Every birth control method works differently: some prevent pregnancy by stopping sperm from reaching an egg or changing the thickness of your uterine lining; others cause side effects. Hormonal methods like the pill, shot, ring, and patch change hormone levels in your body to prevent pregnancy.
The most reliable way to protect against pregnancy is abstinence, but that’s not always possible. Your doctor can help you find a birth control method that fits your lifestyle and goals.
A popular non-hormonal method available without a prescription, condoms create a physical barrier that prevents sperm from fertilizing an egg. These devices are also 79 percent effective in preventing STIs, Planned Parenthood says.
The classic condom — a thin covering made of latex, plastic or lambskin that is rolled over an erect penis before sexual intercourse — protects against pregnancy and STDs by catching semen and releasing spermicide. These are readily available in stores and at many clinics. However, they aren’t as effective as some other methods and can tear or rip, so people need to use them every time they have sex. They’re also not great for people with a latex allergy or for those who prefer lubrication. People should always use a water-based lubricant with condoms; oil-based products can break them down.
Internal condoms, such as a diaphragm or cervical cap, are similar to a menstrual cup and work by sitting inside the vagina or anus, blocking sperm from reaching an egg. They’re 79 percent effective, but they aren’t as easy to use as male condoms.
A sponge is a doughnut-shaped piece of polyurethane foam that’s coated with spermicide—a chemical that kills sperm. Women insert it into their vagina before sex to prevent a man’s sperm from entering the uterus and making them pregnant. It’s reversible, over-the-counter, and hormone-free. It’s also incredibly effective: Of 100 women who have never given birth, 14 will get pregnant when using the sponge.
But the device has its drawbacks. The spermicide may irritate the cervix or penis and increase your risk of infections like STIs and cystitis. Plus, leaving the sponge in too long can cause toxic shock syndrome (TSS), a rare but serious condition that can lead to death.
It’s easier to use than a diaphragm or cervical cap, but it still isn’t the most reliable option. That’s because childbirth can stretch your cervix, so it doesn’t fit as tightly. A sponge also doesn’t protect against STIs, so it’s best to use in combination with the pill or other hormonal methods. It’s also harder to find these days. Fortunately, the pill and IUDs are even more effective than a sponge.
There isn’t one type of birth control that works best for everyone. The right method depends on how a girl wants to have children someday, her health concerns, her lifestyle and insurance coverage.
Girls can choose from many types of birth control pills, the contraceptive vaginal ring NuvaRing and hormonal implantable devices, such as the copper IUD. Pills can help protect against pregnancy and STDs by thickening cervical mucus so sperm can’t reach an egg. They also thin the lining of the uterus, so menstrual bleeding is lighter. Most birth control pills contain both estrogen and progestin. A low-dose progestin-only “minipill” can be effective, too, but is less reliable. Pills work best when taken at the same time every day.
Girls who take the Pill should use a backup form of birth control, like condoms, for the first 7 days after starting the pill to prevent pregnancy. Forgetting to take the pill or having irregular periods can increase a woman’s risk of getting pregnant. For this reason, it’s important to talk to a doctor or nurse practitioner (NP) before choosing this method of birth control.
Both copper and hormonal IUDs are more than 99 percent effective at preventing pregnancy. They’re also more affordable than most other methods, and if you have insurance they don’t cost anything up-front.
These long-term birth control options are implanted in the uterus and last for years. They can only be removed by your doctor.
A hormonal IUD releases progestin, which thickens the mucus in the cervix and changes the lining of the uterus to make it nearly impossible for an egg to implant. It also works as emergency contraception if you insert it within five days of unprotected sex.
There are several types of IUDs, but Mirena, Skyla, Liletta, and Kyleena all release progestin. Copper IUDs, like Paragard, don’t release hormones and work by releasing copper that damages sperm and prevents pregnancy.
Inserting an IUD is a quick, easy procedure that only takes a few minutes. You’ll have some side effects afterward, including cramping, backaches, and dizziness, but they usually go away a few days later. Your doctor can quickly remove your IUD if you want to get pregnant or if it becomes uncomfortable or painful.
Women who are done having children may choose a permanent procedure like female sterilization (also known as tubal ligation or getting your tubes tied) to prevent pregnancy. This surgical procedure can be 95 to 99 percent effective, and it can also decrease a woman’s risk for ovarian cancer.
During a tubal ligation, the fallopian tubes that connect the ovaries to the uterus are either burned shut or cut. These tubes offer a passage for an egg to travel to the uterus when it is released, but intubation stops the egg from connecting with male sperm. The procedure can be performed right after a baby is born or during a c-section, and it does not increase complications during delivery.
Keep in mind that tubal ligation does not protect against sexually transmitted infections (STDs). If you are interested in a permanent birth control method, talk to your doctor about options like the IUD and birth control implant, which can last several years and are more than 99% effective. But be sure to use condoms with any partner you have so you don’t get an STD.