Many women in the United States use birth control at some point in their lives. And choosing the best birth control for your own personal lifestyle and goals can be very rewarding, allowing you to take control of your future and live the way you want.
But you can spend a lot of time and energy trying out different types of birth control, and if you just want to know how to prevent pregnancy in the best way for you, that can be frustrating. With so many possibilities, where do you start? What should you keep in mind?
Below, we’ve collected the most important details so you can easily compare different birth control options and start a conversation with your doctor.
Forms of birth control
Generally, there are five categories of birth control methods:
- One-time use
Each method works in a different way, like preventing sperm from getting to an egg or discouraging your body from releasing eggs. But every form of birth control has the same primary goal of helping you avoid unwanted pregnancy.
However, there are a couple of important things to know. First, birth control effectiveness is different for every method. Second, birth control and sexually transmitted infection (STI) prevention aren’t the same thing. Only condoms protect against STIs when used correctly. To prevent STIs, you’ll want to use condoms in combination with another birth control method.
Birth control options at a glance
|Short-term (pills, patches, etc.)||Long-term (IUD, implants)||One-time use (condoms, sponges, etc.)||Permanent (tubal ligation, vasectomy, etc.)||Emergency (Plan B, Ella)|
1. Short-acting hormonal birth control
Hormonal birth control involves adjusting your body’s natural levels of estrogen, progestin or both to make pregnancy much less likely. Common methods include birth control pills you take every day, a patch you replace every week, a vaginal ring you change every month or a shot your doctor gives you every three months. All of these methods require a prescription.
Low-hormone birth control pills
There are also birth control pills that contain a lower amount of hormones than regular pills. Low-hormone birth control pills can be a good choice for people who have hormone sensitivities or who want relief from menopause or perimenopause symptoms.
What are the side effects of short-acting hormonal birth controls?
The short and long-term side effects of birth control pills, patches, rings and shots can vary. If you find that you’re experiencing negative side effects like weight gain, headaches or nausea that don’t go away after a few months, talk to your care provider about switching birth control methods. But a benefit of birth control pills and other hormonal birth control options that many women notice is a decrease in period pain, frequency or flow. If your menstrual cycle gives you trouble, a hormonal birth control option may be worth exploring.
How effective are short-acting hormonal birth control options?
Short-acting hormonal birth control methods, including birth control pills, are about 91-95% effective at preventing pregnancy for most women when taken as directed. When it comes to lower-hormone birth control pills specifically, you have to be especially strict about taking them at the same time every day, otherwise they won’t be as effective at preventing pregnancy.
2. Long-term reversible birth control
A long-term reversible birth control option may be a good choice if you want effective, lasting birth control without much maintenance. One option is an intrauterine device (IUD) that’s inserted into your uterus, which has both hormonal and nonhormonal options. Another option is an implant that’s inserted into your arm.
IUDs most frequently use the hormone progestin to prevent pregnancy. The small amounts of progestin that these IUDs release over time prevent your ovaries from releasing eggs, and thicken your cervical mucus so that sperm can’t get through. Brands of IUDs that use hormones include Skyla, Mirena and Kyleena. Depending on which brand you choose, an IUD can last 3-7 years.
ParaGard brand IUDs don’t use hormones. Instead, they use copper, which is a natural spermicide. ParaGard IUDs can last for up to 10 years.
The Nexplanon birth control implant uses progestin just like a hormonal IUD. But instead of being inserted into your uterus, the implant goes into your upper arm. It’s about the size of a matchstick, and can last for up to three years.
How effective are IUDs and implants?
IUDs and implants are 99% effective at preventing pregnancy and can be removed by a doctor if you decide you want to have kids.
3. One-time barrier contraception
Condoms, sponges, diaphragms, cervical caps and spermicide are all barrier birth control methods. They each work differently, but they all create a sperm “barrier” during sex to physically prevent sperm from reaching an egg. Barrier contraception methods don’t require a prescription and are available at many stores or online. Additionally, condoms help protect against STIs – the only birth control method to do so.
How effective are barrier birth control methods?
You only use barrier contraception when you’re actually having sex. You need to use it every time you have sex and you need to use barrier contraception correctly for it to be most effective. Because of this, barrier contraceptive techniques don’t usually work as well – they prevent pregnancy 71-88% of the time, depending on the method. But you can also combine them with other methods for greater effectiveness. For example, it’s recommended that you also use spermicide if you’re using a diaphragm or cervical cap. Talk to your doctor for more information.
4. Permanent contraception
Tubal ligation or salpingectomy (for women) or vasectomy (for men) are relatively simple surgical procedures intended to make pregnancy impossible. If you’re very sure you don’t want to have children in the future, they’re a great option to consider.
With tubal ligation, the fallopian tubes are tied, cut or sealed to prevent eggs from reaching the uterus. And with salpingectomy, the fallopian tubes are removed, which has an added benefit of reducing lifetime risk of ovarian cancer by about 50%.
Recovery time from these procedures usually takes only a few days. Your (and your partner’s) sexual function won’t be impacted, and with either procedure, you’ll still get your period. Essentially, nothing will change in your day-to-day life, except that you won’t be able to get pregnant. This makes permanent contraception one of the most convenient birth control options, but only if you’re confident you don’t want kids going forward. Reversing a tubal ligation or vasectomy is possible, but there isn’t any guarantee your fertility will return. A salpingectomy is not reversible.
How effective are permanent contraception options?
Tubal ligations, salpingectomies, and vasectomies almost 100% effective at preventing pregnancy.
5. Emergency contraception
If you have sex without using birth control – or your birth control fails – emergency contraception can help prevent pregnancy. If you need emergency birth control, there are two types of pills available, as well as a copper IUD. No matter which method you prefer, you’ll want to use emergency contraception as soon as possible for it to be most effective.
How effective is emergency contraception?
One type of pill, often called “Plan B,” is available from most pharmacies without a prescription – it can prevent pregnancy up to three days after sex. The more effective pill, often called “Ella,” does need a prescription but can prevent pregnancy up to five days after sex. Copper IUDs also require you to see a doctor, but they’re almost 100% effective when inserted within five days of intercourse.
Emergency contraception isn’t meant to be your primary birth control method – only a backup in case something doesn’t go as planned. You’ll have more control if you regularly use other methods first.
Is birth control bad for you?
Most people can use birth control without any problems, though side effects are possible. And even though there are slight risks associated with hormonal birth control, these mostly depend on an individual’s health conditions and risk factors. For example, heightened estrogen levels can increase the risk of blood clots in women with other blood clot risk factors like obesity, heart disease or age. Your doctor will take these kinds of factors into account during discussions about birth control.
So what’s the best birth control?
It all depends on you. For starters, you’ll want to consider what your goals are, what your lifestyle is like, how often you have sex, your insurance coverage, what you and your partner are comfortable with, and what you’re planning for the future.
Because everyone is different, the contraception that works best for your friends or family members may not be convenient or most effective for you. But regardless of the birth control method you end up choosing, use it as directed for the lowest chance of pregnancy.
Of course, you’ll want to talk to an OB-GYN provider, certified nurse-midwife (CNM) or nurse practitioner (NP) to get personalized birth control advice. Your care provider can give you more details about each option, and they’ll help you make a choice (or choices) you’ll feel great about.
Taking time to make sure you’ve selected the best birth control option for you can give you more power over your choices. And that’s well worth it for your health, your well-being, your peace of mind and your future.