What Is Non-Hormonal Birth Control?

Medically reviewed by Cordelia Nwankwo, MD

Non-hormonal birth control is any method of pregnancy prevention that does not impact your hormones. Common non-hormonal methods include barrier methods like condoms and diaphragms, non-hormonal IUDs, natural family planning methods, and sterilization.

In the United States, about 88% of folks assigned female at birth have used some type of birth control during their lives. Hormonal birth control methods, like birth control pills, are popular for their high efficacy rates. However, many people turn to non-hormonal methods for preventing pregnancy to avoid the potential risks and side effects of hormonal methods.

Related: Birth Control Overview

Barrier Methods

Barrier methods of birth control work by preventing sperm from entering the cervix (opening to your uterus) and fertilizing your egg. Each barrier method works a little differently. Here are the most common types.

Condoms

Condoms are the most common type of birth control method, after sterilization. This is likely because they are relatively easy to acquire and simple to use.

Male condoms are made of latex or polyurethane, and are worn over the penis during intercourse, preventing sperm from reaching the cervix. Besides preventing pregnancy, they can prevent sexually transmitted infections (STIs) when worn correctly and during every instance of contact.

Failure rates for typical (imperfect) condom use are 13%, meaning out of every 100 couples using condoms as their birth control, 13 would become pregnant within the year. However, when condoms are used perfectly, they are more effective, with a failure rate of 2%.

Diaphragm

Diaphragms are shallow cups that are inserted into the vagina to create a barrier between sperm and the cervix. The cup is flexible and can be folded in half for easy insertion; they are made of rubber or latex. Before intercourse, you add spermicidal jelly to the diaphragm and insert it into the vagina so that the diaphragm covers your cervix.

Diaphragms have to be left in the vagina for six to eight hours after sex, but shouldn’t be left in for more than 24 hours. Diaphragms have to be fitted and sized by a healthcare provider and replaced after a year or two. Importantly, they don’t prevent STDs. Their failure rate is similar to other barrier methods, with a typical use failure rate of 17%.

Cervical Caps

Cervical caps are similar to diaphragms but they are smaller in size and less flexible. They are made of silicone rather than latex or rubber. Like the diaphragm, they are filled with spermicide and inserted into the vagina before sex. They must be left in for six to eight hours but can be removed up to 48 hours later.  Their typical failure rate is also 17%. Cervical caps don’t prevent STIs.

Related: What Is a Birth Control Sponge?

Non-Hormonal IUDs

An IUD is a device that’s surgically inserted into your uterus through your cervix and works by preventing fertilization or preventing fertilized eggs from being implanted. There are two types of IUDs: hormonal and non-hormonal. The non-hormonal IUD is the copper IUD (Paragard). Copper IUDs do not prevent STDs and may cause heavier-than-normal periods. Copper IUDs are very effective at preventing pregnancy, however, with a failure rate of 1%.

Related: How Does IUD Insertion Work?

Natural Family Planning

In a 28-day menstrual cycle, there are only about six days that are considered the peak fertility window for getting pregnant. These are the five days leading up to ovulation and the day of ovulation.

In theory, if you can determine what your fertile days are and avoid unprotected sex during those days, you could prevent pregnancy. Natural family planning methods include tracking your cycle on a calendar, using temperature tracking, using ovulation predictor kids, or noting changes in cervical mucus that may indicate ovulation. Often, several of these methods are combined.

However, determining the exact days of this fertility window can be difficult. Natural family planning methods typically have a high failure rate of about 23%.

Related: The Best Birth Control Options To Consider for Your 20s and Beyond

Permanent Methods

Permanent methods of birth control involve sterilization through surgical methods. There are two types of sterilization: tubal ligation for people assigned female at birth and vasectomy for people assigned male at birth.

Tubal ligation is the most common birth control method in the world, with a 24% prevalence. Vasectomies are a primary birth control method for only 2% of people.

Tubal Ligation

During a tubal ligation, the fallopian tubes are surgically closed off so that fertilized eggs cannot reach the uterus. This makes pregnancy nearly impossible. Tubal ligation is usually performed under general anesthesia, but may also be performed under local anesthesia. Tubal ligation is effective right away and has a very low failure rate of 0.5%.

Vasectomy

Male sterilization involves a procedure called a vasectomy, where the vas deferens (tubes connecting to the testes) are cut so that sperm can no longer be transported out of your testicles during ejaculation. This procedure is usually done under local anesthetic and is a 15-minute long procedure.

However, vasectomies aren’t effective immediately. It can take up to 12 weeks for sperm count to reach zero. Similar to tubal ligation, vasectomies are highly effective, with failure rates of about 0.15%.

Related: Can You Get a Vasectomy Reversed?

Who Should Use Non-Hormonal Birth Control?

Up to 40% of people use some type of hormonal birth control to prevent pregnancy. Although hormonal birth control methods work well for many people, they are not suitable for everyone. People often consider non-hormonal methods of birth control because of the potential side effects and risks of using hormonal methods.

Many people experience side effects while using hormonal methods. Side effects can include nausea, dizziness, weight gain, and moodiness. Research also shows about two-fifths of women are concerned about the long-term risks of using hormonal birth control, and consider it to be unsafe.

Certain hormonal birth control methods have been associated with an increased risk of blood clots, which could lead to several life-threatening conditions.

Some studies have also found that people using oral hormonal contraceptives (birth control pills) have an overall increased rate of breast and cervical cancer, but a lower risk of endometrial, ovarian, and colorectal cancer. However, more research is needed to understand the relationship between hormonal birth control and cancer.

Related: 2 Side Effects of Not Having a Period on Birth Control

How to Choose a Non-Hormonal Birth Control

When considering what type of non-hormonal birth control method to use, it’s best to first consult with your healthcare provider. They know your medical history, sexual history, and can suggest the most effective and user-friendly method for you.

Still, the final decision rests with you and your sexual partner. When considering a non-hormonal method, you should consider whether you need the method to protect against STDs in addition to pregnancy (only condoms protect against STDs). You should also pick a method that is effective and that you will be able to use consistently each time you have sex.

You can try different methods to see which works best for you, or combine more than one method. For example, many people using natural family planning will use condoms on their fertile days. Some people who use IUDs may also use condoms when having sex with new partners to protect against STDs.

A Quick Review

Non-hormonal birth control methods are great choices for people looking for alternatives to hormonal methods, like birth control pills, patches, and injections. However, some of the non-hormonal methods are less effective than birth control pills, and involve more planning ahead and inconvenience. Many people prefer non-hormonal methods because of the potential risks and side effects of hormonal methods. Reach out to your healthcare provider to help you select the best birth control method for you.

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