If you are sexually active and don’t want to get pregnant (or get your partner pregnant), you may want to think about contraception, also known as birth control. Birth control can help prevent unintended pregnancy, but there are so many options. How do you know which method is right for you?
Below is a birth control guide that will help you get started. Take a look at the options, weigh the pros and cons, and when you’re ready, talk to a healthcare provider about which method or methods are right for you.
Hormonal Methods
The largest class of birth control, hormonal methods, uses the hormones estrogen and progestin—alone or in combination—to prevent ovulation (the release of an egg from the ovaries). If the egg isn’t released, then sperm can’t fertilize it and pregnancy can’t occur. Hormonal birth control also thickens the mucus lining of the cervix, which makes it difficult for sperm to reach an egg.
There are several types of hormonal birth control methods, including “the pill”, hormonal intrauterine device, birth control implant, shot, patch, or ring. These methods are considered very effective at preventing pregnancy. However, keep in mind that hormonal methods alone will not prevent sexually transmitted infections (STIs), so consider using a barrier method (like a condom) in addition to one of these methods.
What it is: Birth control pill, aka “the pill”
How it’s used: The birth control pill is taken once a day, every day, at the same time
Effectiveness: When taken correctly, it prevents pregnancy 99 percent of the time
Possible advantages:
- Easy to use
- Safe and effective
- Can be discontinued at any time
- May have other effects such as fewer menstrual cramps, lighter periods, clearer skin and possibly lower risk of some cancers
Possible disadvantages:
- Must be taken at the same time each day for full effectiveness
- Some medications (including some antibiotics) may decrease effectiveness
- Possible side effects such as changes to menstrual cycle, breast tenderness and headaches
What it is: Emergency contraceptive pill, aka “the morning after pill”
How it’s used: The emergency contraceptive pill prevents or delays ovulation. It may be taken up to 5 days after having unprotected sex. Over the counter methods are more effective the earlier they are taken, and work best when taken within 3 days.
Effectiveness: Up to 89% if taken within 3 days, and up to 95% if taken within 24 hours
Possible advantages:
- Some brands are available over the counter without a prescription
- Easy to use
- Safe and effective
- Effective as a backup method if primary birth control failed (broken condom, missed birth control pill)
Possible disadvantages:
- Must be taken within 5 days to be effective
- Some over the counter brands may be expensive
- Possible side effects include unexpected bleeding, nausea, headaches
- Not recommended for routine use
- May be less effective if your BMI (body mass index) is over 30
What it is: Hormonal intrauterine device (IUD)
How it’s used: A small device is implanted in the uterus and releases progestin
Effectiveness: More than 99 percent
Possible advantages:
- Lasts up to three to five years
- Can be removed at any time
- Private
- No pill to have to remember to take
Possible disadvantages:
- Possible side effects such as cramping and bleeding
What it is: Birth control implant
How it’s used: A small, flexible matchstick-sized device is implanted in the arm
Effectiveness: More than 99 percent
Possible advantages:
- Lasts up to five years
- Can be removed at any time
- Private
- No pill to have to remember to take
Possible disadvantages:
- Possible side effects such as cramping, weight gain, breast tenderness, abdominal pain, irregular periods
What it is: Birth control shot
How it’s used: An injection of progestin every 12 weeks
Effectiveness: 94 percent or higher
Possible advantages:
- Safe and effective
- Light or no periods and fewer menstrual cramps
- May be easier to remember than daily pill
- Private
Possible disadvantages:
- May delay fertility after it’s stopped
- Risk of osteoporosis (bone weakness) may be higher when used for more than two years
What it is: Birth control patch
How it’s used: A patch that releases progestin and estrogen is placed on the skin and changed every four weeks
Effectiveness: 91 percent effective
Possible advantages:
- Easy and discreet
- Safe and effective
- Possible beneficial side effects like reducing periods and menstrual cramps, clearer skin, may reduce risk of certain cancers
Possible disadvantages
- Some medications, including antibiotics, may make it less effective
- May take one to two months for normal menstrual cycle to resume after stopping
What it is: Vaginal ring (brand name NuvaRing)
How it’s used: A small, flexible plastic ring is placed in the vagina and releases birth control hormones and is changed after three weeks (with a one-week break for period)
Effectiveness: 99 percent effective when used correctly; 91 percent effective when inserted late
Possible advantages:
- Easy to use
- Can insert the ring at home
- May have lighter periods, fewer menstrual cramps, clear skin
- Private
Possible disadvantages:
- Some medications, including antibiotics, may reduce effectiveness
- May slightly increase risk of toxic shock syndrome (rare)
Spermicidal Methods
Spermicidal methods of birth control use chemicals to kill sperm on contact. These are often combined with barrier methods of birth control (like condoms), and are generally less effective than hormonal birth control. It’s also a good idea to use condoms with these methods because, like hormonal birth control, they won’t protect against sexually transmitted infections.
What it is: Spermicide
How it’s used: Can be a cream, foam, jelly, tablet, suppository or film that contains nonoxynol-9, inserted into the vagina to kill sperm
Effectiveness: 72 percent effective
Possible advantages:
- Over-the-counter
- Can be used up to one hour before sex
Possible disadvantages:
- May cause allergic reaction, irritation or urinary tract infection
- Yeast infection medication may make it less effective
What it is: Copper IUD
How it’s used: A small copper and plastic device is placed in the uterus, with the copper acting as spermicide
Effectiveness: More than 99 percent effective
Possible advantages:
- Effective up to 10 years
- Can be used as emergency contraception
- Can be removed at any time
- Private
- Safe and effective
Possible disadvantages
- Possible side effects such as cramping and irregular bleeding
What it is: Birth control sponge
How it’s used: A small disc-shaped device made of soft plastic foam that covers the cervix and contains spermicide
Effectiveness: 76 to 88 percent effective; less effective after childbirth
Possible advantages:
- Safe
- Simple and private
- Over-the-counter
- May be inserted up to 24 hours before sex
- Disposable
Possible disadvantages:
- May cause irritation
- Must be kept in for six hours after sex
- Must be removed within 24 to 36 hours after sex to avoid increased risk of toxic shock syndrome
What it is: Diaphragm or cervical cap
How it’s used: These are silicone cups coated with spermicide that are either inserted into the vagina or placed over the cervix
Effectiveness: 77 to 88 percent effective
Possible advantages:
- Simple, easy to use
- Private
- Safe
- Can be inserted at home
Possible disadvantages:
- Must be inserted before every sex act
- Less effective if used incorrectly
- May be difficult to insert
- Should not be used while menstruating
- May cause allergic reaction or irritation
- Risk of toxic shock syndrome if left in place
- Not compatible with all lubricants
Barrier Methods
Barrier methods physically prevent sperm from reaching an egg. Barrier devices are often used with spermicide to increase the effectiveness of both methods.
What it is: Male condom
How it’s used: A thin film, usually made from latex, that goes over the penis and catches sperm
Effectiveness: 85 to 98 percent effective
Possible advantages:
- Also protects against STIs
- Safe
- Easy to use
- Over-the-counter
- Disposable
Possible disadvantages:
- Must use new condom for every sex act
- Latex may cause allergic reaction (although male condoms are available in other materials that are less likely to cause a reaction)
- May alter sensation during sex
- Must be used correctly for maximum effectiveness
What it is: Internal condom
How it’s used: Sheath that goes into the vagina and catches sperm
Effectiveness: 79 percent effective
Possible advantages:
- Safe
- Latex-free
- Covered by most insurance plans
- Sometimes available over-the-counter
- Provides some protection from STIs
- Any lubricant may be used
Possible disadvantages:
- Less effective STI protection than male condoms
- May require prescription
- Must use new internal condom for each sex act
- Can be more expensive than male condoms
Other Methods
These birth control methods don’t fit into the other three categories.
What it is: Fertility awareness method
How it’s used: Tracking fertility signs and planning sexual activity when the woman is the least fertile
Effectiveness: 75 percent effective
Possible advantages:
- Free
- Safe
- Non-medical
Possible disadvantages:
- Inexact, with a large potential margin of error
- It takes 3–6 menstrual cycles to learn effectively
- May be difficult to accurately predict ovulation or fertile times.
- Takes time and effort to track fertilityBoth partners must be committed
What it is: Vasectomy (male sterilization)
How it’s used: The tubes that carry sperm to the penis (the vas deferens) are cut or blocked
Effectiveness: There is a small chance that surgery is unsuccessful, but a successful surgery is almost 100 percent effective in preventing pregnancy by three months after the surgery
Possible advantages:
- Outpatient procedure done under local anesthesia
- Effective
- Low risk of complications
- Effectively permanent
- Quick recovery
- Private
Possible disadvantages:
- Effectively permanent—reversal surgery doesn’t always work
- No STI protection
What it is: Tubal ligation (female sterilization, “having your tubes tied”)
How it’s used: The fallopian tubes are cut, sealed, clipped, or tied
Effectiveness: More than 99 percent effective
Possible advantages:
- Effectively permanent
- Extremely effective
- Some forms may decrease risk of ovarian cancer
- Outpatient procedure
Possible disadvantages:
- Effectively permanent—reversal surgery is complicated, expensive and often ineffective
- General anesthesia necessary
- Risk of complications
- Typically a more involved surgery than male sterilization
- No protection from STIs
Need Help Choosing?
Now you know more about your choices, but picking one can still be pretty overwhelming. We’re here to help. Find the nearest NJFPL provider health center, make an appointment, and learn more about finding the birth control method that’s right for you.