Types of contraceptives – what’s right for you?

23rd November, 2022 • 24 min read

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.

What is contraception?

It’s anything that helps prevent a pregnancy when you have sex. It includes

, hormonal contraceptives like
the pill
, long-acting reversible contraceptives (LARCs) such as the implant, and sterilization (having your Fallopian tubes tied or sealed, or having a

Condoms also help prevent

sexually transmitted infections (STIs)
, while some methods have other health benefits, such as making heavy periods lighter.

Types of birth control and how effective they are

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.

Combination (combined) pill

What is it? Often just called ‘

the pill
’, this combined oral contraceptive (COC) contains the hormones estrogen and progestin.

It prevents pregnancy by stopping your ovaries from releasing an egg (

); making the mucus in the neck of your womb (cervix) thicker, so sperm can’t get through; and making the lining of your womb (endometrium) thinner, so a fertilized egg wouldn’t be able to implant.

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.

Contraceptive arm implant

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

local anesthetic
to numb the area.

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.

Birth control shot

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%.

Contraceptive patch

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.

Progestin-only pill

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.

Hormonal intrauterine device (IUD)

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.

Copper (non-hormonal) intrauterine device (IUD)

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.

Male condom

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%.

Female condom

What is it? Like the male condom, the

female condom
is a barrier contraceptive, which means it protects against STIs.

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.

Vaginal ring

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

is a small dome made of soft, flexible silicone, which you put into your vagina before you have sex. It’s designed to cover your cervix, stopping sperm from getting into your womb to fertilize an egg.

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.

Natural family planning

What is it? Also called the rhythm method, natural contraception and fertility awareness method (FAM),

natural family planning
involves tracking your
menstrual cycle
, so that you know when your body releases an egg.

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.

Pull out method

What is it? Also known as the withdrawal method, the

pull out method
is when your partner takes his penis out of your vagina before he comes (ejaculates). If no semen gets into your vagina, you can’t get pregnant.

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.

Watch this space: the male pill

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.

Emergency contraception

What is it?

Emergency contraception
prevents pregnancy after you’ve had unprotected sex, or if your contraception hasn’t worked – for example, if a condom split during sex.

There are 2 types:

  • morning-after pills – Plan B One Step (or Levonelle in the UK) contains levonorgestrel, and you can get it from a pharmacy or drugstore without a prescription. You need to take it as soon as possible, within 3 days after unprotected sex. Another pill, ella (or ellaOne in the UK), contains ulipristal acetate and can be taken up to 5 days after unprotected sex – but you need a prescription. Both work by stopping or delaying ovulation, and work better the sooner you take them
  • an
    intrauterine device (IUD)
    – some types of IUD can be used as emergency contraception, as well as regular contraception. You need to have an IUD inserted by a doctor or nurse within 5 days of having unprotected sex, but it works as well on day 5 as on day 1

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.

Can I use regular birth control pills as emergency contraception?

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.

How to choose the right birth control for you

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.

How effective does it need to be?

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:

  • contraceptive implant
  • hormonal IUD
  • copper IUD
  • female or male sterilization (usually permanent)

The following methods can be more than 99% effective when they’re used perfectly – but with typical use, they’re less than 95% effective:

  • combination pill
  • birth control shot
  • contraceptive patch
  • progestin-only pill
  • vaginal ring

Do I want protection from STIs?

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.

Do I have any health concerns that I need to take into account?

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

    quit smoking

  • if you’re

    – the combination pill can raise your risk of a blood clot. And there’s some evidence that the birth control shot may cause you to gain a little more weight. Most other types of birth control should be safe for you, but talk to your doctor if you have other risk factors for
    heart disease
    , such as smoking,
    high cholesterol
    high blood pressure

  • if you have (or have had)

    breast cancer
    – you may need to avoid hormonal birth control, as synthetic hormones can sometimes make breast cancers grow. You’ll still be able to use non-hormonal methods, such as the copper IUD and condoms

  • 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

    Factor V Leiden
    , and
    with aura

  • 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

    Are there any other health benefits I could get?

Some types of contraception can help with other conditions, such as

heavy periods

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:

  • for heavy periods – the combination pill, progestin-only pill and hormonal IUD are most effective. They stop the lining of your womb from thickening, and reduce blood loss
  • for acne – the combination pill is often prescribed. Some types of contraception can actually make acne worse, including the implant

What if I want to get pregnant soon?

Your fertility will usually return to what’s normal for you soon after you stop using contraception (unless you’ve gone through

– when your periods stop – while you’ve been on it).

But there are some exceptions:

  • when you stop the birth control shot, it may take up to a year for your fertility to return to normal
  • after stopping some other forms, including the combination pill and vaginal ring, it can take about a month

If you don’t want any delay in your fertility returning, the implant, IUD, condoms or the diaphragm/cap are good options.

How organized am I?

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:

  • take the pill at the same time every day
  • replace the vaginal ring each month
  • make an appointment to have a birth control shot every 3 months

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.

Do I want something that doesn’t spoil the moment?

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.

Do I want help with perimenopause symptoms?

Most women can carry on using most types of contraceptive in the lead-up to the menopause, known as the

(the exception may be if you have a health or lifestyle risk).

But there are a few things you may want to think about at this life stage:

  • the hormonal IUD can help treat heavy period bleeding – which can be a symptom of the perimenopause (read about the
    Mirena coil
    and the menopause)
  • if you want to try
    hormone replacement therapy (HRT)
    for perimenopause symptoms and you still have a womb, you’ll need to take progestin as well as estrogen. As the hormonal IUD releases progestin, it can double up as HRT
  • the combination pill can help regulate periods and may ease symptoms such as hot flushes – it can be used until you’re 50 if you don’t have any other health issues

Do I mind if my period changes?

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.

What side effects can I put up with?

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:

  • irregular bleeding (spotting) when using the combination pill, birth control shot or implant – especially when you start using them
  • breast tenderness, mood changes, bloating and nausea when using the combination pill – again, these should ease after the first few months

How much does it cost?

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 –

Planned Parenthood
can help with questions about costs.

In the UK, birth control is free on the NHS.

How to get contraception

There are a few different ways you can get contraception:

  • condoms are easy to buy – you can get them from drugstores, supermarkets, vending machines and online. You can also get them for free at some health centers
  • other forms of birth control need to be prescribed by a doctor – whether that’s a primary care physician or OB-GYN. If you don’t want to see your usual doctor, you can also go to a community health center or a sexual health or family planning clinic, such as a
    Planned Parenthood
    center. Some people prefer the anonymity of a clinic

When to see a doctor

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.

What to do before you see a healthcare professional

You could:

  • spend some time reading this article, and the others linked to it, so you have good information about your options
  • show a partner this article, and discuss your options with them. After all, contraception is a joint responsibility – it’s not just on you
  • write down any questions you want to ask. These might include whether there are any side effects, what will happen to your period, and how you should start a type of contraception

What happens at your appointment

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:

  • ask about your health and family history – to help them recommend the best contraceptive for you
  • do some basic checks before prescribing hormonal contraceptives – such as checking your
    blood pressure
    , weight and height
  • carry out a physical check-up before prescribing certain types of birth control – if you have an IUD or diaphragm/cap, you’ll usually need a pelvic exam. For other types of contraception, you shouldn’t need one

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.

Ongoing help from your doctor

“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:

  • you have any concerns about the birth control you’re using, from side effects to how well it works
  • you want to change to a different type of contraception
  • you’ve been on the same contraception for years and want to review whether it’s still the best one for you
  • you’re starting to plan for pregnancy and wondering what the next steps are and how to stop contraception

Switching between contraception methods

There are lots of possible reasons for wanting to change which contraceptive you use, including:

  • you don’t like the side effects of the method you’re using
  • something in your life has changed, so you need a more effective contraceptive
  • you’ve started a committed relationship and want to move away from condoms to a longer-term contraceptive
  • you want a type of contraception that also helps you manage a health condition or perimenopause symptoms

How to switch

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.

Birth control myths

You don’t need contraception in your 40s

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 skip contraception while you’re breastfeeding

Known as

lactational amenorrhea (LAM)
, breastfeeding is a recognised method of natural birth control, which can be about 98% effective if certain conditions are met.

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:

  • it’s possible to get pregnant even if your periods haven’t returned. Because you ovulate 2 weeks before you have a period, it’s hard to predict exactly when you’ll be able to get pregnant again
  • most types of contraception are safe after childbirth. But ones that contain high levels of estrogen – like the combination pill – should only be started after 6 weeks, as there’s some limited evidence that they could affect your milk production
  • you can use the contraceptive implant, shot, mini pill and male or female condoms straight away
  • if you want to use an IUD, you can have it fitted soon after giving birth
    talk to your midwife or another healthcare professional about the best options for you after giving birth

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.