This article has been republished with permission of Purewow
The pill. The patch. The shot. The…sponge?
There are dozens of birth control methods out there, and some are way more effective than others. Wading through so many different options can feel daunting (especially when you only see your OB-GYN for a few minutes a year), so we’re breaking it all down for you. Here’s every form of birth control, explained.
1. IUD (99% EFFECTIVE)
There are two types of IUDs (aka intrauterine devices): copper and hormonal. Copper prevents sperm from reaching the egg (fun fact: sperm hate copper), and hormonal IUDs work by thickening cervical mucus, preventing sperm from fertilizing the egg, and can prevent eggs from being released from the ovaries. IUDs look kind of like a small fishing line that is inserted into the uterus.
The good: Hormonal IUDs can last anywhere from three to seven years, depending on the brand. Copper IUDs are hormone-free and prevent pregnancy for up to 12 years.
The bad: Some users experience pain or cramping after the IUD is inserted, as well as spotting and irregular periods. These symptoms typically only last a couple of months. Neither copper nor hormonal IUDs prevent STIs.
How much is it? $0 to $1,300 for one IUD, depending on your health insurance coverage.
2. VASECTOMY (99% EFFECTIVE)
It’s a quick surgical procedure that blocks or cuts the vas deferens tubes in the scrotum (vasectomy—get it?). It can be done in the doctor’s office in about half an hour and thanks to local anesthesia, it’s not super painful.
The good: After the surgery, there will be no noticeable change in the way sex feels for either partner. (Semen is still released; it just won’t contain any sperm.)
The bad: After a vasectomy, you’ll need about a week of recovery (and might need to take off of work). It’s meant to be a permanent procedure, and while it can sometimes be reversed, it’s not recommended or guaranteed. It also doesn’t kick in for about three months, so you’ll have to use another type of birth control until then. Vasectomies also don’t prevent STDs.
How much is it? $0 to $1,000, depending on your health insurance coverage.
3. STERILIZATION (99% EFFECTIVE)
It’s sometimes called “tubal ligation,” or “getting your tubes tied.” There are a few different methods of sterilization, including the Essure procedure (where a doctor places a coil in each of your fallopian tubes) and incision sterilizations (where a doctor cuts into the fallopian tubes to close them off). General anesthesia is used in both methods. It usually takes about a week to recover from an incision sterilization, and only about a day if you’ve had an Essure procedure.
The good: It’s hormone-free, it’s one of the most effective forms of birth control out there, and it’s permanent.
The bad: Welp, it’s permanent—and unlike a vasectomy, it can never be reversed. It also doesn’t protect against STIs. You’ll need to hold off on sex for about two weeks after the procedure (but we’re willing to guess you’re not going to feel up to it anyway).
How much is it? $0 to $6,000 for the procedure, depending on your insurance coverage.
4. BREASTFEEDING (98% EFFECTIVE)
OK, hear us out. We know you have a friend who accidentally got pregnant while breastfeeding. But if you use it perfectly—exclusively breastfeeding your baby every four hours all day and every six hours all night—it actually is one of the most effective forms of birth control for the first six months of a baby’s life.
The good: It’s completely free, you don’t need a prescription from a doctor, and if you’re going to be breastfeeding anyway, it’s a no-brainer.
The bad: If you’re not able to nurse every four hours during the day, sorry—it’s no longer an effective form of birth control. (Shout-out to your old friend from college who now has three under three.)
How much is it? Free.
5. BIRTH CONTROL IMPLANT (99% EFFECTIVE)
Also known as Nexplanon, the birth control implant is a small rod about the size of a bobby pin that is inserted into the arm, releasing the hormone progestin. When you have the implant, your cervical mucus thickens, preventing sperm from reaching the egg. Progestin may also prevent eggs from leaving the ovaries.
The good: The implant lasts for five years, and if you decide you want to get pregnant before then, a doctor can remove it. It’s basically the Crock-Pot of birth control—set it and forget it.
The bad: Because hormones are involved, some users may have side effects, including nausea, headaches, weight gain and ovarian cysts. Birth control implants also don’t prevent STDs.
How much is it? $0 to $1,300, depending on your insurance coverage.
6. THE DEPO-PROVERA SHOT (94% EFFECTIVE)
Also known as the Depo shot or the DMPA, a solution containing progestin is injected into the body every three months. The progestin prevents ovulation, so there is no egg for the sperm to fertilize.
The good: The convenience of not having to remember to set an alarm and take a pill every night? Priceless. The shot might also keep you from getting your period as often, and your flow might be lighter.
The bad: Typically, a doctor will have to give you the shot, so you’ll have to make appointments every three months to get a new one. You’ll have to wait about a week until the shot becomes effective. Even after stopping the shot, it might take up to a year to get pregnant, so if you’re planning a family soon, it might not be the best fit for you. The shot doesn’t prevent against STIs, either.
How much is it? $0 to $100, depending on your health insurance coverage.
7. TRANSDERMAL CONTRACEPTIVE PATCH (91% EFFECTIVE)
The patch contains a combination of the hormones progestin and estrogen, which are absorbed into the body when you wear it. Place a patch on your stomach, butt, upper arm or back, then change it every week.
The good: If you hate swallowing pills or don’t want to have to constantly remember to take them, the patch is a bit of a lower lift.
The bad: On the other hand, you still need to remember to change the patch regularly, or it will be less effective. (It also takes about a week to become effective.) And because it’s a hormone medication, some women may experience side effects like nausea, tender breasts or spotting. It also doesn’t protect against STIs.
How much is it? $0 to $150 for a pack of three, depending on your insurance coverage.
8. NUVARING (91% EFFECTIVE)
A small, flexible ring that contains the hormones progestin and estrogen is inserted into the vagina. The hormones thicken cervical mucus and stop ovulation, so sperm can’t fertilize the egg.
The good: You can remove and insert the ring yourself, and you only need to do it once a month. The hormones in the ring may help reduce symptoms of acne, heavy periods and cysts in your breasts.
The bad: You have to remove the ring on time, or it won’t be as effective—but unless you replace the ring during the first five days of your period, it takes another week to become effective. Like most hormonal birth control methods, side effects may include spotting, nausea, sore breasts and headaches. The ring doesn’t protect against STIs.
How much is it? $0 to $200, depending on your health insurance coverage.
9. CONDOMS (85% EFFECTIVE)
Typically made of latex (but also sometimes made of lambskin or plastic), condoms stop sperm from being released into the vagina. They also prevent STDs by reducing the contact of semen and vaginal fluid, and reduce the risk of developing STIs by limiting skin contact between both partners.
The good: They’re super cheap, convenient and have no side effects (unless you’re allergic to one of the ingredients). They also help other birth control methods (like the pill or the shot) become more effective by using both at once.
The bad: Sex can feel different when you’re wearing a condom (womp womp). Plus, you must always have them on hand and remember to use one every time you have sex.
How much is it? $0 to $3. (You can often get them for free at a clinic or doctors office.)
10. DIAPHRAGM (88% EFFECTIVE)
A diaphragm is a small, shallow cup that is inserted into the vagina to cover the cervix. You’re probably not that familiar with it, because it was most popular in the 1960s. Fewer than 1 percent of women use it now, but it’s been immortalized in episodes of Friends and Sex and the City.
The good: Unlike a condom, they’re reusable. They can last up to two years if you clean and care for them regularly. Plus, they’re hormone free.
The bad: You need to be fitted for a diaphragm, and if you get pregnant or lose more than a few pounds, you’ll have to go back to the doctor to get it refitted. It can be tricky to know when a diaphragm is placed correctly, and it’s easy for it to slip. It’s not that effective compared to newer forms of birth control. You also need to leave it in for six hours (!) after having sex, but can’t leave it in for longer than 24 hours. You also need to use spermicide with it, which can irritate the vagina and actually increase your risk of getting an STI. Yeah, now we understand why diaphragms are no longer in vogue.
How much is it? $0 to $75, depending on your insurance.
11. THE SPONGE (76 TO 88% EFFECTIVE)
Chances are, your knowledge of the sponge is mostly thanks to Elaine on Seinfeld. It’s a small, plastic sponge that you place inside your vagina to cover your cervix. It contains spermicide to keep sperm from entering and fertilizing the egg.
The good: The sponge is sold over the counter, so you don’t need a prescription to get it. They’re also hormone-free, so if you have a negative reaction to the pill or shot, it could be a decent option.
The bad: Compared to other birth control methods, it’s pretty ineffective. Like the diaphragm, you have to leave it in for six hours after having sex, but you can’t leave it in for longer than 30 hours. Because the sponge contains spermicide, it may increase your risk of getting an STD, because it can irritate the vagina.
How much is it? Up to $15 for a pack of three.
12. INTERNAL CONDOMS (79% EFFECTIVE)
Sometimes called “female condoms,” these are little pouches made of soft plastic that are inserted into the vagina, preventing sperm from reaching the egg.
The good: Internal condoms help prevent STIs by preventing exposure to semen and reducing skin contact. If you have a latex allergy, internal condoms can be a great solution because they’re hypoallergenic. Internal condoms also have a small lip that can stimulate both partners, making sex feel better. (Yep, really.)
The bad: You might need a few practice tries before you get the hang of putting in an internal condom. Like condoms, you need to always have them on hand and remember to use one every time you have sex—but they’re also slightly less effective than condoms.
How much is it? $0 to $3 for a pack of 12.
13. WITHDRAWAL METHOD (78% EFFECTIVE)
Yep, this is basically “pulling out,” where the penis is removed from the vagina before ejaculation.
The good: It’s hormone-free. If you use it alongside other birth control, like the pill, it will be even more effective.
The bad: Remember, it’s 78 percent effective when used perfectly every time. But there’s a huge margin for error with the withdrawal method, because it can be tricky to pull out at the right time.
How much is it? Free.
14. FERTILITY AWARENESS (FAMS) (76 TO 88% EFFECTIVE)
Ever heard of “the rhythm method” or “natural family planning”? These birth control strategies use your ovulation cycle, your basal body temperature or changes in your cervical mucus (or all three) to determine your most fertile days. Then, you simply don’t have sex (or use another form of birth control) on those fertile days.
The good: It’s inexpensive and hormone-free, and it never hurts to learn more about the way your body works. If you do want to get pregnant later down the line, it will be a breeze to figure out when you’re ovulating.
The bad: Um, up to 24 out of 100 couples will get pregnant while using this method every year. As a primary birth control method, it’s just not that effective. You’ll also need to download an app, get a special thermometer and possibly buy a special calendar to track your data.
How much is it? Up to $20 for supplies.
15. THE PILL (91% EFFECTIVE)
Birth control pills contain a variety of hormones (estrogen, progestin or both) that prevent ovulation and thicken cervical mucus to prevent eggs from getting fertilized.
The good: It’s tried-and-true. (Your mom probably used it at some point.) If you have heavy periods, acne, PMS or cysts in your breasts, the pill may actually be able to reduce your symptoms—talk to your doctor for more info.
The bad: Remembering to take a pill every single day? Not exactly on our list of favorite things to do. The pill doesn’t protect against sexually transmitted infections, either. It also takes at least one menstrual cycle to kick in, so if time is of the essence, it might not be the best fit.
How much is it? $0 to $50 for a one-month pack, depending on your insurance coverage.
16. CERVICAL CAP (71 TO 80% EFFECTIVE)
Similar to a diaphragm, the cervical cap is a small cup made of soft silicone that is inserted into the vagina and covers the cervix. For it to work best, it needs to be paired with spermicide. Unlike condoms, you’ll need to get a prescription from your doctor.
The good: It’s OK to leave the cervical cap in longer than a diaphragm (up to two days). Unlike condoms, which need to be tossed after one use, the cervical cap is reusable.
The bad: They aren’t as effective as diaphragms…which aren’t even that effective anyway. It’s really easy for a cervical cap to be bumped out of place and using spermicide can increase your chance of developing STIs because it can cause vaginal irritation.
How much is it? $0 to $90, depending on your health insurance.
17. SPERMICIDE (71% EFFECTIVE)
It’s a gel or cream containing chemicals that prevents sperm from swimming and reaching the egg.
The good: It’s inexpensive, hormone-free and super easy to use. It can be used alone or alongside other birth control methods, like a condom or cervical cap.
The bad: Spermicide contains a chemical called nonoxynol-9, which can irritate the genitals and make it easier to transmit a STI (ugh).
How much is it? $0 to $8 per tube, depending on your health insurance.
18. ABSTINENCE (100% EFFECTIVE)
The O.G. birth control. Don’t want to get pregnant? Don’t have sex. Simple.
The good: It’s the only form of birth control that’s 100 percent effective.
The bad: Well, you don’t get to have sex. That’s definitely a drawback.
How much is it? Free.
Data on method effectiveness and cost provided by Planned Parenthood.