Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 1/27/2021
As women, we’re responsible for our own health — and that includes our sexual health. Using birth control doesn’t just protect us from unintended pregnancy. It can also protect us from STDs, help regulate our menstrual cycle and afford us plenty of other benefits outside of keeping our “no babies” streak going strong.
If you’re wondering which method of birth control is best, or what the options are, you’re not alone! Let’s take some time to explore the different types of birth control, the most popular options, and the things you should consider in making your choice.
When it comes to birth control, there are many options to choose from, and they generally fall into four different categories: barrier methods, chemical methods, short-term hormonal methods and long-acting reversible contraceptives.
Barrier methods work by preventing sperm from reaching an egg after it is released from the ovaries. These include options such as condoms, diaphragms, cervical caps and contraceptive sponges.
Chemical methods of birth control slow the sperm’s ability to swim and may also block the sperm from entering the cervix. Spermicide is the most commonly used chemical method of birth control, and it is a mandatory component of cervical caps and diaphragms.
Hormonal birth control methods take several forms including pills, injections and patches. Oral contraceptives or birth control pills may contain progestin-only or a combination of estrogen and progestin.
The former thickens the cervical mucus to prevent sperm from passing through the cervix while the latter prevents ovulation. Contraceptive injections typically contain a synthetic form of progestin that lasts for three months and patches contain a combination of estrogen and progestin.
Long-acting reversible contraceptives typically take the form of intrauterine devices (or IUDs) and implants. Some IUDs release hormones like progestin which thickens cervical mucus to inhibit sperm from reaching and fertilizing the egg, while other hormonal IUDs prevent the ovaries from releasing eggs altogether.
Hormone-free IUDs contain spermicide and irritate the lining of the uterus to make implantation more difficult. Implants release progestin to provide similar benefits to hormone-releasing IUDs.
The final option for contraception is permanent sterilization. For males, a vasectomy is the most common form of permanent sterilization, and it involves cutting and sealing the tubes that deliver sperm into the semen.
For women, tubal ligation surgery is one option, or an implantable device may be inserted to block the fallopian tubes to prevent fertilization.
Now that you understand the different forms of birth control, let’s take a closer look at the 10 common birth control options available for women:
Oral contraceptives or birth control pills are the most common form of birth control. Generally considered the safest and most effective option, birth control pills come in two forms — progestin-only and combination pills. These pills work by preventing ovulation, and they can also be used to regulate your menstrual cycle.
Also known as DMPA or the Depo shot, Depo-Provera shot is an injectable form of synthetic progestin (medroxyprogesterone acetate) which is administered every 12 weeks.
A small, flexible ring about two inches in diameter, the NuvaRing is inserted into the vagina and left in place for three weeks. During that time, the ring releases synthetic estrogen and progestin to prevent pregnancy and allows you to have a normal period after you remove it.
A small plastic patch, the Ortho Evra patch is applied to the skin on the stomach, buttocks, upper torso, shoulder or upper outer arm for three weeks at a time. This patch releases synthetic estrogen and progestin and allows a normal period after removal.
Typically made from latex or silicone, a diaphragm is a dome-like device with a flexible rim that is inserted into the vagina to form a physical barrier covering the cervix. These devices should be used in combination with spermicides and must be left in place for six to eight hours after sexual activity.
Similar to a diaphragm, a cervical cap is a silicone or latex cup that fits onto the cervix and should be used in combination with spermicide. The difference is that it can be left in place for up to 24 hours without using additional spermicide.
This is a small, T-shaped plastic device with copper coiled around it. The IUD itself irritates the lining of the uterus, making it more difficult for eggs to implant, and also triggers white blood cells to flood the uterus which helps destroy sperm. This device can be left in place for up to 10 years and can be removed at any time.
Also a T-shaped plastic device, the Mirena IUD releases a low but continuous stream of progestin which thickens the cervical mucus to create a physical barrier against sperm. It may also suppress ovulation to prevent pregnancy for up to five years.
One of the newest IUDs available, the Skyla IUD is smaller than the Mirena and can be left in place up to three years. This IUD releases the progestin levonorgestrel at 14 mcg/day.
A progestin-only method of hormonal birth control, the Nexplanon implant is made of soft, medical-grade polymer and is inserted into the skin of the upper arm. This device offers three years of protection against pregnancy and can be removed any time.
As you can see, each method of birth control offers different pros and cons, not to mention different levels of efficacy.
So, how do you make your choice?
Simply knowing what your options are isn’t enough to choose a birth control method — you also need to understand the implications of that choice.
When it comes to choosing a method of birth control, many women consider convenience first and foremost. For example, if you don’t like the idea of having to take a pill at the same time every day, you might choose a long-term birth control method such as the NuvaRing or IUD.
Side effects are also an important component to consider.
Every woman tolerates different forms of birth control differently, but some methods have a higher risk for side effects than others.
For example, hormonal birth control methods come with a risk for breakthrough bleeding, blood clots, and nausea while intrauterine devices come with a risk for uterine wall puncture or damage to the internal organs.
In addition to considering the side effects of any birth control method, you also need to consider additional factors such as protection from STDs, contraindications with other medications and, of course, the level of efficacy.
Let’s start by exploring the side effects that have been linked with some of the most common birth control methods:
Birth Control Pills – Common side effects of oral contraceptives include spotting, nausea, breast tenderness, headaches, weight gain, mood changes, decreased libido and vaginal discharge.
Depo Provera Shot – Many women who take the Depo-Provera shot report irregular bleeding for up to six months, with other common side effects that include abdominal pain, headache, dizziness, weakness and fatigue. There is also a serious risk for loss of bone mineral density.
NuvaRing – Generally the NuvaRing has a low incidence of side effects, but potential problems include breast tenderness, headaches, weight changes, nausea, mood changes, breakthrough bleeding and vaginal irritation.
Xulene (Ortha Evra) Patch – The most common side effects seen with birth control patches include body aches, chills, cough, fever, headache, nasal congestion, runny nose, sore throat and tiredness.
Cervical Cap – These devices can be tricky to use, but they generally don’t cause side effects other than minor irritation or, in extreme cases, latex allergies. There is, however, the potential for side effects caused by spermicides such as vaginal irritation or increased risk of urinary tract infection.
Intrauterine Devices – Though rare, IUDs do come with a risk for puncturing the uterine wall during insertion, and if they aren’t inserted correctly, they may migrate and cause internal damage. Other side effects may include cramping, heavy periods, spotting, PID, and infertility.
Nexplanon Implant – Irregular menstrual bleeding is the most common side effect of Nexplanon, but others may include headaches, weight gain, acne, breast pain, sore throat, and abdominal pain.
Though the risk for side effects is certainly important to consider when choosing a birth control method, you might be more concerned about how effective it is.
Here is a quick summary of the effectiveness of the birth control methods listed above:
Birth Control Pills – When used properly, birth control pills are 99 percent effective. Due to the potential for human error (such as missed doses), however, the true efficacy is about 91 percent.
Depo Provera Shot – This birth control method is 99 percent effective when used properly, but the real-life efficacy is about 94 percent because some women forget to get the shot on time.
NuvaRing – Like birth control pills, NuvaRing is designed to be 99 percent effective, but issues with insertion and placement result in an overall 91 percent efficacy.
Xulene (Ortho Evra) Patch – On its own, the patch is 99 percent effective, but if you forget to change it on time, if it falls off or if you take certain medications it may not work — overall efficacy is about 91 percent.
Diaphragm – When used perfectly, diaphragms are about 94 percent effective, but if you don’t insert it properly or forget to use it, the overall efficacy is only about 88 percent.
Cervical Cap – The efficacy of this method of birth control ranges from 71 percent to 86 percent. It is more effective if you have never given birth and less effective if you don’t insert it right or forget to.
Intrauterine Devices – These devices are over 99 percent effective because, once inserted, you can’t make any mistakes and it offers continuous protection.
Nexplanon Implant – This method of birth control is over 99 percent effective because you can’t forget to put it in or use it incorrectly.
Based on these statistics, you can see how important it is to use your chosen method of birth control properly.
For some methods, you need to be very careful about replacing the device at the right time and using it consistently.
But there is one more thing to talk about – sexually transmitted diseases (STDs).
According to the Center for Disease Control and Prevention (CDC), there are over 1.4 million reported cases of chlamydia each year, 350,000 cases of gonorrhea, and 20,000 cases of syphilis. The birth control methods discussed in this article are designed to prevent unintended pregnancy, but some of them also offer a certain degree of protection against STDs.
Condoms are the best method of birth control for protection against STDs. Cervical caps offer partial protection, but they are the only other method of birth control that offers any STD protection at all. Your sexual health is important, and the decisions you make now could impact the rest of your life.
Take the time to learn about your options for birth control and to choose the method that is best for you. Keep in mind as well that the option that best suits your lifestyle now may not always be the best choice, so be prepared to reevaluate in the future and talk to your doctor if you aren’t sure which option is the right choice.