Abstinence
Pros: No physical side effects; nothing to purchase; excellent protection against sexually transmitted diseases Cons: Both partners have to commit to this option; often no protection is used when abstinence ends Effectiveness: The only method that is 100% effective
Implant (Nexplanon)
Pros: Continuous but reversible protection against pregnancy for three years; one-time insertion procedure with nothing to apply or insert at the time of intercourse; menstruation can become lighter or stop; no obvious visible sign that person is using it once the incision heals (although the implant can occasionally be seen, and can be recognized easily if touched) Cons: Requires small incision in the arm for placement of implant; occasionally temporary pain at the insertion site; side effects include irregular bleeding, headaches or change in appetite (but these usually resolve within three months); no protection against sexually transmitted diseases Effectiveness: 99.9%
Contraceptive Injections (Depo-Provera)
Pros: Continuous but reversible protection against pregnancy for three months; nothing to apply or insert at the time of intercourse; menstruation stops for over half of women; no visible sign that person is using the methodCons: Requires injection from a health care provider every three months; side effects include irregular period, weight gain or headaches; return to fertility may take a few months; no protection against sexually transmitted diseasesEffectiveness: 99% if used consistently but there can be anywhere from 6 to 12 accidental pregnancies in every 100 Depo users, especially among younger women and adolescents.
Vaginal Ring (Nuva Ring, Annovera)
Pros: Continuous protection against pregnancy for one month; placement doesn’t need to be exact; nothing to apply or insert at the time of intercourse Cons: Must remember to remove for one week to allow for menstruation and then must remember to insert new ring for next three weeks (with Annovera, reinsert same ring for up to a year); is inserted vaginally; no protection from sexually transmitted diseases; the ring is occasionally felt by the partner; ring sometimes comes out during sexual intercourse Effectiveness: 99% if used correctly and consistently (ring removed and replaced each month)
Patch
Pros: Nothing to apply or insert at the time of intercourseCons: Must remember to replace patch weekly and not wear it the week of menstruation; visible—worn on the skin and not available in all skin tones; no protection against sexually transmitted diseases; not recommended for women over 198 pounds; risk of blood clot might be higher than the pill, shot, ring, or implantEffectiveness: 99% if used correctly and consistently (patch removed and replaced each week)
Intrauterine Device (IUD)
There are two types of IUDs: One contains the hormone progesterone and is effective for five years but reversible. One does not contain hormones and is effective for 10 years.
Pros: Nothing to apply or insert at the time of intercourse; IUDs with hormones may reduce menstrual cramps and bleeding; non-hormonal IUDs are an alternative for women who cannot use hormonal birth control methods; can also be used for emergency birth control if inserted within five days after intercourseCons: Must be inserted and removed by a clinician; heavier periods (non-hormonal IUD); rare but serious health risks include uterine perforation or pelvic inflammatory disease; no protection against sexually transmitted diseasesEffectiveness: >99.9%
Birth Control Pill
Pros: Nothing to apply or insert at the time of intercourse; periods are shorter and more regular; ability to become pregnant returns quickly when not used; protects against certain cancers and heavy, painful periodsCons: Must remember to take daily; possible side effects of nausea, breast tenderness, change in appetite or appetite loss; rare but serious health risks such as heart attack and stroke can occur (risks are higher for women over 35 or women who smoke and those with migraine with aura); no protection against sexually transmitted diseasesEffectiveness: 99% if used correctly and consistently; missing one or more pills increases the risk of pregnancy significantly making it about 91% effective meaning 9 out of 100 pill users will get pregnant each year
Condoms
Pros: Available over the counter; prevents most sexually transmitted diseases; can sometimes be obtained for free from clinics or other health care providersCons: Must be used with each act of intercourse; must be put on and removed correctly; males sometimes complain of loss of sensationEffectiveness: 98% if used consistently and correctly; but many people don’t use them perfectly making them 85% effective meaning 15 out of 100 people who use condoms will get pregnant
Female Condom
Pros: Available over the counter; prevents most sexually transmitted diseases; good for those with latex allergiesCons: Sometimes difficult to insert; must be used with each act of intercourse; can become dislodged during sexEffectiveness: 75% to 82% effective with normal use and 95% effective when used correctly all the time
Diaphragm or Cervical Cap
Pros: Can be inserted up to two hours before intercourse; can remain in place for multiple acts of intercourse (diaphragm—24 hours, cervical cap—48 hours); an option for those who can’t tolerate hormonal birth controlCons: Requires precise insertion and comfort with one’s body; may become dislodged with intercourse; may interfere with spontaneity; must be left in place for 6 to 8 hours after sex; increased risk of urinary tract infectionsEffectiveness: 80% (cap); 94% (diaphragm) if used consistently and correctly but are more likely to be 88% effective due to normal human error
Spermicides
Pros: Available over-the-counter in different forms—creams, gels, films, foams, suppositories; adds lubrication (creams, foams, gels)Cons: Must insert right before each act of intercourse; can cause allergic reactions; possibility of irritation that could aid sexually transmitted disease transmissionEffectiveness: 72% or 28 out of 100 people using spermicides will get pregnant
Vaginal Insert (Phexxi)
Phexxi is a newly approved vaginal insert that works by altering pH to incapacitate sperm.
Pros: Easy to insert applicator; one-time useCons: Prescription needed; must be inserted at time of intercourse; may increase the risk of urinary tract infectionsEffectiveness: 86% to 93% if used consistently
Natural Family Planning
Pros: Free; no hormones or medicationsCons: Must have regular cycle; need to be diligent about charting and abstaining during fertile periodsEffectiveness: 95% to 99% with perfect use
A Word From Verywell
It’s always advisable to discuss birth control options with an experienced health care provider. Adolescent medicine practices and Planned Parenthood are good choices.
