Contraception

In this Article

Long-Acting Reversible Contraception (LARC): Implants and IUDs

These methods are “long acting” because they are placed in your body and work for a long time without any maintenance. They are “reversible” because if you stop using them, you can get pregnant. They are not permanent.

How they work:

An implant is a thin rod containing the hormone progestin that is placed under the skin in your upper arm. The implant releases the hormone into your body. An IUD (intrauterine device) is a small T-shaped device that a doctor puts into your uterus. A hormone IUD releases progestin into the uterus to prevent pregnancy. The copper IUD (ParaGard) does not use hormones but makes the environment in the uterus unfriendly for pregnancy.

How well they work:

These are very effective birth control methods. For all three, the unintended pregnancy rate (failure rate) is less than 1%: less than 1 out of every 100 women gets pregnant during the first year of typical use of these methods. But they don’t protect against HIV infection or other sexually transmitted diseases (STDs).

What you have to do:

You have to go to the doctor to get these put in, but after that you don’t have to do anything else. The implant lasts 3 years, the hormone IUD lasts 5 years, and the copper IUD lasts 10 years.

Hormonal Birth Control: Pills, Injections, Patch, and Ring

How they work:

Hormonal birth control methods work by preventing a woman from ovulating, or releasing eggs. If no egg is released, it can’t be fertilized by sperm during sex and the woman can’t become pregnant. How well they work: The unintended pregnancy rate for these methods is low (6-9%), so most people who use these methods do not get pregnant while using them. But they don’t protect against HIV or other STDs.

What you have to do:

For pills, you have to take one every day or according to the schedule you are given. For injections, you have to go to the doctor every 3 months for a shot of progestin. For the patch, you put a new patch on your skin every week for 3 weeks, and then skip the fourth week so you can get a period. For the ring, you place it in your vagina for 3 weeks, take it out so you can get a period, and then put a new ring in after your period week.

Barriers: Diaphragm, Sponge, Condoms, and Spermicide

How they work:

Barrier birth control works by keeping sperm away from eggs. Male condoms go over the penis and female condoms are inserted into the vagina. The diaphragm or cervical cap goes over a woman’s cervix so sperm can’t get into the uterus. The sponge also goes over the cervix but has a spermicide that kills sperm before it can reach the egg. You can also buy spermicide alone as a foam, gel, film, cream, suppository or tablet and insert it into the vagina before sex.

How well they work:

The diaphragm and cervical cap have an unintended pregnancy rate of 12%, male condoms 18%, female condoms 21%, and spermicides 28%. Condoms protect against HIV and other STDs, but the other methods do not.

What you have to do:

You must have these with you and use them correctly every time you have sex. You can buy most of these over-the-counter, except for the diaphragm or cervical cap. You must go to the doctor to get a diaphragm or cervical cap that fits you.

Sterilization

How it works:

If you never want to become pregnant in the future, sterilization is a permanent and safe birth control method. Women can have their Fallopian tubes tied so sperm can’t get to the egg. Women can also have a small device put into the tubes to make scar tissue grow and close the tubes off. Men can be sterilized by having a vasectomy. This surgery prevents sperm from going into the penis. The man will still have ejaculate but there will be no sperm in it.

How well it works:

This method works very well for preventing pregnancy. The unintended pregnancy rate is less than 1% (0.15% for male vasectomy and 0.50% for female sterilization). It does not protect against HIV or other STDs.

What you have to do:

Most importantly, you have to make a decision about your fertility and plans for the future because this is permanent birth control. Vasectomy and tubal ligation (tubes tied) are outpatient surgeries, and you can go home the same day. Women who have trans-cervical sterilization (tube scarring) can have it done in the doctor’s office.

Fertility Awareness (also called Natural Family Planning or the Rhythm Method)

How it works:

A woman tracks her cycle so she knows which days she is most likely to be fertile, and avoids sex or uses other birth control during those times. This is easier to do if you have a regular cycle.

How well it works:

Success with this method varies quite a bit, but on average it has an unintended pregnancy rate of 24%.

What you have to do:

You must track your cycle carefully so you know which days you are more likely to get pregnant. You must also plan for other birth control during those times, or avoid sex.

Emergency Contraception

Emergency contraception should not be used as regular birth control, but is a good option for preventing pregnancy if your birth control failed or you were not using any. There are two types of emergency contraception:

  • Copper IUD. Go to a doctor to have a copper IUD inserted up to 5 days after unprotected sex.
  • Pill (“morning-after pill”). You can get the “morning-after pill” over the counter at a pharmacy or from your doctor. If you get the Ella pill (made with ulipristal acetate), you can take it up to 5 days after unprotected sex. A pill made with levonorgestrel such as Plan B One Step works best within 3 days, but can be taken up to 5 days after unprotected sex. While Ella requires a prescription, the levonorgestrel pills do not. Do not take both of these pills together.

Decisions about birth control and pregnancy are important and personal. You need birth control that works for your body, goals, and lifestyle. Birth control methods vary by how they affect your body, how well they work and how easy they are to use. While some use hormones, others do not. Some require you to do something every day or every time you have sex, while others are put in your body and work without you having to think about them. Some permanently affect your ability to get pregnant, but most don’t.

This article explains the options for birth control as well as important things to think about when choosing birth control that works for you.