Non-Hormonal Birth Control: A Complete Guide to Your Options

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    Mary Lucas, RN
    Medically reviewed by Mary Lucas, RN Written by Our Editorial Team Last updated 8/25/2020

    From the pill to the patch, ring and more, a large variety of hormonal birth control methods are available. While they’re convenient and typically very safe, hormonal contraceptives can cause side effects and aren’t always the best choice for everyone.

    Luckily, there are also several non-hormonal forms of birth control that can keep you safe from pregnancy and, in some cases, from sexually transmitted diseases (STDs). 

    Common non-hormonal methods of birth control include barrier methods such as condoms or the contraceptive sponge, as well as long-term options such as the copper intrauterine device (IUD).

    Below, we’ve listed all of the non-hormonal forms of birth control options that are currently available, as well as the unique advantages and disadvantages of each option. We’ve also discussed how you can choose a safe, effective and convenient form of birth control to meet your needs. 

    Why Use Non-Hormonal Birth Control?

    Many women feel confident using a hormonal form of birth control, such as the birth control pill or patch. These hormonal contraceptives are a convenient, widely used and, for the majority of women, safe way to avoid pregnancy.

    However, hormonal birth control isn’t without disadvantages. You may want to consider using a non-hormonal form of contraception if you:

    • Get persistent or unpleasant side effects from hormonal birth control, such as spotting (bleeding between periods), nausea, breast pain, weight gain or unwanted changes to your menstrual cycle.

    • Don’t have sex often and as a result, don’t need to take a daily pill, use a weekly patch or keep yourself protected from pregnancy all the time.

    • Don’t like the idea of taking hormones or continually staying on medication.

    • Find it difficult to remember to take the birth control pill and don’t want to worry about missed doses or not being fully protected.

    • Find hormonal birth control too expensive, and want a more affordable way to reduce your risk of becoming pregnant.

    • Smoke and can’t use a hormonal method of birth control due to the increased risk of stroke, blood clots and other side effects.

    • Already use hormonal birth control, but want to use a second method of contraception for extra protection or to protect from certain STDs. 

    There’s no “perfect” method of birth control for everyone. If one or several of the descriptions above sounds like you, using a non-hormonal form of birth control could be a better, safer or more convenient option than using a hormonal method like the pill, patch, ring or shot. 

    Barrier Birth Control Methods

    Barrier methods of birth control reduce your risk of becoming pregnant by physically blocking your partner’s sperm from coming into contact with an egg. Although they aren’t perfect, most are readily available and highly effective if used correctly. 

    Condoms

    Condoms are a safe and convenient method of non-hormonal birth control. Designed for your partner to wear over their penis, condoms prevent pregnancy by blocking semen from getting into the vagina and coming into contact with an egg. 

    One of the biggest advantages of condoms is that they’re inexpensive and sold in almost every major supermarket, drugstore, convenience store or community health center. 

    Unlike hormonal methods of birth control, you don’t need a prescription to purchase condoms. 

    Used perfectly, condoms are 98 percent effective at preventing pregnancy. Like other forms of contraception, they’re slightly less effective in real life conditions, with an effectiveness rate of about 85 percent. 

    One extra advantage of condoms is that, unless faulty, they also provide protection against certain sexually transmitted diseases (STDs). For this reason, many people use condoms even if they already use a non-barrier form of birth control. 

    However, it’s worth noting that certain STDs, such as herpes and other diseases that spread through skin-to-skin contact, can sometimes still spread even with the use of condoms. 

    Interested in learning more about the advantages and disadvantages of condoms? Our guide to the pill vs. condoms compares condoms to the hormonal birth control pill on effectiveness, ease of use and other factors. 

    Spermicide

    Spermicide is a type of foam, cream, jelly, gel, tablet or suppository that contains chemicals that either kill sperm or stop it from moving. It’s typically used with other forms of barrier birth control, such as condoms, the diaphragm or the contraceptive sponge. 

    Used on its own, spermicide is not very effective. Used perfectly, approximately 18 percent of all women who correctly use spermicide every year will become pregnant. 

    In real life conditions, this rises to 28 percent because not everyone will use it correctly, meaning 28 out of every 100 women using spermicide as a method of birth control become pregnant every year. 

    However, when it’s used with other forms of contraception, spermicide can help to increase your level of protection from pregnancy. 

    Like other forms of birth control, spermicide has both advantages and disadvantages. If you use it frequently, the chemicals in spermicide — for example, nonoxynol-9 — may irritate your vagina, potentially increasing your risk for STDs and viruses such as HIV.

    Spermicide may also cause irritation for your partner, resulting in soreness and itchiness of their penis. Finally, because it doesn’t create a physical barrier between you and your partner’s skin, it also doesn’t provide any protection from STDs. 

    Diaphragm

    A diaphragm is a small, reusable, dome-shaped cup that you put inside your vagina. It works by stopping sperm from passing through your cervix into your uterus and coming into contact with an egg, reducing your risk of becoming pregnant.

    Diagrams are designed to be effective for use only in combination with spermicide. 

    Used perfectly, diaphragms are 94 percent effective at preventing pregnancy. In real life, they’re about 88 percent effective at preventing pregnancy, meaning about 12 percent of all women who use a diaphragm for birth control will become pregnant every year. 

    One advantage of the diaphragm is that you can put it inside your vagina up to two hours before you have sex, meaning there’s no need to stop foreplay to prepare contraception. If it’s properly cared for, a diaphragm can also last for as long as two years. 

    However, the diaphragm also has several downsides. Unlike condoms, a diaphragm won’t offer any protection from STDs. Due to its position in the vagina and pressure on the urethra, using a diaphragm may also increase your risk of developing a urinary tract infection (UTI).

    Cervical Cap

    A cervical cap is a reusable silicone cup that fits over your cervix. It looks similar to a sailor’s hat and holds itself in place through suction, covering your cervix and stopping your partner’s sperm from making its way into your uterus and coming into contact with an egg.

    The effectiveness of the cervical cap can vary depending on whether or not you’ve given birth. If you’ve never given birth, the cervical cap is 86 percent effective at preventing pregnancy. If you have given birth before, the cervical cup is 71 percent effective, on average. 

    Like many other barrier methods of birth control, the cervical cap is more effective at preventing pregnancy when it’s used with spermicide. It’s also more effective when used with other forms of contraception, such as condoms or the withdrawal method.

    Because the cervical cap doesn’t prevent skin-on-skin contact between you and your partner, it won’t provide any protection from STDs. As such, it’s best to use a condom for more complete protection, both from STDs and pregnancy. 

    Contraceptive Sponge

    The contraceptive sponge is a small, donut-shaped cup that fits inside your vagina, preventing your partner’s sperm from entering into your uterus and fertilizing an egg. The cup is made out of soft plastic form and contains a spermicide. 

    Like the cervical cap, the contraceptive sponge is more effective for women who’ve never given birth. If you’ve never given birth, the sponge is 91 percent effective if used perfectly. If you have given birth before, it’s approximately 80 percent effective at preventing pregnancy. 

    Just like with many other barrier methods of birth control, you can use the sponge with condoms to increase its effectiveness. 

    The contraceptive sponge has advantages and disadvantages. One advantage is that you can put it in place up to 24 hours before sex, meaning there’s no need to interrupt foreplay to use a contraceptive.

    On the other hand, the sponge isn’t always easy to fit in place. Like other non-condom forms of birth control, it also doesn’t provide any protection against STDs. Finally, some people might be irritated by the spermicide and/or polyurethane used to manufacture the sponge.

    Copper IUD

    The copper IUD, sold as ParaGard®, offers long term, reliable, non-hormonal protection against pregnancy. Short for “intrauterine device,” the ParaGard IUD is a small, T-shaped device that’s fitted inside your uterus by a healthcare professional. 

    Non-hormonal IUDs like ParaGard prevent pregnancy using copper, which is toxic to sperm. A copper IUD repels sperm, preventing them from entering into your uterus and making contact with an egg.

    Like the hormonal IUD, the copper IUD is highly effective. After it’s fitted by a qualified healthcare professional, it’s more than 99 percent effective at preventing pregnancy. 

    Since it’s fitted inside your uterus, there’s no issue with “real life” effectiveness — instead, it’s always 99 percent effective.

    The copper IUD is also long lasting. After it’s fitted, you can leave it in place for up to 12 years, during which it will keep working to protect you from becoming pregnant.

    Another advantage of the copper IUD is that it works as a form of emergency contraception. If you have the ParaGard IUD fitted within 120 hours (five days) of having unprotected sex, it will be more than 99.9 percent effective at stopping you from becoming pregnant.

    Despite these advantages, the copper IUD does have some downsides. Some women feel pain after the IUD is placed, while others experience side effects such as irregular periods, cramping and spotting (bleeding between periods).

    The IUD also won’t protect you from STDs, meaning it’s best to use it with condoms to give you and your partner additional protection. 

    Interested in learning more about the copper IUD? Our guide to the IUD vs. the birth control pill goes into more detail on how the hormonal and non-hormonal IUD compare to the pill in terms of convenience, effectiveness, side effects and more. 

    Fertility Awareness Methods (FAMs)

    Fertility awareness methods (FAMs), also referred to as Natural family planning (NFP), involve tracking your menstrual cycle and avoiding sex (or using another form of contraception) on the days when you’re most fertile.

    There are three common approaches to fertility awareness — the cervical mucus method, the temperature method and the calendar method.  Fertility awareness is generally most effective when all three methods are combined.

    In general, fertility awareness isn’t a very effective form of birth control. According to Planned Parenthood, FAMs are only 76 to 88 percent effective, meaning that 12 to 24 women who use FAMs as their only form of birth control will become pregnant each year.

    Using fertility awareness methods can also be time consuming and complicated, as you’ll need to track your menstrual cycle and other fertility signs on a daily basis. Even if followed perfectly, there’s also still a risk that you could become pregnant due to their low effectiveness rate. 

    Withdrawal Method

    The withdrawal method (also referred to as the pull out method, or coitus interruptus) involves your partner pulling their penis out of your vagina before ejaculating. The principle behind this method is simple — by keeping semen out of your vagina, you’re less likely to get pregnant. 

    Done perfectly, the withdrawal method is surprisingly effective. According to data from Planned Parenthood, only around four women out of every 100 will become pregnant every year if their partner uses the withdrawal method perfectly.

    However, the withdrawal method isn’t always so easy to do, meaning its real-life effectiveness rate is only about 78 percent.

    The withdrawal method works best when it’s combined with another form of birth control, such as condoms, a diaphragm, a cervical cap or the contraceptive sponge. Doing this can increase the effectiveness rate of your regular form of birth control, protecting you from pregnancy.

    As you’d expect, since it doesn’t involve any physical barrier between you and your partner, the withdrawal method also doesn’t provide any protection from STDs. 

    Interested in using the withdrawal method? We’ve explained how it compares to the pill, as well as its unique advantages and disadvantages, in our full guide to the birth control pill vs. pulling out

    Abstinence

    The abstinence method, which involves simply not having sexual intercourse, is a safe, effective way to prevent pregnancy. 

    The exact definition of abstinence can vary from person to person. 

    For some people, abstinence might mean not engaging in any sexual activity at all. For others, abstinence may mean not having vaginal sex but still enjoying other types of sexual activity. 

    Depending on your lifestyle, the abstinence method might be a convenient, zero-cost method of non-hormonal birth control, or something that requires serious dedication and willpower. 

    Sterilization

    Finally, sterilization is a very effective, permanent method of birth control that doesn’t involve the use of hormones. Also known as tubal ligation, sterilization is a surgical procedure that involves blocking the fallopian tubes and preventing sperm from fertilizing your eggs. 

    Sterilization is very effective at preventing pregnancy, with an effectiveness rate of more than 99 percent when performed correctly. However, it’s also a permanent treatment that’s only suitable if you’re absolutely sure you never want to become pregnant in the future. 

    Although there are procedures to reverse sterilization, they can be expensive, risky and aren’t always successful.

    While sterilization is highly effective at preventing pregnancy, it doesn’t provide any protection from STDs. As such, it’s still important to use condoms and/or undergo regular STD testing to keep yourself and your partner protected. 

    Learn More About Birth Control

    There’s no “best” form of birth control for everyone. If you don’t like using hormonal birth control, or can’t use hormonal birth control due to a health condition or side effects, using non-hormonal birth control can be a safe, effective way to protect yourself from pregnancy.

    Interested in learning more about your birth control options? Our guide to the different forms of birth control goes into more detail on your options, from the pill, patch, ring and other hormonal contraceptives to the IUD, cervical cap and more. 

    This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.