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.

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Many current contraceptive methods are safe, convenient, effective, and inexpensive.Adobe Stock

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.

Hormonal methods generally prevent ovulation (the release of an egg), make it more difficult for sperm to enter the uterus, or prevent a fertilized egg from implanting in the uterus, according to ReproductiveFacts.org.

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.”

RELATED:?Birth Control in America: A Brief History of Contraception

How Effective Is Birth Control?

The effectiveness rate of various birth control methods is based on perfect use — meaning the method is used consistently and correctly every single time — and typical use, which includes people who use the method inconsistently or incorrectly, according to the sexual and reproductive health research group the Guttmacher Institute.

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.

RELATED: Learn More About Contraception Speak: What Is Perfect Use of Birth Control?

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

There are two types of birth control pills: combination pills that contain both estrogen and a form of?progesterone?called progestin, and progestin-only pills (also known as the mini pill), according to Planned Parenthood.

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.

How effective are birth control pills? According to the Guttmacher Institute, combined and progestin-only birth control pills are more than 99 percent effective if used perfectly, and 93 percent effective if used typically.

How much do they cost? You need a prescription to get birth control pills. They may cost nothing or up to $50 a month, and can be free or low-cost with most types of health insurance, Medicaid, or other government programs.

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:

  • Nausea
  • 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

An injection of?Depo-Provera?(also known as the birth control shot) can prevent pregnancy for three months, according to Planned Parenthood.

The shot contains high-dose progestin to prevent ovulation, and it also makes cervical mucus thicker to prevent sperm from reaching the egg.

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.

How effective is the shot? According to the Guttmacher Institute, injectables are more than 99 percent effective with perfect use, and 96 percent effective with typical use.

How much does it cost? It can cost nothing or up to $150, and it can be free or low-cost with many health insurance plans, Medicaid, and some government programs, according to Planned Parenthood.

Hormonal Contraception Option: Birth Control Implant, or?Nexplanon

The birth control implant, also called Nexplanon, is a small rod about the size of a matchstick that is placed into the upper arm. It releases progestin to prevent pregnancy for up to three years.

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)

Like combination birth control pills, the vaginal ring contains both progestin and?estrogen, according to Planned Parenthood.

It’s a small ring that a woman wears inside her vagina, and the hormones work to prevent ovulation and pregnancy.

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.

How effective is the vaginal ring? Vaginal rings are more than 99 percent effective if used perfectly, and 93 percent effective if used typically, according to the Guttmacher Institute.

How much does it cost? You need a prescription to get the vaginal ring. NuvaRing can cost anywhere from $0 to $200, and Annovera can cost anywhere from $0 to $2,200. But vaginal rings can be free or low-cost with most health insurance plans, Medicaid, and some government programs.

Hormonal Birth Control Option: The Patch (Xulane or Twirla)

Like the vaginal ring, the patch (brand names Xulane or Twirla) also releases estrogen and progestin, but through a patch worn on your stomach, buttocks, or back, notes Planned Parenthood.

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.

How effective is the patch? The patch is more than 99 percent effective if used perfectly, and 93 percent effective if used typically, according to the Guttmacher Institute.

How much does it cost? You need a prescription to get the patch. One pack of three patches lasts for up to one month, and can cost from $0 to $150. It is free with most health insurance plans, Medicaid, and some government programs, notes Planned Parenthood.

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.

The copper IUD can be used as a regular form of birth control, or as a form of emergency contraception (see more information about emergency contraception below). Per Planned Parenthood, Paragard IUDs are the most effective form of emergency contraception. If you have one inserted within five days after having unprotected sex, it’s more than 99.9 percent effective against pregnancy and then provides very reliable contraception for up to 10 years.

Hormonal IUDs

Like the nonhormonal IUD, hormonal IUDs are a small piece of flexible plastic shaped like a T. They release a tiny amount of progestin into your body over several years, which helps prevent pregnancy, explains Planned Parenthood.

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 effective is the IUD? According to the Guttmacher Institute, all IUDs?are more than 99 percent effective both for perfect and typical use.

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

A diaphragm is a shallow, flexible cup made of silicone that you put inside your vagina. It covers the cervix and acts as a barrier so sperm can’t reach an egg, according to Planned Parenthood.

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 effective is the diaphragm? If used perfectly with spermicide, the diaphragm is 84 percent effective. With typical use, it’s 83 percent effective, according to the Guttmacher Institute.

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

The sponge is small and round and made of soft, squishy plastic, according to Planned Parenthood.

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 effective is the sponge? With perfect use, the sponge is 80 to 91 percent effective (it’s more effective if you’ve never given birth); with typical use, it’s 73 to 86 percent effective, according to the Guttmacher Institute.

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

Like the diaphragm, the cervical cap is a silicone cup, but it’s smaller. You insert the cap deep in your vagina to cover the cervix and prevent sperm from reaching an egg. It’s also more effective when used with spermicide, according to Planned Parenthood.

FemCap is the only type of cervical cap available in the United States.

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 worn as a sheath over the penis during sex. They prevent pregnancy by stopping sperm from getting into the vagina, so it can’t reach and fertilize an egg, explains Planned Parenthood.

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.

How effective are condoms? If used perfectly, male condoms are 98 percent effective, or 87 percent effective if used typically, notes the Guttmacher Institute.

How much do they cost? Male condoms are available in most drugstores, grocery stores, convenience stores, health clinics, online, and vending machines. A box of three usually costs $2–$6. Lower-cost or free condoms are available at various health centers.

Barrier Method Option: Internal Condoms

Internal condoms are soft plastic pouches that you put inside your vagina or anus before you have sex. They prevent pregnancy by covering the inside of your vagina, creating a barrier that stops sperm from reaching an egg. They also help prevent transmission of STIs if worn in the vagina or anus.

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 effective are internal condoms? If used perfectly, internal condoms are 95 percent effective, according to the Guttmacher Institute. If used typically, they are 79 percent effective.

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)

Natural family planning or fertility awareness methods (FAM) generally involve a woman taking note of the most fertile days of her menstrual cycle and avoiding sex during these days.

They include the Billings ovulation method, in which a woman looks at the consistency of her cervical mucus (long and stringy just before ovulation), and tracking basal body temperature (which rises a small amount during ovulation) to predict the time with the lowest odds of pregnancy, according to the Mayo Clinic.

RELATED: 6 Family Planning and Natural Approaches to Birth Control That Are Legitimate Contraception Methods

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 effective is FAM? According to the Guttmacher Institute, the effectiveness of fertility awareness methods including the Billings method varies widely, with a failure rate of less than 1 percent to up to 12 percent with perfect use, and from 2 percent all the way up to 34 percent with typical use.

How much does it cost? About $10 for a thermometer.

Type of Contraception: Pulling Out, or Withdrawal

Pulling out, also known as withdrawal, is when a man removes his penis from the vagina just before ejaculating. It’s tricky, because pre-ejaculate can form before withdrawal. Avoiding pregnancy means keeping all sperm away from the vagina, and even a small amount of sperm can get into the vagina and lead to pregnancy. This method is best used when combined with another birth control method, such as condoms, notes Planned Parenthood.

How effective is withdrawal? According to the Guttmacher Institute, the withdrawal method is 96 percent effective with perfect use and 80 percent effective with typical use.

How much does it cost? Nothing, but condoms are recommended.

Type of Contraception: Abstinence and Outercourse

Avoiding any kind of vaginal, anal, or oral sex is called abstinence, and activities such as kissing, dry-humping, masturbating, massage, and talking about fantasies are considered outercourse. The idea is to keep sperm away from the vagina to avoid pregnancy, but these methods require a lot of dedication and willpower.

How effective are abstinence and outercourse? 100 percent.

How much does it cost? Nothing.

Permanent Methods of Contraception: Tubal Ligation and Vasectomy

For women, sterilization or tubal ligation is a way to permanently prevent pregnancy. It requires surgery to seal off the fallopian tubes so that an egg can never reach a sperm and be fertilized.

Learn More About How to Get Your Tubes Tied: What to Know About Permanent Birth Control

For men, vasectomy is the option for?permanent birth control. A vasectomy is a simple surgery in which the small tubes in the scrotum that carry sperm are cut or blocked off, so sperm can’t leave the body and cause pregnancy.

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).

How effective is permanent contraception? According to the Guttmacher Institute, tubal sterilization and vasectomy both have a failure rate close to 0 percent.

How much does it cost? According to Planned Parenthood, tubal ligation can cost anywhere from $0 to $6,000.

A vasectomy costs between $0 and $1,000.

Both tubal ligation and vasectomies may be totally free (or low cost) with some health insurance plans, Medicaid, and other government programs.

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 effective is the progestin (levonorgestrel) pill? According to Planned Parenthood, levonorgestrel pills can lower your chance of getting pregnant by 75 to 89 percent if you take them within three days after 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.

Ella

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 effective is Ella? According to Planned Parenthood, Ella reduces your chances of getting pregnant by 85 percent if you take it within five days after unprotected sex.

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 effective is the Yuzpe method? The Yuzpe method is thought to be about 75 percent effective at preventing pregnancy, according to the Cleveland Clinic.

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

The copper Paragard IUD is a nonhormonal IUD. Once the IUD is inserted into the uterus, it makes it hard for sperm to fertilize an egg. When used as a form of EC, the copper IUD is most effective if used within five days after unprotected sex.

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.

RELATED: Learn More About Emergency Contraception

Resources We Love

Planned Parenthood

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.

Guttmacher Institute

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.

Learn More About Birth Control Resources

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.
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