The Many Pregnancy Prevention Options

By Everyday Health. Listen to the ► Podcast at How To Sex.



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Contraception Options 101: Everything You Need to Know About Birth Control

Here’s the lowdown on pregnancy prevention with pills, patches, implants, and other types of birth control, plus information on effectiveness, availability, cost, and more.

By Cheryl Alkon; By John Paul McHugh, MD courtesy of American College of Lifestyle Medicine

Updated on August 28, 2023

It’s a fact: If you’re a woman, and you have sex with a man, it’s possible you’ll get pregnant. But if you don’t want to have a baby, there are many forms of birth control to help prevent pregnancy.

Birth Control: A Definition and Overview

While abstinence, or refraining from intercourse, is the only way to prevent pregnancy with 100 percent certainty, contraception, or birth control, comes in several different forms, both non-hormonal and hormonal.

Non-hormonal methods generally create a physical barrier between the sperm and the egg; a notable exception is the copper IUD, which changes the uterine environment but does not actually present a physical barrier. Two permanent contraception methods require surgery: sterilization, or tubal ligation, for women and vasectomy for men.

Hormonal methods generally prevent ovulation (the release of an egg), make it more difficult for sperm to enter the uterus, or prevent a fertilized egg from implanting in the uterus.

What’s the Best Birth Control Method?

“It varies, and it depends on you and your lifestyle,” says Keosha T. Bond, an assistant medical professor at The City University of New York School of Medicine in New York City. “I try to explain there’s no one-size-fits-all. It’s more, ‘What can I do, and how does my body react?’ There are so many contraceptive methods out there, but not every one will fit every person.”

How Effective Is Birth Control?

The effectiveness rate of various birth control methods is based on perfect use; meaning the method is used consistently and correctly every single time, and typical use, which includes people who use the method inconsistently or incorrectly.

Knowing what all your birth control options are will help you and your partner choose what works best for you. “I think it’s awesome to be talking about it. A lot of people just don’t know” about birth control, says Christine Carlan Greves, MD, an obstetrician and gynecologist with Orlando Health in Florida.

Birth Control Methods: All Your Contraception Options

Here’s a look at the various kinds of birth control available today.

Hormonal Birth Control

Contraceptive methods that use hormones alter how your body works in order to prevent pregnancy. These range from daily-use options, such as birth control pills, to long-term-use approaches, such as hormonal IUDs, which can stay in place for several years, says Dr. Bond.

Hormonal Contraception Option: Birth Control Pills

There are two types of birth control pills: combination pills that contain both estrogen and a form of progesterone called progestin, as well as progestin-only pills (also known as the mini pill).

The pills work by preventing ovulation, so there is no egg for sperm to fertilize, or by thickening cervical mucus so sperm cannot travel to an egg.

Birth control pills need to be taken every day as directed. Most types of progestin-only pills must be taken within the same three-hour time window every day. Some pills can also be used to stop your period.

How effective are birth control pills? Combined and progestin-only birth control pills are more than 99 percent effective if used perfectly and 93 percent effective if used typically.

How much do they cost? You need a prescription to get birth control pills. They may cost nothing or up to $50 a month and can be free or low-cost with most types of health insurance, Medicaid, or other government programs.

Hormonal Birth Control Side Effects

Some people don’t do well on hormonal contraception. “Each woman is different, and you have to understand your body,” says Bond. If you notice one or more of these side effects, let your doctor know:

• Nausea
• Weight gain
• Changed menstrual cycles, including spotting

Some women like the effect of ‘the pill’ on their breast size. They are glad to have that kind of ‘weight gain’.

Who Shouldn’t Take Hormonal Birth Control?

For some people, the use of hormones is not recommended. “The pill is easy and awesome, but if you have migraines with aura (vision changes during a bad headache) or have a history of deep vein thrombosis, stroke, or other cardiac changes,” talk to your doctor to learn if you should consider another birth control option, says Dr. Greves. Moreover, if you have a blood-clotting disorder, you don’t want to take estrogen, and if you have breast cancer, you don’t want to take estrogen or progestin. Smokers and those considered overweight or obese should talk to their doctors about which contraceptives are recommended for them.

Hormonal Contraception Option: The Shot, Depo, or Depo-Provera

An injection of medroxyprogesterone (Depo-Provera) (also known as the birth control shot) can prevent pregnancy for three months.

The shot contains high-dose progestin to prevent ovulation, and it also makes cervical mucus thicker to prevent sperm from reaching the egg.

In most cases, your doctor or nurse will give you the shot every quarter, but in some cases, you may be able to bring the shot home to give it to yourself.

How effective is the shot? Injectables are more than 99 percent effective with perfect use and 96 percent effective with typical use.

How much does it cost? It can cost nothing or up to $150, and it can be free or low-cost with many health insurance plans, Medicaid, and some government programs.

Hormonal Contraception Option: Birth Control Implant, or Nexplanon

The birth control implant, also called Nexplanon, is a small rod about the size of a matchstick that is placed into the upper arm. It releases progestin to prevent pregnancy for up to three years.

The implant must be inserted by a trained healthcare provider and can be removed at any time if you want to get pregnant.

How effective is the implant? The implant is more than 99 percent effective.

How much does it cost? It can cost anywhere between $0 and $1,300, but it’s totally free with most health insurance plans, Medicaid, and some government programs.

Hormonal Birth Control Option: Vaginal Ring (NuvaRing or Annovera)

Like combination birth control pills, the vaginal ring contains both progestin and estrogen.

It’s a small ring that a woman wears inside her vagina, and the hormones work to prevent ovulation and pregnancy.

There are two types of vaginal rings: ethinyl estradiol and etonogestrel (NuvaRing) and ethinyl estradiol and segesterone (Annovera). Each NuvaRing lasts for up to five weeks. You take the old one out and put in a new one about once a month, and it can be used to safely skip your period. Each Annovera ring lasts for one year, but you must put it in your vagina for three weeks, then take it out for one week every month, during which