Sexual Health > Reproductive Health > Reproductive Health - Birth Control

The Facts About Birth Control

Many types of contraception exist and can be tailored to your individual or relationship goals.

a sleeve of birth control pills on a purple background

Birth control comes in many different types. Some involve hormones and some don't. Other types are more expensive and long term. Still others require less upkeep.

Birth control definitely isn't a one-size-fits-all proposition, which makes it tricky to find the correct method specifically for yourself.

A number of options exist, however, and understanding which one—or ones—best fits your personal goals or relationship goals and making sure it works correctly are critical to maintaining your sexual health and well-being.

The American College of Obstetricians and Gynecologists provides a chart outlining the effectiveness rates of various birth control methods. While "perfect" use rates appear high for many options, perfect use rarely occurs, so it's more realistic to consider "typical" use percentages.

What is birth control?

Birth control is the use of devices, medicines, surgeries or other methods to prevent pregnancy. There are some short-acting types, such as the contraceptive pill, patch and vaginal ring, and long-acting types, like an intrauterine device (IUD), intrauterine system (IUS) and hormonal implant.

Nonhormonal options are available for people who want to avoid hormones. These include condoms, a copper IUD, withdrawal and spermicides.

Some birth control options are used for purposes outside of preventing pregnancy. For instance, the contraceptive pill is sometimes used to reduce period pain and heavy bleeding, which can be beneficial for women with endometriosis or polycystic ovary syndrome (PCOS).

The list of birth control methods can seem lengthy, but there's likely a specific one that fits your current situation and can be switched if your situation or relationship changes.

Birth control shot

The Depo-Provera contraceptive shot works by releasing the hormone progestin into the bloodstream, which prevents ovulation from happening. When ovulation does not occur, an egg can't be released and you can't get pregnant.

You have to get the shot every three months to prevent pregnancy. This option is convenient for some women who often forget to take birth control pills.

The birth control shot is more than 99 percent effective with perfect use, but you must remember to get your birth control shot on time. If you miss or delay it, the effectiveness decreases and you may be at risk of an unwanted pregnancy.

Cervical cap

A cervical cap is a reusable device made of silicone or rubber. You insert it into your vagina to prevent sperm from passing through the cervix. The cervical cap must be used with spermicide to make it effective at preventing pregnancy.

The overall effectiveness of this birth control method depends on whether you have given birth before. For people who have never given birth, it is 86 percent effective based on typical use. However, if you have given birth, the effectiveness drops to 71 percent.

The pill

Oral contraceptives remain one of the most common forms of birth control. The pill contains the hormones estrogen and progesterone, which prevent sperm from passing through the cervix and stop ovulation from happening.

Another type of oral contraceptive is the mini-pill, or the progestin-only pill, which thickens the cervical mucus to prevent sperm from reaching an egg. The pill has to be taken every day to prevent pregnancy.

With perfect use, the pill is 99 percent effective, but almost no one uses it perfectly. Typical use efficacy rates for the birth control pill are around 91 percent to 93 percent. However, you must remember to take the pill every day for it to be effective. Setting an alarm on your phone can help you remember to take it.


Spermicide is a type of birth control that contains chemicals to prevent pregnancy. It comes in the form of a gel, cream, foam or suppository. To prevent sperm from reaching an egg, you must insert the spermicide into your vagina up to 30 minutes before sex.

When used correctly, spermicide is around 82 percent effective at preventing an unwanted pregnancy. However, you can increase the effectiveness by combining it with another birth control option, such as the cervical cap, condoms or withdrawal method.


Similar to a cervical cap, a diaphragm is a silicone cup that is placed inside the vagina to prevent pregnancy. It covers the cervix and stops sperm from reaching an egg. However, it must be used with spermicide.

Diaphragms are 94 percent effective at preventing pregnancy with perfect use, which means it must be used every time before sex and must be placed correctly. If it isn't, the effectiveness greatly decreases; typical use efficacy is 88 percent. You can increase the effectiveness by using condoms or the withdrawal method as well. Diaphragms also must be refitted after childbirth to maintain typical use efficacy.

Copper coil

The copper coil is a T-shaped device that is inserted into the uterus to prevent pregnancy. This type of IUD does not contain any synthetic hormones. It slowly releases copper, which makes it difficult for sperm to survive.

The copper coil is a long-acting form of birth control and has to be replaced every 10 to 12 years. However, you can get it removed at any point if you wish. IUDs are more than 99 percent effective at preventing pregnancy. As there is no typical use versus perfect use comparison since it is placed by a medical professional, long-acting reversible contraception (IUD, Nexplanon) is among the most effective contraception options available.

Hormonal IUD

The hormonal IUD is a T-shaped plastic device that is inserted into the uterus, where it releases progestin to prevent pregnancy. The hormonal IUD thickens the cervical mucus, which stops sperm from reaching an egg, and it may prevent ovulation from occurring.

There are a few different types of hormonal IUDs, such as Mirena, Kyleena, Liletta and Skyla. Depending on the type you have, it needs to be replaced every five to 10 years. Hormonal IUDs are 99 percent effective at preventing pregnancy.

Fertility awareness methods

Fertility awareness methods, commonly referred to as natural family planning and the rhythm method, involve tracking your menstrual cycle to know when you are ovulating.

You can track ovulation by taking your temperature first thing in the morning, examining your vaginal discharge or charting your menstrual cycle on a calendar or an app, or combining all three of these methods.

People using this method avoid having sex or always use a condom on their most fertile days, which are the days leading up to and during ovulation. The effectiveness rate is about 75 percent because it can be difficult to accurately track ovulation, making this one of the least effective methods.


Unlike most other forms of birth control, sterilization is a permanent method. For women, this procedure is called tubal ligation, which involves closing off or removing the fallopian tubes. This procedure prevents an egg from moving down the fallopian tube, which is effective at preventing pregnancy.

Female sterilization is more than 99 percent effective at preventing pregnancy.

For women who do not want to have children or are done having children, this can be an appealing option because it protects against pregnancy for the rest of your life.


A vasectomy is a procedure in which a man's vasa deferentia are blocked or cut to stop sperm from mixing with the seminal fluids. This means when a man ejaculates, no sperm is released. Without the release of sperm, pregnancy cannot occur.

A vasectomy is considered a minor procedure and is usually carried out with local anesthetic, so men can go home the same day. This form of birth control is permanent and more than 99 percent effective at preventing pregnancy.


Condoms are stretchy, thin pouches that are used to cover the penis during sex. They protect against pregnancy by collecting semen, which you then dispose of after sex. In addition to protecting against pregnancy, they are the only birth control designed to protect against sexually transmitted infections (STIs).

Condoms are 98 percent effective at preventing pregnancy when used perfectly, and about 82 percent effective with typical use. However, if there are any holes in the condom or it is not used for the entire duration of sex, this can decrease the effectiveness. It's important to wear the condom from the beginning of sex, as preejaculate can lead to an unwanted pregnancy.

Internal condoms

Internal condoms, sometimes called "female condoms," are pouches that you put inside your vagina to protect against pregnancy and STIs. They work by covering the vagina to prevent sperm from reaching an egg.

It may take more time to get used to internal condoms compared with other condoms, but they still prove to be effective. With perfect use, they are 95 percent effective at preventing pregnancy, and 79 percent effective with typical use.

You can increase the effectiveness by ensuring they are fitted correctly and combining it with the withdrawal method.

Withdrawal (pull-out method)

Withdrawal, known as the "pull-out method," occurs when a man pulls his penis out of the vagina before ejaculating. This greatly decreases the chances of semen entering the vagina, which lowers the chances of an unwanted pregnancy.

The effectiveness depends on whether you pull out before any semen enters the vagina or whether there is any sperm in your preejaculate. With perfect use, it could be up to 96 percent effective at preventing pregnancy, but research shows that realistically, it's actually around 78 percent effective.

Outercourse and abstinence

Outercourse refers to any sexual activity that doesn't involve intercourse or penetration. This could include touching, kissing, using sex toys and grinding against each other. Some people may prefer oral or anal sex, which can't lead to pregnancy.

Abstinence means the avoidance of sex. Some people may choose to avoid vaginal penetration and participate only in oral or anal sex. For others, it could involve avoiding all sexual activities.

This decision greatly depends on your circumstances and your views toward sex.

Breastfeeding as birth control

When you breastfeed exclusively, your body stops ovulating and you won't get periods. Without ovulation, you won't be able to get pregnant. It's for this reason that some women use breastfeeding as a form of birth control.

Breastfeeding can be up to 98 percent effective at preventing pregnancy, but there are many factors to take into consideration. If you use formula or a breast pump, they can decrease the effectiveness of this approach. Going more than three hours between pumping or nursing, and the use of pacifiers can also decrease the efficacy. Therefore, it's recommended that individuals discuss contraception options with their healthcare provider before relying on this method. After six months, or whenever your period returns, you will not be protected against pregnancy and will need to switch to another form of birth control.

How to get birth control

There are many ways you can get access to birth control. Many people choose to see a doctor or nurse to get a prescription. Seeing a healthcare provider enables you to get more information about birth control methods and make an informed decision based on what's best for you and your circumstances.

Alternatively, you can visit a health clinic. You may be able to get a prescription from a pharmacist or online if that's convenient to you.

If you prefer not to visit a doctor or nurse, some types of birth control are available over the counter in local pharmacies or grocery stores. These include condoms, internal condoms, spermicide and contraceptive sponges, but these are among the least effective options.

If your birth control fails, you can get emergency contraception (the morning after pill) over the counter as well.

Other nonhormonal options, such as fertility awareness, don't require a prescription, so you may wish to combine this with another option, like condoms or contraceptive sponges.


If you need additional information about birth control, the following resources may be helpful:


What type of birth control is best?

There's no single best birth control, as it depends on your circumstances and what you need from birth control. Preventing an unwanted pregnancy is important, but only condoms can protect against STIs, so you may wish to use more than one method. In terms of effectiveness, long-acting or permanent methods—such as the IUD and sterilization—are considered the most effective at preventing pregnancy.

What does birth control do to a woman's body?

Birth control works in different ways to prevent pregnancy. Some types of birth control, like the birth control shot, work by releasing progestin and stopping ovulation from occurring. Other types of birth control, such as condoms, work by creating a barrier and preventing semen from entering the vagina. When taking hormonal birth control, you may notice other changes in your body and mood, but this varies from person to person.

What are the four types of birth control?

The four different types of birth control include sterilization; long-acting methods, such as the IUD; short-acting methods, such as the pill, patch or shot; and barrier methods, which include condoms, caps and diaphragms. Some other methods, such as fertility awareness, abstinence and withdrawal, do not fall into these categories.