Contraception, or birth control, helps prevent pregnancies and plan the number and spacing of children. There are many options to choose from to prevent pregnancy. Some methods are more effective than others, and no one product is best for everyone.

Birth Control Methods

Birth control falls into two broad categories: reversible and permanent. Reversible methods allow individuals to stop birth control when they would like to become pregnant. Permanent methods cannot generally be undone once completed.

Reversible Methods of Birth Control

Long-acting Reversible Contraceptives

These contraceptive methods allow individuals to prevent pregnancy for multiple years.

• Copper Intrauterine Device (IUD): The copper IUD contains no hormones and is made with copper and plastic. The copper acts as a spermicide (substance that kills sperm) and prevents sperm from reaching and fertilizing an egg.
• Hormonal IUD: Hormonal IUDs contain the hormone progestin levonorgestrel. The progestin causes cervical mucus to thicken and the lining of the uterus to thin, which keeps the sperm from reaching and fertilizing an egg.
• Implantable Rod: This is a thin, matchstick-sized rod that contains a progestin hormone. It is put under the skin on the inside of your upper arm. It stops the ovaries from releasing eggs and thickens the cervical mucus, which keeps sperm from getting to the egg.

Contraceptive Shots

The contraceptive shot is an injection of progestin, one of the hormones found in birth control pills. Individuals using this method get the shot from their doctor once every three months.

Short-acting Hormonal Methods

These contraceptive methods use hormones to keep the ovaries from releasing eggs and possibly prevent the sperm from reaching and fertilizing an egg.

• Birth Control Pill: This method is also known as oral contraceptive or “the pill.” There are two main kinds: combined pills, which contain estrogen and progestin, and mini-pills, which only contain progestin.
• Birth Control Patch: The birth control patch is a thin, beige plastic square about two inches across that delivers hormones. Patches are used on a four-week cycle (three weeks on and one week off).
• Vaginal Ring: This small, flexible, plastic ring is inserted in the vagina and contains the same hormones (progestin and estrogen) found in most birth control pills.

Barrier Methods

There are several birth control methods that involve using a physical barrier to block the sperm from reaching and fertilizing an egg. When deciding how to prevent pregnancy, the Centers for Disease Control and Prevention (CDC) encourages couples to consider methods that offer dual protection from risk for HIV and other sexually transmitted infections (STIs).

• Male Condom: A male condom is a thin film cover that is placed over the penis and keeps sperm from entering a partner’s body. Using a male condom consistently and correctly reduces the risk for HIV infection and other STIs.
• Diaphragm and Cervical Cap: The diaphragm and cervical cap are silicone cups that are used with spermicide gel or cream. It is inserted into the vagina and over the cervix to keep sperm from entering the uterus.
• Female Condom: The female condom is a thin, soft, loose-fitting pouch (or sheath) with a flexible soft ring on each end. One end of the female condom fits inside of the vagina to keep it in place, and the other stays outside of the vagina.
• Sponge with Spermicide: The sponge is a small, disk-shaped device made of soft plastic foam that covers the cervix and contains the spermicide nonoxynol-9 (N-9). The spermicide in the sponge is placed inside the vagina, covering the cervix, prior to having sex and works by continuously releasing spermicide to kill sperm.

Permanent Methods of Birth Control

There are two options for sterilization, a form of contraception that is meant to be permanent.

• Tubal ligation (females): In this procedure—also known as “having your tubes tied”—the fallopian tubes are cut, sealed, clipped, or tied, so the egg and sperm can’t meet in the fallopian tube.
• Vasectomy (males): This procedure involves cutting, tying, or blocking the vas deferens—two tubes that carry sperm to the penis.

Other Forms of Pregnancy Prevention

The following forms of pregnancy prevention do not require any physical or medical materials.

• Abstinence: Sexual abstinence is defined as refraining from all forms of sexual activity and genital contact, such as vaginal, oral, or anal sex. This method is the only 100 percent effective way to protect against pregnancy, ensuring there is no exchange of bodily fluids (such as vaginal secretions and semen).
• Natural Family Planning and Fertility Awareness: Fertility awareness-based methods (FABM) help women and couples become more familiar with the signs of ovulation and the pattern of the menstrual cycle to understand how to plan sexual activity to either avoid pregnancy or become pregnant.
• Lactational Amenorrhea Method (LAM): LAM is a form of natural birth control that relies on the new mother feeding her baby only breastmilk for up to six months and having no periods or spotting during that time.
• Withdrawal: While having intercourse, before ejaculating, a person pulls the penis out of the partner’s vagina and away from the partner’s genitals (sex organs). It prevents fertilization by not allowing semen (and sperm) to enter the vagina so that sperm does not reach the egg.

Emergency Contraception

Emergency contraception is not a regular method of birth control. Emergency contraception is birth control that a person can use after unprotected sex—if you did not use birth control or if regular birth control failed. It should be used as soon as possible within three to five days after unprotected sex to prevent pregnancy. Emergency contraception methods are more effective the sooner they are taken. Emergency contraception does not work if the person is already pregnant. There are two main types of emergency contraception: emergency contraceptive pills and the copper T intrauterine device (IUD).

There are many different types of contraception, but not all types are appropriate for all situations. The most appropriate method of birth control depends on an individual's overall health, age, frequency of sexual activity, number of sexual partners, desire to have children in the future, and family history of certain diseases.

Designed to prevent sperm from entering the uterus, barrier methods are removable and may be an option for women who cannot use hormonal methods of contraception. Failure rates for barrier methods differ depending on the method.

Types of barrier methods that do not require a health care provider visit include the following:

• Male condoms. This condom is athin sheath that covers the penis to collect sperm and prevent it from entering the woman's body. Male condoms are generally made of latex or polyurethane, but a natural alternative is lambskin (made from the intestinal membrane of lambs). Latex or polyurethane condoms reduce the risk of spreading sexually transmitted diseases (STDs). Lambskin condoms do not prevent STDs. Male condoms are disposed of after a single use.
• Female condoms. These are thin, flexible plastic pouches. A portion of the condom is inserted into a woman's vagina before intercourse to prevent sperm from entering the uterus. The female condom also reduces the risk of STDs. Female condoms are disposed of after a single use.
• Contraceptive sponges. These are soft, disposable, spermicide-filled foam sponges. One is inserted into the vagina before intercourse. The sponge helps block sperm from entering the uterus, and the spermicide also kills the sperm cells. The sponge should be left in place for at least 6 hours after intercourse and then removed within 30 hours after intercourse. Currently, the Today® Vaginal Contraceptive Sponge is the only sponge approved by the FDA.
• Spermicides. A spermicide can kill sperm cells. A spermicide can be used alone or in combination with a diaphragm or cervical cap. The most common spermicidal agent is a chemical called nonoxynol-9 (N-9). It is available in several concentrations and forms, including foam, jelly, cream, suppository, and film. A spermicide should be inserted into the vagina close to the uterus no more than 30 minutes prior to intercourse and left in place 6 to 8 hours after intercourse to prevent pregnancy. Spermicides do not prevent the transmission of STDs and may cause allergic reactions or vaginitis (pronounced vaj-uh-NAHY-tis).

Methods that require a health care provider visit include the following:

• Diaphragms. Each diaphragm is a shallow, flexible cup made of latex or soft rubber that is inserted into the vagina before intercourse, blocking sperm from entering the uterus. Spermicidal cream or jelly should be used with a diaphragm. The diaphragm should remain in place for 6 to 8 hours after intercourse to prevent pregnancy, but it should be removed within 24 hours. Traditional latex diaphragms must be the correct size to work properly, and a health care provider can determine the proper fit.
  
  A diaphragm should be replaced after 1 or 2 years. Women also need to be measured for a new diaphragm after giving birth, having pelvic surgery, or gaining or losing more than 15 pounds. Newer diaphragms, such as Caya, are designed to fit most women and do not require fitting by a health care provider.
• Cervical caps. These are similar to diaphragms but are smaller and more rigid. The cervical cap is a thin silicone cup that is inserted into the vagina before intercourse to block sperm from entering the uterus. As with a diaphragm, the cervical cap should be used with spermicidal cream or jelly. The cap must remain in place for 6 to 8 hours after intercourse to prevent pregnancy, but it should be removed within 48 hours. Cervical caps come in different sizes, and a health care provider determines the proper fit. With proper care, a cervical cap can be used for 2 years before replacement. Currently, FemCap is the only cervical cap approved by the FDA.

Emergency contraception can be used after unprotected intercourse or if a condom breaks.

• Copper IUD. The copper IUD is the most effective method of emergency contraception. The device can be inserted within 120 hours of unprotected intercourse. The method is nearly 100% effective at preventing pregnancy and has the added benefit of providing a highly effective method of contraception for as long as the device remains in place. There are very few contraindications to use of the copper IUD, and there are no issues related to weight or obesity associated with the effectiveness of the method.
• Emergency contraceptive pills (ECPs) are hormonal pills, taken either as a single dose or two doses 12 hours apart, that are intended for use in the event of unprotected intercourse. If taken prior to ovulation, the pills can delay or inhibit ovulation for at least 5 days to allow the sperm to become inactive. They also cause thickening of cervical mucus and may interfere with sperm function. ECPs should be taken as soon as possible after semen exposure and should not be used as a regular contraceptive method. Pregnancy can occur if the pills are taken after ovulation or if the woman has unprotected sex in the same cycle.

Short-Acting Hormonal Methods

Hormonal methods of birth control use hormones to regulate or stop ovulation and prevent pregnancy. Ovulation is the biological process in which the ovary releases an egg, making it available for fertilization. Hormones can be introduced into the body through various methods, including pills, injections, skin patches, transdermal gels, vaginal rings, intrauterine systems, and implantable rods. Depending on the types of hormones that are used, these methods can prevent ovulation; thicken cervical mucus, which helps block sperm from reaching the egg; or thin the lining of the uterus. Health care providers prescribe and monitor hormonal contraceptives.

Short-acting hormonal methods (e.g., injectables, pills, patches, rings) are highly effective if used perfectly, but in typical use, they have a range of failure rates.

• Injectable birth control. This method involves injection of a progestin, Depo-Provera® (depot medroxyprogesterone acetate [DMPA]), given in the arm or buttocks once every 3 months. This method of birth control can cause a temporary loss of bone density, particularly in adolescents. However, this bone loss is generally regained after discontinuing use of DMPA. Most patients using injectable birth control should eat a diet rich in calcium and vitamin D or take vitamin supplements while using this medication. A new self-injectable formulation of DMPA, Sayana® Press, is approved in the United Kingdom and is expected to be approved more widely in the near future. This subcutaneous injectable product has a lower amount of hormone and may be more acceptable for some users.
• Progestin-only pills (POPs). A woman takes one pill daily, preferably at the same time each day. POPs may interfere with ovulation or with sperm function. POPs thicken cervical mucus, making it difficult for sperm to swim into the uterus or to enter the fallopian tube. POPs alter the normal cyclical changes in the uterine lining and may result in unscheduled or breakthrough bleeding. These hormones do not appear to be associated with an increased risk of blood clots.

Combined Hormonal Methods

Combined hormonal methods contain a synthetic estrogen (ethinyl estradiol) and one of the many progestins approved in the United States. All of the products work by inhibiting ovulation and thickening cervical mucus. The combined estrogen/progestin drugs can be delivered by pills, a patch, or a vaginal ring. The combined hormonal methods have some medical risks, such as blood clots, that are associated with the synthetic estrogen in the product. These risks have not been observed with progestin-only hormonal methods such as injectable birth control, POPs, or hormonal LARCs. Your health care provider can discuss your risk factors and help you select the most appropriate contraceptive method for you.

• Combined oral contraceptives (COCs, "the pill"). COCs contain a synthetic estrogen and a progestin, which functions to inhibit ovulation. A woman takes one pill daily, preferably at the same time each day. Many types of oral contraceptives are available, and a health care provider helps to determine which type best meets a woman's needs.
• Contraceptive patch. This is a thin, plastic patch that sticks to the skin and releases hormones through the skin into the bloodstream. The patch is placed on the lower abdomen, buttocks, outer arm, or upper body. A new patch is applied once a week for 3 weeks, and no patch is used on the fourth week to enable menstruation. Currently, Ortho Evra® is the only patch that is FDA approved.
• Vaginal ring. The ring is thin, flexible, and approximately 2 inches in diameter. It delivers a combination of ethinyl estradiol and a progestin. The ring is inserted into the vagina, where it continually releases hormones for 3 weeks. The woman removes it for the fourth week and reinserts a new ring 7 days later. Risks for this method of contraception are similar to those for the combined oral contraceptive pills. A vaginal ring may not be recommended for women with certain health conditions, including high blood pressure, heart disease, or certain types of cancer. Currently, the NuvaRing® is the only FDA-approved vaginal ring. A new contraceptive vaginal ring that can be used for 13 cycles is under clinical development.

Intrauterine Methods

An intrauterine device (IUD), also known as an intrauterine system (IUS), is a small, T-shaped device that is inserted into the uterus to prevent pregnancy. A health care provider inserts the device. An IUD can remain in place and function effectively for many years at a time. After the recommended length of time, or when the woman no longer needs or desires contraception, a health care provider removes or replaces the device.

• A hormonal IUD or IUS releases a progestin hormone (levonorgestrel) into the uterus. The released hormone causes thickening of the cervical mucus, inhibits sperm from reaching or fertilizing the egg, thins the uterine lining, and may prevent the ovaries from releasing eggs. The failure rate of a hormonal IUS is less than 1%; however, a small percentage of women may experience expulsion of the device and have to have it reinserted. Some research also suggests that these IUDs maintain their effectiveness up to a year beyond their recommended use period. This method may also be used to treat heavy menstrual bleeding because the hormone often reduces or eliminates uterine bleeding.
• A copper IUD prevents sperm from reaching and fertilizing the egg, and it may prevent the egg from attaching in the womb. If fertilization of the egg does occur, the physical presence of the device prevents the fertilized egg from implanting into the lining of the uterus. The failure and expulsion/reinsertion rates of a copper IUD is similar to those of a hormonal IUD. Copper IUDs may remain in the body for 10 years. A copper IUD is not recommended for women who may be pregnant, have pelvic infections, or had uterine perforations during previous IUD insertions. It also is not recommended for women who have cervical cancer or cancer of the uterus, unexplained vaginal bleeding, or pelvic tuberculosis. Currently, ParaGard® is the only FDA-approved copper IUD.

Implants

Implants are implantable rods. Each rod is matchstick-sized, flexible, and plastic. The method has a failure rate of less than 1%. A physician surgically inserts the rod under the skin of the woman's upper arm.

The rod releases a progestin and can remain implanted for up to 5 years. Currently, Implanon and Nexplanon, which release etonogestrel, are the only implantable rods available in the United States. A two-rod method, Jadelle, which releases levonorgestrel, is FDA approved but not currently distributed in America. A new levonorgestrel-releasing, two-rod method, Sino-implant (II), is in clinical development.

Sterilization is a permanent form of birth control that either prevents a woman from getting pregnant or prevents a man from releasing sperm. A health care provider must perform the sterilization procedure, which usually involves surgery. These procedures usually are not reversible.

• A sterilization implant is a nonsurgical method for permanently blocking the fallopian (pronounced fuh-LOH-pee-uhn) tubes. A health care provider threads a thin tube through the vagina and into the uterus to place a soft, flexible insert into each fallopian tube. No incisions are necessary. During the next 3 months, scar tissue forms around the inserts and blocks the fallopian tubes so that sperm cannot reach an egg. After 3 months, a health care provider conducts tests to ensure that scar tissue has fully blocked the fallopian tubes. A backup method of contraception is used until the tests show that the tubes are fully blocked.
• Tubal ligation (pronounced TOO-buhllahy-GEY-shuhn) is a surgical procedure in which a doctor cuts, ties, or seals the fallopian tubes. This procedure blocks the path between the ovaries and the uterus. The sperm cannot reach the egg to fertilize it, and the egg cannot reach the uterus.
• Vasectomy (va-SEK-tuh-mee) is a surgical procedure that cuts, closes, or blocks the vas deferens (pronounced vas DEF-uh-renz). This procedure blocks the path between the testes and the urethra (yoo-REE-thruh). The sperm cannot leave the testes and cannot reach the egg. It can take as long as 3 months for the procedure to be fully effective. A backup method of contraception is used until tests confirm that there is no sperm in the semen.

Coitus interruptus, also known as withdrawal, is a traditional family planning method in which the man completely removes his penis from the vagina, and away from the external genitalia of the female partner before he ejaculates. Coitus interruptus prevents sperm from entering the woman’s vagina, thereby preventing contact between spermatozoa and the ovum.

This method might be appropriate for couples

• who are highly motivated and able to use this method effectively;
• with religious or philosophical reasons for not using other methods of contraception;
• who need contraception immediately and have entered into a sexual act without alternative methods available;
• who need a temporary method while awaiting the start of another method; or
• who have intercourse infrequently.

Some benefits of coitus interruptus are that the method, if used correctly, does not affect breastfeeding and is always available for primary use or use as a back-up method. In addition, coitus interruptus involves no economic cost or use of chemicals and has no directly associated health risks. Coitus interruptus does not protect against sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), and women using this method should be counseled that consistent and correct use of the male latex condom reduces the risk for transmission of HIV and other STDs. Use of female condoms can provide protection from transmission of STDs, although data are limited.

Coitus interruptus is unforgiving of incorrect use, and its effectiveness depends on the willingness and ability of the couple to use withdrawal with every act of intercourse. Women with conditions that make pregnancy an unacceptable risk should be advised that coitus interruptus might not be appropriate for them because of its relatively higher typical-use failure rates.

What is it?

• It is a flexible ring that is about 2 inches around.
• It releases two hormones (progestin and estrogen) to stop the ovaries from releasing eggs.
• It also thickens the cervical mucus, which keeps sperm from getting to the egg.

Vaginal Contraceptive Ring - How Do I Use It?

• You put the ring into your vagina.
• Keep the ring in your vagina for 3 weeks and then take it out for 1 week. Your menstrual period should start during this ring-free week.
• If the ring falls out and stays out for more than 3 hours, replace it but use another method of birth control, like a condom and spermicide, until the ring has been in place for 7 days in a row.

How do I get it?

• You need a prescription from a healthcare provider.

Chance of getting pregnant with typical use (Number of pregnancies expected per 100 women who use this method for one year)

• Out of 100 women who use this method, about 9 may get pregnant.

Some Side Effects and Risks

• Vaginal discharge, discomfort in the vagina, and mild irritation.
• Headache
• Mood changes
• Nausea
• Breast tenderness

Some Less Common Risks

• It is not common, but some women who take the pill develop high blood pressure.
• It is rare, but some women will have blood clots, heart attacks, or strokes.

Does it protect me from sexually transmitted infections (STIs)?

No.

Many factors figure into the choice of birth control, such as your overall health, your age, how often you have sex, your number of sexual partners, your desire to have children in the future, and your family medical history. In addition, some forms of contraception are associated with health risks and side effects.

It is important to talk to a health care provider to determine your specific health requirements and which method of contraception is right for you.

If you do not want to get pregnant, there are many birth control options to choose from. No one product is best for everyone. Some methods are more effective than others at preventing pregnancy. Check the pregnancy rates on this chart to get an idea of how effective the product is at preventing pregnancy. The pregnancy rates tell you the number of pregnancies expected per 100 women during the first year of typical use. Typical use shows how effective the different methods are during actual use (including sometimes using a method in a way that is not correct or not consistent). The only sure way to avoid pregnancy is not to have any sexual contact. Talk to your healthcare provider about the best method for you.

OTHER CONTRACEPTION

Emergency Contraceptives (EC): May be used if you did not use birth control or if your regular birth control fails (such as a condom breaks). It should not be used as a regular form of birth control. Emergency contraception prevents about 55 - 85% of predicted pregnancies.

Overview

Birth control (also called contraception) can help you prevent pregnancy when you don’t want to have a baby. Male and female condoms are types of birth control that can also help protect you and your sex partner from STDs (sexually transmitted diseases).

How do I choose the right birth control?

There isn’t one method of birth control that’s right for everyone. Each type of birth control has pros and cons.

Here are some things to think about when choosing a birth control method:

• Do you want to have children someday? How soon?
• Do you have any health conditions?
• How often do you have sex?
• How many sex partners do you have?
• Do you also need protection against HIV and other STDs?
• How well does the birth control method work?
• Are there any side effects?
• Will you be able to use it correctly every time?

How does birth control work?

It depends on the type of birth control you choose. Different methods of birth control work in different ways.

IUDs

IUDs (intrauterine devices)

An IUD is a small, T-shaped piece of plastic with copper or hormones that a doctor or nurse places inside a woman's uterus.

There are 2 kinds:

• Copper IUDs release a small amount of copper to prevent sperm from fertilizing an egg. It can last for up to 10 years.
• Hormonal IUDs release a small amount of hormone to prevent pregnancy. There are 4 different types of hormonal IUDs. Some kinds can last for up to 5 years and some can last for up to 3 years.

IUDs are very effective at preventing pregnancy. You don't feel the IUD when it’s in place – and there's nothing to do or remember once it's there. IUDs don't protect you or your sex partner from STDs. But you can use a condom with your IUD to help protect against STDs.

If you have an IUD and you want to get pregnant, a doctor or nurse can easily remove it.

The Basics: Hormonal Methods

Hormonal methods

These methods work by preventing a woman’s ovaries from releasing an egg each month. They also cause other changes that make it less likely that you'll get pregnant.

Some hormonal methods work better than others, and some require more effort to use. For example, you have to take birth control pills every day – but once an implant is in place, it lasts for up to 3 years.

Hormonal methods include:

• Hormonal IUD – can last for 3 to 5 years, depending on the type
• Implant (a small rod put under the skin) – can last for 3 years
• Shot – given by a doctor or nurse every 3 months
• Patch – worn on the skin and replaced once a week, with one week off every month
• Ring – put in the vagina and replaced once a month
• Birth control pills – taken every day

These methods don't protect you or your sex partner from STDs. But you can use condoms to help protect against STDs while using hormonal birth control.

If you're interested in a hormonal method of birth control, talk with your doctor or nurse about which kind is best for you.

Barrier Methods

Barrier methods

Barrier methods work by preventing the sperm and egg from touching each other. Common barrier methods include:

• Male condoms (worn on the penis)
• Female condoms (placed inside the vagina)
• Birth control diaphragm or cervical cap (placed inside the vagina)
• Birth control sponge (placed inside the vagina)

Male condoms are also very effective at preventing HIV and reducing the risk of other STDs when used correctly every time you have sex.

Female condoms may also help prevent HIV and other STDs. Diaphragms, cervical caps, and sponges don't protect against STDs.

Fertility Awareness Methods

Fertility Awareness Methods

Fertility Awareness Methods (FAMs) are sometimes called natural family planning. With FAMs, you learn which days you're more likely to get pregnant. If you want to prevent pregnancy, you don’t have sex on those days – or you use another method of birth control.

FAMs are only an option for women who have regular periods. It's important to know that FAMs are not typically as effective at preventing pregnancies as some other forms of birth control, like IUDs or hormonal methods.

Couples can also use FAMs when they're trying to get pregnant.

Emergency Contraception

Emergency contraception

Sometimes you may forget to use birth control – for example, you could miss a pill or shot. And sometimes birth control methods can fail, like if a condom breaks.

There are 2 options for emergency contraception:

• Copper IUD – A doctor or nurse will need to place this inside your uterus within 5 days of unprotected sex.
• Emergency contraception pills (ECPs) – You'll need to take ECPs as soon as possible within 5 days of unprotected sex. The sooner you take them, the more effective they are. You can buy some ECPs at a drugstore without a prescription. To get other ECPs, you need a prescription from a doctor.

Taking ECPs won’t harm a pregnancy if you're already pregnant. ECPs won't protect you from STDs, so consider getting tested for STDs if you didn't use a condom – or if the condom broke.

Sterilization

Sterilization

Sterilization is a permanent method of birth control. This is an option for people who are 100% sure they don’t want children – or don't want any more children than they already have.

• In men, this means cutting or blocking the tubes that carry sperm to the outside of the penis. This is called a vasectomy.
• In women, this means cutting or blocking the tubes that carry eggs into the uterus. Cutting the tubes is called tubal ligation and blocking the tubes is called a tubal implant.

STD Prevention

What types of birth control help prevent STDs?

Abstinence (not having vaginal, anal, or oral sex) is the only sure way to prevent STDs. Using a male condom correctly every time you have sex is a very effective way to prevent many STDs, including HIV. Female condoms may also lower the risk of some STDs.

Non-barrier methods (like birth control pills, IUDs, and other hormonal methods) don’t prevent STDs. If you choose one of these types of birth control, it won't protect you or your sex partner from HIV and other STDs – so you may also want to use condoms for protection.

How to Get It

Do I need to see a doctor to get birth control?

It depends on which birth control method you choose. You can buy some birth control methods at a store without a prescription. For other methods, you'll need to see a doctor or nurse.

Birth control methods you can get without a prescription include:

• Male condoms
• Female condoms
• ECPs
• Birth control sponge

Birth control methods you can get only from a doctor, nurse, or pharmacist include:

• Birth control pills
• Patch
• Diaphragm and cervical cap
• Shot
• Ring

You need a medical procedure for:

• Sterilization (for both women and men)
• IUD
• Implant

Get Help

Follow these steps to choose the right birth control for you.

Talk to a nurse, doctor, or family planning educator.

Ask about the types of birth control that are available to you. There are many things to consider, including:

• Your overall health
• Whether you want to have children in the future
• How well the birth control works
• What side effects the birth control may cause

What about cost?

The Affordable Care Act requires most insurance plans to cover birth control that's prescribed by a woman's doctor. Most plans must also cover birth control education and counseling for women.

Depending on your insurance plan, you may be able to get these services at no cost to you. Talk to your insurance company to learn more.

For information about other preventive services for women covered by the Affordable Care Act, visit HealthCare.gov.

Find free or low-cost services near you.

If you don’t have insurance that covers birth control, you may be able to get free or low-cost birth control through a family planning clinic or community health center.

Family planning clinics provide education, counseling, and medical services. No one is turned away for not being able to pay.

Talk about It

Talk to your sex partner.

Some types of birth control are used by men, and some types are used by women. It's a good idea to have a conversation with your partner to make sure that both of you are comfortable with the birth control method you choose. Be sure to talk about getting tested for STDs and how you can stay safe.

And when you both understand how a method works, it'll be easier to use the method correctly.

Make sure you understand the instructions.

Be sure you understand what you need to do to protect yourself from an unplanned pregnancy or an STD. If you have questions, talk to a doctor or pharmacist.

Have a back-up plan.

It's important to know what to do if you forget to use birth control or if your birth control method fails. For example, you may want to buy ECPs in advance. That way, you'll have them if you need them.

STD Testing

Get tested for STDs.

Most people who have an STD don’t have any symptoms. Getting tested is the only way to know for sure if you have one.

Have an honest conversation with your doctor or nurse about your sexual activity and ask if you need to get tested for STDs.

To find a place to get tested:

• Call 1-800-CDC-INFO (1-800-232-4636).

It's also important to talk with your partner about getting tested.

Get tested for HIV.

As with other STDs, getting tested for HIV is the only way to know for sure if you have it.

Different methods of contraception have different rates of effectiveness in preventing pregnancy.

Contraception is most effective when used correctly and consistently. The failure rate increases if a method of contraception is used incorrectly or inconsistently.

Only male and female condoms are effective at reducing the spread of STDs.

Different forms of contraception carry different health risks and side effects, and some of them can be serious. For instance, some combined hormonal birth control methods can increase the risk of heart disease, high blood pressure, and blood clots. This risk may be higher in women with certain health conditions.

For this and other reasons, it is important to talk to a health care provider about your health and health history to figure out which method of contraception is right for you.

Only condoms have been proven to reduce the risk of getting some STDs.

According to the HHS Office on Women's Health, the male latex condom is the best method for protecting against STDs, including HIV/AIDS. Polyurethane condoms are an effective alternative if either partner has a latex allergy. Natural/lambskin condoms do not prevent the spread of STDs because of the presence of tiny pores (holes) that may allow viruses such as HIV, hepatitis B, and herpes to spread.

The female condom has properties similar to the male condom, but researchers have not studied its effectiveness in reducing the spread of STDs as much as they have studied the male condom.

The most common STD is the human papilloma (pronounced pap-uh-LOH-muh) virus, or HPV. No method of contraception can fully prevent the transmission of HPV, because it can infect areas not covered by a condom. However, using a condom with every sex act can lower the risk of transmission.

If you have questions about birth control and STDs, talk to your health care provider.

If you think you may have an STD, you should see your health care provider.

If you want to become pregnant, talk to your health care provider about stopping your birth control.

When taking oral contraceptives, ovulation can be restarted by stopping taking the pill. It is possible to become pregnant during the next menstrual cycle after stopping the pill, but it may take 1 or 2 months before you return to the previous timing of your cycle. If you are using a contraceptive patch or vaginal ring, removing the device stops the delivery of hormones, and the results are similar to stopping oral contraception. Recovery of fertility after injections of Depo-Provera may take longer, up to 10 months in some cases.

IUDs must be removed by a health care professional. After removal, pregnancy is possible at any time.

An implanted rod must also be removed by a health care provider. The implant is removed through a small cut in your arm, and pregnancy is possible any time after the implant is removed.

Yes. Health care providers may prescribe different types of birth control to reduce or treat symptoms and certain disorders. For example, oral contraceptives can reduce severe menstrual cramps, make menstrual bleeding lighter, and reduce acne. There is also evidence that the pill reduces the risk of endometrial, ovarian, and colon cancers, reduces the occurrence of cysts in the breasts and ovaries, protects against iron-deficiency anemia, and improves bone density. The hormonal IUD can also reduce severe menstrual cramps and make menstrual bleeding lighter.

Oral contraception is also used to treat gynecological disorders, such as uterine fibroids, endometriosis, and polycystic ovary syndrome.

If you have questions about birth control methods and uses, talk with your health care provider.