Birth Control Methods: How to Find the Best Option for You

Medically reviewed by Renita White, MD

There are many birth control methods to help prevent pregnancy, and it’s understandable if you’re not sure which may be best for you. Choosing the right one can be challenging when faced with so many options.

This article will explain methods of birth control, including lifestyle and barrier methods, natural methods, and hormonal or medical birth control methods.

How Does Birth Control Work?

There are different types of birth control to consider. Some birth control methods rely on lifestyle such as practicing abstinence or avoiding sexual intercourse, having outercourse instead, or monitoring your fertility and timing your sexual intercourse accordingly.

Other methods include the barrier method, which creates a physical or natural barrier between the sperm and the egg. The barrier prevents egg fertilization and unwanted pregnancy. Hormonal birth control works by stopping ovulation, stopping the egg from joining with sperm, and in some cases, thickening the cervical lining, making it more challenging for sperm to reach the egg.

Sterilization is a permanent method of birth control for people certain they do not want pregnancy.

Choosing the Right Birth Control Method

Birth control needs are highly individual, and many options are birth control methods exist.

The Centers for Disease Control and Prevention (CDC) suggests asking yourself the following questions to determine the right method for you:

• Do you ever want to get pregnant or have children? If yes, how soon?

• Do you have any preexisting health conditions?

• How often do you have vaginal intercourse?

• How many sex partners do you have?

• How effective is your method of birth control?

• What side effects are there to consider?

• Will you be able to use it correctly every time?

• Do you also need protection from sexually transmitted infections (STIs)?

A healthcare professional can help by providing in-depth information and answering your questions about each option.

Related: How to Choose Contraception

Is Birth Control Available If You Don’t Have Insurance?

If you’re wondering about options for free birth control, you may consider patient assistance programs run by nonprofit organizations, pharmaceutical companies, and medical device companies that can help you access birth control at reduced or no cost.

Takeaway

Over-the-counter (OTC) barrier birth control methods like condoms, spermicides, and even select mini pills can be bought at most pharmacies. Health clinics or family planning clinics provide low-cost or free options, and OTC options at pharmacies and drug stores are available for a fee. Depending on state laws, local pharmacists may also be able to prescribe access to the pill, patch, or ring without seeing a separate healthcare provider. 

Lifestyle-Changing Birth Control Methods

The following are lifestyle changes you may consider to prevent pregnancy:

Abstinence

Abstinence or celibacy is when you avoid having sexual intercourse. Abstinence is the most effective or best method of birth control as there is no risk of unwanted pregnancy.

Choosing not to have sex is a cost-free method of birth control with no associated side effects and that doesn’t require any prescription, insurance, medical appointments or follow-up appointments.

Learn More: Using Sexual Abstinence as a Birth Control Method

Outercourse

Outercourse is any other type of sexual activity that doesn't involve penetrative vaginal sex. This includes everything from kissing to mutual masturbation to oral sex, and the definition can differ. Since there is no exposure of semen to egg in these sexual activities, there is no associated cost, risk of pregnancy, or side effects. 

What Is Outercourse?

Outercourse involves sexual activity that can lead to genital fluid or semen exposure. Barrier methods can be used during outercourse, such as with anal and oral sex, to prevent semen or genital fluids from being shared between sexual partners to significantly reduce risk of STIs.

Learn More: Outercourse Sexual Activity Overview

Fertility Awareness Methods

Fertility awareness methods (FAMs) involve tracking the menstrual cycle to determine fertility levels. FAMs include temperature checking and cervical mucus monitoring. This method can be difficult to perfect as it requires monitoring, tracking, and scheduling. FAMs are around 77%–98% effective. These methods are free unless you use a paid app, fertility tests, or purchase a planner.

Learn More: At-Home Fertility Tests to Help With Your Reproductive Health

Birth Control Methods to Use as Needed

The following are as-needed birth control methods:

External Condom

External condoms (also known as male condoms) provide a barrier to semen entering the vagina and swimming to the egg. They are highly effective when used perfectly (about 87% effective on average). Condoms can be purchased for a small fee ($2 to $3 apiece) or accessed through health clinics. They don’t have side effects, unless you're allergic to latex.

What to Avoid

When using condoms, avoid oil-based products like baby oil, lotion, petroleum jelly, or cooking oil because they will cause the condom to break.

Internal Condom

Internal condoms (female condoms) go inside the vaginal cavity creating a barrier that blocks semen from the egg. They are about 95% effective when used perfectly and about 79% effective on average.

They may cost the same but are more difficult to find than external condoms because there’s only one approved by the Food and Drug Administration (FDA). Find them at FC2 female condom website or through family planning or health clinics. Some people using internal condoms may experience irritation.

Related: How Big Are Condoms? Condom Size Guide

Sponge

The Today Sponge is the only sponge available in the United States, but it can be found anywhere you buy condoms including pharmacies, drugstores, and some grocery stores. However, it has been out of stock for some time. It costs about $15, although you may be able to find lower-cost versions at family planning and health clinics. People who are allergic to spermicide (nonoxynol-9) should not use the sponge.

Some people may experience discomfort.

Takeaway

Do not leave inserted for more than 30 hours or when menstruating, as this can increase risk of toxic shock syndrome.

Related: How to Reduce Your Risk of Toxic Shock Syndrome

Diaphragm

The diaphragm covers the cervix to prevent sperm from fertilizing the egg. It is shaped like a shallow cup. It has 94% effectiveness in perfect conditions or about 84% average effectiveness.

You need a prescription and a visit with a healthcare provider to be fitted for a diaphragm. You can then purchase the product at your local pharmacy, health clinic, or drugstore. Depending on your insurance coverage, it can be free or cost up to $250 for the exam, appointment, and diaphragm. Diaphragms need spermicide to prevent pregnancy. They have similar side effects to sponges but also include a risk of urinary tract infection.

Related: Discovering If a Diaphragm Is the Best Option for You

Cervical Cap

Cervical caps are similar to diaphragms but instead of a shallow cup, they are smaller and like a thimble. As with a diaphragm, a prescription and fitting are needed, cost varies, and spermicide is necessary for pregnancy prevention.

Related: 9 Non-Hormonal Birth Control Options

Spermicide

Spermicide is used to kill sperm. It comes in a cream, gel, foam, film, suppository, or tablet costing between $0.60 and $3 per dose. Spermicide can be purchased in drugstores without a prescription. It is 79–86% effective.

Some people develop irritation from using spermicide, which can increase the risk of sexually transmitted infections.

Related: The Pros and Cons of Spermicidal Lubricant External Condoms

Birth Control Methods to Use on a Schedule

The following are scheduled methods of birth control:

Shot

The shot (Depo-Provera) is an injection of progestin. It is 96% effective with a particularly low failure rate since it is administered every three months (i.e., you don’t have to rely on a barrier method or remember to take a pill every day). It costs between $0 and $150, depending on your insurance coverage and if you go through Medicaid or other government assistance programs.

Side effects of the birth control shot include menstrual changes, weight gain, headaches, and breast tenderness, and depression.

Related: Why Does Birth Control Require a Prescription?

Ring

The ring (NuvaRing) is an insertable estrogen and progestin hormone-releasing birth control method. People wear the ring for roughly three weeks and then remove it the week of menstruation. It’s inserted at home and has a 93% effectiveness rate. It costs between $0 and $200 for each ring or up to $2200 for a one-year option.

Some people experience temporary side effects, including headaches, nausea, sore breasts, vaginal discharge, and bleeding changes.

Related: Spotting Between Periods While on Birth Control

Patch

The patch is a hormonal option available by prescription and costs between $0 and $150. It’s said to be 99% effective when used perfectly, but since mistakes can happen, real-world effectiveness is closer to 93%. Certain medications, including antibiotics, can make the patch less effective, though.

Side effects are the same as other hormonal birth control options, and tend to resolve within two to three months.

Related: Is the Birth Control Patch Right for Me?

Combination Pill

The combination pill is an oral contraceptive option that delivers progestin and estrogen. It's 99% effective when used as directed, and 93% effective on average since you'll need to remember to take it daily. It requires an appointment and prescription that costs up to $50 a pack per month, but usually are free with most insurance plans and under government programs.

Side effects are similar to those of other hormonal birth control methods but also include increased risk of deep vein thrombosis or blood clot, heart attack, and stoke (especially in people who smoke).

Related: What Are Combination Birth Control Pills?

Mini Pill

The mini pill is progestin-only. It’s said to have similar effectiveness rates as combination pills. Taking this type of birth control pill requires consistency, as it is most effective when taken at roughly the same time each day. Side effects include ovarian cysts that tend to resolve on their own and slight increase in breast cancer risk, which returns to normal 10 years after stopping the mini pill.

Related: Progesterone-Only Birth Control

Birth Control Methods to Use as Needed

The following are as-needed birth control methods:

Implant

The implant, a brand of which is Nexplanon (etonogestrel), is a thin rod inserted under the upper arm skin that slowly releases progestin. This slow-method is highly effective with a 99% effectiveness. It has the greatest upfront price range, from $0 to $1,300.

Side effects include menstrual spotting or changes (heavier or lighter), symptoms associated with the progestin hormone such as nausea or headache, and discomfort from the insertion can also occur.

Related: An Overview of Birth Control While Breastfeeding

Copper IUD

Copper IUDs are nonhormonal; the copper provides protection against pregnancy. It changes the environment of the uterus and cervix, reducing the likelihood that sperm will make it to the egg. Pricing ranges up to $1,300. Find them with your healthcare provider or clinic for low or no cost.

Side effects, including menstrual changes, cramping, and pain the days after insertion, may ease up after three to six months.

Effectiveness of IUDs

Intrauterine devices, or IUDs are T-shaped devices inserted into the uterus. IUD birth control options are highly effective, with a 99% effective rate and low maintenance profile for birth control.

Related: What Are IUDs?

Hormonal IUD

Hormonal IUDs release progestin to prevent pregnancy. Several types on the market last between three and 12 years, although they can be removed at any healthcare appointment. While similar to copper IUDs, hormonal options work to reduce period heaviness and can be used to treat painful menstrual cramps.

Related: IUD Risks and Complications

Permanent Birth Control Methods

The following are permanent methods of birth control:

Tubal Ligation

Tubal ligation is a permanent method (sterilization), involving surgically altering the fallopian tubes that connect the ovaries to the uterus to prevent sperm from reaching an egg. It’s 99% effective. Risks common to any surgical procedure and anesthesia apply.

Cost ranges between $0 and $6,000, including post-op healthcare visits. It’s a same-day procedure, with most people returning to work within a few days. 

Related: Tubal Ligation Surgery: Everything You Need to Know

Vasectomy

Vasectomy is a sterilization method that permanently closes off the vas deferens, tubes that transport semen, so there’s no chance of the sperm reaching an egg. It’s also 99% effective and lasts for life, but it is a more minor (local anesthesia only) surgery than a tubal ligation. A vasectomy can cost between $0 and $1,000 and can be accessed at health clinics, private clinics, hospitals, and Planned Parenthood.

Related: Vasectomy: Overview

Read Next: Online Birth Control for PCOS to Help Ease Your Symptoms

Takeaway

People who are assigned female at birth can still get pregnant if they’re taking testosterone and haven’t undergone bottom surgery. They will require using birth control if wanting to prevent pregnancy.

Summary

Many different types of birth control are available, and it may take some time to figure out what works for you. It's important to weigh the side effects and benefits of each option and keep in mind that it may take some trial and error. Your healthcare provider can help you pick a safe and effective birth control method depending on your individual needs.

Read the original article on Verywell Health.