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Birth Control Options Compared
Birth control options compared: how effective each method is with typical use, how long it lasts, common side effects, and which also protect against STIs.
Key takeaways
- Implants and IUDs are the most effective reversible methods, with fewer than 1 pregnancy per 100 users a year.
- Pills, patches and rings are about 93% effective with typical use; the shot is about 96%.
- Only condoms protect against sexually transmitted infections.
On this page
There’s no single best birth control method, only the one that best fits your body, health and life right now. This guide compares the main options on the things that matter most: effectiveness, how often you need to think about it, side effects and STI protection.
How effective is each method?
Effectiveness depends on real life, not perfect use. These figures, from the CDC, show roughly how many people out of 100 become pregnant in the first year of typical use.
| Method | Pregnancies per 100 users a year | How long it lasts |
|---|---|---|
| Implant | Fewer than 1 | Up to 3 years (labeled) |
| Hormonal IUD | Fewer than 1 | 3–8 years, depending on type |
| Copper IUD | About 1 | Up to 10 years |
| Tubal sterilization | Fewer than 1 | Permanent |
| Vasectomy (partner) | Fewer than 1 | Permanent |
| Shot (injection) | About 4 | 3 months |
| Pill, patch or ring | About 7 | Daily, weekly or monthly |
| External (male) condom | About 13 | Each time |
| Diaphragm | About 17 | Each time |
| Withdrawal | About 20 | Each time |
| Fertility awareness methods | 2–23 | Daily tracking |
Long-acting reversible contraception (LARC)
Implants and IUDs work for years once placed, and there’s nothing to remember. Hormonal IUDs often make periods lighter; copper IUDs contain no hormones but can make periods heavier at first. Insertion involves a short procedure and a pelvic exam, and removal is quick if you want to become pregnant.
Short-acting hormonal methods
- The pill: combined pills contain estrogen and progestin; progestin-only pills contain one hormone. A progestin-only pill has been available over the counter in the US since 2024.
- The patch: changed weekly.
- The ring: placed in the vagina, changed monthly or yearly, depending on type.
- The shot: an injection every three months.
Methods containing estrogen aren’t safe for everyone. They’re usually avoided if you’re 35 or older and smoke, have had a blood clot or have migraines with aura, for example. Your clinician will check using the CDC’s medical eligibility criteria.
Barrier methods and fertility awareness
Condoms, diaphragms and sponges are used each time you have sex. Condoms are the only method that also protects against STIs, so many people use them alongside another method. Fertility awareness methods track your cycle to avoid sex or use a barrier on fertile days; they work best with training and regular cycles.
Emergency contraception
If you’ve had unprotected sex or a method failed:
- Levonorgestrel pills are available over the counter and work best within 72 hours.
- Ulipristal needs a prescription and works up to 5 days afterward.
- A copper IUD placed within 5 days is the most effective option and keeps working afterward.
Choosing what’s right for you
Consider how important it is to avoid pregnancy right now, whether you want lighter periods, how you feel about hormones, and whether you want to become pregnant soon. Bring these to your appointment; our list of questions to ask your gynecologist can help. Most plans must cover contraception without cost-sharing, as explained in our insurance guide.
Frequently asked questions
Does birth control affect future fertility?
No, for most methods fertility returns quickly after stopping. After the shot, it can take several months or longer.
Can birth control help with painful or heavy periods?
Yes. Hormonal methods, especially hormonal IUDs and combined pills, are often used to treat heavy or painful periods.
Is it safe to skip periods on the pill?
For most people, yes. Continuous use of combined pills is a common, safe option; talk to your clinician about how to do it.
Sources
Every article is edited by a human and checked against our editorial policy. Spotted a mistake? Tell us.
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