What to Know About Using a Second Birth Control Method

Birth control is highly effective when used correctly. However, some methods are more effective than others. People may opt for a second birth control method for a variety of reasons. Correctly using different birth control methods together can help further reduce the risk of unintended pregnancy.

There are a multitude of birth control options that vary in cost, frequency of use, side effects and effectiveness. While many options are highly effective at preventing unintended pregnancy, no method is 100 percent successful except for abstinence.

How effective is birth control?

Birth control effectiveness varies among products. Planned Parenthood provides a rundown on the effectiveness of nonpermanent contraceptive methods:

• Implant or intrauterine device (IUD): 99 percent effective
• Breastfeeding as birth control: 98 percent
• Shot: 96 percent
• Vaginal ring, patch or pill: 93 percent
• Condom: 87 percent
• Diaphragm: 83 percent
• Internal condom: 79 percent

Bear in mind that these effectiveness rates are based on correct and consistent use of the products, which doesn't always occur.

Permanent birth control methods, such as vasectomy and tubal ligation, virtually eliminate the chance of an unexpected pregnancy (99 percent effective) for the rest of your life. If you want to keep the option to have children, they may not be the right choice for you.

"It's important to understand each person's needs in order to increase effectiveness when protecting against unwanted pregnancy, and sometimes, combining two methods is a good way to ensure this protection," said Claudia Pastorelli Mosca, M.D., an OB-GYN in Germany and a medical advisor for Flo, an ovulation and period tracker app.

Reasons to double up on birth control

With such strong effectiveness numbers, why would someone want to double up on contraception?

One survey published in 2016 suggested that most respondents utilized multiple birth control methods out of concern over pregnancy and efficacy around specific methods.

Avoid pregnancy

Some people may have a preference for a certain method, but they don't like the associated risks. For example, cervical caps, sponges, spermicides and gels range from 71 percent to 86 percent effective.

"When someone needs to avoid a pregnancy for medical reasons or is using a less effective method, they might want to double up," explained Aimee D. Eyvazzadeh, M.D., M.P.H., an OB-GYN in San Francisco and a medical advisor for Proov, a health tech company that offers ovulation and pregnancy tests.

Adding a second method can increase the chances of protection.

"Condoms are only about 87 percent effective, so adding a spermicide or other method might instead increase effectiveness. Similarly, someone that is prone to forget their birth control pill might consider adding condoms as a second method," Eyvazzadeh said.

Noncontraceptive reasons

Sometimes people opt to add a second method of birth control for noncontraceptive benefits, such as acne reduction or alleviating period symptoms.

Using a second method can also help if a primary method fails, especially if it has a margin for error.

"Research shows that using one effective method consistently and correctly is enough to avoid pregnancy. However, if these methods are used in an irregular, non-recommended way or the method chosen is considered not effective, this protection decreases," Pastorelli Mosca said.

While many forms of birth control are highly effective at preventing unintended pregnancy, they do not always protect against sexually transmitted infections (STIs). Methods such as IUDs, pills, rings, patches and shots do not prevent STIs. In this case, wearing a condom is always a good choice, Pastorelli Mosca said.

External latex condoms are known to be the best way, other than abstinence, to help prevent STIs, but few studies have looked at the effectiveness of internal condoms, sometimes referred to as female condoms. Regardless, while consistent and correct use of latex condoms can reduce the risk of STI transmission, they cannot provide absolute protection.

Which method can be avoided?

If you're considering doubling up on your birth control, more does not always mean better. Using two different methods is essential.

"It is important to know how each method of birth control works when thinking about doubling up. To most effectively double up, you should be preventing pregnancy two different ways," Eyvazzadeh explained.

Birth control methods work in varying ways, whether to prevent fertilization, inactivate sperm, prevent ovulation, thicken cervical mucus or thin the lining of the uterus.

Taking two of the same methods together can decrease efficacy. Combining hormonal methods is typically not recommended.

"If you take hormonal birth control to stop the body from ovulating, you don't want your second method to also be preventing ovulation. The second method should be to stop or kill sperm," Eyvazzadeh said. "You don't want to have an IUD and take a hormone birth control pill, as that might not be safe or increase the effectiveness."

Using two barrier methods, such as two external condoms, two internal condoms or an internal and external condom together, is less effective and can increase the risk of tearing.

How to combine methods

Not all birth control works the same for everyone. Pastorelli Mosca explained that some methods, such as a cervical cap, which is 71 percent effective for people who have given birth vaginally, can be less effective than others, and people might choose to combine two for some extra security.

Eyvazzadeh said common combinations include birth control pills and condoms, spermicide and condoms, and using a birth control app that tracks fertility status with condoms.

"There are a lot of possible combinations that can be safely used, but not every method is suitable for everyone, and some methods might be less effective than others when combined with specific other ones," Pastorelli Mosca said.

Speak with your healthcare provider to weigh your options.

"Hormonal methods can be used for medical reasons to relieve symptoms and to manage some gynecological conditions," Pastorelli Mosca said.

These conditions could include the management of endometriosis or fibroids.

Some types of birth control can come with side effects, so choices can depend on the person, their preferences and their medical history.

"Choosing a method should be aligned with what the person feels comfortable using and with what they are able to use in a good, effective, regular and safe way," Pastorelli Mosca said.

If you are adding a second method, don't hesitate to speak with your healthcare professional.

"It is always best to talk with your doctor before adding things to your birth control methods. They can help you decide which methods are best for you," Eyvazzadeh said.

The bottom line

Birth control can be highly effective at preventing unintended pregnancy. When considering which method might be suitable for you, consider STI protection, long-term fertility goals and your lifestyle. Contact your healthcare professional to learn what method would best suit your needs.

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