Sometimes a woman may not
use birth control, or her method may fail. If this happens to you, you may
still be able to prevent pregnancy if you act quickly. For more information,
see the topic Emergency Contraception.
What is birth control?
Birth control is any method
used to prevent pregnancy. Another word for birth control is contraception (say
If you have sex without birth control, there
is a chance that you could get pregnant. This is true even if you have not
started having periods yet or you are getting close to menopause.
The only sure way to prevent pregnancy is to not have sex. But
finding a good method of birth control you can use every time can help you
avoid an unplanned pregnancy.
What are the types of birth control?
many different kinds of birth control. Each has pros and cons. Learning about
all the methods will help you find one that is right for you.
Hormonal methods include birth control
pills, shots, the skin patch, the implant, and the vaginal ring. There is also a hormonal IUD that releases a small amount of hormone. Birth control that uses
hormones is very good at preventing pregnancy.
Intrauterine devices (IUDs) are
inserted into your
uterus. IUDs work very well and are very safe. There are two main types of IUDs: copper IUDs and hormonal IUDs.
Barrier methods include condoms,
diaphragms, and sponges. In general, these do not prevent pregnancy as well as
IUDs or hormonal methods do. Barrier methods must be used every time you have
Natural family planning (also called fertility
awareness) can work if you and your partner are very careful. You will need to
keep good records so you know when you are fertile. And during times when you
are fertile, you will need to skip sex or use a barrier method.
Permanent birth control (sterilization) gives you lasting
protection against pregnancy. A man can have a vasectomy, or a woman can have her tubes tied (tubal ligation). But this is only a good choice if you
are sure that you don’t want any (or any more) children.
Emergency contraception is a backup method to prevent
pregnancy if you forget to use birth control or a condom breaks.
For hormonal or barrier methods to work best, you have
to use them exactly the way your doctor or the package instructions say. Even
then, accidents can happen. So it is a good idea to keep emergency birth
control on hand as backup protection.
How do you choose the best method?
The best method
of birth control is one that protects you every time you have sex. And with
many types of birth control, that depends on how well you use it. To find a
method that will work for you every time, some things to think about
How well it works. Think about how
important it is to you to avoid pregnancy. Then look at how well each method
works. For example, if you plan to have a child soon anyway, you may not need a
very reliable method. If you don’t want children but feel it is wrong to end a
pregnancy, choose a type of birth control that works very
How much effort it takes. For
example, birth control pills may not be a good choice if you often forget to
take medicine. If you are not sure you will stop and use a barrier method each
time you have sex, pick another method.
When you want to have children. For example, if you want to have children in the
next year or two, birth control shots may not be a good choice. They can make it hard
to get pregnant for several months after you stop them. If you never want to
have children, natural family planning is not a good choice because it often
How much the method costs. For
example, condoms are cheap or free in some clinics. Some insurance companies
cover the cost of prescription birth control. But cost can sometimes be
misleading. An IUD costs a lot up front. But it works for years, making it
low-cost over time.
Whether it protects you from infection. Latex condoms can help protect you from sexually transmitted infections (STIs), such as HIV. But they are not the best way to prevent
pregnancy. To avoid both STIs and pregnancy, use condoms along with another
type of birth control.
If you’ve had a problem with one kind of birth control. Finding the best method of birth control may involve trying
something different. Also, you may need to change a method that once worked
well for you.
If you are using a method now that you are not happy
with, talk to your doctor about other choices.
What health issues might limit your choices?
birth control methods may not be safe for you, depending on your health. To
make sure a method is right for you, your doctor will need to know if
Are or could be pregnant.
Have any serious health problems, such as
high blood pressure,
migraine headaches, or
Have had blood clots in the
legs (deep vein thrombosis) or lungs (pulmonary embolism), or have a close family member who
had blood clots in the legs or lungs.
Have ever had breast cancer.
Have a sexually transmitted infection.
How can you get birth control?
You can buy:
Condoms, sponges, and spermicides without a prescription at
Emergency contraception without a prescription at most drugstores.
You need to see a doctor or other health professional
Get a prescription for birth control pills
and other methods that use hormones.
There are many methods of
birth control. Learn about the different kinds of
birth control to help you choose the best one for you. When making your choice,
also consider that only a condom will help protect you from sexually transmitted infections (STIs). To protect
yourself and your partner against STIs, use a condom (along with your chosen
birth control method) every time you have sex.
Hormonal methods are very
reliable means of birth control. Hormonal methods use two basic
Progestin-only hormonal methods include pills, also
called “mini-pills”; a shot (such as Depo-Provera); and implants (such as Implanon or Nexplanon). If you
can’t take estrogen, a progestin-only method may be an option for you. There is also a hormonal IUD that releases a type of progestin.
Combination and progestin-only methods are prescribed for
women for different reasons. Each
type of method has its pros and cons.
Combination pills may reduce acne, pain
during ovulation, and premenstrual symptoms. Both types of pill reduce heavy
bleeding and cramping. Unlike the combination pill, the progestin-only pill can
be taken by almost all women, including those who are breastfeeding. Depending on when you start taking either type of birth control pill, you may
need to use a backup birth control method for the first week.
Patches or vaginal rings are similar to combination
pills, but they don’t require taking a daily pill. The patch is changed weekly,
and the ring is changed monthly (with 1 week off after 3 weeks of
Some birth control pills reduce severe mood and physical
symptoms that some women get before they start their monthly periods. These
symptoms are called premenstrual dysphoric disorder (PMDD). There are also birth
control pills for women who want fewer periods or who want to stop having
The birth control shot does not require
taking a daily pill. Instead, you see your health professional once every 3
months for the injection.
The hormone implant releases
hormones that prevent pregnancy for about 3 years. It must be inserted and
removed by a trained health professional. The actual implant is about the size
of a matchstick and is inserted under the skin on the inside of the upper
Intrauterine device (IUD)
An intrauterine device (IUD) is a small device that is placed in the uterus to prevent pregnancy. There are two main types of IUDs:
copper IUDs (such as ParaGard) and hormonal IUDs (such as Mirena or Skyla). When an IUD
is in place, it can provide birth control for 3 to 10 years, depending on the
The hormonal IUD typically reduces menstrual flow and cramping
over time. On the other hand, the copper IUD can cause longer and heavier
periods. But the hormonal IUD can have other side effects, including
spotting, mood swings, and breast tenderness. These side effects occur less
frequently than with other progestin-only methods.
(including the diaphragm; cervical cap; male condom; female
condom; and spermicidal foam, sponge, gel, suppository, or film) prevent sperm
from entering the uterus and reaching the egg. Typically, barrier methods are not highly effective, but they generally have fewer side
effects than hormonal methods or IUDs. Spermicides and condoms should be used
together or along with another method to increase their effectiveness. Barrier
methods can interrupt sex, because they must be used every time you have
Fertility awareness (periodic abstinence or natural family planning)
Fertility awareness requires that a
couple chart the time during a woman’s menstrual cycle when she is most likely to become pregnant and avoid intercourse
or use a barrier method during that time. Fertility awareness is not a good
choice if you need a highly effective form of birth control.
Breastfeeding may work as a form of birth control in the first 6 months after
giving birth if you follow specific guidelines. For this method to work, you
must breastfeed your baby every time. You can’t use formula or other
supplements. This is called the lactational amenorrhea method (LAM).
Permanent birth control (sterilization)
Sterilization is a surgical procedure done for men or women who decide
that they do not want to have any (or more) children. Sterilization is one of
the most effective forms of birth control. Sterilization is intended to be
permanent, and although you can try to reverse it with another surgery,
reversal is not always successful.
Tubal ligation or implants. Tubal ligation is a
surgical procedure where the fallopian tubes, which carry the eggs from the
ovaries to the uterus, are tied, cut, or blocked. A new nonsurgical
sterilization technique uses a small metal coil, or tubal implant, inserted up into each fallopian tube. Over time, scar tissue
grows around each tubal implant, permanently blocking the tubes. Most women are
able to return home within a couple of hours after either procedure. You must
use another form of birth control for 3 months after receiving tubal implants.
At 3 months, you will need to have an X-ray taken to make sure that your tubes
Vasectomy. In this minor surgery, the vas deferens,
the tubes that carry sperm from the testicles to the seminal fluid (semen), are cut and
blocked so that the semen no longer contains sperm. This does not interfere with a man’s ability to
have an erection or enjoy sex. Men must have a sperm count check after having a
vasectomy before relying on this for birth control.
Female sterilization is more complicated, has higher
risks of problems after surgery, and is more expensive than male
Contraception following pregnancy
Birth control is
an important consideration after you have had a child. Your ability to become
pregnant again may return within 3 to 6 weeks after childbirth. Think about
what type of birth control you will be using, and make a plan during your
pregnancy. Most methods of birth control are safe and effective after delivery. But in the first couple of weeks after delivery or if you are breastfeeding, it’s best to use a method that doesn’t contain estrogen. Talk to your doctor about which type is best for you.
Choosing a Birth Control Method
With so many methods
available and so many factors to consider, choosing
birth control can be difficult. You may be able to
decide on a method by asking yourself the following questions:
Might I want to have a biological child in the future?
One of your first considerations might be to determine whether you want
permanent or temporary birth control. In other words, you should consider
whether you want to conceive any (or more) children. This is a decision that
will affect the rest of your life and can be made only after thinking it
If you are not sure about the future even though you
know how you feel now, a temporary method is a better choice. If you are young,
have few or no children, are choosing sterilization because your partner wants
it, or think it will solve money or relationship problems, you may regret your
How would an unplanned pregnancy affect my life?
If an unplanned pregnancy would seriously impact your plans for the
future, choose a birth control method that is highly effective. Or if you have
a stable relationship and income and plan to have children in the future
anyway, you may feel comfortable using a less reliable method.
How effective are different types of birth control?
Consider how important it is to you to avoid pregnancy, and then look at how well each birth control method works. Hormonal methods and IUDs work very well. Barrier methods such as condoms, diaphragms, and spermicides are only moderately effective. Fertility awareness is even less effective.
Be honest about how much effort you are willing to put into birth control. To be effective, birth control pills require you to take a pill every day. Barrier methods have to be used before sex. Fertility awareness requires that you watch your temperature and other signs closely. You must also avoid sex on days when you could get pregnant. If you are not willing to put in the effort, choose another method of birth control.
comfortable you feel about using a particular method of birth control. If you
are not comfortable with or might not consistently use a birth control method
for any reason, that method is not likely to be reliable for you in the long
How can I prevent sexually transmitted infections?
Unless you know that your partner has no other sex
partners and is free of sexually transmitted infections (STIs), you are at risk
for STI infection. If you are at risk, protect yourself from infection every
time you have sex. Use a condom in addition to any other birth control method
You can choose between a
male or female condom to reduce your risk for
HIV (the virus that causes AIDS),
herpes, pelvic inflammatory disease (PID), and other
What health factors could limit my choice of birth control?
If you have health problems or other risk factors, some
birth control methods may not be right for you.
Smoking. If you smoke more than 15 cigarettes
a day and are 35 or older or have
high blood pressure, a history of
stroke, a history of
blood clots, liver disease, or
heart disease, you may not be able to use combined
Migraines. If you have migraine headaches, talk
to your health professional about whether you can try combined hormonal
Diabetes. If you have advanced or long-standing
diabetes, discuss the risks of taking hormonal birth
control methods with your health professional.
Breastfeeding. If you are breastfeeding, the estrogen in
combined hormonal birth control can lower your milk supply. Progestin-only
pills, an implant, both kinds of IUDs, or birth control shots do
not affect your milk supply and are a good option for breastfeeding women.
Other health problems that might keep you from using a
particular birth control method are relatively rare, especially in young women. But before using any method, talk with your health professional
to see if it is safe for you.
What are some other considerations in choosing a birth control method?
Other things to consider when choosing a method of birth
Health benefits, such as decreased risk of sexually
transmitted infections with condoms and reduced risk of ovarian cancer and
uterine cancer with use of birth control pills for one year or
Convenience and ease of use. Birth control forms such
as patches, shots, implants, IUDs, and vaginal rings are convenient for women
who have trouble remembering to take a daily pill or couples who know they
won’t use a barrier method every time they have sex.
Cost. Over time, the higher one-time cost of IUD
insertion or sterilization surgery may be less than the continued costs of
buying pills or condoms and spermicide.
If you are planning to become pregnant in the future. The amount of time it takes for a woman’s full fertility to return after stopping birth control varies for each woman
and depends on the birth control method she is using.
Risks and side effects of the method. Some birth control methods may have a greater risk of causing certain health problems. And some methods cause more side effects than others. For example, hormonal birth control usually has more risks and side effects than barrier methods. Talk to your doctor about the risks and side effects.
After you have looked at the facts about the different
methods and thought about your own values and needs, you can choose the method
that will work best for you. Using condoms with any method may increase its
reliability and helps to protect you from sexually transmitted infections (STIs).
Are you interested in what others decided to do? Many people have faced
this decision. Personal stories may help you decide.
You can use emergency
contraception if a condom breaks, you’ve forgotten a pill, you are taking other
medicines that may affect contraception medicines, or you have had
unprotected sex. Emergency contraception does not
protect against sexually transmitted infections.
For many methods of birth control, you’ll need to see your doctor to get a prescription. If you want to start birth control, talk with your doctor about options that are right for you. And if you have problems with a birth control method, talk with your doctor. He or she may recommend another birth control method or help you solve the problem you are having.
Other Places To Get Help
American Congress of Obstetricians and Gynecologists
American College of Obstetricians and Gynecologists (2010). Noncontraceptive uses of hormonal contraceptives. ACOG Practice Bulletin No. 110. Obstetrics and Gynecology, 115(1): 207-218.
American College of Obstetricians and Gynecologists (2011). Long-acting reversible contraception: Implants and intrauterine devices. ACOG Practice Bulletin No. 121. Obstetrics and Gynecology, 118(1): 184-196.
American College of Obstetricians and Gynecologists (2015). Emergency contraception. Practice Bulletin No. 152. Obstetrics and Gynecology, 126(3): e1-e11. DOI: 10.1097/ACOG.0000000000001047. Accessed online September 18, 2015.
Centers for Disease Control and Prevention (2010). U.S. medical eligibility criteria for contraceptive use. MMWR, 59(RR-4). Available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5904a1.htm?s_cid=rr5904a1_w.
Mishell DR (2007). Family planning: Contraception, sterilization, and pregnancy termination. In VL Katz et al., eds., Comprehensive Gynecology, 5th ed., pp. 275-325. Philadelphia: Mosby Elsevier.
Mishell DR (2012). Contraception. In L Goldman, A Shafer, eds., Goldman’s Cecil Medicine, 24th ed., pp. 1552-1555. Philadelphia: Saunders.
Stubblefield PG, Roncari, DM. (2012). Family planning. In JS Berek, ed., Berek and Novak’s Gynecology, 15th ed., pp. 211-269. Philadelphia: Lippincott Williams and Wilkins.
ByHealthwise Staff Primary Medical ReviewerSarah Marshall, MD – Family Medicine Kathleen Romito, MD – Family Medicine E. Gregory Thompson, MD – Internal Medicine Adam Husney, MD – Family Medicine Specialist Medical ReviewerFemi Olatunbosun, MB, FRCSC – Obstetrics and Gynecology