What Are the Best Birth Control Options?

There are two types of barrier methods: condoms and diaphragms.

Condoms

Condoms are designed to cover a penis and catch semen, as well as prevent contact with bodily fluids.

It’s important to always use a water-based lubricant with latex condoms. Oil-based products can damage the latex, making them less effective.

“Condoms are an incredible method of contraception, it’s just that they aren’t always used,” says Shah. She notes that if you don’t use one every time, it’s a good idea to have another method, like emergency contraception, on hand.

Pros Latex and plastic condoms protect against most STIs, are easily accessible in stores, and are often free at clinics.

Cons They're only about 85 percent effective at preventing pregnancy, in part because they can break.

Internal Condoms

Pros They're made of soft plastic and protect against some STIs and pregnancy.

Cons They're only 79 percent effective at preventing pregnancy.

Diaphragms and Cervical Caps

A diaphragm is a shallow, bendable cup that is placed inside your vagina to cover your cervix, similar to a menstrual cup, and it is often used together with a spermicide gel or cream.

Pros Used with spermicide, diaphragms are 88 percent effective — more effective than condoms.

Cons They don't protect against STIs and are less effective without spermicide.

IUDs are small, flexible, T-shaped plastic devices placed at the bottom of the uterus. They are a type of long-acting reversible contraceptive (LARC), popular for their ease of use and effectiveness.

There are two general types of IUDs: copper IUDs and hormonal IUDs.

Copper IUD

ParaGard is the only copper IUD approved for use in the United States.

Pros They're more than 99 percent effective at preventing pregnancy, are long-lasting, and don't require regular maintenance.

Cons They may not be an option if you have uterine abnormalities like fibroids, and they require a procedure to remove. They can increase cramping, heaviness of flow, and the number of menstruation days.

Hormonal Intrauterine Device (IUD)

Hormonal IUDs work similarly to copper IUDs by preventing sperm from reaching an egg. Instead of copper, they release a small amount of the hormone progestin over several years.

Hormonal IUDs last anywhere from 3 to 8 years.

Pros They're more than 99 percent effective, last several years, and don't require regular clinic visits or prescription refills.

Cons Similar to copper IUDs, they require a procedure and may not be an option if you have uterine abnormalities.

While generally safe, "the estrogen in some hormonal contraceptives may increase the likelihood of blood clots, high blood pressure, and stroke in people with risk factors like smoking and being over age 35," says Dr. Cheng.

Birth Control Pill

Combination pills, also known as the pill, are the most common type of birth control pill.

Your healthcare provider can help you determine which type of birth control pill is right for you.

Pros The pill can help regulate your menstrual cycle, reduce cramps, and may even clear up acne. It's about 93 percent effective when used correctly.

Cons It offers no STI protection, and you have to commit to taking it around the same time every day.

Birth Control Patches

Like the pill, patches contain hormones that keep you from ovulating, except you don’t have to remember to take a pill every day.

Cons They don't prevent STIs, and you have to remember to fill your prescription every month.

Birth Control Rings

Pros They're 93 percent effective and can be more convenient than the pill, with the same effect on your cycle.

Cons They don't protect against STIs and products containing silicone or oil can damage them.

Birth Control Shots

Pros It's 96 percent effective, private, and may be more convenient than a pill or device. It's progestin-only, which may make it safer for some people.

Cons It requires a healthcare visit four times a year to get the shot and doesn’t protect against STIs.

Birth Control Implants

Implants are another form of long-acting reversible contraceptive (LARC) that can be convenient and effective for many users.

Pros They're 99 percent effective at preventing pregnancy and last for up to 5 years. Because they're progestin-only, they may be safer for some people.

Con They don't prevent STIs, and you may not want a device implanted into your body.

There are several types of nonhormonal gels and creams that use active ingredients to kill sperm or prevent it from reaching an egg in other ways, like changing the pH of the vagina. These are typically applied each time before sex.

Spermicide Gel, Cream, or Foam

By themselves, spermicides are only about 79 percent effective and are often used in tandem with another form of birth control, such as condoms or a cervical cup.

Pros They're available without a prescription or medical appointment.

Cons They're only about 79 percent effective and best used with another form of birth control. They don't protect against STIs.

Contraceptive Gel (Phexxi)

Phexxi works best when you combine it with another form of birth control. But you shouldn't use Phexxi with a vaginal ring.

Pros It can be a good nonhormonal birth control option if that's important to you.

Cons You need to have it with you so you can use it every time you have sex, and it requires a prescription. It doesn't protect against STIs and is only effective for up to 1 hour.

Birth Control Sponges

Birth control sponges are small, round sponges made of soft, squishy polyurethane foam that you insert deep into your vagina just before sex.

Pros They can be a good option for people who feel a device or medication is not right for them.

Cons They're only about 79 to 86 percent effective and you need to use them every time you have sex. They don't prevent STIs.

Emergency contraceptives (EC) help to prevent pregnancy after unprotected sex. While most people may think of Plan B, certain IUDs can now also be used as emergency contraceptives.

For people not using a long-acting form of birth control, “if not getting pregnant is the goal, we recommend patients keep a morning-after pill on the bedside,” says Shah. She adds that in cases of sexual assault, a medical clinic can provide emergency contraception.

If you or someone you know has been the victim of sexual assault, the national nonprofit RAINN can connect you with confidential support and resources in your area.

Levonorgestrel Pill

If you're looking to keep some on hand, you can order morning after pills online from sites like Wisp and Bedsider. If you need one immediately, they should be available at your local pharmacy.

Pros It's available over the counter and by mail.

Cons It may not work if you weigh more than 165 pounds (lb) and won’t protect against STIs.

Ella

Ella is more effective than plan B, but requires a prescription. It also works better than other morning-after pills for people who weigh more than 165 lb.

Pros It's more effective than other morning-after pills and for people who weigh more than 165 lb.

Cons It may be less effective if you weigh 195 lb or more. It requires a prescription, but may be covered by some insurance plans.

IUDs

IUDs remain effective for up to 12 years depending on the type, or until you have it taken out. It also works the same regardless of your weight.

Pros They are the most effective type of emergency contraception. Their effectiveness isn't affected by body weight, and you can continue to use an IUD as long-term birth control.

Cons They require an office visit and procedure. It may be difficult to get an appointment for an IUD within 5 days after unprotected sex.

Surgery is a permanent (in rare cases reversible) method of birth control that can be a great choice for people who are sure they don't want to get pregnant in the future.

Vasectomy

According to Shah, it’s a bit of a misconception that vasectomies are reversible. “If there is any chance you want to get pregnant in the future, you may want to consider another form of birth control,” she says.

Vasectomy reversal is not always possible, and very few doctors are skilled in the procedure, says Shah. Some people may opt to preserve their sperm in a sperm bank for extra insurance.

Pros It's almost 100 percent effective at preventing pregnancy. The procedure is simple, and you can go home the same day. It's permanent, requiring no maintenance.

Cons It can’t always be reversed, so may not be the best option for some people.

Tubal Ligation

Like a vasectomy, tubal ligation is an outpatient procedure, but it does require general anesthesia or a spinal block (if done during a C-section).

Pros It's more than 99 percent effective at preventing pregnancy and is permanent, requiring no maintenance.

Cons It’s permanent, which may not be the best option for everyone, and it requires surgery.

Fertility Awareness Methods (FAM)

With fertility awareness methods, you keep track of your cycle so you know when you’re ovulating and can get pregnant.

“Tracking is one of the oldest forms of birth control, and some people like it because they are really in tune with their bodies,” says Shah. Tracking and understanding your cycle can help you plan a wanted pregnancy, avoid pregnancy, and spot potential health problems.

Your cervical mucus changes in consistency throughout your cycle. Shah notes that cervical mucus is thicker and whiter around the time of ovulation.

You can also use other signs to track peak fertility, such as body temperature and cervical position. FAM can be useful if you’d like to get pregnant quickly.

Pros The concept is free (though not all tools are) and doesn’t require a doctor’s visit. Learning about your cycle is empowering.

Cons You have to be diligent about paying attention to your cycle. It may not work for people with irregular periods. It requires partner cooperation and doesn’t protect against STIs.

Withdrawal

With the withdrawal method, commonly called "pulling out," people have condomless sex until just before the person with a penis ejaculates. They then “pull out” so they don’t ejaculate in the vagina.

Pros It's free and doesn’t require any medical visits or tracking.

Cons "Pulling out" can be difficult and requires a lot of self control. Sperm can still be released before withdrawal. It doesn't protect against STIs.

Breastfeeding

When you exclusively breastfeed your baby every four to six hours, your body stops ovulating. You can't get pregnant if an egg isn't released.

According to Planned Parenthood, breastfeeding full-time (lactational amenorrhea method) is about 98 percent effective at preventing pregnancy. “We see people get pregnant while breastfeeding all the time, but it certainly does decrease your chances,” says Shah.

Pros It's free, and it may be something healthy that you’re doing anyway.

Cons It's reliable only for the first six months of a baby’s life, or until your period returns, whichever comes first.

You can still have sex without vaginal penetration, and that can be the best birth control option for some people.

If abstinence is your first line of defense, it’s a good idea to have another form of birth control on hand, just in case.

“Refraining from sex is certainly not feasible for everyone — nor is it easy. We’re all human beings and we all have a sex drive,” says Sara Newmann, MD, MPH, an assistant professor of obstetrics, gynecology, and reproductive sciences at the University of California in San Francisco.

“If abstinence is your only plan, you should always have a backup contraception on hand, such as condoms.”

Pros It’s free and 100 percent effective at preventing pregnancy.