Which Birth Control is Right for You?

Written by Elea Carey | Published on July 30, 2015
Medically Reviewed by Dr. Jeanne Morrison on July 30, 2015

With so many options available, it's easy to be overwhelmed. Learn the pros and cons of 13 types of birth control based on cost, effectiveness, flexibility, and potential side effects.

Perhaps you know you want a family someday, but now’s not the time. Or you have a family and don’t want to add to it. Or maybe your life plan doesn’t include having children. There’s a great variety of birth control options regardless of your personal situation — in fact, there are so many options it might be hard to choose. Each comes with its particular benefits and side effects, and many may not be right for you, whether because of affordability, your health choices, or accessibility.

It’s easy to get confused. Here are the most commonly used birth control options, assessed by effectiveness, availability, price, and pros and cons.

Over-the-Counter Options

These birth control methods don’t require a prescription or doctor visit. They’re available at most drug stores and pharmacies. They’re also available online.

Male Condom

male condommale condom 2

What is it? A thin tube of latex or other material that is unrolled over the penis to block sperm from entering the vagina.

Effectiveness: 82 percent

Availability: Male condoms are widely available at grocery stores, pharmacies, convenience stores, and sexual health clinics.

Price: Very affordable, from free to $1 each.

Pros: This method is the best protection against sexually transmitted diseases (STDs), but remember that it still doesn’t provide perfect protection.

Cons: Some users, both male and female, think condoms reduce sensitivity. Condoms may break. It’s also possible to have an allergic reaction to the material.

Female Condom

female condomfemale condom

What is it? A thin tube of latex or other material that fits inside the vagina and blocks sperm.

Effectiveness: 79 percent

Availability: Generally available in pharmacies.

Price: Affordable, from $2 to $4.

Pros: This method may prevent some STDs. It can be inserted up to eight hours in advance of intercourse.

Cons: Some users, both male and female, think female condoms reduce sensitivity. Condoms may break. It’s also possible to have an allergic reaction to the material.

Contraceptive Sponge

contraceptive spongecontraceptive sponge

What is it? A round plastic sponge saturated with spermicide that fits in the vagina to block and kill sperm.

Effectiveness: 76 to 88 percent

Availability: Generally available in pharmacies and some grocery stores.

Price: From $4 to $6

Pros: It can be left in for multiple acts of intercourse in 24 hours.

Cons: There’s a possible increased risk for toxic shock syndrome with this method. It’s possible to develop sensitivity or an allergic reaction to spermicide. The sponge also has to be left in the vagina for six hours after sex, and some users find it messy.

Prescription Options

You can get these birth control methods by prescription from your own doctor or from a doctor in a sexual health clinic.

Cervical Cap

cervical capcervical cap

What is it? A soft, flexible covering that fits over the cervix to prevent sperm from entering the uterus. You fill it with spermicide before use.

Effectiveness: 80 percent

Availability: Available from most doctors and sexual health clinics.

Price: Depending on your health insurance coverage, free to $75, plus the cost of the doctor visit and the cost of the spermicide.

Pros: The cap is a possible option for you if you don’t want the hormonal effects of the pill, implant, shot, or patch. It can be left in for multiple acts of intercourse in 48 hours.

Cons: There’s a possible increased risk for toxic shock syndrome. It’s possible to develop sensitivity or an allergic reaction to spermicide. The cap also has to be left in the vagina for four hours after sex, and some users find it messy.

Diaphragm

diaphragmdiaphragm

What is it? A soft, flexible disk that blocks the cervix. You cover it with spermicide before use.

Effectiveness: 88 percent

Availability: Available from most doctors and sexual health clinics.

Price: Depending on your health insurance coverage, free to $80, plus the cost of the doctor visit and the cost of the spermicide.

Pros: The diaphragm is a possible option for you if you don’t want the hormonal effects of the pill, implant, shot, or patch. It can be left in for multiple acts of intercourse in 24 hours, if you insert more spermicide every six hours.

Cons: There’s a possible increased risk for toxic shock syndrome and urinary tract infection. It’s possible to develop sensitivity or an allergic reaction to spermicide. The diaphragm has to be left in the vagina for six hours after sex. Some users also find it messy, or don’t like reapplying spermicide.

Implant

implantimplant

What is it? A plastic rod about half the size of a matchstick that’s placed under your skin, it releases the hormone progestin, which affects ovulation and makes cervical mucus thicker to block sperm.

Effectiveness: 99 percent

Availability: Available from most doctors and sexual health clinics.

Price: Depending on your health insurance coverage, free to $800 for implanting, free to $300 for removal.

Pros: One of the most effective options available. Lasts up to three years but can be removed at any time.

Cons: It disrupts periods and can cause minor side effects such as acne, breast tenderness, and weight gain.

Copper Intrauterine Device (IUD)

coppercopper 2

What is it? Intrauterine devices (IUDs) are small T-shaped instruments that are placed in your uterus during a doctor visit and remain there for several years. There are two kinds of IUDs. The copper IUD prevents a fertilized egg from implanting in your uterus.

Effectiveness: 99 percent

Availability: Available from most doctors and sexual health clinics.

Price: Depending on your health insurance coverage, free to $800, plus the cost of the doctor visit.

Pros: It can be left in place for up to 10 years.

Cons: Side effects include random spotting during early use, more cramps during your period, and heavier PMS effects.

Hormonal Intrauterine Device (IUD)

hormonal IUDhormonal IUD

What is it? IUDs are small T-shaped instruments that are placed in your uterus during a doctor visit and remain there for several years. The hormonal version is the second kind of IUD. It releases progestin, which affects ovulation and makes cervical mucus thicker to block sperm.
Effectiveness:
99+ percent

Availability: Available from most doctors and sexual health clinics.

Price: Depending on your health insurance coverage, free to $800, plus doctor visit.

Pros: It can be left in place for three to five years.

Cons: The hormonal IUD can make you stop having periods (which some users may consider a “pro”).

Combination Pill

combination pillcombination pill

What is it? The combination pill uses estrogen and progestin to prevent ovaries from releasing eggs, and helps prevent sperm from entering the uterus by thickening cervical mucus.

Effectiveness: 91 percent

Availability: Available from most doctors and sexual health clinics.

Price: Depending on your health insurance coverage, free to $50 per month, plus the cost of the initial doctor visit.

Pros: Some women prefer the pill because they don’t like the idea of having a birth control method that has to be inserted or implanted. The pill can also reduce the severity of period symptoms.

Cons: If you forget to take it on time every day, you have to use another birth control method as well.

Hormonal Pill

hormonal pillhormonal pill

What is it? The hormonal pill — also known as the minipill — uses progestin to thicken cervical mucus and, to a lesser degree, affects how your ovaries release eggs.

Effectiveness: 91 percent

Availability: Available from most doctors and sexual health clinics.

Price: Depending on your health insurance coverage, free to $50 per month, plus the cost of the initial doctor visit.

Pros: Some women prefer it because they don’t like the idea of having a birth control method that has to be inserted or implanted.

Cons: If you forget to take the pill on time every day, you have to use another birth control method as well. The hormonal pill can also increase some effects of your period, like breast tenderness.

The Pill and Cancer: Pros and Cons

Research suggests that both forms of the pill slightly reduce risk of endometrial and ovarian cancers, but it could slightly increase risk of breast, cervical, and liver cancers. Many factors influence the likelihood of contracting these cancers, regardless of your birth control use, including your inherited risk.

Patch

patchpatch

What is it? A flat patch, about 2 square inches. You place it on your skin and it releases the hormones estrogen and progestin. These affect the release of eggs and their ability to implant and thicken cervical mucus. Apply a fresh patch every week for three weeks and then use no patch for a week so you can have your period.

Effectiveness: 92 percent

Availability: Available from most doctors and sexual health clinics.

Price: Depending on your health insurance coverage, free to $50 per month, plus the cost of the initial doctor visit.

Pros: Most users experience no side effects. You just have to remember to change it once a week.

Cons: If mild side effects are experienced, they include nausea, headaches, and breast tenderness. You’re more likely to have these side effects if you smoke.

Shot

shotshot

What is it? An injection of the hormone progestin, given every 90 days in a doctor’s office. It prevents pregnancy by affecting ovulation and the uterine lining, and thickening cervical mucus.

Effectiveness: 98 percent

Availability: Available from most doctors and sexual health clinics.

Price: Depending on your health insurance coverage, free to $60 every 3 months, plus the cost of the doctor visit.

Pros: All you have to remember is your doctor’s appointment.

Cons: Most users notice some effect on their period, including having no period at all. Nausea, headaches, and depression have also been reported. You’re more likely to have these side effects if you smoke. Inability to conceive can last for up to a year after you stop taking the shot. Studies have linked the shot to loss of bone density, which could cause osteoporosis. It’s possible this effect is temporary.

Vaginal Ring

vaginal ringvaginal ring

What is it? A flexible ring about 2 inches wide that’s placed in your vagina. You insert the ring yourself and leave it there for three weeks, then remove it for one week to have a period. It releases progestin and estrogen, preventing pregnancy by affecting ovulation and the uterine lining and thickening cervical mucus.

Effectiveness: 92 percent

Availability: Available from most doctors and sexual health clinics.

Price: Depending on your health insurance coverage, free to $80 a month, plus the cost of the doctor visit.

Pros: Put it in and forget it for three weeks. You may have lighter periods and fewer premenstrual effects.

Cons: Breast tenderness and headaches have been reported.

Options for Men

The development of birth control options for men is very far behind the options for women. Hormonal combinations for men are in development, as is a procedure that injects solvent into the duct that brings sperm into the penis, temporarily blocking its passage.

Men can participate in birth control by getting a vasectomy or using condoms. “Pulling out,” a term known for not ejaculating while the penis is in the vagina, is a notoriously faulty method. You can get pregnant because some sperm has leaked out before orgasm, or because pulling out didn’t happen fast enough. The Mayo Clinic estimates that over a quarter of the women who are using the pull out method with their partners could get pregnant.

Vasectomy

vasectomyvasectomy

What is it? An outpatient surgery in which the tubes that carry sperm are cut and sealed so no sperm is released during ejaculation.

Effectiveness: 99+ percent

Availability: Widely available through a doctor’s referral.

Price: Depending on your health insurance coverage, free to $1,000, plus the cost of the doctor visits.

Pros: This is one of the most effective methods of birth control. Outpatient procedure.

Cons: It’s effective only after three months, when a doctor has verified that no semen is passing into the ejaculate. While a vasectomy can be reversed, you should consider it a permanent birth control solution.

After the Fact: The Morning-After Pill

If you think you may have accidentally gotten pregnant because you misused your regular birth control method or didn’t use any, you might consider taking emergency contraception. It is important to note that these hormonal combinations are not a safe birth control method for regular use, but they can prevent pregnancy in the event of an emergency. There are two kinds: levonorgestrel (brand names: Plan B and Next Choice) and ulipristal acetate (brand name: Ella). They are pills consisting of hormones that prevent an egg from implanting in the uterine lining.

Levonorgestrel

LevonorgestrelLevonorgestrel

Effectiveness: 98 percent

Availability: Available at many pharmacies if you’re over 18 in most states.

Price: Depending on your health insurance coverage, free to $80.

Pros: No doctor visit required. Works up to 72 hours after unprotected sex.

Cons: You might experience brief episodes of nausea, vomiting, breast tenderness, abdominal pain, headache, dizziness, and fatigue. Your period could also be irregular for a cycle or two.

Ulipristal acetate

Ulipristal acetateUlipristal acetate

Effectiveness: 98 percent

Availability: Available from many doctors and most sexual health clinics.

Price: Depending on your health insurance coverage, free to $80.

Pros: It works up to five days after unprotected sex.

Cons: You might experience brief episodes of nausea, vomiting, breast tenderness, abdominal pain, headache, dizziness, and fatigue. Your period could also be irregular for a cycle or two.

Talk to Your Doctor

There’s a birth control option to fit almost any lifestyle. For the most part, the more effective methods are available via prescription. Visiting a doctor might seem a little inconvenient, but it also brings benefits like an opportunity to check up on all aspects of your reproductive health. That’s important whether you decide to have kids or not. Remember that the male condom is the only birth control method that protects you from sexually transmitted diseases, and even it isn’t perfect in that regard. 

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