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15 Forms of Contraception

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Last updated July 15, 2022

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From abstinence, to IUDs, to the pull out method, we’re ranking how likely you can get pregnant from your prevention method of choice.


Are you sexually active, or looking to be sexually active, but not ready for children? Let’s talk about birth control. Birth control is not a new topic. Birth control is the act of preventing pregnancy in many forms such as medications, procedures, devices, and behaviors. Different methods have been around for thousands of years. However, as time goes on, new and more effective forms of contraceptives have come into our lives. If the timing is not right for you to have children, you need the most effective form of birth control to give you peace of mind. The type of birth control you use is a personal decision, and it is important to have all the facts. We’re breaking down the different forms of birth control, and how effective they are for you.

Below is a chart to break down the different forms of birth control and their effectiveness. Two things to consider when reading this chart:

  • Use effectiveness: this percentage takes into account how well the contraceptive works in typical daily life use. Human error and other non-ideal factors play into this number.
  • Theoretical effectiveness: this percentage represents how effective the birth control would be if used perfectly and under ideal conditions.
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Sexual abstinence and outercourse (100% use effectiveness)

Abstaining from sex is the most effective method of birth control. There are different interpretations for what “abstinence” truly means. For some, abstinence means not having vaginal intercourse, but experience other sexual activities that do not lead to pregnancy. This is better known as outercourse. Others believe abstinence means completely refraining from sexual activities altogether. True abstinence has many benefits as well such as no hormonal or medical side effects, no cost, and can prevent pregnancies, and STDs. To summarize, if sperm has no chance to enter the vagina, you’re chances of getting pregnant are basically nonexistent.

Vasectomy (99% use effectiveness)

A vasectomy is a surgical sterilization procedure that involves cutting the tubes that carry sperm. This is done typically by men who are certain they do not to father any, or more, children. In a typical vasectomy, a doctor will administer local anesthesia, and then make a small incision in the scrotum, cut the two vans deferens tubes and either ties, stitches, or cauterize them to prevent sperm from passing. A vasectomy needs about three months to fully work, as it takes this amount of time for sperm to be fully sperm free. There are many benefits to vasectomies, such as very low chance of pregnancy and ability to have sex without a condom. However, one potential downside is the vasectomy cost. For patients not covered by insurance, a vasectomy costs around $250-$1000. If a patient is are covered by insurance, it can cost $10-$100. If you change your mind later on, the cost of vasectomy reversal can be anywhere from $6000 to $15000.

Tubal litigation or tubal implants (99% use effectiveness)

Tubal Litigation, or commonly known as getting tubes tied, is a surgical procedure where a woman’s fallopian tubes are blocked, tied, or cut. Tubal implants (such as Essure) is a nonsurgical procedure where small metal springs are placed in each fallopian tube. Over time, scar tissue will grow around each implant, permanently blocking the tubes. Both procedures prevent eggs from passing into the ovaries into the tubes, thus stopping the fertilization process. Both procedures are seen as permanent birth control methods, and thus extremely effective. This form of birth control should only be considered if you are sure you do not want any, or more, children.

IUD (99% use effectiveness)

An intrauterine device (IUD) is a small, T-shaped plastic device that is used to prevent pregnancy. Your doctor inserts this device into your uterus. A plastic string that is tied to the end of the IUD hangs down through the cervix into the vagina, making it easier to check that the IUD is in place or for doctors to eventually remove the IUD. This type of birth control helps prevent the fertilization of eggs by damaging or killing sperm and making mucus in the cervix thick and creamy, so sperm cannot get through to the uterus. It also keeps the uterus lining from growing very thick, making it harder for an egg to fertilize and grow. IUDs can be wrapped in either hormones or copper. Hormonal IUDs releases levonorgestral, a form of the hormone progestin. This type of IUD is slightly more effective than copper IUDs and can prevent pregnancy for up to 3-5 years. A copper IUD is the most commonly used form of IUD. Copper wire is wound around the stem of the T-shaped device. It can stay in place for up to 10 years and is a highly effective form of birth control. Following your IUD procedure, have someone drive you home from the doctor office. You may experience some mild cramping and light bleeding, or spotting, for 1-2 days. Avoid inserting anything into your vagina for the first 24 hours after your procedure, including sex and tampons. Also, check in with your doctor 4-6 weeks after inserting the IUD, to make sure it is still in place.

Depo-Provera (97% use effectiveness)

Depo-Provera is a long-acting prescription form of birth control that only contains the hormone progestin. It is given by injection and repeated every 12 weeks. Depo-Provera stops your body from ovulating, makes your cervical mucus thicker, and thins out the lining of your uterus, all making it harder to get pregnant. The contraceptive starts to go into full effect within 24 hours if the shot is injected within 5 days of starting your period. However, if you get your Depo-Provera shot later than 5 days after your period, use condoms for a week after the shot to be safe. Depo-Provera is a highly effective birth control option for women who have completed childbearing, but do not want tubal litigation. It is also a good option for women who can't use other forms of birth control because of medical conditions or side effects from other forms of contraceptives.

Evra Patch (92% use effectiveness)

The Evra Patch, or commonly known as the birth control patch, is a hormonal contraception. This method is highly effective at preventing pregnancy. It is a small, square patch that looks like a plastic bandage and sticks to your skin while it gradually releases hormones into your body. The patch contains the hormones estrogen and progestin that gets absorbed into the body. It usually takes a week to go into full effect. The Evra Patch is fairly easy to use. Choose a clean area of the body to place the patch, such as your stomach, upper arm, upper back, or shoulders. Avoid touching the sticky part when placing it on your skin and make sure the patch is firmly on. The patch gets changed out once a week. Benefits include a higher rate of effectiveness, regulation of your menstrual cycle, shorter and lighter periods, and only need to apply it once a week. However, risks include deep vein thrombosis, stroke, heart attack, and pulmonary embolism. Talk to a doctor if this method is right for you.

Birth control pill (92% use effectiveness)

Oral contraceptives, or birth control pills, are medications you take by mouth to prevent pregnancy. Choosing a birth control pill can be intimidating as there are so many options out there. There are two types of birth control pills: combination pills and progestin only pills. Combination pills contain synthetic forms of estrogen and progestin. Most pills in each cycle are active, meaning they contain hormones. The remaining pills are inactive, or “placebo pills.” There are many types of combination pills, such as monophasic pills, multiphasic pills, and extended-cycle pills. Progestin only pills, or minipills, do not contain the hormone estrogen. These pills are good choices for women who can’t take estrogen for health reasons. With progestin only pills, all pills are active. When deciding which type of pill to take, talk to your doctor about factors such as your menstrual symptoms, your cardiovascular health, other medications you currently take, and any chronic conditions you may have.

NuvaRing (92% use effectiveness)

The NuvaRing is another birth control option for women. It is a small, flexible contraceptive ring that contains hormones seen in other forms of birth control. A woman inserts the ring into her vagina, where it stays for 3 weeks, releasing a steady, low dose of hormones. A week before her period, a woman will remove the ring. The ring is good for women who do not want to remember to take a pill every day or wear a patch on their skin. NuvaRing is not for women with a history of blood clots, strokes, or heart attacks, has had breast cancer, could be or is pregnant, or smokes, especially over the age of 35. While very effective, the NuvaRing side effects can include headaches, weight gain, nausea, breast tenderness, or vaginal irritation.

Male condoms (85% use effectiveness)

The male condom is a thin sheath made of latex, non-latex condom, or other synthetic materials, that fits over an erect penis. The condom catches semen during ejaculation to prevent it from entering the vagina and cervix. A new condom should be used after each act of sex. Condoms are a very popular form of contraception as they are inexpensive and sold in accessible places. Male condoms come in many sizes with many benefits, making it appealing to both men and women for sexual activity. They also have no risks or side effects, unless you may be allergic to the type of condom being used. However, condoms are also not as effective as some other forms of contraceptives. They also reduce the male sensation, making sex slightly less pleasurable.

Diaphragm contraceptive (84% use effectiveness)

The vaginal diaphragm is a thin silicone dome with a flexible rim that, once inserted into the vagina, fits over the cervix and is held in place by vaginal muscles. The diaphragm holds spermicide in place over the opening of the uterus. If a diaphragm is the contraceptive method you choose, the first step is to go to a doctor to get a fitting. The doctor inserts a few sizes to ensure which is best. The next step is to choose between which type of diaphragm you want: coil, flat, or arcing spring. Before sex, insert the diaphragm up to two hours before. Spermicide is ineffective after 2 hours, so this should be the maximum time you insert it prior to intercourse. After sex, the diaphragm should be left in place for 6-8 hours. After using the diaphragm, wash it with mild soap and water. Benefits include easy to carry around, comfortable, does not change menstrual cycle, and does not affect future fertility. Risks include not protecting against STDs, requiring a fitting at a clinic, need occasional refitting, possible allergic reaction, may increase risk of bladder infections and can be messy.

Cervical cap (84% or 68% use effectiveness)

A Cervical Cap, also known as a cervical cover, is another device that is inserted into the vagina that fits over your cervix. A fitting is also required for a cervical cap, but it is ultimately kept in place by suction. Similar to a diaphragm, it blocks semen from entering the uterus and should be left in for 8 hours. It is important to note that cervical caps are much more effective in women who have not had children versus those who have already given birth. This is because the cap needs to hug the cervix tightly, and women who have given birth already have widened their cervix to pass a baby through. Spermicide should be used with a cervical cap to kill any sperm that does go into the body.

Contraceptive sponge (84% or 68% use effectiveness)

The contraceptive sponge, popularly branded as the Today Sponge, is a sponge contraceptive that is saturated with spermicide to prevent pregnancy. It is made of plastic foam, soft, round, and has a nylon loop attached to the bottom for removal. It is inserted deep into the vagina prior to intercourse. The saturated sponge covers the cervix to block semen from entering the uterus while continuously releasing spermicide to stop sperm from traveling. Similar to the cervical cap, the sponge is less effective in women who have given birth. For women who have had children, her partner can help make the sponge more effective by using a condom. The sponge is not for women who are allergic to sulfra drugs, are not comfortable touching the vagina or vulva, have physical problems with the vagina, have difficulty inserting things into the vagina, had a recent abortion, child, or miscarriage, or have a reproductive tract infection. It is also important to note the sponge cannot be used if there is any vaginal bleeding, including during your period.

Spermicides (71% use effectiveness)

Spermicides are foams, jellies, tablets, creams, suppositories, and dissolvable films that contain chemicals that kill sperm. The spermicide stops sperm from moving to and entering an egg. Although spermicides can be used alone, they are frequently used and more effective if combined with condoms, diaphragms, or other forms of contraceptives. Spermicides are available without prescription at many local drug stores and supermarkets. It is important to follow the directions carefully and ensure you are not allergic to any of the chemicals in the spermicide. before using.

Fertility awareness method (FAM, 75% use effectiveness)

Fertility Awareness Method, also known as natural family planning or the rhythm method, is a way to predict when you are most fertile or unfertile based on your menstrual cycle. FAM is based on facts and signs you receive from your body, which change during each menstrual cycle in response to the hormones that cause ovulation. If FAM is your method of birth control, you must abstain from sex completely, or use another form of contraceptive, during your fertile times. If you choose natural family planning, you need to learn the facts about pregnancy, such as when an egg is released, how long sperm can live in the body, and when do you ovulate. Compared to other forms of birth control, FAM is not highly effective and should only be used if you are against other forms of birth control, or are very aware of your body.

Pull Out Method (73% use effectiveness)

Does the pull out method work? Well, it is a form of birth control, but must less effective than the choices previously mentioned. The Withdrawal Method, also known as coitus interruptus or “the pull out method,” is when a man pulls his penis out of a woman’s vagina right before he ejaculates, limiting the chance of any sperm reaching and entering an egg. This method requires great self- control, experience, and trust, as if not done correctly, can end up in pregnancy. Some experts believe that pre-ejaculate, or precum, can pick up enough sperm left in the urethra from a previous ejaculation to cause pregnancy. While precum pregnancy isn’t likely, it is a possibility. There are benefits to the pull out method: it isn’t affected by other medications, can be done while breastfeeding, it is hormone free, and it is free. However, coitus interruptus, if not done properly is not reliable, it interrupts sex, and does not protect against any STDs.

Doing nothing (15% use effectiveness)

No Method is essentially taking the risk and having sex with no form of birth control. This is the least effective way to prevent a pregnancy. In fact, it is only 15% effective. If you are having intercourse without birth control, you can get pregnant- whether it is your first time or 50th time. This method should only be used if the partners are okay with the chance of pregnancy. Otherwise, use birth control to prevent pregnancy.

Many women who are interested in birth control are trying to find which method is best for them. It can be a tough decision with so many options out there. However, it is important to learn about each method to help make a final decision. After learning about all the different options out there, the choice is up to the individual. We want you to feel informed, assured, and honest in regards to contraceptives. Talk to your partner, talk to your doctor, talk to your friends, and talk to your family. And we’re here to help provide any information for any decisions you decide to make.

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Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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