Contraception Options 101: Everything You Need to Know About Birth Control
Here's the lowdown on pregnancy prevention with pills, patches, implants, and other types of birth control, plus information on effectiveness, availability, cost, and more.
It’s a fact: If you're a woman, and you have sex with a man, it’s possible you'll get pregnant. But if you don’t want to have a baby, there are many forms of birth control to help prevent pregnancy.
Birth Control: A Definition and Overview
While abstinence, or refraining from intercourse, is the only way to prevent pregnancy with 100 percent certainty, contraception or birth control comes in several different forms, both nonhormonal and hormonal.
Nonhormonal methods generally create a physical barrier between the sperm and the egg; a notable exception is the copper IUD, which changes the uterine environment but does not actually present a physical barrier. Two permanent contraception methods require surgery: sterilization, or?tubal ligation, for women, and vasectomy for men.
What’s the Best Birth Control Method?
“It varies, and it depends on you and your lifestyle,” says?Keosha T. Bond, EdD, MPH, an adjunct assistant professor of health behavior and community health at New York Medical College in Valhalla. “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 not every one will fit every person.”
How Effective Is Birth Control?
Knowing what all your birth control options are will help you and your partner choose what works best for you. “I think it’s awesome to be talking about it. A lot of people just don’t know” about birth control, says?Christine Carlan Greves, MD, an obstetrician-gynecologist based in Orlando, Florida.
Birth Control Methods: All Your Contraception Options
Here’s a look at the various kinds of birth control available today.
Type of?Contraception: Hormonal Birth Control
Contraceptive methods the use hormones alter how your body works in order to prevent pregnancy. These range from daily-use options, such as birth control pills, to long-term-use approaches, such as hormonal IUDs, which can stay in place for several years, says Dr. Bond.
Hormonal Contraception Option: Birth Control Pills
The pills work by preventing ovulation, so there is no egg for sperm to fertilize, or by thickening cervical mucus so sperm cannot travel to an egg.
Birth control pills need to be taken every day as directed. Most types of progestin-only pills must be taken within the same three-hour time window every day. Some pills can also be used to stop your period.
Hormonal Birth Control Side Effects
Some people don’t do well on hormonal contraception. “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:
- Weight gain
- Changed menstrual cycles, including spotting
Who Shouldn’t Take Hormonal Birth Control?
For some people, use of 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 Dr. Greves. Moreover, if you have a blood-clotting disorder, you don't want to take estrogen, and if you have breast cancer, you don’t want to take estrogen or progestin. Smokers, and those considered overweight or obese, should talk to their doctors about which contraceptives are recommended for them.
Hormonal Contraception Option: The Shot,?Depo, or?Depo-Provera
In most cases, your doctor or nurse will give you the shot every quarter, but in some cases, you may be able to bring the shot home to give it to yourself.
Hormonal Contraception Option: Birth Control Implant, or?Nexplanon
The implant must be inserted by a trained healthcare provider, and can be removed at any time if you want to get pregnant.
How effective is the implant? The implant is more than 99 percent effective, notes Planned Parenthood.
How much does it cost? It can cost anywhere between $0 and $1,300, but it’s totally free with most health insurance plans, Medicaid, and some government programs.
Hormonal Birth Control Option: Vaginal Ring (NuvaRing or Annovera)
There are two types of vaginal rings: NuvaRing and Annovera. Each NuvaRing lasts for up to five weeks. You take the old one out and put in a new one about once a month, and it can be used to safely skip your period. Each Annovera ring lasts for one year, but you must put it in your vagina for three weeks, then take it out for one week every month, during which time you'll typically have a period.
Hormonal Birth Control Option: The Patch (Xulane or Twirla)
The patch must be changed once a week for three weeks, and then you skip a week and have your period. Xulane can also be used to prevent your period if you add a new patch on the fourth week instead of skipping a week.
Type of Contraception: Intrauterine Devices (IUDs)
Intrauterine devices (IUDs) are one of the most effective forms of birth control. IUDs are inserted into the uterus by a trained healthcare professional, and can work for up to 10 years, depending on which type you choose. They can also be removed any time if you want to get pregnant.
Copper (Nonhormonal) IUD
The Paragard copper IUD (also called the copper IUD) is the only nonhormonal IUD on the market. It’s a small piece of flexible plastic shaped like a T that has copper wrapped around it, which prevents sperm from reaching an egg because sperm are repelled by copper.
There are four brands of hormonal IUDs available in the United States: Mirena, Kyleena, Liletta, and Skyla. Different brands last for different lengths of time. Whichever you choose, you can have your IUD removed whenever you want.
An IUD must be inserted and removed by a doctor, nurse, or another trained healthcare provider.
How much do they cost? Anywhere from $0 to $1,300; they are free or low cost with many health insurance plans, Medicaid, and other government programs.
Type of Contraception: Barrier Methods
Other than condoms, these older methods of contraception typically aren’t as effective. “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. Most barrier methods need to be inserted into the vagina before sex, so “they take away from the romance aspect of engaging in sex,” she adds.
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 to someone.”
On the other hand, male condoms and internal condoms remain effective forms of contraception that can also help prevent sexually transmitted infections (STIs).
Barrier Method Option: Diaphragm
Diaphragms are most effective when they’re used with spermicide (a cream or gel that kills sperm).
Your doctor must fit you for a diaphragm and give you a prescription, and then you can get one at a pharmacy, drugstore, or health center. After that, you can insert it and remove it yourself.
How much does it cost? Anywhere from $0 to $250. You can probably get a free or inexpensive diaphragm with most types of health insurance, Medicaid, and some government programs. Spermicide, which is available over-the-counter at the drugstore, costs about $5 to $15 per kit.
Barrier Method Option: Sponge
You insert it deep inside your vagina up to 24 hours before you have sex. It covers your cervix and contains spermicide to help prevent pregnancy. The?Today?sponge — the only brand of sponge available in the United States — is sold at pharmacies, drugstores, and some supermarkets.
How much does it cost? It costs about $15 for a pack of three. You may be able to get low-cost or free sponges at Planned Parenthood or another health center.
Barrier Method Option: Cervical Cap
Cervical caps are sold in pharmacies, drugstores, and health centers, but you need a prescription. A nurse or doctor will need to examine you to determine which size cervical cap is best for you.
How effective is the cervical cap? Like the sponge, the cervical cap is more effective if you’ve never given birth. Per Planned Parenthood, if you’ve never given birth, the cervical cap is 86 percent effective. If you have given birth, the cap is 71 percent effective.
How much does it cost? The cap costs between $0 and $275, not including spermicide. You can probably get a cervical cap for free or low cost with most types of health insurance, Medicaid, and other government programs.
Barrier Method Option: Male Condoms
Male condoms are used to avoid pregnancy, and they can also reduce the transmission of STIs. Most male condoms are made of latex, but some are made of plastics like polyurethane, polyisoprene, and nitrile for those who are allergic to latex. Lambskin and other animal membrane condoms also prevent pregnancy, but they don’t protect you from STIs.
Barrier Method Option: Internal Condoms
Internal condoms were once known as “female” condoms, but they can be used by people of any gender. The only brand of internal condom that’s available in the United States is the FC2 Female Condom. It’s available online, at many health centers, and by prescription in drugstores.
How much do they cost? They usually cost about $2 or $3 each, but they are covered by most types of health insurance if you have a prescription. Some health centers may offer them for free.
Type of Contraception: Natural Family Planning and Fertility Awareness Methods (FAM)
FAM takes a lot of dedication, both to track changes over several months and to avoid vaginal sex (or use condoms) when most fertile.?“I don’t think FAM is reliable,” says Bond. “There is pre-ejaculation that can contain sperm that you can become pregnant by. If you are not sure about taking some kind of pill, or other hormonal contraception, you should consider using condoms, because they are easy and don’t require that much change in the body.”?
How much does it cost? About $10 for a thermometer.
Type of Contraception: Pulling Out, or Withdrawal
How much does it cost? Nothing, but condoms are recommended.
Type of Contraception: Abstinence and Outercourse
How effective are abstinence and outercourse? 100 percent.
How much does it cost? Nothing.
Permanent Methods of Contraception: Tubal Ligation and Vasectomy
Permanent sterilization methods do not protect against sexually transmitted infections; condoms are still necessary to reduce the chances of contracting an STI. While vasectomy and tubal ligation reversal procedures exist, they are pricey and not always effective. Choose these options if you are sure you don’t want to have children (or more children).
Type of Contraception: Emergency Contraception
If used as soon as possible after unprotected sex, emergency contraception (EC) is a safe way to prevent pregnancy. Methods are more or less effective depending on a few variables, such as how long it has been since you had unprotected sex and your weight.
EC comes in several forms:
The Progestin (Levonorgestrel) Pill, or Plan B One-Step
The progestin (levonorgestrel) pill, also known as the “morning-after pill” and by the leading brand name, Plan B One-Step, must be taken within 72 hours (three days) of unprotected sex.
How much does it cost? Plan B usually retails for approximately $40 to $50 nationwide, according to Planned Parenthood. On the Plan B website, it costs $49.99 plus tax. Generic versions usually cost about $11 to $45. If you have health insurance or Medicaid, it’s likely that you can get the progestin pill for free — you just have to ask your nurse or doctor for a prescription (even though you don’t need a prescription to buy these types of pills over-the-counter). You may also be able to get the morning-after pill for free or low cost from a health center or family planning clinic.
A pill that contains ulipristal acetate, also known by the brand-name Ella, must be taken within five days of unprotected sex. You need a prescription to get Ella, either by seeing your doctor or getting a prescription online.
How much does it cost? Ella usually costs about $50 at a pharmacy or drugstore, but it might be free if you have health insurance or Medicaid. You may also be able to get Ella for free or low cost from a health center or family planning clinic. Depending on which state you live in, you may be able to get a prescription for Ella directly from your pharmacist. An online?prescription costs $105.
The Yuzpe method
The Yuzpe method involves taking higher than usual doses of combination birth control pills that have both?estrogen and progestin.?This method is most effective within three days of unprotected sex, and it must be done under the supervision of a physician (the number of pills you would take depends on the brand of birth control you use).
How much does it cost? It costs?the same as combination birth control pills, which you would usually already have on hand if you are using this method.
The Copper IUD
How effective is the copper IUD? It's more than 99.9 percent effective against pregnancy and then provides very reliable contraception for up to 10 years.
How much does it cost? It costs the same as when it’s used for regular contraception, anywhere from $0 to $1,300, but they are often free or low cost with many health insurance plans, Medicaid, and other government programs.
Resources We Love
Planned Parenthood is a nonprofit organization with the mission of ensuring that everyone has access to the care and resources they need to make informed decisions about their body, their life, and their future. Planned Parenthood delivers sexual and reproductive healthcare, sex education, and information to millions of people every year.
The Guttmacher Institute is a leading research and policy organization committed to advancing sexual and reproductive health and rights worldwide. The institute dreams of a future in which everyone can realize their rights and access the resources they need to achieve sexual and reproductive health.
Editorial Sources and Fact-Checking
- Hormonal Contraception. ReproductiveFacts.org. 2018.
- Phone Interview.?Keosha T. Bond.?June 19, 2018.
- Contraceptive Effectiveness in the United States by Method. Guttmacher Institute. April 2020.
- Phone Interview.?Christine Greves, MD. June 19, 2018.
- Birth Control Pill. Planned Parenthood.
- Birth Control Shot. Planned Parenthood.
- Birth Control Implant. Planned Parenthood.
- Birth Control Ring. Planned Parenthood.
- Birth Control Patch. Planned Parenthood.
- What Are Non-Hormonal IUDs? Planned Parenthood.
- What Are Hormonal IUDs? Planned Parenthood.
- Diaphragm. Planned Parenthood.
- Birth Control Sponge. Planned Parenthood.
- Cervical Cap. Planned Parenthood.
- Condom. Planned Parenthood.
- Internal Condom. Planned Parenthood.
- Cervical Mucus Method for Natural Family Planning. Mayo Clinic. March 24, 2021.
- Withdrawal (Pull Out Method). Planned Parenthood.
- Abstinence and Outercourse. Planned Parenthood.
- Sterilization. Planned Parenthood.
- Vasectomy. Planned Parenthood.
- What’s the Plan B Morning-After Pill? Planned Parenthood.
- What’s the Ella Morning-After Pill? Planned Parenthood.
- Does Taking Multiple Birth Control Pills at Once Work the Same as the Morning-After Pill? Cleveland Clinic. January 15, 2020.