The most common birth control methods and how effective they are at preventing pregnancy

·8 min read
There are many different birth control options out there and what works for one person may not be ideal for the next. (Getty Images)
There are many different birth control options out there and what works for one person may not be ideal for the next. (Getty Images)

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Now that Roe v. Wade has been overturned, leaving states to decide whether or not to allow abortion within their borders, it's understandable that some people have been thinking about their birth control methods — or are considering going on one — and how effective they are at preventing pregnancy. But there are many different birth control options out there and what works for one person may not be ideal for the next.

"Certain birth control options work better for some people, while others may prefer a different option," women's health expert Dr. Jennifer Wider, tells Yahoo Life. "Some people are more susceptible to side effects than others, too. So while the birth control pill, for example, will work well with minimal side effects for one person, someone else may experience side effects that they wouldn't experience with a different option — therefore dictating their choice."

With that in mind, here's a breakdown of the most common birth control methods plus how they work.

Sterilization

Sterilization is an option for both men and women, but the procedure is different depending on your anatomy.

How does it work?

Female sterilization is the chosen birth control method for nearly 19% of women in the U.S. who are currently using contraception, according to the Centers for Disease Control and Prevention (CDC). Female sterilization, which typically means a tubal ligation, is when the fallopian tubes are removed or cut and tied with special thread, or closed shut with bands or clips, or sealed with an electric current, according to the American College of Obstetricians and Gynecologists (ACOG). A tubal ligation, also known as a tubal sterilization, works by preventing sperm from reaching the egg.

Male sterilization comes in the form of a vasectomy, which is a surgical procedure that cuts the vas deferens, tubes that carry sperm from the testicles to the urethra, per the U.S. National Library of Medicine. After a vasectomy, sperm can't move out of the testicles. Because of this, a person who has had a successful vasectomy cannot make a woman pregnant, the U.S. National Library of Medicine explains.

How effective is it?

Both male and female sterilizations are more than 99% effective at preventing a pregnancy, according to ACOG. However, the organization says, a vasectomy is slightly more effective.

How do you get it?

Both require surgery, so you'll need to consult your doctor about next steps, Dr. Christine Greves, an ob-gyn at the Winnie Palmer Hospital for Women and Babies, tells Yahoo Life.

Other key facts

Sterilization is permanent, and it's not a decision to be taken lightly. "A tubal ligation is only for folks who are 100% convinced they never want to be pregnant again [or ever pregnant]," Dr. Mary Jane Minkin, a clinical professor of obstetrics and gynecology and reproductive sciences at Yale Medical School, tells Yahoo Life. "For anyone else who has any hesitation at all, a long-acting reversible contraceptive is better."

If couples are considering sterilization, Minkin recommends a vasectomy over tubal ligation. "It's a lot easier — their plumbing is outdoors; ours is indoors," she says.

IUDs are one of the most effective forms of reversible birth control available. (Getty Images)
IUDs are one of the most effective forms of reversible birth control available. (Getty Images)

Long-acting reversible contraception (LARC)

LARC is a class of birth control used by about 10% of women who use contraception. This category includes intrauterine devices (IUDs) and the implant.

How does it work?

LARC is designed to be a "set it and forget it" method of birth control, Greves says. This means that you need to replace them only after a period of time. IUDs are typically replaced anywhere from three to 10 years, depending on which one you choose, ACOG says. The implant lasts for up to three years, according to ACOG.

There are two major forms of IUDs: hormonal and nonhormonal. Both forms work to create an inhospitable environment for sperm and implantation, Wider says. "Hormonal IUDs release a type of hormone — progestin — that acts to thicken the cervical mucus to make it difficult for the sperm to meet the egg, suppress ovulation and thin the lining of the uterus, thus preventing a pregnancy," she says. The copper IUD, which is nonhormonal, interferes with the sperm's ability to move, ACOG explains, and to reach an egg to fertilize it.

The implant is a flexible, plastic rod about the size of a matchstick that's inserted just under the skin in the upper arm, where it releases progestin into the body, per ACOG.

How effective is it?

IUDs and the implant are the most effective forms of reversible birth control available, ACOG says, noting that they're 20 times more effective than birth control pills, the patch or the ring. During the first year of use, less than 1% of women who have an IUD or implant will get pregnant.

How do you get it?

You'll need to meet with a health care provider to get an IUD or the implant, Greves says.

Other key facts

"A LARC is for someone who doesn't want to think about contraception — and have it acting all the time," Minkin says. This can also be helpful for "someone who either has a hard time remembering to take a pill every day or knows they don't want kids right now but aren't sure if they are permanently done or not," Greves says.

The hormones progestin and estrogen are combined in birth control pills to prevent ovulation. (Getty Images)
The hormones progestin and estrogen are combined in birth control pills to prevent ovulation. (Getty Images)

Oral contraceptives

There are different forms of oral contraceptives, but this is collectively referred to as "the Pill."

How does it work?

The Pill uses the hormones progestin and estrogen to prevent ovulation, Minkin explains, so no egg is released. "You don't get pregnant without an egg out there," she says. However, there is also something called the "mini Pill" that is progestin-only, which is an option for women who are breastfeeding or unable to take contraceptives with estrogen.

How effective is it?

With typical use (i.e., it may not be used perfectly), 9% of women will become pregnant during the first year of using a combined hormonal birth control method, ACOG says. With perfect use, less than 1% of women will become pregnant during the first year on the Pill. The mini Pill is estimated to be 87% effective at preventing pregnancy, according to the Mayo Clinic.

How do you get it?

The Pill is available only via prescription, so you'll need to consult your doctor first, Greves says.

Other key facts

Oral contraceptives are the second most common form of birth control in the U.S., with nearly 13% of women on birth control using it. The Pill may also help lessen period cramps and heavy bleeding. "If you have crummy periods and need contraception, birth control pills are very nice," Minkin says.

Unlike many other forms of birth control, condoms can also protect against many sexually transmitted infections. (Getty Images)
Unlike many other forms of birth control, condoms can also protect against many sexually transmitted infections. (Getty Images)

Condoms

Condoms are available for men and women. However, male condoms are much more popular than female condoms — they're used by about 9% of women who use contraception.

How does it work?

Male condoms are a barrier method of birth control that fits over a penis. A condom prevents pregnancy because it "stops the sperm from entering the vaginal canal," Wider explains.

How effective is it?

When used perfectly, condoms are 98% effective at preventing pregnancy, according to Planned Parenthood. In real life, though, they're about 85% effective, the organization says.

How do you get it?

Condoms can be easily purchased online and in select stores, such as pharmacies and grocery stores.

Other key facts

Unlike many other forms of birth control, condoms can also protect against many sexually transmitted infections (STIs), Greves points out. "Condoms can be helpful for someone who doesn't want to have hormones or is worried about their body being sensitive to medication and wants to try other options," she says.

The ring is placed in the vagina and releases estrogen and progestin to prevent pregnancy. (Getty Images)
The ring is placed in the vagina and releases estrogen and progestin to prevent pregnancy. (Getty Images)

Other birth control options

While the above are the main forms of birth control used in the U.S., there are other options. Those include:

  • The patch, a combined hormonal birth control method that delivers estrogen and progestin via a patch worn on the skin.

  • The ring, a flexible, plastic ring that's placed in the vagina that releases estrogen and progestin.

  • The shot, an injection that contains the hormone depot medroxyprogesterone acetate (DMPA, or Depo-Provera), which protects against pregnancy for 13 weeks.

If you're interested in using birth control or are considering switching methods, Greves recommends talking to your doctor about your options. They should be able to offer personalized guidance.

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