There is no "best" method of birth control for every woman. The birth control method that is right for you and your partner depends on many things, and may change over time.

Before choosing a birth control method, talk to your doctor or nurse about:

• Whether you want to get pregnant soon, in a few years, or never
• How well each method works to prevent pregnancy
• Possible side effects
• How often you have sex
• The number of sex partners you have
• Your overall health
• How comfortable you are with using the method (For example, can you remember to take a pill every day? Will you have to ask your partner to put on a condom each time?)

Learn about types of birth control that you or your partner can use to prevent pregnancy.

Keep in mind that even the most effective birth control methods can fail. But your chances of getting pregnant are lower if you use a more effective method.

Women can choose from many different types of birth control methods. These include, in order of most effective to least effective at preventing pregnancy:

• Female and male sterilization (female tubal ligation or occlusion, male vasectomy) — Birth control that prevents pregnancy for the rest of your life through surgery or a medical procedure.
• Long-acting reversible contraceptives or "LARC" methods (intrauterine devices, hormonal implants) — Birth control your doctor inserts one time and you do not have to remember to use birth control every day or month. LARCs last for 3 to 10 years, depending on the method.
• Short-acting hormonal methods (pill, mini pills, patch, shot, vaginal ring) — Birth control your doctor prescribes that you remember to take every day or month. The shot requires you to get a shot from your doctor every 3 months.
• Barrier methods (condoms, diaphragms, sponge, cervical cap) — Birth control you use each time you have sex.
• Natural rhythm methods — Not using a type of birth control but instead avoiding sex and/or using birth control only on the days when you are most fertile (most likely to get pregnant). An ovulation home test kit or a fertility monitor can help you find your most fertile days.

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.

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.

What is it?

• A thin film sheath placed over the erect penis.

How do I use it?

• Put it on the erect penis right before sex.
• Pull out before the penis softens.
• Hold the condom against the base of the penis before pulling out.
• Use it only once and then throw it away.

How do I get it?

• You do not need a prescription.
• You can buy it over-the-counter or online.

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 whose partners’ use this method, 18 may get pregnant.
• The most important thing is that you use a condom every time you have sex.
• It can be used with other barrier methods to decrease your chances of becoming pregnant.

Some Risks

• Irritation
• Allergic reactions (If you are allergic to latex, you can try condoms made of polyurethane).

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

• Yes. Consistent and correct use of the male latex condom reduces the risk of STIs. The condom cannot provide absolute protection against STIs.

What is it?

• A thin, lubricated pouch that is put into the vagina. It consists of a nitrile (non-latex) sheath, a flexible larger outer ring, and a polyurethane inner ring to place in the vagina. Nitrile is also commonly used to make surgical gloves.

How do I use it?

• Put the female condom into the vagina before sex.
• Follow the directions on the package to be sure the penis stays within the condom during sex and does not move outside the condom.
• Use it only once and then throw it away.

How do I get it?

• You do not need a prescription.
• You can buy it over-the-counter or online.

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 21 may get pregnant.
• The most important thing is that you use a condom every time you have sex.

Some Risks

• Discomfort or pain during insertion or sex.
• Burning sensation, rash or itching.

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

• Yes. When used in the vagina, the female condom reduces the risks of STIs. The condom cannot provide absolute protection against STIs.

Spermicides containing N9 (nonoxynol-9) can irritate the vagina and rectum. It may increase the risk of getting HIV (the virus that causes AIDS) from an infected partner.

What is it?

• A disk-shaped polyurethane sponge-like device with the spermicide N9 (nonoxynol-9) in it.

How do I use it?

• Put it into the vagina before you have sex.
• Protects for up to 24 hours.
• You do not need to use more spermicide each time you have sex.
• You must leave the sponge in place for at least 6 hours after last having sex.
• You must take the sponge out within 30 hours after you put it in. Throw it away after you use it.

How do I get it?

• You do not need a prescription.
• You can buy it over-the-counter.

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, 12 may get pregnant.
• It may not work as well for women who have given birth. Childbirth stretches the vagina and cervix and the sponge may not fit as well. Out of 100 women who use this method who gave birth, 24 may get pregnant.

Some Side Effects

• Irritation

Some Less Common Risks

• If you keep it in place longer than 24-30 hours, there is a risk of toxic shock syndrome. Toxic shock syndrome is a rare but serious infection.

Does it protect me from sexually transmitted infections (STIs)? No.

Spermicides containing N9 (nonoxynol-9) can irritate the vagina and rectum. It may increase the risk of getting HIV (the virus that causes AIDS) from an infected partner.

What is it?

• A soft latex or silicone cup with a round rim, which fits snugly around the cervix.

How do I use it?

• You need to put spermicide inside the cap before you use it.
• You must put the cap in the vagina before you have sex.
• You must leave the cap in place for at least 6 hours after having sex.
• You may leave the cap in for up to 48 hours.
• You do NOT need to use more spermicide each time you have sex.

How do I get it?

• First, a healthcare provider needs to determine the correct cervical cap size for you. Then you need a prescription for the device.

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 17 to 23 may get pregnant.
• It may not work as well for women who have given birth. Childbirth stretches the vagina and cervix and the cap may not fit as well.

Some Side Effects and Risks

• Irritation
• Allergic reactions
• Aabnormal Pap test

Some Less Common Risks

• If you keep it in place longer than 48 hours, there is a risk of toxic shock syndrome. Toxic shock syndrome is a rare but serious infection.

Does it protect me from sexually transmitted infections (STIs)? No.

A vasectomy is a surgical procedure performed as a method of birth control. It involves cutting the vas deferens to close off the tubes that carry sperm from the testicles (there is one vas deferens per testicle). If a man has a successful vasectomy, he can no longer get a woman pregnant.

Sperm are made in the two testicles, which are inside the scrotum. Sperm is stored in a tube attached to each testicle called the epididymis. When a man ejaculates, the sperm travel from the epididymis, through the vas deferens, and then mix with seminal fluid to form semen. The semen then travels through the urethra and out the penis.

Before a vasectomy, semen contains sperm and seminal fluid. After a vasectomy, sperm are no longer in the semen. The man's testicles will make less sperm over time, and his body will harmlessly absorb any sperm that are made.

Tubal ligation (getting your "tubes tied") is a type of surgery. It prevents a woman from getting pregnant. It is a permanent form of birth control, and is effective right away.

The surgery cuts, ties, or seals the fallopian tubes. This 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. You get the surgery in a hospital or outpatient surgical center. It usually takes about 30 minutes. Almost all women go home the same day. They can return to most normal activities within a few days.

Tubal ligation can sometimes be reversed. The reversal is major surgery, and does not always work.

Patch (transdermal system)

What is it?

• A skin patch you can wear on the lower abdomen, buttocks, upper arm, or upper back

How do I use it?

• You put on a new patch and take off the old patch once a week for 3 weeks (wear a patch for 21 consecutive days).
• Do not put on a patch during the fourth week (the following 7 days). Your menstrual period should start during this patch-free week.
• If the patch comes loose or falls off, you (or your partner) may need to use another non-hormonal contraceptive, like a condom and spermicide.

How do I get it?

• You need a prescription from a health care provider.

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

• Out of 100 women who use this contraceptive, about 7 may get pregnant.

Some side effects

• Breast tenderness
• Headache
• Nausea, stomach pain
• Skin irritation
• Spotting or bleeding between periods

Some risks

• It may expose you to higher levels of estrogen compared to most combined oral contraceptives.
• There may be an increased risk of blood clots among women who use the patch as compared to women who use certain combination oral contraceptives.

Does it provide protection from sexually transmitted infections (STIs)?

No.

IUD or IUS (intrauterine device or system)

What is it?

• A T-shaped device containing copper that is put into the uterus by a healthcare provider.
• It is a type of Long-acting Reversible Contraceptives (LARC)

How does it work?

• The IUD prevents sperm from reaching the egg, from fertilizing the egg, and may prevent the egg from attaching (implanting) in the womb (uterus).
• It does not stop the ovaries from making an egg (ovulating) each month.
• The copper IUD can be used for up to 10 years.
• After the IUD is taken out, it is possible to get pregnant.

How do I get it?

• A doctor or other healthcare provider needs to put in the IUD.

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, less than 1 may get pregnant.

Some side effects

• Cramps
• Heavier, longer periods or spotting between periods.

Some less common risks

• Pelvic inflammatory disease
• Ectopic pregnancy (a pregnancy outside of the uterus)
• Uterine perforation
• Expulsion - the IUD is no longer in the uterus and therefore there is no pregnancy protection

Does it protect me from sexually transmitted infections (STIs)? No.

IUD or IUS (intrauterine device or system)

What is it?

• A T-shaped device containing a progestin that is put into the uterus by a healthcare provider.
• It is a type of Long-acting Reversible Contraceptives (LARC)

How does it work?

• It may thicken the mucus of your cervix, which makes it harder for sperm to get to the egg, and also thins the lining of your uterus.
• The IUD with progestin can be used for up to 3 to 5 years, depending on the type.
• After the IUD is taken out, it is possible to get pregnant.

How do I get it?

• A healthcare provider needs to put in the IUD.
• You may need local anesthesia.

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, less than 1 may get pregnant.

Some side effects

• Irregular bleeding
• No periods (amenorrhea)
• Abdominal/pelvic pain

Some less common risks

• Pelvic inflammatory disease
• Severe infection
• Ectopic Pregnancy
• Uterine perforation
• Expulsion - the IUD is no longer in the uterus and therefore there is no pregnancy protection
• Ovarian cysts

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

No.

What is it?

• A thin, matchstick-sized rod that contains a progestin hormone.
• It is put under the skin on the inside of your upper arm.

How does it work?

• It stops the ovaries from releasing eggs.
• It thickens the cervical mucus, which keeps sperm from getting to the egg.
• It can be used for up to 3 years.

How do I get it?

• After giving you local anesthesia, a healthcare provider will put it under the skin of your arm with a special needle.

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, less than 1 may get pregnant.

Some Side Effects

• Changes in menstrual bleeding patterns
• Weight gain
• Headache
• Acne

Some Less Common Risks

• Complication of insertion and removing including pain, bleeding, scarring, infection or movement of the implant to another part of the body.
• Ectopic pregnancy
• Ovarian cysts
• It is rare but some women will have blood clots, heart attacks or strokes.

Does it protect me from sexually transmitted infections (STIs)? No.

This method is given as a shot (injection) every 3 months. If you want to get pregnant, you can stop using this at any time.

Progestin Shot/Injection (Depo-Provera)

What is it?

• A shot of a progestin hormone, either in the muscle or under the skin.

How does it work?

• The shot stops the ovaries from releasing eggs
• It also thickens the cervical mucus, which keeps the sperm from getting to the egg.

How do I get it?

• You need one shot every 3 months 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, including women who don’t get the shot on time, up to 6 may get pregnant.

Some Side Effects

• Loss of bone density
• Irregular bleeding or bleeding between periods
• Headaches
• Weight gain
• Nervousness
• Dizziness
• Abdominal discomfort

Some Less Common Risks

• Ectopic pregnancy
• It is rare, but some women will have blood clots.

Does it protect me from sexually transmitted infections (STIs)? No.

Lactational Amenorrhea Methods

Types of birth control

Only two types can protect you from STIs, including HIV: male condoms and female condoms.

While condoms are the best way to prevent STIs if you have sex, they are not the most effective type of birth control. If you have sex, the best way to prevent both STIs and pregnancy is to use what is called "dual protection." Dual protection means you use a condom to prevent STIs each time you have sex, and at the same time, you use a more effective form of birth control, such as an IUD, implant, or shot.

You can buy these types of birth control over the counter at a drugstore or supermarket:

• Male condoms
• Female condoms
• Sponges
• Spermicides
• Emergency contraception (EC) pills. Plan B One-Step® and its generic versions are available in drugstores and some supermarkets to anyone, without a prescription. However you should not use EC as your regular birth control because it does not work as well as regular birth control. EC is meant to be used only when your regular birth control does not work for some unexpected reason.

You need a prescription for these types of birth control:

• Oral contraceptives: the pill and the mini-pill (in some states, birth control pills are now available without a prescription, through the pharmacy)
• Patch
• Vaginal ring
• Diaphragms (your doctor or nurse needs to fit one to the shape of your vagina)
• Shot/injection (you get the shot at your doctor's office or family planning clinic)

• Cervical cap
• Implantable rod (inserted by a doctor in the office or clinic)
• IUD (inserted by a doctor in the office or clinic)

You will need surgery or a medical procedure for:

• Female sterilization (tubal ligation)
• Male sterilization (vasectomy)
• Tubal implant (Essure®)

Please note that Essure® will not be sold or distributed in the United States after December 31, 2018.

Birth control works to prevent pregnancy in different ways, depending upon the type of birth control you choose:

• Female or male sterilization surgery prevents the sperm from reaching the egg by cutting or damaging the tubes that carry sperm (in men) or eggs (in women).
• Long-acting reversible contraceptives or "LARC" methods (intrauterine devices, hormonal implants) prevent your ovaries from releasing eggs, prevent sperm from getting to the egg, or make implantation of the egg in the uterus (womb) unlikely.
• Short-acting hormonal methods, such as the pill, mini-pill, patch, shot, and vaginal ring, prevent your ovaries from releasing eggs or prevent sperm from getting to the egg.
• Barrier methods, such as condoms, diaphragms, sponge, cervical cap, prevent sperm from getting to the egg.
• Natural rhythm methods involve avoiding sex or using other forms of birth control on the days when you are most fertile (most likely to get pregnant).

Yes, hormonal birth control methods, such as the pill, are safe for most women. Today's birth control pills have lower doses of hormones than in the past. This has lowered the risk of side effects and serious health problems.

Today's birth control pills can have health benefitsfor some women, such as a lower risk of some kinds of cancer. Also, different brands and types of birth control pills (and other forms of hormonal birth control) can increase your risk for some health problems and side effects. Side effects can include weight gain, headaches, irregular bleeding, breast tenderness, and mood changes.

Talk to your doctor about whether hormonal birth control is right for you.

It can, depending on your health and the type of birth control you use. Talk to your doctor to find the birth control method that is right for you.

Different forms of birth control have different health risks and side effects. Some birth control methods that increase your risk for health problems include:

• Hormonal birth control. Combination birth control pills (birth control with both estrogen and progesterone) and some other forms of hormonal birth control, such as the vaginal ring or skin patch, may raise your risk for blood clots and high blood pressure. Blood clots and high blood pressure can cause a heart attack or stroke. A blood clot in the legs can also go to your lungs, causing serious damage or even death. These are serious side effects of hormonal birth control, but they are rare.
• Spermicides (used alone or with the cervical cap, diaphragm or sponge). Spermicides that have nonoxynol-9 can irritate the vagina. This can raise your risk for getting HIV. Use spermicides with nonoxynol-9 only if you are in a monogamous relationship (you have sex only with each other) with a man you know is HIV-negative. Also, medicines for vaginal yeast infections may make spermicides less effective.
• Intrauterine devices (IUDs). IUDs can slightly raise your risk of an ectopic pregnancy. Ectopic pregnancies happen when a fertilized egg implants somewhere outside of the uterus (womb), usually in one of the fallopian tubes. An ectopic pregnancy is a serious medical problem that should be treated as soon as possible. IUDs also have a very rare but serious risk of infection or puncture of the uterus.

If you smoke and are 35 or older, you should not use hormonal birth control. Smoking tobacco and using hormonal birth control raises your risk for blood clots and high blood pressure. Smoking and high blood pressure are risk factors for a heart attack or stroke. The risk for a heart attack or stroke also goes up as you age.

Maybe. Research shows that hormonal birth control, such as the pill, patch, shot, ring, implantable rod, and hormonal IUD, may help with heavy, painful, or long-term bleeding. These methods can also help you have lighter, shorter periods.

Research shows that other benefits of hormonal birth control may include:

• More regular and lighter periods
• Fewer menstrual cramps
• Less acne
• A lower risk of ovary, endometrial (uterus), and colon cancers, pelvic inflammatory disease (PID), noncancerous ovarian cysts, and iron-deficiency anemia

Read more about how birth control can help with the following health problems:

• Ovarian cysts
• Endometriosis
• Polycystic ovary syndrome
• Uterine fibroids

Follow the instructions that came with your birth control about using back-up birth control (such as a condom and spermicide). You also can follow these recommendations from the Centers for Disease Control and Prevention.¹

If you are late or miss a day taking your pill:

• Take the late or missed pill as soon as possible.
• Continue taking the rest of your pills at your normal time, even if it means taking two pills on the same day.
• You do not need other forms of birth control, such as a condom, unless you need to protect against STIs.

If you miss two or more days in a row:

• Take only the most recent missed pill as soon as possible.
• Continue taking the rest of your pills at your normal time, even if it means taking two pills on the same day.
• Use back-up birth control, such as a condom and spermicide, or do not have sex until you have taken a pill for seven days in a row.
• If you missed pills during days in the last week of active pills (days 15–21 for 28-day pill packs), start a new pack the next day. If you are not able to start a new pack right away, use back-up birth control or avoid sex until hormone pills from a new pack have been taken for 7 days in a row.
• Consider emergency contraception if you missed pills during the first week and had sex.

Talk to your doctor if you continue to miss taking your birth control pill or find it hard to take the pill at the same time each day. You may want to consider a different type of birth control, such as an IUD, an implant, shot, ring, or patch that you don't have to remember to take every day.

Not very! About 22 out of 100 women who use withdrawal as their only form of birth control for a year will get pregnant. See the chart above for how this number compares to other methods of birth control.

Withdrawal is when a man takes his penis out of a woman's vagina ("pulls out") before he ejaculates or "comes" (has an orgasm). This lowers the chance of sperm from going to the egg. "Pulling out" can be hard for a man to do. It takes a lot of self-control.

Even if you use withdrawal, sperm can be released before the man pulls out. When a man's penis first becomes erect, some fluid may be on the tip of the penis. This fluid has sperm in it, so you could still get pregnant. Withdrawal also does not protect you from STIs, including HIV.

Breastfeeding can be a short-term method of birth control in very specific situations. The risk of pregnancy is less than 2 in 100 if all three of these describe you:¹

• You have a baby who is less than 6 months old

and

• You exclusively breastfeed, meaning that you only feed your baby your breastmilk all of the time (no formula, no breastmilk from other people, and no solid food)

and

• You have not gotten a period after childbirth

Talk to your doctor about birth control if you do not want to get pregnant while nursing.

Under the Affordable Care Act (the health care law), most insurance plans cover FDA-approved prescription birth control for women, such as the pill, IUDs, and female sterilization, at no additional cost to you. This also includes birth control counseling.

• If you have insurance, check with your insurance provider to find out what is included in your plan.
• If you have Medicaid, your insurance covers birth control. This includes birth control prescriptions and visits to your doctor related to birth control. Programs vary between states, so check with your state's Medicaid program to learn what your benefits are.
• If you don't have insurance, don't panic. Family planning (reproductive health) clinics may provide some birth control methods for free or at low cost.