Birth Control Comparison Chart

What is it? A thin covering that you unroll over the hard penis. Made of latex, polyurethane or animal membrane.

How to use: Put on before any genital contact. At withdrawal, hold the rim in place at the base of the penis so it doesn’t slip off.

Health Impacts: Condoms protect against HIV/STI, except for the condom made of animal membrane. Some people are allergic to latex (rubber); polyurethane condoms are a good alternative for them.

Note: May decrease sensation for men. Increased moisture from personal lubricants or from sexual arousal makes condoms less likely to break. To maintain arousal and encourage continued use, be creative and playful.

Access: Easy to buy in a pharmacy or online. Inexpensive. Can be found for free.

Effectiveness: 82%-98%

What is it? A soft, loose pouch that you put inside your vagina. Flexible rings at each end hold it in place. Sperm get trapped in the pouch. You can put it in up to 8 hours before sex. Made of nitrile.

How to use: The small ring goes deep inside and the larger ring stays outside partially covering your vaginal lips. As intercourse begins, holding the outer ring in place ensures the penis goes into the pouch.

Health Impacts: Also protects against HIV and other sexually transmitted infections. You can use it if you are allergic to latex.

Note: The pouch can make a rustling sound during movement. This can be lessened by using extra lubricant. Men usually feel no reduction in sensation.

Access: Available at many pharmacies, clinics and online.

Effectiveness: 79% to 95%

What is it? Spermicidal chemical comes in several forms; you can choose foam, gel, cream, film, suppository or sponge. Put into your vagina before sex. It works by immobilizing or killing sperm. Most types work for 1 hour; a sponge works for 24 hours.

How to use: Put in your vagina carefully following the package instructions. Most types need to be in at least 10 minutes before intercourse, but the sponge starts working immediately.

Health impacts: Bad taste can interfere with oral sex unless you gently wipe it off with a damp cloth first. If you usually have intercourse more than once a day, spermicide is not recommended because Nonoxynol9 can weaken cell membranes allowing transmission of HIV and sexually transmitted infections from male to female.

Note: Neither you nor your partner should notice the spermicide unless you have an allergy or irritation. Sponge is less effective for women who have given birth.

Access: Easy to buy in a pharmacy or online.

Effectiveness: 72%-91%

What is it? A soft silicone dome with a flexible rim that holds spermicide. The spermicide kills or immobilizes sperm and the diaphragm holds spermicide in place over the cervix. Keeps working for 2 hours.

How to use: Put about a tablespoon of spermicide in the diaphragm, slide it into your vagina, and then check with a finger to be sure it is covering your cervix. Protection from pregnancy lasts for 2 hours. For subsequent intercourse, add more spermicide to vagina without removing diaphragm. Needs to stay in at least 6 hours after sex.

Health impacts: Some women are allergic to or become irritated by spermicide. Get re-fitted if you gain or lose more than 15 pounds.

Note: Neither you nor your partner should feel it. Some increased risk of bladder infection.

Access: Clinic visit needed. Not all providers know how to fit it.

Effectiveness: 88%-94%

What is it? A small, soft silicone cup holding spermicide. Designed to fit snugly over cervical opening. Keeps working for almost 2 days, which is longer than other barrier methods.

How to use: Put about a teaspoon of gel or cream spermicide in the cap, slide it deep into your vagina, and then check with a finger to be sure it is covering your cervix. You can keep it in and be protected from pregnancy for 42 hours. Keep at least 6 hours after sex.

Health Impacts: Some women are allergic to spermicide. Less effective if you have given birth. You need to get re-fitted after giving birth.

Note:Neither you nor your partner should feel it. If you do, see your health provider.

Access: Clinic visit needed. Not all providers know how to fit it.

Effectiveness: 77%

What is it? The man takes his penis out of his partner’s vagina before climax and ejaculation (before he comes). He needs to ejaculate away from the woman’s body. Even sperm on her legs or vaginal lips can travel into her vagina. Depends on a man’s self knowledge and self control.

How to use: To remove any stray sperm from previous ejaculations, the man should urinate and wipe the tip of his penis before intercourse. Contrary to public perception, pre-ejaculate usually does not contain sperm.

Health Impacts: Drugs, alcohol, young age or lack of sexual experience can reduce success. It is less effective for men who have multiple orgasms.

Note: It can be much more effective than many health providers realize. Reduces, but does not eliminate risk of transfer of HIV from male to female.

Access: Free and available anytime.

Effectiveness: 78%-96%

What is it? When you understand your fertile time (days you can get pregnant), you can prevent pregnancy by avoiding intercourse or using a barrier method or withdrawal on fertile days.

How to use: With a calendar and special charts, keep a written record of first and last days of periods, monitor and document changes in your vaginal fluid, position and appearance of cervix daily, and take your basal body temperature daily (at rest, first thing in the morning). It is easier with support from a partner.

Health Impacts: No health risks or side effects. Increases knowledge and awareness of your body.

Note: Takes time and effort daily, especially at first. Many couples say this method is rewarding and brings them closer. Knowing your fertile time can help you become pregnant when you want to.

Access: Learn this method from books, classes or online. Tools like thermometers, charts, and ovulation tests are easily available.

Effectiveness: 76%-99.6%

What is it? Breastfeeding stops egg development if the following three things are true: the baby feeds solely on mother’s breast milk, the mother hasn’t had a menstrual period since childbirth, and the baby is six months old or less.

How to use: If you infrequently give the baby small amounts of liquid or solid, the method is still effective as long as you breastfeed every 4 to 6 hours, including at night.

Health Impacts: Breast milk has positive health effects for the baby including protection from many different illnesses and allergies.

Note: If the mother has HIV, breastfeeding can pass the infection to her baby.

Access :If you need help, contact your local midwife, doula or lactation consultant. There are many online resources and hotlines you can call.

Effectiveness: 98%

What is it? You can experience intimacy, closeness, pleasure and orgasms when you engage in touching but avoid vaginal intercourse.

This opens the door for a better understanding of your own and your partner’s bodies which can bring better communication and more satisfaction.

How to use: Examples include kissing, petting, use of sex toys, oral or anal sex, manual stimulation, masturbation, same-sex sex, telephone or talking sex, fantasizing, play-acting, reading or writing your own erotic literature.

If release of sperm occurs, make sure it is far away from your vaginal opening.

Waiting to have sex, taking a break from sex, or saying no to sex are also ways you can assert your personal power to prevent pregnancy.

Health Impacts: Use condoms to prevent spread of STI/HIV for anal or oral sex, or when using sex toys.

Access: Free and available anytime.

What is it? A pill or combination of pills you take after sex to prevent pregnancy. It gives you a short burst of a high dose of a hormone-like drug that affects your body’s ability to get pregnant. Various formulas exist.

Use: Use after unprotected sex

Hormone-like substances that affect ovulation, movement of sperm, or other conditions necessary for pregnancy to develop.

Several options exist. You may buy specially labeled pills or use a large dose of specific brands of regular birth control pills.

How to use: Take as soon as possible after unprotected sex.

Health Impacts: Usually safe for women who can’t use other hormone methods due to health risks. Your next menstrual period should begin on time. If not, get a pregnancy test.

Note: Won’t stop an existing pregnancy.

Access: One type is easy to buy in a pharmacy if you are 17 or older; under 17 need a prescription. Others require a prescription for all ages. Many clinics will call in a prescription or give you one ahead of time. You can buy it to keep on hand “just in case.” Also available online.

Effectiveness: Depends on the type you take and how soon you take it.

What is it? A pill containing synthetic hormones you take orally every day at about the same time. Regular birth control pills release both estrogen and progestin into your body. Mini-pills release only progestin.

Use: Daily.

Note: There are many different brands. If you have bad reactions to one, work with your health care provider to find another that works well.

Smokers or women with high blood pressure can use the Mini-Pill (progestin only pill) but it is a little less effective and needs to be taken at exactly the same time daily.

Health Impacts: Your “period” can occur monthly, every 3 months, or not at all, depending on when you stop taking hormone pills.

Access: Prescription needed.

Effectiveness: 91% – 99.7%

What is it? A bandage-like patch that sticks to your skin. Hormones are absorbed through your skin; releases estrogen and progestin.

Use: Change it weekly.

How to use: Apply one Patch per week for three weeks. No Patch on the fourth week.

Health Impacts: May cause skin irritation. Possible higher risk of heart attack and stroke than with other hormonal methods.

Note: Less effective if you weigh over 198 pounds.

Access: Prescription needed.

Effectiveness: 91% – 99.7%

What is it? A clear, soft, flexible 2-inch circle worn in vagina. Your body absorbs hormones from the Ring through your vaginal wall. Releases estrogen and progestin.

Use: Monthly

How to use: Fold and slide into your vagina. Leave in for 3 weeks then remove. Your “period” can occur monthly, every 3 months, or not at all, depending on how you soon you insert the next Ring.

Health Impacts: May cause vaginal irritation.

Note: One size fits all. Neither partner usually feels the Ring.

Access: Prescription needed.

Effectiveness: 91% – 99.7%

What is it? A long-acting injection of synthetic progestin hormone.

Use: Get a shot every 3 months.

Health Impacts: More chance of weight gain than with other methods. May cause loss of bone density and risk of osteoporosis. May increase chance of HIV transmission. Not recommended if you have high blood pressure or are high risk for heart attack or stroke.

Note: It is not reversible. Once a woman gets the shot, the hormone is in her system for at least three months. It may take a long time to get pregnant after last shot.

Access: Clinic visit needed every 3 months.

Effectiveness: 94% – 99.8%

What is it? A soft rod 1½ inches long that is placed under the skin in your upper arm and slowly releases hormone into your body.

Use: Lasts 3 years

Health Impacts: Irregular, light bleeding is common. Rare side effects include allergy or infection of the skin when inserted, weight gain or mood changes. Rarely, minor surgery is needed for removal.

Note: The implant prevents pregnancy for 3 years. It is your right to have it taken out at any time. Effectiveness has not been tested on heavier women.

Access: Clinic visit needed every 3 years.

Effectiveness: 99.95%

What is it? Intra-Uterine Device shaped like a small plastic T with a string. It is Inserted through the cervix into the uterus where it releases synthetic progestin hormone.

Use: Lasts 5 years

How it works: Changes the cervical mucus, fallopian tubes and the lining of the uterus. It stops or slows the sperm and egg.

Health Impacts: Usually decreases cramping, but sometimes causes cramps. You can check that it hasn’t come out by feeling for the string at your cervix.

Note: Although insertion can cause a few minutes of pain, removal is usually fast and easy.

Access: Clinic visit needed for insertion and removal. It is your right to have it removed at any time.

Effectiveness: 99.8%

What is it? Intra-Uterine Device shaped like a small plastic T wrapped in copper with a string attached. Inserted through the cervix into the uterus.

Use: Lasts 10 or more years.

How it works: Changes the cervical mucus, fallopian tubes and the lining of the uterus. It stops or slows the sperm and egg.

Health Impacts: Usually causes more painful, heavier periods. Should not be used by women who are allergic to copper. You can check that it hasn’t come out by feeling for the string at your cervix.

Note: Although insertion can cause a few minutes of pain, removal is usually fast and easy.

Access: Clinic visit needed for insertion and removal. It is your right to have it removed at any time.

Effectiveness: 99.2%-99.4%

What is it? For Females, the fallopian tubes are blocked or cut, either through a small incision or by injecting a substance into the tubes. For the non-surgical options, a follow up test is important to be sure it was successful.

For Males, a vasectomy closes or cuts the vas deferens or tubes inside scrotum to prevent sperm from being released. The man’s erection and ejaculation stay the same but semen contains no sperm. A sperm count about 30 days after the procedure is important to be sure all the sperm have cleared.

Once. Permanent. Not reversible

Health Impacts: Excellent choice if you don’t want to reproduce or are finished having children. Does not protect against HIV/STI.

Note: Young adults with no children may have difficulty finding a doctor to perform sterilization.

Access: Hospital or clinic.

Effectiveness: 99.5-99.9%