Above image from Bedsider, which has an excellent birth control method guide.
Before we get started, it should be noted that while birth control methods are meant to prevent pregnancy, they may not have any effect, or limited effect, on protecting against STDs. Read more about the different kinds of STDs and how they are spread here.
The costs of each kind of method varies depending on your health care coverage and location. Abstinence and withdrawal are the only methods that don’t cost anything. Many clinics and schools offer free male condoms; the app Condom Finder can help you locate free condoms based on your zip code.
Abstinence: Abstinence means you are not having intercourse at all. It is the only 100% guaranteed way not to get pregnant. Some people include other sexual play, like blow jobs and eating a woman out, as part of abstinence, but you will not get a woman pregnant from a blow job or by eating her out. You can, however, spread STDs through those forms of sexual play.
Condoms (male): Typical brands of condoms are Durex, LifeStyles, and Trojan, which are all highly effective at preventing pregnancy and protecting against some STDs. If your partner is allergic to latex, you’ll have to find another option, like polyurethane condoms, polyisoprene condoms (the brand SKYN offers several alternatives), or female condoms. Read more about alternatives to latex condoms in this YourTango post. If you are using latex condoms be sure to use a water-based lubricant like Aloe Cadabra that doesn’t degrade the latex, unlike oil-based lubricants. Read more about different kinds of lube here. Scarleteen also has a ton of great articles about everything you want to know about condoms, preventing pregnancy, and staying safe.
Condoms (female): A baggier looking version of the male condom, the female condom is made of a thin soft plastic that is inserted deep into the vagina. The general consensus is that male condoms are more effective at preventing STDs and pregnancy than female condoms, but nonetheless female condoms do offer moderate protection, can be put in place up to 8 hours before sex, and will accommodate any penis size.
Diaphragm/ Cervical Cap: a custom sized rubber dome-shaped cap that covers a woman’s cervix. A diaphragm must always be used with spermicide to be effective.
Fertility Awareness: Most women get pregnant when they are ovulating (which is usually the halfway point between her periods); some women who are really in touch with their bodies and have regular, predictable periods avoid having sex a few days before and after they are ovulating – or use a different method of birth control during that time – to prevent pregnancy. Learn more here on WebMD.
Implant: A single, thin rod that is inserted underneath the skin of a women’s upper arm. The implant contains the hormone progestin, which is released into the body over 3 years. Typical use failure rate is less than 1%.
IUD: IUD stands for intrauterine device. It is essentially a small “T” shaped device that a doctor places inside a woman’s uterus. There are 2 different kinds:
- Copper T intrauterine device (IUD): Has a plastic T frame wrapped in copper wire coils that can stay in your uterus for up to 10 years. It prevents pregnancy by creating an inflammatory reaction in the uterus that is toxic to sperm. Typical use failure rate is less than 1%. Learn more here on the Mayo Clinic’s site.
- Levonorgestrel intrauterine system (LNG IUD)—The LNG IUD is similar in size and shape to the Copper IUD. It releases tiny amounts of progestin each day to keep you from getting pregnant. The LNG IUD stays in your uterus for up to 5 years. Typical use failure rate is less than 1%.
NuvaRing: Is a vaginal ring made of flexible plastic that releases estrogen and progestin. You place it in your vagina for 3 weeks and take it out on the 4th week in order to have a regular period.
Oral Contraceptives: aka “The Pill” is a pill containing a combination of progestin and estrogen hormones (though sometimes just progestin) taken orally at the same time every day. Some of the most common brands are Estrostep Fe, LoEstrin 1/20, Ortho-Novum 7/7/7, Ortho Tri-Cyclen Lo, Yasmin, and Yaz. Progestin only pills, like Micronor, Nora-BE, Nor-QD, and Ovrette, are more appropriate for smokers, diabetics, those at risk for heart disease, as well as those at risk for blood clots. Extended-cycle pills like Lybrel, Seasonale, and Seasonique cause you to have a period only every 3 months.
Many women use both oral contraceptives and condoms with their male partners to reduce their chances of getting pregnant. There are side effects to every kind of oral contraceptive, some good (clears acne, regulates periods, eases cramps), some bad (breast tenderness, weight gain, moodiness); make sure you ask your doctor about the potential risks of the brand you’re considering and keep track of any symptoms you may have.
Patch: According to the CDC, the skin patch, usually Ortho Evra, is worn by women on the lower abdomen, buttocks, or upper body like the back or arms (not breasts). It releases hormones progestin and estrogen into the bloodstream. You put on a new patch once a week for three weeks. During the fourth week, you do not wear a patch, so you can have a period. Typical use failure rate: 9%, but may be higher in women who weigh more than 198 pounds.
Permanent forms of birth control: From the CDC, the following are appropriate for people that know they do not want pregnancy at any time in the future:
- Female Sterilization – aka Tubal Ligation or “tying tubes”: A woman can have her fallopian tubes tied (or closed) so that sperm and eggs cannot meet for fertilization. The procedure can be done in a hospital or in an outpatient surgical center. You can go home the same day of the surgery and resume your normal activities within a few days. This method is effective immediately.
- Transcervical Sterilization: A thin tube is used to thread a tiny device into each fallopian tube. It irritates the fallopian tubes and causes scar tissue to grow and permanently plug the tubes. It can take about three months for the scar tissue to grow, so use another form of birth control during this time. Return to your doctor for a test to see if scar tissue has fully blocked your fallopian tubes.
- Male Sterilization – Vasectomy: This operation is done to keep a man’s sperm from going to his penis, so his ejaculate never has any sperm in it that can fertilize an egg. The procedure is done at an outpatient surgical center. The man can go home the same day. Recovery time is less than one week. After the operation, a man visits his doctor for tests to count his sperm and to make sure the sperm count has dropped to zero; this takes about 12 weeks. Another form of birth control should be used until the man’s sperm count has dropped to zero.
- Although most women and men who undergo contraceptive sterilization do not regret having had the procedure, the permanence of the method is an important consideration, as regret has been documented in studies. For example, the U.S. Collaborative Review of Sterilization (CREST) study found that women who were younger at the time of the procedure were more likely to experience regret.An additional issue addressed by the CREST study was the question of whether women who underwent contraceptive sterilization developed a “post-tubal ligation syndrome” of menstrual abnormalities, something that had been debated for years. Results indicated that menstrual abnormalities were no more common among women who had undergone tubal sterilization than among women who had not.When considering a vasectomy, it’s important to understand that failures can occur. CDC research has estimated there is a probability of 11 failures per 1,000 procedures over 2 years; half of the failures occurred in the first three months after the vasectomy, and no failures occurred after 72 weeks. CDC research also examined regret among women whose partner underwent a vasectomy. In interviews with female partners of men who received vasectomies, CDC found that while most women did not regret their husband’s vasectomies, the probability of regret over 5 years was about 6%. This is why it is important to know facts about this and other permanent forms of birth control before making a decision.
The Shot: Known as “Depo” or Depo-Provera, the shot is a single injection for women that contains the hormone progestin, which prevents the ovaries from releasing eggs and thickens the cervical mucous, which makes it more difficult for sperm to get to travel to the eggs. The shot is effective for 3 months, so you’ll need to get 4 shots a year.
Spermicides: Come as creams, foams, films, gels, and suppositories that contain chemicals that stop sperm from moving and getting through the cervix where they can fertilize an egg. Spermicides all work a bit differently, but generally a woman inserts spermicides with an applicator deep into her vagina. Be sure to read the instructions on the box.
Sponge: A round piece of white plastic foam with a little dimple on one side and a nylon loop on the other (to remove the sponge after use) that is inserted deep into the vagina up to 24 hours before sex. The sponge prevents pregnancy by simultaneously releasing spermicide and blocking entry to the cervix. Learn more about how to use the sponge here on Bedsider.
Withdrawal: Also called the “pull out method” or “coitus interruptus”, withdrawal is only effective if it’s done right every time, which means a guy has got to have a lot of control and awareness about what his body is doing, be able to pull out of a woman before he ejaculates, and keep all semen away from her vagina. Withdrawal is not a recommended method unless you don’t mind getting pregnant.
Plan B pill: is also called emergency contraception or the “morning after pill.” It is not a form of regular birth control and should only be used as back up. If you are a woman in a heterosexual relationship and you did not use any birth control methods, or think you may be pregnant because the condom you were using broke for example, the Plan B pill might be an appropriate option for you. The Plan B pill can be taken within 5 days of unprotected sex – the sooner you take it, the more effective it will be. Essentially the pill forces you to have your period, flushing out whatever egg may have been fertilized by your partner. IMPORTANT: New research has come out suggesting that the Plan B emergency contraceptive pill may not be effective for overweight and obese women. Read more about that here in an NPR report.
Got more questions? Planned Parenthood and the Centers for Disease Control and Prevention (CDC) have some great information and resources available. You can also consult your doctor, nurse practitioner, or an expert from your local clinic.