What is the Most Effective Method of Birth Control?

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Many factors come into play when choosing a birth control method. But effectiveness is usually top of mind.

And it’s important to note that birth control prevents pregnancy and sexually transmitted infections (STIs) — but only if used correctly. Keep reading to learn about the most effective methods for your body and your lifestyle.

Hormonal Contraceptives

Hormonal contraceptives prevent pregnancy by changing the conditions in your uterus and fallopian tubes. They include the pill, the mini pill, the contraceptive patch and ring, and long-acting reversible hormonal methods (IUDs). Some of these hormones make the lining of your uterus thinner so it is less likely to accept a fertilised egg. Others make the lining thicker, some also stop eggs being released.

These methods can be up to 99% effective if used correctly, but they require daily or weekly use and need to be remembered and used consistently. Some have side effects like irregular bleeding and acne. They don’t protect against sexually transmitted infections, but you can use condoms with them to help prevent STIs.

Barrier methods prevent sperm from entering your uterus or fallopian tubes by creating a physical or chemical barrier (male and female condoms, diaphragm, cervical cap, Lea’s shield, contraceptive sponge). The rhythm method involves tracking and recording your menstrual cycle to predict when you are most fertile. You avoid sexual intercourse during that time to prevent pregnancy. It is effective about 75% to 88% of the time, but it is not easy to keep up with and can be unreliable. The cervical mucus method involves analyzing your vaginal discharge to determine when you’re most fertile. It’s more reliable than the rhythm method, but is only about 91% effective.

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Hormone Injections

Hormone injections, such as Depo-Provera and birth control implants, are very effective at preventing pregnancy. You can get them from your doctor or a nurse in a clinic or at home. They work by thickening your cervical mucus so sperm can’t reach an egg or by changing the thickness of the lining in your uterus. They also offer some protection against sexually transmitted infections (STIs).

Birth control pills (including the progestogen-only “minipills” available with a prescription) can be up to 99% effective at preventing pregnancy. However, they’re only as effective as when you take them at the same time every day. Missing a pill, vomiting or severe diarrhoea can reduce their effectiveness. And they don’t protect against STIs.

The rhythm method of birth control uses a calendar to identify the days when you’re most fertile and avoids sexual activity on those days. It’s easy and inexpensive but does not provide as much protection against pregnancy as barrier methods or hormones.

The most effective way to prevent pregnancy is not to have sex at all (abstinence). But that’s not always possible for everyone. The next most effective options include a condom, a diaphragm and female condoms, male condoms, spermicidal cream, ring or clip vasectomy and the copper intrauterine device (IUD). Doubling-up on birth control is typically best — using a barrier method and taking hormonal birth control at the same time.

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Pills

There are tons of different birth control pills out there, but they all work pretty similarly: The hormones in the pill prevent pregnancy by stopping sperm from reaching an egg. They can be 99% effective if you take them exactly at the same time each day (but that’s not always easy). There are also progestin-only “minipills” like Depo-Provera, which is injected by your healthcare provider, that can be up to 99% effective and work just as well as combination birth control. These don’t have estrogen and typically cause lighter periods.

A vasectomy is a surgical procedure where your healthcare provider seals the tubes in your penis that carry sperm, making it impossible for sperm to reach an egg and cause pregnancy. This can be up to 99 percent effective, and it can also protect you from STIs. However, it doesn’t offer STI protection against oral or anal sex, so it’s best to use condoms with it.

Emergency contraception — sometimes called the morning-after pill — is a type of birth control that works within five days after unprotected sex to prevent pregnancy. You can get it over-the-counter at most pharmacies and some healthcare providers offer it without a prescription. It won’t work if you have already started your period, though, so it should be used as soon as possible after unprotected sex.

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IUDs

A small, T-shaped device placed in your uterus. It’s among the most effective reversible methods of birth control. The copper or hormonal IUDs (ParaGard or Mirena) are long lasting and prevent pregnancy by making it harder for sperm to reach an egg or fertilize it. They’re also reversible, so they can be removed at any time. They’re more effective than the Pill and can last 3 to 12 years, depending on the type you choose. They’re hassle-free and don’t require a prescription or daily reminders to use them. Some women have spotting or heavier periods in the first 3 months after an IUD is put in. This usually improves with time.

The hormone IUD releases progestin, which thickens the cervical mucus so sperm can’t swim to an egg and changes the thickness of your uterus lining so a fertilized egg can’t implant. This type of IUD can be used for up to 5 years, depending on the brand you choose.

The rhythm method involves tracking your menstrual cycle to predict when you’re most fertile, then avoiding sexual activity during that time. It’s reversible and can be used for several years, but it’s not as effective as other methods and doesn’t protect against STIs. The most effective way to prevent pregnancy is to not have sexual intercourse (abstinence). However, even for the most motivated couples, abstinence can be challenging. That’s why it’s important to always have a backup form of birth control.

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