Although birth control can be an effective way to prevent unintended pregnancy, no method is 100 percent successful. Each type has pros and cons, including how effective it is.
Hormonal intrauterine devices (IUD) and hormonal implants are the most effective forms of reversible birth control. Once inserted, the hormonal implant and hormonal IUD are more than effective at preventing pregnancy.
Other forms of birth control can be equally effective if used perfectly. However, typical use ultimately makes the actual success rate much lower.
Read on to learn more about each type of birth control, including how effective it is and what you can do to make it more efficient.
| Type | Efficacy with perfect use | Efficacy with typical use | Failure rate |
| Combination pill | 99 percent | ||
| Progestin-only pill | 99 percent | ||
| Hormonal IUD | N/A | ||
| Copper IUD | N/A | ||
| Implant | N/A | ||
| Depo-Provera shot | 99.7 percent | ||
| Patch | 99 percent | ||
| NuvaRing | 98 percent | ||
| Male condom | 98 percent | ||
| Female condom | 95 percent | ||
| Diaphragm | 92 to 96 percent | ||
| Cervical cap | 92 to 96 percent | 71 to 88 percent | 12 to 29 percent |
| Sponge | 80 to 91 percent | ||
| Spermicide | |||
| Fertility awareness method | 99 percent | ||
| Pull out/withdrawal | |||
| Breastfeeding | |||
| Tubal ligation (sterilization) | N/A | ||
| Tubal occlusion | N/A | ||
| Vasectomy | N/A |
Combination pill
The combination pill is 99 percent effective with perfect use. With typical use, it’s effective.
The combination pill uses two hormones, estrogen and progestin, to prevent ovulation. It also thickens your cervical mucus. This may prevent sperm from traveling into the uterus and reaching an egg.
The combination pill may be less effective if you:
- don’t take it at the same time every day or miss pills
- vomit within two hours of taking the pill
- are taking certain antibiotics or other medications
- are overweight
Progestin-only pill
The progestin-only pill (or minipill) is effective with perfect use. With typical use, it’s effective. Efficacy data is combined for the progestin-only pill and combination pill. In general, the minipill is considered to be less effective than the combination pills. It’s also often used in special populations, such as women who are also breastfeeding.
Like the combination pill, the minipill may suppress ovulation and also thickens your cervical mucus. It also thins your uterine lining.
The minipill may be less effective if you:
- don’t take it at the same time every day (delaying your dose by three hours or more is considered a missed dose)
- vomit within two hours of taking the pill
- are taking certain antibiotics or other medications
- are overweight
Hormonal IUD
The hormonal IUD is effective once it’s placed. This makes it the ultimate “set it and forget it” birth control method.
This T-shaped plastic device releases the hormone progestin to prevent ovulation, fertilization, and implantation.
It must be replaced on time to remain effective. Depending on the brand, this may be anywhere from three to five years.
Copper IUD
A copper IUD is effective at preventing pregnancy. It interrupts sperm motility and damages the sperm, ultimately preventing fertilization.
It must be replaced on time every 10 years to remain effective.
The implant is effective. It releases progestin to stop ovulation and thicken cervical mucus.
It must be replaced every three years to remain effective.
The implant may be less effective if you’re taking certain antivirals or other medications.
The Depo-Provera shot is 99.7 percent effective with perfect use. With typical use, it’s effective.
This injected form of birth control releases progestin to prevent ovulation and thicken cervical mucus.
You must receive a shot every 12 weeks to remain fully protected against unintended pregnancy.
The patch is more than 99 percent effective with perfect use. With typical use, it’s effective.
Like the combination pill, the patch releases estrogen and progestin to prevent ovulation and thicken cervical mucus.
It must be replaced on the same day every week to remain effective.
The patch may be less effective if you:
- are unable to keep the patch in place
- are taking certain antibiotics or other medications
- have a body weight or BMI considered obese
NuvaRing is 98 percent effective with perfect use. With typical use, it’s effective.
Like the combination pill, the NuvaRing releases estrogen and progestin to prevent ovulation and thicken cervical mucus.
You should take the ring out after three weeks to give your body a one-week break. You must replace the ring on the same day every fourth week for it to remain effective.
NuvaRing may be less effective if you:
- aren’t able to keep the ring in place
- are taking certain antibiotics or other medications
Male condom
The male condom is effective with perfect use. With typical use, it’s only effective.
This type of condom catches ejaculate in a reservoir, preventing semen from entering the vagina.
The male condom may be less effective if it:
- was stored improperly
- has expired
- is worn incorrectly
- is used with an oil-based lubricant
- isn’t worn before first penetration
Female condom
The female condom is effective with perfect use. With typical use, it’s only effective.
This type of condom is inserted into the vagina. It creates a barrier, preventing semen from entering the cervix and uterus.
The female condom may be less effective if it:
- was stored improperly
- has expired
- is inserted incorrectly
- is used with an oil-based lubricant
- isn’t worn before first penetration
Diaphragm
The diaphragm is 92 to 96 percent effective with perfect use. With typical use, it’s 71 to 88 percent effective.
A diaphragm is a flexible, shallow cup that fits into the vagina and covers the cervix. Applying spermicide to the outside of the diaphragm may make it more effective.
It must be inserted correctly and left in for six to eight hours after intercourse to prevent pregnancy.
Cervical cap
The cervical cap is 92 to 96 percent effective with perfect use. With typical use, it’s 71 to 88 percent effective.
Like a diaphragm, a cervical cap covers the cervix to prevent sperm from reaching the uterus. Applying spermicide to the outside of the diaphragm may make it more effective.
It must be inserted correctly and left in for at least six hours after intercourse to prevent pregnancy.
Sponge
The sponge is 80 to 91 percent effective with perfect use. With typical use, it’s only effective.
A sponge is a soft, round piece of foam that’s inserted into the vagina. It’s typically used with spermicide to prevent semen from reaching the uterus.
It must be inserted correctly and left in for at least six hours after intercourse to prevent pregnancy.
The sponge may be less effective if you’ve had a prior vaginal delivery.
Spermicide
Spermicide is effective with perfect use. With typical use, it’s only effective.
Spermicide is available as a gel, cream, or foam. It’s inserted into the vagina with an applicator. It works best if the spermicide is deep inside, closer to the cervix.
Spermicide may be less effective if:
- the product isn’t stored correctly
- the product has expired
- you don’t use enough
- it isn’t inserted deep enough
FAM, or the rhythm method, is 99 percent effective with perfect use. With typical use, it’s only 76 percent effective.
With FAM, you track your menstrual cycle to determine when you’re the most fertile. During this time period, you and your partner may avoid intercourse or use a backup method to reduce the chance of pregnancy.
FAM may be less effective if you:
- aren’t calculating your cycle correctly
- have an irregular cycle that’s difficult to track
- don’t abstain or use a backup method during fertile days
The pull-out method is effective when it’s performed perfectly. With typical use, it’s only effective.
This method relies on your ability to remove the penis from the vagina before ejaculation so no semen enters the vagina or uterus.
Withdrawal may be less effective if:
- you pull out too late
- don’t pull out far enough
- sperm is present in pre-ejaculate fluids
The lactational amenorrhea method (LAM) is effective if the person using it meets all the criteria for the method. Only 26 percent of people meet the criteria.
When you’re breastfeeding, your body stops ovulation. If your ovaries aren’t releasing an egg, you can’t get pregnant or menstruate. However, you must breastfeed at least once every four hours for maximum efficacy.
LAM may be less effective if you:
- don’t breastfeed frequently enough
- pump instead of breastfeed
- are more than six months postpartum
Tubal ligation
Tubal ligation, or female sterilization, is effective. It’s also permanent.
To do this, your surgeon will cut or tie your fallopian tubes. This will prevent eggs from traveling from the ovaries into the uterus, where they could be fertilized by sperm.
Tubal occlusion
Tubal occlusion is another form of female sterilization. It’s more than effective.
To do this, your surgeon will insert a small metal coil into both of your fallopian tubes. The coils are then unrolled to prevent passage between the tubes and your uterus.
Over time, tissue will grow into the gaps of the coil, permanently preventing eggs from getting into the uterus.
You must use a backup contraceptive for the first three months after the procedure. Your doctor will perform a follow-up exam to determine whether the surgery was effective or if you should continue using backup contraception.
Vasectomy
A vasectomy, or male sterilization, is effective.
To do this, your surgeon will cut or seal the tubes that carry sperm into semen. You’ll still ejaculate semen, but it won’t contain sperm. This will permanently prevent pregnancy.
You must use a backup contraceptive for the first three months after the procedure. Your doctor will perform a follow-up exam to determine whether the surgery was effective or if you should continue using backup contraception.
When used properly, birth control is a highly effective way to prevent pregnancy. Work with your doctor or another healthcare provider to pick the best method for your individual needs. They can walk you through any associated risks and help you understand how to use it correctly.
Condoms are the only method to protect against both unwanted pregnancy and sexually transmitted infections (STIs). Consider using condoms as a secondary method and make STI testing a part of your regular health routine.
