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What are the different kinds of birth control? How do they work and how effective are they?

Birth control refers to something that is used to prevent pregnancy. There are so many methods available! They all fall into one of four different categories: hormonal, barrier, behavioral or spermicidal.

Below, we explain what these different methods are, how they work and how effective they are—when used correctly and consistently—at preventing pregnancy. When birth control fails, it’s usually because it wasn’t used properly. Human error (“Oops, I forgot my Pill!”) is a huge factor in whether birth control works or not. This is why manufacturers of drugs actually note two different rates of effectiveness for each birth control method. One rate is with “perfect use,” and the other is the “typical use” rate.

Keep in mind that the effectiveness rates represent the number of couples who do not get pregnant out of a hundred. For example, condoms are 98-percent effective with perfect use, which means that if 100 couples correctly use condoms every time they have sex, 98 couples don’t get pregnant and two do.

Barrier Methods

Barrier methods (such as condoms or diaphragms) create a physical barrier between sperm and the egg.

Condom
These latex or polyurethane sheaths cover the penis and prevent bodily fluids from transferring from one person to another. Condoms are effective in preventing pregnancy and the transmission of STDs.

  • Effectiveness
    Perfect use: 98 %
    Typical use: 82 %
  • How It Works
    The condom fits right over an erect penis and should be put on before engaging in any type of sexual intercourse. This creates a barrier so no bodily fluids are exchanged between partners. This means sperm can’t enter a vagina to cause a pregnancy, if the couple is male-female. It also means partners are less likely to be at risk of getting sexually transmitted diseases (STDs).
  • Keep in Mind
    Condoms are really effective at protecting against pregnancy and most STDs when they’re used correctly. They are also cheap, easy to obtain and use and come in a variety of sizes, shapes and textures and flavors for oral sex. Use water-based lubricant when engaging in vaginal or anal sex.

Female Condom
The female condom—also known as an internal or receptive condom—is a polyurethane or nitrile sheath with flexible rings at the ends that help the condom stay in place.

  • Effectiveness
    Perfect use: 95 %
    Typical use: 79 %
  • How It Works
    The female condom is inserted into the vagina and held in by a ring that covers the cervix. On the other end is another ring that stays outside of the vagina, partly covering the labia. Like the male condom, this creates a barrier that prevents the exchange of bodily fluids that could cause STDs or pregnancy.
  • Keep in Mind
    Female condoms can be a bit tricky to insert, but anyone can get the hang of it with some practice. The female condom gets some major points because it can be inserted up to 8 hours before sex.

 Cervical Cap
The cervical cap is a small latex, plastic or silicone rubber cup that covers the cervix—the lower part of the uterus—and prevents sperm from entering the uterus. Spermicide can be placed on the inside and outside of the cap.

  •  Effectiveness
    Perfect use: 91 %
    Typical use: 86 %
  • How It Works
    The cervical cap fits over the cervix—the lower part of the uterus—and keeps sperm from entering the uterus.
  • Keep in Mind
    You have to visit a clinic or see a health care provider to be fitted for a cervical cap. Like diaphragms, cervical caps are most effective when used with spermicide. They are also reusable and must be washed and stored in a dry container. Cervical caps do not provide protection from STDs.

Diaphragm
The diaphragm is a thin rubber or silicone dome with a springy, flexible rim that is held in place by the muscles in the vagina. It must be used with spermicides and should be inserted before engaging in any sexual behaviors. After intercourse, the diaphragm must be left in place for at least six hours to be effective.

  • Effectiveness
    Perfect use: 94 %
    Typical use: 88 %
  • How It Works
    The diaphragm works as a barrier that covers the cervix—the lower part of the uterus— and keeps sperm from entering the uterus.
  • Keep in Mind
    Women have to visit a clinic or see a health care provider to be fitted for a diaphragm. They are most effective when used with spermicide. Diaphragms are reusable; they must be washed and stored in a dry container. They do not provide protection from STDs.

Today Sponge
The Today Sponge is a single-use polyurethane sponge that contains spermicide. The sponge has a loop for easy removal.

  • Effectiveness
    Perfect use: 80-91 %
    Typical Use: 76-88 %
  • How It Works
    The Today Sponge fits over the cervix—the lower part of the uterus—and keeps sperm from entering the uterus, while the spermicide kills sperm.
  • Keep in Mind
    The Today Sponge can be bought in drugstores. It must stay in place at least six hours after vaginal sex to be effective. The Today Sponge is not reusable and does not provide protection against STDs.

Hormonal Methods

Hormonal methods (such as the Pill, the Patch and the Ring) use hormones to prevent ovulation and thicken cervical mucus, creating a barrier that can prevent sperm from entering the uterus. Without an egg, pregnancy can’t happen. Hormonal methods of birth control are more than 99-percent effective. But that’s only if they’re used correctly and consistently.

Birth Control Pill (the Pill)
Often referred to as simply “the Pill,” this hormonal birth control method is a pill taken at the same time each day.

  • Effectiveness
    Perfect Use: 99.7 %
    Typical Use: 91 %
  • How It Works
    The Pill works by releasing synthetic hormones similar to estrogen and progesterone. The Pill stops ovulation so no eggs are released. It also thickens cervical mucus to make it difficult for sperm to enter the uterus.
  • Keep in Mind
    The Pill requires a prescription and a visit to a health care provider. The Pill must be taken every day at the same time. When taken with some drugs, such as antibiotics, the effectiveness may be lowered. The Pill does not provide protection against STDs.

Depo-Provera (the Shot)
Depo-Provera is a shot that injects hormones into the body to prevent pregnancy for three months.

  • Effectiveness
    Perfect Use: 99.8 %
    Typical Use: 94 %
  •  How It Works
    The Depo-Provera shot injects high levels of progestin, a synthetic hormone similar to progesterone, into the body. This stops the ovaries from releasing eggs, thickens the cervical mucus and changes the lining of the uterus. Depo-Provera users get an injection (shot) once every three months in their upper arm or upper buttocks/lower back.
  • Keep in Mind
    The Shot requires a prescription and a visit to a health care provider. It is effective after 24 hours and requires no daily attention. The Shot does not provide protection against STDs.

Implanon
This flexible rod is inserted into the body through a small incision in the upper arm. The rod is must be inserted by a healthcare provider and is about 1.5 inches long.

  • Effectiveness
    Perfect use: 99.95 %
    Typical use: 99.95 %
  • How It Works
    Implanon is another device that releases progestin in order to prevent ovulation and thicken the cervical mucus.
  • Keep in Mind
    Implanon requires no attention for up to three years. It has to be inserted by a health care professional and requires an incision in the arm. Implanon does not provide protection against STDs.

NuvaRing (the Ring)
This small, soft, clear, flexible ring is inserted into the vagina once a month for three weeks with one week being ring-free when withdrawal bleeding similar to a period takes place.

  • Effectiveness
    Perfect use: 99.7 %
    Typical use: 92 %
  • How It Works
    NuvaRing releases synthetic hormones similar to estrogen and progesterone, which prevents ovulation and thickens the cervical mucus.
  • Keep in Mind
    The Ring only requires attention monthly, but it may be difficult to insert the ring until a girl or woman gets the hang of it. The Ring does not provide protection against STDs.

Ortho Evra (the Patch)
Often referred to simply as “the Patch,” this thin, beige, smooth patch looks like an over-sized Band-Aid and is worn on a girl’s or woman’s buttocks, lower back, abdomen or upper arm.

  • Effectiveness
    Perfect use: 99.7 %
    Typical use: 91 %
  • How It Works
    The Patch releases synthetic hormones through the skin to prevent ovulation. After the girl or woman places the Patch on her skin, and it remains in place for one week. She replaces it once a week for three weeks in a row. On the fourth week, she removes the patch so that withdrawal bleeding similar to a period can take place. The next week, she applies a new patch and the cycle repeats.
  • Keep in Mind
    The Patch does not provide protection against STDs. The Patch also delivers more hormones into the body than the Pill does. This can mean that girls and women who should not take estrogen-based products should not use the Patch. Talk with your health care provider to find out more.

Behavioral Methods

Behavioral methods (such as abstaining from sex or using the withdrawal method) are ways that people change their sexual behavior and patterns in order to attempt to prevent pregnancy.

Abstinence
The only completely safe sex is no sex—including vaginal, oral and anal sex.

  • Effectiveness: 100 %
  • How It Works
    No intercourse whatsoever.
  • Keep in Mind
    Resisting natural sexual urges can make it difficult to remain abstinent. For abstinence to be 100-percent effective, it requires that you not have any type of intercourse, including vaginal, oral and anal sex. When abstinence is used properly it prevents any risk of pregnancy or STDs.

Coitus Interruptus (The Withdrawal Method or Pulling Out)
The withdrawal method. Pulling out. Call it what you like, it’s all about getting the penis out of the vagina and away from the vulva before ejaculation.

  • Effectiveness
    Perfect use: 96 %
    Typical use: 78 %
  • How It Works
    This method works by removing the penis from the vagina before the male ejaculates so that sperm cannot enter the female’s body.
  • Keep in Mind
    It is a better form of birth control than none at all. It is always available when needed, but it is not very reliable. Many younger men may not be able to totally control their ejaculation and so run the risk of ejaculating too early or too close to the vulva. The withdrawal method offers zero protection against STDs.

Spermicidal Methods

Spermicides are chemicals that kill sperm. They come in a variety of forms including gel, cream, foam, suppositories and film, which can be purchased in most drugstores or grocery stores and don’t require a prescription. They are meant to be used as a back-up method with one of the other methods, such as a condom.

Spermicides When Used Alone

  • Effectiveness
    Perfect use: 82 %
    Typical use: 72 %
  • How It Works
    Spermicides work by killing sperm and keeping them from joining with an egg. They come in many types—creams, films, foams, gels, and suppositories. A girl or woman lies down or squats, then gently inserts the spermicide deep into her vagina using her fingers or an applicator.
  • Keep in Mind
    For most spermicides, a girl or woman will need to wait 10-15 minutes after inserting the spermicide before having vaginal intercourse. This allows time for the spermicide to dissolve. Spermicide typically remains effective for only one hour after insertion, and more spermicide must be inserted each time a girl or woman has vaginal intercourse. Spermicides can also cause irritation. Some people are allergic to them. Spermicides do not provide protection against STDs.

Keep in mind that 85 percent of sexually active, heterosexual couples who do not use ANY method of birth control will become pregnant within a year. If you don’t want to get pregnant, it’s important to use birth control, correctly and consistently—this means every time.