Which of These Types of Contraception Is Right for You?
Yes, you read that right, there are 18 types of contraception. And those are only the primary types, thus, not counting subtypes of different pills and brands.
You'll likely ask yourself: What's going to work best for me? What's the most effective but also the most convenient? Do I mind taking a pill every day or would I rather have a device that can last up to 10 years?
The questions can seem overwhelming, so let's break it down in alphabetical order:
The self-enforced restraint from any kind of sexual contact. If you don't have sex or any sexual contact, there's no possibility of pregnancy. It's 100 percent effective. However, a commitment to abstinence is a very personal choice.
2. Cervical cap with spermicide
A silicone cup that's inserted into the vagina with spermicide at least three hours before sex to be effective. You must also leave it in for at least six hours (or longer) after sex. The reasons you might choose a cervical cap over a diaphragm (see below) are because it's relatively inexpensive and requires less spermicide. When used correctly with spermicide, a cervical cap is 92 percent to 96 percent effective at preventing pregnancy.
3. Combined pill
Also known simply as "the pill," it prevents ovulation, as in the ovaries releasing an egg each month. The pill also thickens the mucus in the neck of the womb, making it harder for sperm to enter. The pill can also make periods less intense and painful, and shorten their duration.
The standard way to take the pill is once a day for 21 days and then seven days off during menstruation. When taken as prescribed, the pill is more than 99 percent effective at preventing pregnancy.
A barrier method of contraception and the only type of contraception that prevents pregnancy and protects against sexually transmitted infections (STIs), though not all of them; some STIs can still be spread through other skin-to-skin contact. There are two types of condoms:
- Male condoms: External condoms worn on the penis. When used correctly—and the operative word here is "correctly"—every time you have sex, they are 98 percent effective.
- Female condoms: Worn inside the vagina, they are estimated to be 95 percent effective when worn correctly. As long as there's no genital contact prior to wearing the female condom, they are an effective protection against STIs.
5. Contraceptive injection
Commonly injected into the arm or buttocks, this contraceptive releases progestogen into the bloodstream. Depending on the contraceptive chosen, it is effective for eight to 13 weeks. When administered regularly as prescribed, the contraceptive injection is more than 99 percent effective. The injection might not be suitable for you if you want to get pregnant soon; have arterial disease, heart disease, liver disease or breast cancer; or are at risk of osteoporosis.
6. Diaphragm with spermicide
A dome-shaped silicone cup is inserted into the vagina with spermicide to prevent pregnancy. Very similar to the cervical cap, it must be placed in the vagina at least three hours before sex and left in for at least six hours after sex to be effective. It is 92 percent to 96 percent effective at preventing pregnancy.
7. Emergency contraception
If you've had unprotected sex and are concerned you're at risk of being pregnant, there are two types of emergency contraception:
- The emergency contraceptive pill: Also known as the "morning after" pill, depending on the brand. You need to take it within three to five days of having sex. The sooner you take it, the more effective it'll be.
- The intrauterine device (IUD or coil): There are specific types of IUDs that can be inserted within five days of unprotected sex. These are the most effective types of emergency contraception.
You are much less likely to get pregnant if you use emergency contraception correctly after you have unprotected sex. Emergency contraception is safe, doesn't cause long-term side effects and won't affect your ability to get pregnant in the future.
8. Hormonal and copper intrauterine devices (IUDs)
An IUD is a small, T-shaped piece of plastic inserted into the uterus. Depending on the type of IUD, it can provide birth control for five to 10 years. The copper coil contains no hormones and releases copper to stop you from getting pregnant. The hormonal coil releases progestogen.
When inserted correctly, IUDs are more than 99 percent effective.
9. Implantable rod
Also known as a contraceptive implant, it's a thin rod, about 2 inches long, made out of flexible plastic polymer. Located under the skin of the upper arm, it releases a dose of progestin to thin the lining of the uterus and thicken cervical mucus. It is effective to prevent pregnancy for about three years. It's more than 99 percent effective and can be helpful for patients who can't use contraception that contains estrogen.
10. Natural family planning
Also known as fertility awareness or the rhythm method, this is a technique whereby a woman monitors the progression of her fertility against the calendar. This allows her to calculate when she's likely to get pregnant. She can then avoid intercourse during that period.
It relies on monitoring your menstruation cycle, ovulation, basal body temperature and cervical mucus. It can be up to 99 percent effective if followed diligently with good understanding. This method can be complicated and takes commitment and practice.
11. Progesterone-only pill
Known as the "mini pill," this oral contraceptive is taken every day. It releases the hormone progestin, which thins the lining of the uterus and thickens the cervical mucus, thus, preventing sperm from fertilizing an egg.
When taken correctly, it's more than 99 percent effective. However, studies have shown that depending on the way women take the mini pill in their daily lives, this rate of effectiveness may only be 91 percent. This is because you must take your daily mini pill within three hours of the same time every day. Additionally, both vomiting and diarrhea can make it less effective. However, if you cannot use a contraceptive that contains estrogen, the mini pill is a good alternative.
12. Skin patch
The skin patch, or contraceptive patch, is a thin piece of plastic that releases estrogen and progestin hormones over a weeklong period. Like many other forms of birth control, the patch keeps the ovaries from releasing an egg and thickens cervical mucus to keep sperm from fertilizing an egg. The patch is worn every week for three weeks, but not for the fourth week during menstruation. It's 99 percent effective when used properly.
13. Spermicide alone
Vaginal spermicide is a gel inserted into the vagina prior to genital contact or sexual intercourse. The chemicals in the gel damage and kill sperm on contact. Spermicide comes in different forms, such as creams, gels, film, foams and suppositories.
It's best when combined with a condom, cervical cap or diaphragm. It can be pretty tricky (and potentially messy) to use alone and is estimated to only be about 72 percent effective at preventing pregnancy.
14. Sponge with spermicide
A small piece of plastic foam that's placed deep inside the vagina to block the cervix. The sponge contains spermicide to further prevent pregnancy.
This method is about 91 percent effective if you've never given birth. However, if you've had children, it's only about 80 percent effective. These rates of effectiveness are particularly reliant on the sponge being used correctly each time.
15. Tubal ligation (female sterilization)
A medical procedure—often referred to as "tying the tubes"—where a woman's fallopian tubes are closed to the uterus. It's more than 99 percent effective. This should be considered a permanent solution to pregnancy prevention as sterilization surgery is complicated to reverse and even more difficult with time. You need to be sure it's absolutely right for you.
16. Vaginal ring
A soft, plastic ring inserted into the vagina that releases estrogen and progestogen. These hormones prevent an egg from being released, thin the lining of the womb and thicken the cervical mucus.
The ring works for one month before requiring a replacement. It's more than 99 percent effective when used correctly. You need to feel comfortable inserting and removing the ring yourself for it to be effective.
17. Vasectomy (male sterilization)
A medical surgery for men where each vas deferens tube is blocked or cut so sperm cells stay in the testicles away from semen. This procedure is relatively simple and can be performed under local anesthetic in an outpatient setting. Like female sterilization, it's more than 99 percent effective but should be considered permanent because it is difficult to reverse, especially if you wait for a prolonged period of time between procedures.
18. Withdrawal technique
Removing the penis from the vagina before ejaculation—also known as "pulling out"—must be done perfectly. Even the tiniest drop of sperm can make a woman pregnant. It's estimated this method is 78 percent effective.
How should you decide?
That's a lot to take in, and you still may be wondering what form of contraception is right for you. The best thing to do is to speak to your healthcare provider about what birth control method is best for your lifestyle.
It's not all about personal choice, though, because factors such as medical history, age, ease of use, family planning, side effects, cost, gender identity, religion and culture also play a role.
Although it may seem embarrassing to discuss, rest assured your clinician talks about this topic often. There is a birth control method for everyone, and you will find the right one for you.