch, a vaginal ring is worn for three weeks and removed during the fourth to allow menstruation to occur. A fresh ring is then inserted, and this can be done easily at home. Read the directions on the package to ensure you are inserting the ring correctly.
Birth Control Sponge
Birth control sponges are disposable soft foam sponges filled with spermicide. They are inserted into the vagina prior to sex, and should be left in for at least six hours (but no longer than 30) after. If dislodged or removed, you must insert a new sponge before continuing to engage in sex. Contraceptive sponges should not be worn twice or during menstruation.
The effectiveness of birth control sponges varies among women. For women who have never carried a child, they have a failure rate of about 12%. This is even higher (24%) among women who have had at least one child.
Condoms are the only method of birth control that also help protect against sexually transmitted diseases (STDs), including the human immunodeficiency virus (HIV). The Centers for Disease Control and Prevention (CDC) recommends dual protection by using a condom to prevent the spread of STDs–and another method (such as the birth control pill) to ensure effective contraception. Wearing a condom is especially important when engaging in sexual activity with a new partner.
Condoms come in male and female varieties. The most widely used is the male condom, which is a thin covering (typically made of latex or polyurethane) worn over the penis. The female condom is a thin plastic pouch used internally that covers the inside of the vagina. According to the CDC, the use of male condoms still results in unintended pregnancy for about 18% of women. For female condoms, this rate is 21%.
Using condoms correctly can increase their effectiveness against unintended pregnancy. The CDC recommends the following precautions be taken while using a condom:
- Use a fresh condom for every sexual encounter. Dispose of the condom immediately after use.
- Never use an expired condom. The expiration date can be found on the packaging.
- Put the condom on before engaging in any genital contact. Even before ejaculation, sperm can leak from the penis and result in pregnancy.
- When using a male condom, ensure it is the right size for the penis. If it is too loose, it may slip off. If it is too small, it will likely tear.
- If the condom does tear, it must be replaced immediately. If the condom breaks during intercourse, the woman should take an emergency contraceptive as soon as possible, and (regardless) within five days.
- Using lubrication can reduce the risk of the condom tearing. Many varieties of pre-lubricated condoms are available, or lubricant can be applied separately. When using latex condoms, a water-based lubricant is recommended, since oil-based liquids can cause them to tear.
Spermicide is a chemical designed to kill sperm cells. Available in different concentrations and forms (including foam, jelly, cream and suppository), it is inserted into the vagina within 30 minutes of sexual intercourse. To increase the effectiveness of spermicide, it should be placed close to the cervix, and remain the body for six to eight hours after sex.
Since the rate of unintended pregnancy is significantly higher (28%) in couples using spermicide alone compared to other methods, spermicide is usually combined with another contraceptive method like a condom or diaphragm.
Some women are allergic to spermicide. Speak to your doctor if you have any adverse reactions when using this contraceptive method.
A diaphragm is a latex or soft rubber cup inserted into the vagina before sex, and is often used with a spermicide. After sex, the diaphragm should be left in for between six and eight hours. When used correctly, diaphragms have a failure rate of about 12%.
Your healthcare provider will fit you for a diaphragm. You should replace the device every two years, or immediately if you notice any tear.
Permanent Methods of Birth Control
The only permanent method of birth control (besides abstinence) is sterilization. This is an option many couples choose after their family has grown to a size they are happy with, and means they are able to engage freely in sexual intercourse without worrying about other contraceptive measures. Sterilization must be performed by a healthcare provider, and usually can’t be reversed. It is about 99% effective in preventing unwanted pregnancy.
Women can receive a sterilization implant without surgery. It involves a flexible insert being placed in the fallopian tubes. After three months, the formation of scar tissue around the inserts blocks sperm from reaching an egg. Within this three month period, another method of contraception should be used.
This procedure requires surgery, and involves a woman’s fallopian tubes being cut, tied, or sealed.
A vasectomy sterilizes the male partner by preventing sperm from leaving the testes. It is a simple surgical procedure in which the duct that carries the sperm to the urethra (the vas deferens) is cut, clamped, or sealed. Couples should use another method of contraception for three months after the procedure to ensure effectiveness.
Sexual Practices to Reduce Risk of Pregnancy
Some couples engage in certain sexual practices to reduce their risk of unintended pregnancy. This can include the male withdrawing before ejaculating, or only engaging in sex on days when the woman is not fertile. When used without another method of contraception, withdrawal results in pregnancy in about 22% of women, and fertility awareness in about 24%. Neither method can prevent against STDs. It is recommended that you use at least one other method of contraception.
Emergency contraception should not be considered a form of regular birth control. It is designed to prevent pregnancy after unprotected sex or when a condom has broken during intercouse.
Emergency contraceptive pills (ECPs) are often called morning-after pills, and should be taken as soon as possible after sex and always within five days to help prevent pregnancy. Taken within 24 hours, they can be up to 95% effective. Many ECPs are single dosage, but some come in two doses to be taken at 12 hour intervals. Some brands of ECP are available over-the-counter without requiring ID.
The Copper T IUD is also an emergency contraceptive option. Inserted within five days of sex, it is successful in preventing pregnancy in about 99% of cases.