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What Contraception Could Be Right for You?

Updated: Oct 26

Contraception refers to any method used to prevent pregnancy. Some are more effective than others, and many different options are available. Specific methods of contraception are also important to prevent sexually transmitted diseases.


This article is pending medical review.

Contributors

Written by Juliëtte Gossens

Reviewed by Sophie Oppelt and Selina Voßen

Edited by Juliëtte Gossens

 

Contraception is incredibly important for family planning: you should get to decide if and when you become pregnant. But research has shown that around half of all pregnancies are unintended (1) – meaning the pregnant person didn’t choose or decide to become pregnant about 50% of the time. That’s over 120 million unintended pregnancies each year (1, 2), and over 60% of those unintended pregnancies end in abortion (2). Over 250 million of women, girls, and people able to become pregnant are not using safe and effective contraception methods for one reason or another, often because of fear or experience of side-effects (1). Many people are also unaware of the many different options available, even if they are aware of basic contraception methods. Whatever your situation is, we want to help you make a well-informed decision regarding your contraception, so you can feel safe during and after sex.

Below, we've collected all of our articles on different methods of contraception. In each, we explain what types of contraception are available, how they work, how effective they are, and what their side-effects might be. Remember, though, that side-effects differ enormously from person to person – what works for you might not work for somebody else. What’s important is that you choose something that fits with your goals and lifestyle, so you can make consistent use of that method.


Two statistics are given for effectiveness of each method. One, “perfect use”, is the proportion of users becoming pregnant within the first year of use while they’re using the method perfectly (meaning: as prescribed, consistently, completely according to instructions; basically, how you’re theoretically supposed to use it). The other, “typical use”, is the proportion of users becoming pregnant within the first year of use while they’re using the method as the average user would. Nobody’s perfect, and that’s reflected in this number.

Why do we give both typical use and perfect use?

We present both numbers, because different people have different degrees of motivation and care when using different types of contraception. Maybe you have an iron-clad morning routine that means you would never forget a contraceptive pill. In that case, your risk of pregnancy is more like perfect use than typical use. On the other hand, if you’re travelling often or work different hours on different days, or you know you’re forgetful, your risk of pregnancy with a contraceptive pill is more like typical use or worse. Scenarios like these exist for any method of contraception. Providing both numbers allows you to estimate how well a given method would work for you, knowing your strengths and weaknesses.

Please note: the information we provide here is based on a variety of high-quality sources, and we do our best to include the most recent available and validated statistics. However, we’re not your doctor and we don’t give medical advice. We recommend you talk to your doctor about family planning and contraceptives.


What we're covering


Barrier contraception

Cervical cap • Diaphragm • Outside condom • Inside condom • Spermicides • Dental dam


Natural methods

Calendar-based method • Symptoms-based method • Breastfeeding • Withdrawal


Intra-uterine devices (IUDs)

Hormonal IUD • Copper IUD


Hormonal contraception

Implant • Injections • Oral contraceptives • Patch • Vaginal ring


Permanent contraception

Female sterilization • Male sterilization


Emergency contraception

Abstinence

No contraception

 

Methods of Contraception


Barrier Contraception

Barrier methods of contraception rely on a physical barrier between sperm and egg cells.


Cervical capDiaphragmOutside (male) condomInside (female) condomSpermicidesDental dam


Natural Methods

These methods rely on your body's physiology to protect your from pregnancy.


Calendar-based methodSymptoms-based methodBreastfeedingWithdrawal


Intra-uterine Devices (IUDs)

These are small objects that are placed inside the womb.


Hormonal IUDCopper IUD


Hormone Methods

These methods rely on mimicking hormones that your body produces naturally to protect your from pregnancy.


ImplantInjectionsOral contraceptivesPatchVaginal ring


Permanent Contraception

These methods will make you permanently infertile, meaning you can never have biological children naturally again. If you want to have children after getting permanent contraception, you may have to rely on assisted reproductive technologies (read more about those here) or adoption.

Female sterilizationMale sterilization


Emergency Contraception

Emergency contraception can be used if you’ve had unprotected sex, you think your normal contraception method has failed, or if you’ve been sexually assaulted.


While these methods are effective at preventing pregnancy, none are effective at preventing sexually transmitted diseases (STDs). If there’s a chance you have been infected with an STD – which can be any case of sexual contact with somebody whose STD status you don’t know – you should contact your health provider to ask if you need to get tested.


Some forms of emergency contraception are available in pharmacies or drug stores in many regions. In other regions and for some methods, you can only get them on prescription – and in some areas, you can’t get them at all (3).


We explain the two categories of emergency contraception below. Which is right for you depends on your personal circumstances. Discuss your options with your healthcare provider if you’re not sure what’s best.


Hormone methods

Different medications are available as emergency contraception. You might have heard these medications referred to as the “morning-after pill”. Well-known brand names for emergency contraception include Plan B and Ella, for example.

They don’t cause an abortion, but they prevent or delay ovulation and make the environment in the womb unfit for implantation of a fertilized egg (4). They also aren’t harmful to an existing pregnancy, and they won’t impact your future ability to have children (5).


Several types of hormonal emergency contraception are available (4, 6):

  • Progestin-only: contain a progestin, which is a synthetic version of the natural hormone progesterone

  • Combined hormones: contain both a progestin and an estrogen

  • Hormone receptor modulator: contain ulipristal acetate, which acts on the proteins on cells that respond to progesterone

Evidence shows that progestin-only pills are more effective in preventing pregnancy than combined hormone pills (these have an estimated protection rate of 98.8% to 97.9%), and that a hormone receptor modulator may be even more effective with an estimated protection rate of 98.8% (4, 5).


These pills or tablets are taken as soon as possible but within five days after sexual contact (5). Exactly within what time frame you can still take them depends on the exact medication available in your area.


After taking a hormonal emergency contraception, you might feel tired, there may be some irregular bleeding, and you might feel a bit sick. If you have taken emergency contraception that contains estrogen, you might be especially nauseous and you might vomit. Your doctor might prescribe you a pill to prevent this, but if you do vomit closely after taking the medication, you might need another dose.


If you have a BMI that’s over 25, these pills might not work as well on you (7). Check with your healthcare provider whether this applies to you if you have a higher BMI and you purchased emergency contraception without a prescription. They can give you advice on which steps to take to make sure you’re protected against pregnancy.


Copper IUD

The copper IUD (intra-uterine device) is also an effective method or emergency birth control. We’ve explained how a copper IUD works in a different article that you can read here. As an emergency contraceptive, it can be inserted up to five days after unprotected sex. It’s also the most effective method of emergency contraception, with an estimated 99.9% protection against pregnancy. Additionally, you’ll be protected against pregnancy for about 10 years. (4)

What About Abstinence?

Abstinence means you don’t have sex. Of course, choosing not to have sex at all is an effective way to prevent pregnancy and sexually transmitted diseases (STDs). But even abstinence is not 100% effective because a person can experience sexual violence – which is unfortunately incredibly common (8, 9) – and become pregnant this way.

Abstinence is often said to be the right thing to do: if you don’t want to get pregnant, just don’t have sex! Otherwise, it’ll be your own fault! There is also often religious pressure to abstain from sex, because sex before marriage or sex for pleasure (instead of for having children) is seen as immoral. But the reality is that for many people, sex is an important part of life, and it’s not realistic to expect that people abstain from it to prevent pregnancy or STDs. Evidence also shows that teaching teenagers and young adults to abstain from sex instead of teaching them effective birth control methods does not make them have sex later, less, or in a safer way (1).

In conclusion, if you feel that abstinence works for you and aligns with your wants and needs, there is no harm in continuing practicing it. But it’s not a realistic method for the majority of people, and it shouldn’t be encouraged for people who’d rather have sex. Luckily, there’s a lot of other birth control options available, and there will surely be one that fits your lifestyle!


What If I Don't Use Contraception At All?

It might be eye-opening to know that your chances of becoming pregnant if you’re having unprotected sex for a year are roughly 85%.

We’re aware that certain methods of contraception seem like a nuisance, a lot of work, or even scary because of possible side-effects. However, any birth control that a doctor can prescribe to you is going to be much less dangerous to your health than a pregnancy would be (10). Talk to a doctor or healthcare provider you trust to discuss what methods would be suitable for you and your needs if you’re not sure what would be best for you.




We also emphasize that contraception is the responsibility of everyone involved in sex! Have conversations about contraception with all of your partners when possible – even if you’re together for a single night. Make sure you’re on the same page about it before you start having sex.


 

References


  1. McFarlane I (ed.). Seeing the unseen: The case for action in the neglected crisis of unintended pregnancy. United Nations Population Fund. 2022. Available from: https://www.unfpa.org/sites/default/files/pub-pdf/EN_SWP22%20report_0.pdf

  2. Bearak J, Popinchalk A, Ganatra B, Moller A, Tunçalp Ö, Beavin C et al. Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990–2019. The Lancet Global Health. 2020;8(9):E1152-E1161. DOI: 10.1016/S2214-109X(20)30315-6

  3. International Consortium for Emergency Contraception. EC Status and Availability. Available from: https://www.cecinfo.org/country-by-country-information/status-availability-database/countries-with-non-prescription-access-to-ec/ [Accessed September 20th, 2022]

  4. Hoffman BL, Schorge JO, Halvorson LM, Hamid CA, Corton MM, Schaffer JI (eds.). William’s Gynecology. 4th ed. New York: McGraw-Hill Education; 2020.

  5. World Health Organization. Emergency contraception. Available from: https://www.who.int/news-room/fact-sheets/detail/emergency-contraception [Accessed September 16th, 2022]

  6. Kim A, Bridgeman MB. Ulipristal Acetate (ella). Pharmacy and Therapeutics. 2011;36(6):325-326.

  7. Edelman AB, Hennebold JD, Bond K, Lim JY, Cherala G, Archer DF et al. Double Dosing Levonorgestrel-Based Emergency Contraception for Individuals With Obesity. Obstetrics and Gynecology. 2022;140(1):48-54. DOI: 10.1097/AOG.0000000000004717

  8. Borumandnia N, Khadembashi N, Tabatabaei M, Alavi Majd H. The prevalence rate of sexual violence worldwide: a trend analysis. BMC Public Health. 2020;20:1835. DOI: 10.1186/s12889-020-09926-5

  9. Clancy K. Here is Some Legitimate Science on Pregnancy and Rape. Scientific American. August 20th, 2012. https://blogs.scientificamerican.com/context-and-variation/here-is-some-legitimate-science-on-pregnancy-and-rape/ [Accessed September 16th, 2020]

  10. Hacker NF, Gambone JC, Hobel CJ (eds.). Hacker & Moore’s Essentials of Obstetrics & Gynecology. 6th ed. Philadelphia: Elsevier; 2016.


Please note: the information we provide to you here is for educational purposes only. If you’re experiencing any discomfort or have any complaints or questions about your health, please contact your doctor or other relevant health professional. We don’t provide medical advice.