At a glance
There are a number of different kinds of contraceptive methods. You should select your birth control through voluntary, informed choice.
Birth Control Methods
Many elements need to be considered when choosing a contraceptive method. These include safety, effectiveness, availability (including accessibility and affordability), side effects, user control, reversibility, and ease of removal or discontinuation. Contraceptive methods should be chosen through voluntary, informed choice.
You should also consider dual protection from Human Immunodeficiency Virus (HIV) and other sexually transmitted infections (STIs). Although hormonal contraceptives and intrauterine devices (IUDs) are highly effective at preventing pregnancy, they do not protect against STIs, including HIV. Consistent and correct use of the external (male) latex condom reduces the risk for HIV infection and other STIs, including chlamydia, gonorrhea, and trichomoniasis.
Resources for Health Care Providers
Reversible Methods of Birth Control
Intrauterine Contraception
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Levonorgestrel intrauterine system (LNG IUD)—The LNG IUD is a small T-shaped device like the Copper T IUD. It is placed inside the uterus by a doctor. It releases a small amount of progestin each day to keep you from getting pregnant. The LNG IUD stays in your uterus for up to 3 to 8 years, depending on the device. Typical use failure rate: 0.1-0.4%.1 Copper T intrauterine device (IUD)—This IUD is a small device that is shaped in the form of a “T.” Your doctor places it inside the uterus to prevent pregnancy. It can stay in your uterus for up to 10 years. Typical use failure rate: 0.8%.1 |
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Hormonal Methods
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Implant—The implant is a single, thin rod that is inserted under the skin of a women’s upper arm. The rod contains a progestin that is released into the body over 3 years. Typical use failure rate: 0.1%.1 |
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Injection or “shot”—Women get shots of the hormone progestin in the buttocks or arm every three months. Typical use failure rate: 4%.1 |
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Combined oral contraceptives—Also called “the pill,” combined oral contraceptives contain the hormones estrogen and progestin. It is prescribed by a doctor. A pill is taken at the same time each day. If you are older than 35 years and smoke, have a history of blood clots or breast cancer, your doctor may advise you not to take the pill. Typical use failure rate: 7%.1 Progestin only pill—Unlike the combined pill, the progestin-only pill (sometimes called the mini-pill) only has one hormone, progestin, instead of both estrogen and progestin. It is prescribed by a doctor. It is taken at the same time each day. It may be a good option for women who can’t take estrogen. Typical use failure rate: 7%.1 |
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Patch—This skin patch is worn on the lower abdomen, buttocks, or upper body (but not on the breasts). This method is prescribed by a doctor. 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 menstrual period. Typical use failure rate: 7%.1 |
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Hormonal vaginal contraceptive ring—The ring releases the hormones progestin and estrogen. You place the ring inside your vagina. You wear the ring for three weeks, take it out for the week you have your period, and then put in a new ring. Typical use failure rate: 7%1 |
Barrier Methods
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Diaphragm or cervical cap—Each Before sexual intercourse, the diaphragm or cap is inserted in the vagina with spermicide to block or kill sperm. These methods are prescribed by a health care provider. Typical use failure rate for the diaphragm: 17%.1 Typical use failure rate for the cervical cap: 22%.1 Sponge—The contraceptive sponge contains spermicide and is placed in the vagina where it fits over the cervix. The sponge works for up to 24 hours and must be left in the vagina for at least 6 hours after the last act of intercourse, at which time it is removed and discarded. Typical use failure rate: 17%.1 |
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Male condom—External (male) condoms help prevent sperm from entering a partner's body. Latex condoms, the most common type, also help prevent HIV and other STIs. "Natural" or "lambskin" condoms help prevent pregnancy, but may not provide protection against STIs, including HIV. Condoms are available over the counter. Typical use failure rate: 13%.1 |
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Female condom—Internal (female) condoms help prevent pregnancy by blocking sperm from getting to the egg. It is packaged with a lubricant and is available over the counter. It can be inserted up to 8 hours before sexual intercourse. Internal (female) condoms might help prevent STIs. Typical use failure rate: 21%.1 |
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Spermicides—These products include spermicides and vaginal pH regulators and work by killing sperm or making it difficult for sperm to reach the egg. They come in several forms—foam, gel, cream, film, suppository, or tablet. They are placed in the vagina no more than 1 hour before intercourse. They are left in place at least 6 to 8 hours after intercourse. Spermicide can be used with an external (male) condom, diaphragm, or cervical cap. They can be purchased over the counter or prescribed by a health care provider. Typical use failure rate: 21%.1 |
Fertility Awareness-Based Methods
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Fertility awareness-based methods—Understanding your monthly fertility pattern can help you plan to get pregnant or avoid getting pregnant. Your fertility pattern is the number of days in the month when you are fertile (able to get pregnant), days when you are infertile, and days when fertility is unlikely, but possible. If you have a regular menstrual cycle, you have about nine or more fertile days each month. If you do not want to get pregnant, you do not have sex on the days you are fertile, or you use a barrier method of birth control on those days. Failure rates vary across these methods.1-2 Range of typical use failure rates: 2-23%.1 |
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Lactational Amenorrhea Methods
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Breastfeeding can be used as birth control (called Lactational Amenorrhea Method or LAM) when three conditions are met: (1) amenorrhea (not having any menstrual periods after delivering a baby), (2) fully or nearly fully breastfeeding, and it is (3) less than 6 months after delivering a baby. LAM is a temporary method of birth control, and another birth control method should be used when any of the three conditions are not met. |
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Emergency Contraception
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Emergency contraception is not a regular method of birth control. Emergency contraception can be used after no birth control was used during sex, or if the birth control method failed, such as if a condom broke. |
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Copper IUD—The copper IUD can be inserted within 5 days of unprotected sex. Emergency contraceptive pills—Emergency contraceptive pills can be taken up to 5 days after unprotected sex, but the sooner the pills are taken, the better they will work. There are three different types of pills that can be used for emergency contraception. Some emergency contraceptive pills are available over the counter, and some are available only by prescription within the United States. |
Permanent Methods of Birth Control
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Tubal surgery or “tying tubes”—The fallopian tubes are tied (or closed) or cut so that sperm and eggs cannot meet for fertilization. The procedure can be done in a hospital or in an outpatient surgical center. The patient can go home the same day of the surgery and resume normal activities within a few days. This method is effective immediately. Typical use failure rate: 0.5%.1 Vasectomy—This procedure is done to keep sperm from going to the penis, so the ejaculate never has any sperm in it that can fertilize an egg. The procedure is typically done at an outpatient surgical center. The patient can go home the same day. Recovery time is less than 1 week. After the operation, it is important to visit a health care provider 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 sperm count has dropped to zero. Typical use failure rate: 0.15%.1 |
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References
- Bradley SEK, Polis CB, Micks EA, Steiner MJ. Effectiveness, safety, and comparative side effects. In: Cason P, Cwiak C, Edelman A, et al, eds. Contraceptive Technology. 22nd ed. Jones & Bartlett Learning; 2023:130–131.