Birth control, or contraception, is a way to prevent pregnancy – and there are lots of methods to choose from.
Birth control, or contraception, is a way to prevent pregnancy – and there are lots of methods to choose from.
“You have lots of options when it comes to finding contraception that suits you – and you can change what you use as your life and your needs change,” says Dr Adiele Hoffman, family doctor and Healthily medical expert.
Choosing contraception depends on all sorts of factors, including your medical history, age, pregnancy plans, personal preference, and love life. You also need to think about whether or not you want to use hormone-based contraception, and whether a long-lasting option would work better for you.
“The options can feel overwhelming, especially if you’re very anxious about avoiding pregnancy, or you’ve had negative experiences with certain types of contraceptives in the past,” says Dr Adiele.
But contraception can be vital for your health and wellbeing. Research shows that nearly half (49%) of pregnancies in the US are unplanned. So finding the contraception that’s best for you can be life-changing, giving you control, confidence, peace of mind – and a better-quality sex life.
And that’s what Healthily is here for. Here’s what you need to know to help you choose a contraceptive, whatever your situation and life stage.
It’s anything that helps prevent a pregnancy when you have sex. It includes
Condoms also help prevent
No birth control method is 100% effective. No – not even being sterilized. Although it’s known as ‘permanent contraception’, about 1 in 200 women who are sterilized will get pregnant at some point, and about 1 in 2,000 men who have a vasectomy will become fertile again.
The only way to guarantee you won’t get pregnant is to avoid penis-in-vagina sex, and any other sexual activity where sperm might get near your vagina.
That said, some types of contraception are more reliable than others. Some are more than 99% effective. This means that fewer than 1 in 100 women will get pregnant in a year when using them.
But with many contraceptives, their effectiveness depends on you using them correctly. So something can be more than 99% effective when used perfectly, but less effective when it comes to how most people actually use it – known as ‘typical use’. This might mean forgetting to take a pill, for example.
Read on to learn more about the main types of contraception and their effectiveness.
What is it? Often just called ‘
It prevents pregnancy by stopping your ovaries from releasing an egg (
How effective is it? Over 99% effective if you take it the right way, every day – but this drops to about 91% with typical use.
It doesn’t matter what time of day you take the pill. But trying to take it at the same time each day can help you get into a routine of remembering it.
If you forget a pill and it’s been more than 24 hours since you took your last pill, check the ‘missed pill rules’ your doctor will have given you to find out what you should do next.
What is it? The contraceptive implant – called Nexplanon – is a small, flexible plastic rod that’s placed under your skin by a doctor or nurse, using
It’s a long-acting reversible contraceptive (LARC), which releases the hormone progestin steadily for 3 years.
Like the combination pill, it stops ovulation, thickens mucus in your cervix and thins your womb lining. After 3 years, you can have it taken out and replaced.
How effective is it? Over 99% effective – and because it’s implanted by a healthcare professional, it doesn’t depend on you having to remember to take anything, or go to frequent appointments.
What is it? The contraceptive shot – usually Depo-Provera, sometimes called the Depo shot – needs to be taken every 3 months.
It works by releasing the hormone progestin to stop ovulation, make your cervical mucus thicker and your womb lining thinner.
How effective is it? Over 99% effective, and you don’t need to think about it every day or every time you have sex. But you do need to go to regular appointments – so with typical use, its effectiveness drops to about 94%.
What is it? This is a patch you wear on your skin, which releases estrogen and progestin. These are the same hormones as in the combination pill, and the patch works in a similar way – except that you don’t have to remember to take a pill every day.
Instead, you put on a patch, then forget about it until you need to change it. You have to put on a new patch every week for 3 weeks, then have a week without a patch.
In the US, you’ll usually get either a Xulane or Twirla patch. In the UK, the brand name is Evra.
How effective is it? Over 99% effective if you use it properly – and about 93% effective with typical use. You need to remember to change it each week to keep up the regular dose of hormones.
What is it? Sometimes called the POP or mini pill, this is another pill you take every day. But unlike the combined pill, it only contains progestin – making it an option if you can’t have estrogen.
It makes the mucus in your cervix thicker, so it’s harder for sperm to get through. The newer desogestrel POP can also stop ovulation.
How effective is it? Over 99% effective if you take it properly – but this drops to about 91% with typical use.
You need to take the traditional mini pill on time, every day – if you take it more than 3 hours late, it doesn’t work so well. You have a bit more flexibility with the desogestrel pill, but shouldn’t take it more than 12 hours late.
What is it? Sometimes known as the hormonal coil (or IUS in the UK), the hormonal IUD is a small, T-shaped plastic device that a doctor or nurse places in your womb through your cervix. It has strings that hang down into your vagina, so you can feel them and check it’s in place.
It releases progestin to thicken your cervical mucus and thin your womb lining. How long it works for depends on the type of IUD you have, but it ranges from 3 to 8 years. You can have it removed any time by a healthcare professional.
How effective is it? More than 99% effective, as long as it’s fitted properly.
What is it? The copper, or non-hormonal, IUD – also called the coil or the copper coil – is similar to the hormonal IUD. The difference is that it doesn’t use progestin. Instead, it contains copper – which is toxic to sperm and eggs.
The copper stops sperm moving well and affects how long they can live. It also works by changing cervical mucus, and it may also stop a fertilized egg embedding (implanting) itself in the womb. It protects against pregnancy for up to 10 years.
How effective is it? More than 99% effective, as long as it’s inserted correctly.
What is it? Also known as a ‘rubber’ – because it’s usually made of thin latex rubber, polyisoprene or polyurethane – a condom is worn on an erect penis during sex.
Condoms are a type of ‘barrier’ contraception – they stop semen from coming into contact with your vagina. This means they also help prevent
How effective is it? 98% effective when used properly – though with typical use, this drops to about 82%.
What is it? Like the male condom, the
It’s also made of thin latex, but it goes inside your vagina, rather than over a penis. There’s a ring at the closed end you put into your vagina, and a larger ring at the open end, which covers the area around your vaginal opening.
How effective is it? 95% effective with perfect use, but only about 79% effective with typical use.
What is it? A soft plastic ring that sits in your vagina, which steadily releases estrogen and progestin. This prevents the release of an egg, makes cervical mucus thicker and thins your womb lining.
You usually keep the ring in for 21 days, then take it out and have a week’s break (you’ll probably have a bleed in this time), before putting a new one in.
How effective is it? More than 99% effective if you use it properly, and about 91% effective with typical use.
What is it? A
How effective is it? From 92% to 96% effective when you use it the right way, with a spermicide cream, gel or foam. This falls to 71% to 88% with typical use.
What is it? Also called the rhythm method, natural contraception and fertility awareness method (FAM),
You’re only fertile for a few days every month, around the time you ovulate. So with these methods, you avoid having sex on those days – or use another type of contraception – then don’t use any form of birth control for the rest of the month.
There are different ways of tracking your cycle, including checking your cervical mucus – which gets thinner when you ovulate – and taking your temperature first thing each morning – as this goes up around ovulation.
How effective is it? Between about 76% and 88% effective, depending on how well you use it. It generally doesn’t work as well as some other types of contraception, because it can be difficult to use correctly.
What is it? Also known as the withdrawal method, the
How effective is it? About 96% effective, if you use it perfectly. Unsurprisingly, though, it’s difficult to get it right every time you have sex – and even a tiny amount of semen is enough to cause pregnancy. With typical use, it’s only about 78% effective.
You may be wondering if there’s a type of contraceptive pill that men can take. The answer is that scientists are working on a male pill – but think it’s probably still a few years away at the moment.
What is it?
There are 2 types:
How effective is it? The IUD is the most effective type of emergency contraception. Research suggests it’s more than 99.9% effective – meaning less than 1 woman in 1,000 gets pregnant when using it after unprotected sex.
Research suggests that about 0.6% to 2.6% of women who take the Plan B/Levonelle pill will get pregnant, and 1% to 2% of people who take ella/ellaOne. It’s thought that ella is more effective.
You can take many brands of birth control pills as emergency contraception. You take 2 doses, 12 hours apart, taking the first dose as soon as possible after having unprotected sex.
You’ll need to take several pills in each dose, but the number will depend on which brand of pill you’re using – check that with a pharmacist, doctor or nurse if you’re unsure.
There are lots of things to think about when it comes to choosing a contraceptive method. So we’ve rounded up some of the key questions to ask yourself.
Obviously, if you’re using contraception, you want it to work – that’s a no-brainer. But avoiding pregnancy can be more important for some people than others. So that’s probably the first thing to think about when it comes to choosing what’s right for you.
For example, some people might be taking medication that would be dangerous for a developing baby. While other people might not be planning for a baby, but wouldn’t find an unexpected pregnancy totally unwelcome.
If you want the best possible chance of preventing pregnancy, these methods are more than 99% effective – and don’t depend on how you use them:
The following methods can be more than 99% effective when they’re used perfectly – but with typical use, they’re less than 95% effective:
If you do, it’s condoms – male or female – that you need. These are the only methods that help prevent the spread of STIs.
For them to be effective against STIs, you need to make sure your partner’s genitals don’t touch your genitals without a condom on during vaginal, oral or anal sex.
You should use condoms until you’ve both tested negative for STIs and you feel ready. (And also bear in mind that the usual STI screen doesn’t test for all conditions.)
You can use condoms alongside other methods of birth control, too.
Here’s what you need to know:
if you’re a smoker and over 35 – oral estrogen in the combination pill may slightly raise your risk of a blood clot. Your doctor may suggest you try another type of contraceptive. Better yet, get help to
if you have (or have had)
if you have certain health conditions – some other conditions mean it’s not safe for you to use the combination pill. These include inherited conditions that affect the way your blood clots, such as
if you’re having surgery – this can raise your risk of a blood clot, so if you’re on the combination pill, talk to your healthcare team about whether you should pause it or switch to another contraceptive
Some types of contraception can help with other conditions, such as
If you have one of these conditions and you need birth control, talk to your doctor about what might be best for you. In general:
Your fertility will usually return to what’s normal for you soon after you stop using contraception (unless you’ve gone through
But there are some exceptions:
If you don’t want any delay in your fertility returning, the implant, IUD, condoms or the diaphragm/cap are good options.
If you have a regular routine and you easily remember anything you need to take or do, you can choose pretty much any form of contraception.
If not, it’s worth thinking about what will fit your lifestyle. For example, some people may find it difficult to:
If that sounds like you, it may be worth thinking about using a LARC, such as the implant or an IUD. This can also be a more cost-effective option if you need long-term contraception.
Or you might want to opt for a method you only need to think about when you have sex, such as condoms or the diaphragm/cap.
Lots of people make putting on condoms part of sexual foreplay. But you may feel that pausing to put on a condom or insert a diaphragm can spoil the mood.
If that’s important to you, you could try a different method – as long as you and any partners have been checked for STIs.
Most women can carry on using most types of contraceptive in the lead-up to the menopause, known as the
But there are a few things you may want to think about at this life stage:
Some types of contraception may affect your period. For example, the hormonal IUD and birth control shot may stop your period completely after a while (although you may get some irregular bleeding to start with).
You may like the idea of not having your period – or you may prefer that it doesn’t change. So this is something to think about.
Certain contraceptives can cause side effects. These are usually mild and settle after the first few months, but it’s worth asking your doctor about them.
Common side effects include:
If you have health insurance, this should cover contraception. But if you don’t, the cost of different types of birth control may be something you need to take into account.
You may be able to access publicly funded contraceptive services, if you qualify for that help in your state.
It can be worrying to have to think about how you’ll pay for contraception, but support is available –
In the UK, birth control is free on the NHS.
There are a few different ways you can get contraception:
You’ll need to see a doctor to get many types of contraception, and they can help you make a decision that will suit your health and wellbeing needs.
If this is your first contraception appointment, try not to feel nervous – remember, your doctor will want to help you find the right method for you. If you’re looking to change your contraception, you’re likely to have the same kind of appointment.
Your doctor may:
It’s up to you when you start using contraception, and it’s common to need time to think about your options before you make a decision.
“Contraception choice and effectiveness is a key health concern for many women, so remember that your doctor is there for you throughout your contraception journey,” says Dr Adiele.
They can help if:
There are lots of possible reasons for wanting to change which contraceptive you use, including:
With some methods, you may need to overlap them for a few days to make sure you stay protected.
If you don’t like the idea of overlapping your contraception, you can use a back-up method – usually condoms – until you’re protected, or avoid sex. Your doctor can advise on this.
Thinking you can forget about contraception now you’re in midlife? Not so fast.
Sure, you’re less likely to conceive at this age: at 30, your fertility starts to decline and at 40, only about 1 in 10 women will conceive in a menstrual cycle, compared with 1 in 4 in their late 20s or early 30s. By the time you’re 45, you’re very unlikely to get pregnant.
But everyone’s different, and women in their 40s – and even 50s – can and do get pregnant naturally. In the US, the number of women having babies in their 40s has been going up since 1982. In fact, recent figures show the only age group with a rising birth rate is 40 to 44. In the UK, women in their 40s are having more babies than those in their teens.
For some older women, a healthy pregnancy is welcome news. But if it’s not on your to-do list, you need to keep using contraception until 2 years after your last period if you’re under 50, or 1 year if you’re over 50. If it’s not clear you’ve been through menopause, you should carry on until you’re 55.
You can use it as long as your baby is under 6 months old, you’re not having periods, and you’re only breastfeeding – with gaps not longer than 4 hours during the day or 6 hours at night.
If you don’t meet these conditions or you want a more effective method, you’ll need to use another type of contraception.
Here’s what you need to know about birth control after having a baby:
Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.