With so many birth control methods available—each with their own benefits and drawbacks—it can be overwhelming trying to figure out which one best meets your needs. That’s exactly why it’s often easier to just go with what your gynecologist recommends. But knowing all of your options not only helps you find the right fit now, but also in the future. After all, the pregnancy-prevention method that works for you in your 20s may not be ideal in your 30s or 40s.
“Women should feel free to switch between methods and find what works for them,” says Vanessa Cullins, M.D., an obstetrician-gynecologist and vice president for medical affairs at Planned Parenthood Federation of America. “No one method is magical for all women, and most women’s needs change throughout their lives.”
Here’s what you need to know about the most common birth control methods on the market so you can make an informed decision no matter what life stage you’re at.
How it works: A latex or plastic sheath is placed over the penis—or in the case of the female condom, a plastic pouch is put deep inside the vagina—to catch sperm, as well as prevent skin-to-skin contact that can result in STDs. The male condom is 82 percent effective at preventing pregnancy, while the female condom is 76 percent effective at preventing pregnancy.
Biggest side effects: In rare cases, some people have a latex allergy, but they can swap latex condoms for plastic ones. With the female condom, in some cases it can slip inside the vagina (or anus) during intercourse and need to be pulled back out again. Reduced sensation during sex can also be an issue, notes Cullins.
Who it’s good for: Men and women who want a birth control option that prevents both pregnancy and STDs, or for those looking to add STD prevention to their chosen form of birth control. Condoms are also a good option for people who prefer a non-hormonal contraceptive and one that you can use as-needed. “Condoms are over-the-counter and cheap,” says Cullins.
How it works: The dome-shaped silicone cup is filled with a tablespoon of spermicide and then inserted into the vagina. The device prevents pregnancy by blocking the cervix, while the spermicide immobilizes sperm. Diaphragms are 87 percent effective against pregnancy.
Biggest side effects: Some women have frequent urinary tract infections with the diaphragm, which can be helped by peeing before putting in the device and after having sex. Others experience vaginal irritation, which may signal a sensitivity to the spermicide being used or to the silicone cup itself. If you gain 10 or 20 pounds, you’ll need to have the diaphragm refitted by your gyno.
Who it’s good for: Those who prefer a hormone-free contraceptive that they can use—and reuse (for up to two years)—as needed. It’s also better for women who are comfortable inserting a device inside their vaginas.
How it works: A 2-inch foam sponge (Today sponge) that contains spermicide is inserted into the vagina before having sex. As with the diaphragm, the sponge creates a barrier that prevents sperm from reaching the eggs, while the spermicide itself stops sperm. The sponge is 87 percent effective against pregnancy in women who have never given birth and 76 percent effective in those who have given birth.
Biggest side effects: The sponge can cause vaginal irritation. Some sponge-users find the method either too messy or makes them too dry during sex, according to Planned Parenthood.
Who it’s good for: Women who want a non-hormonal birth control option that they can use when they need it (the sponge can be inserted hours before sex and left in for 30 hours afterward) and that doesn’t require a prescription. The device is better for women who are comfortable placing a device inside their vaginas.
How it works: Combination birth control pills contain the hormones estrogen and progestin, while the mini-pill is progestin-only. Oral contraceptives halt ovulation and thicken cervical mucus to prevent sperm from reaching the eggs. Birth control pills are about 91 percent effective at preventing pregnancy.
Biggest side effects: The Pill carries a risk of blood clots and a small risk of stroke, especially if you’re over 35, smoke, or have a family history of stroke. Some women find that birth control pills dampen their libido. For the mini-pill, spotting between periods is a common side effect. Both combination pills and the mini-pill make periods lighter and reduce painful menstrual cramps. (The Pill can lower your risk of ovarian and endometrial cancers, while extended use may increase the risk of cervical cancer and possibly breast cancer.)
Who it’s good for: Women who can remember to pop a pill every day. It’s also a good option if you’re looking to both prevent pregnancy and improve acne, bad cramps, or PMS symptoms. Oral contraceptives can also be taken back-to-back, eliminating the monthly flow, which helps prevent endometriosis-related pain and menstrual migraines.
How it works: You insert a small, flexible ring (NuvaRing) deep inside your vagina where it then releases the hormones estrogen and progestin. The hormones halt ovulation and thicken cervical mucus, which renders sperm immobile. The ring stays in for three weeks and then you remove it for one week. You can also use the ring continuously—removing the ring after one month and replacing it with a new ring right away—to skip your periods. The ring is about 91 percent effective at preventing pregnancy.
Biggest side effects: Many women find that their periods are more regular, shorter, and lighter with the ring. Spotting between periods, breast tenderness, and nausea are the most common side effects, but they tend to go away in about two to three months, according to Planned Parenthood. In some cases, the ring can cause increased vaginal discharge or irritation. Others may find that the ring lowers their libido.
Who it’s good for: Those looking for a hormonal birth control method that doesn’t require a shot or remembering to take a pill every day. It’s also good for women who are comfortable inserting the device inside their vagina and removing it every month.
How it works: The patch (Xulane), which can be placed on the upper outer arm, stomach, upper back, or butt, contains estrogen and progestin. Just as with the ring, the hormonal duo prevents pregnancy by keeping an egg from being released from the ovaries and by thickening the cervical mucus to stop sperm from moving. The patch stays on for three weeks in a row and is removed for the entire fourth week. The method is about 91 percent effective at preventing pregnancy.
Biggest side effects: You can expect reliable, lighter, and shorter periods on the patch. The hormones in the patch help reduce acne, painful cramps, PMS symptoms, endometriosis-related pain, and menstrual migraines. About 10 percent of women have some type of reaction to the patch, like a rash, according to Cullins, while others may have breast tenderness. Some women find that their sex drive dips on the patch.
Who it’s good for: Women who want a hormonal birth control method that doesn’t require popping a daily pill, having shots, or inserting a device into their vaginas.