Birth Control Choices


 
MethodHow Well Does it Work?How to UseProsCons
The Implant (Nexplanon)>99%A healthcare provider places it under the skin of the upper arm. It must be removed by a healthcare provider
  • Long-lasting (up to 5 years)
  • No pill to take daily
  • Often decreases cramps
  • Can be used while breastfeeding
  • You can become pregnant right after it is removed

  • Can cause irregular bleeding
  • After 1 year, you may have no period at all
  • Does not protect again HIV or other sexually transmitted infections (STIs)

Progestin IUD (Lilleta, Mirena, Skyla, and others)>99%Must be placed in uterus by a healthcare provider. Usually removed by a healthcare provider
  • May be left in place 3-7, depending on which IUD you choose
  • No pill to take daily
  • May improve period cramps and bleeding
  • Can be used while breastfeeding
  • You can become pregnant right after it's removed

  • May cause lighter periods, spotting, or no period at all
  • Rarely, uterus is injured during placement
  • Does not protect against HIV or STIs
Copper IUD (Paraguard)>99%Must be placed in uterus by a healthcare provider. Usually removed by a healthcare provider
  • May be left in place for up to 12 years
  • No pill to take daily
  • Can be used while breastfeeding
  • You can become pregnant right after it is removed

  • May cause more cramps heavier periods
  • May cause
  • Spotting between periods
  • Rarely, uterus is injured during placement
  • Does not protect against HIV or other STIs

The Shot (Depo-Provera)94%Get a shot every 3 months
  • Each shot works for 12 weeks
  • Private
  • Usually decreases periods
  • Helps prevents cancer of the uterus
  • No pill to take daily
  • Can be used while breastfeeding

  • May cause spotting, no period, weight gain, depression, hair or skin changes, change in sex drive
  • May cause delay in getting pregnant after you stop the shots
  • Side effects may last up to 6 months after you stop the shots
  • Does not protect against HIV or STIs

The Pill91%You must take the pill daily
  • Can be used while breastfeeding
  • You can become pregnant right after stopping the pills

  • May cause nausea, weight gain, headaches, change in sex drive - some of these can be relieved by changing to a new brand
  • May cause spotting the first 1-2 months
  • Does not protect against HIV or other STIs

Progestin-Only Pills91%You must take the pill daily
  • Can be used while breastfeeding
  • You can become pregnant right after stopping the pills

  • Often causes spotting, which may last for many months
  • May cause depression, hair or skin changes, change in sex drive
  • Does not protect against HIV or other STIs

The Patch (Ortho-Evra)91%Apply a new patch once a week for 3 weeks, no patch in week 4
  • Can make periods more regular and less painful
  • No pill to take daily
  • You can become pregnant right after stopping the patch

  • Can increase vaginal discharge
  • May cause spotting the first 1-2 months of use
  • Does not protect against HIV or STIs

The Ring (NuvaRing)91%Insert a small ring into the vagina. Change ring each month
  • One size fits all
  • Private
  • Does not require spermicide
  • Can make periods more regular and less painful
  • No pill to take daily
  • You can become pregnant right after stopping the ring

  • Can irritate skin under the patch
  • May cause spotting the first 1-2 months
  • Does not protect against HIV or other STIs

External Condom82%Use a new condom each time you have sex, use a polyurethane condom if allergic to latex
  • Can buy at many stores
  • Can put on as part of sex play/foreplay
  • Can help prevent early ejaculation
  • Can be used for oral, vaginal, and anal sex
  • Protects against HIV and other STIs
  • Can be used while breastfeeding

  • Can decrease sensation
  • Can cause loss of erection
  • Can break or slip off

Internal Condom79%Use a new condom each time you have sex, use extra lubrication as needed
  • Can put in as part of sex play/foreplay
  • Can be used for anal and vaginal sex
  • May increase pleasure when used for anal and vaginal sex
  • Good for people with latex allergy
  • Protects against HIV and other STIs
  • Can be used while breastfeeding
  • Can decrease sensation
  • May be noisy
  • May be hard to insert
  • May slip out of place during sex
  • Requires a prescription from your healthcare provider
Withdrawal (Pull-Out)78%Pull penis out of vagina before ejaculation (that is, before coming)
  • Costs nothing
  • Can be used while breastfeeding
  • Less pleasure for some
  • Does not work if penis is not pulled out in time
  • Does not protect against HIV or STIs
  • Must interrupt sex
Diaphragm (Caya, Milex)88%Must be used each time you have sex, must be used with spermicide
  • Can last several years
  • Costs very little to use
  • May protect against some infections, but not HIV
  • Can be used while breastfeeding

  • Using spermicide may raise the risk of getting HIV
  • Should not be used with vaginal bleeding or infection
  • Raises risk of bladder infection
Fertility Awareness (Family Planning)75%Predict fertile days by: taking temperature daily, checking vaginal mucus for changes, and/or keeping record a of your periods. It works best if you use more than one of these - avoid sex or use condoms/spermicide during fertile days
  • Costs little
  • Can be used while breastfeeding
  • Can help with avoiding or trying to become pregnant
  • Must use another method during fertile days
  • Does not work well if your periods are regular
  • Many things to remember with this method
  • Does not protect against HIV or STIs
Spermicide (Cream, gel, sponge, foam, inserts, film)72%Insert spermicide each time you have sex
  • Can buy at many stores
  • Can be put in as part of sex play/foreplay
  • Comes in many forms: cream, gel, sponge, foam, inserts, film
  • Can be used while breastfeeding
  • May raise the risk of getting HIV
  • May irritate vagina, penis
  • Cream, gel, and foam can be messy
Emergency Contraception Pills - Progestin EC (Plan B® One-Step and others) and ulipristal acetate (ella®)58% – 74%
Ulipristal acetate EC works better than progestin EC if you are overweight
Ulipristal acetate EC works better than progestin EC in the 2-5 days after sex.
Works best the sooner you take it after unprotected sex. You can take EC up to 5 days after unprotected sex. If pack contains 2 pills, take both together.
  • Can be used while breastfeeding
  • Available at pharmacies, health centers, or health care providers: call ahead to see if they have it
  • People of any age can get progestin EC without a prescription
  • May cause stomach upset or nausea
  • Your next period may come early or late
  • May cause spotting
  • Does not protect against HIV or other STIs
  • Ulipristal acetate EC requires a prescription
  • May cost a lot