Understanding Birth Control: Methods & Options

Birth control is the use of different devices, sexual practices, techniques, chemicals, drugs, and/or surgical procedures to purposely try to prevent getting pregnant while having sex.

There are several types of birth control methods that have been officially labeled as contraception—i.e., they have been shown to be reliable in preventing conception from taking place.

Also Known As

• Family planning
• Pregnancy prevention
• Fertility control

Available Birth Control Methods

There are multiple contraception methods available. And with so many options, it can get confusing. Learning the pros and cons of each type can help you choose the right method for you.

Each method typically falls under one of five categories:

• Natural: Also known as natural family planning, these are birth control methods in which you need to do specific behavioral actions to avoid getting pregnant. In order to be successful using many of these natural methods, you need to really know your body and the signals it gives off throughout your menstrual cycle.
• Over-the-Counter (OTC): These are the methods you will find in the family planning aisle of your local store. This means that you can buy them without a healthcare provider’s prescription. In general, OTC contraception works by forming some type of barrier that prevents sperm from reaching an egg or has a chemical that reduces their ability to swim.
• Prescription: These are options that require you to get a prescription from your healthcare provider. These methods include hormonal contraception (birth control that contains progestin and/or estrogen), non-hormonal contraception including IUDs, and barrier methods (diaphragms and cervical caps).
• Permanent: Also known as sterilization, these methods permanently prevent you from being able to become pregnant. They are typically performed via surgery.
• Emergency: This is a special category. It includes methods specifically intended to be taken up to 120 hours after unprotected sex or birth control failure to prevent you from getting pregnant. Forms are available both OTC and by prescription.

Who Should Use Contraception?

If you do not want to get pregnant right now—but are having sex—you should be using birth control. Because there are so many methods, you should be able to find an option that fits into your lifestyle and matches your health needs.

So, if you are allergic to latex, for example, they make condoms from other materials. Or, if you can't use estrogen, there are several progestin-only birth control pills to pick from.

When healthy couples in their 20s and early 30s do not use (or stop using) birth control, they have around a 25% chance of getting pregnant during a single menstrual cycle. By age 40, that number drops to 10% for women. Male fertility also decreases as men age, but not as predictably.

A Brief History of Birth Control

There is evidence that contraception has been used since ancient times. But safe and effective birth control methods have only been available since the 20th century.

Did you know that birth control use did not become legal in the United States until 1965? Before then, it was either outlawed or restricted in most states. But, on June 7, 1965, in the case of Griswold v. Connecticut, the Supreme Court ruled that people who were married had the right to make their own decisions about whether or not to use contraception. This meant, however, that only married couples were legally allowed to use contraception.

This continued to be the law until March 22, 1972. On that date, in the case of Eisenstadt v. Baird, the Supreme Court ruled that unmarried people had the same right as married couples to use birth control.

It wasn't until Tummino v. Hamburg in 2013 that most forms of emergency contraception became available over the counter to people of any age.

Specific Types of Birth Control

It is easiest to understand the different contraception types based on the five categories:

• Natural: Abstinence, outercourse, withdrawal, natural family planning (Billings method, symptothermal method, and standard days method), and continuous breastfeeding (lactational amenorrhea method)
• Over-the-Counter: Male condoms (available in latex, polyurethane plastic, polyisoprene non-latex natural rubber, and lambskin), female condoms, spermicide, and the sponge
• Prescription: The pill, NuvaRing, the patch, Depo-Provera, Nexplanon, IUDs (ParaGard, Skyla, Mirena, Kyleena, Liletta), Phexxi (a non-hormonal gel), a cervical cap, and the diaphragm
• Permanent: Traditional vasectomy, keyhole/non-scalpel vasectomy, tubal ligation (most common procedures include mini-laparotomy and laparoscopic sterilization)
• Emergency: Morning-after pill has two forms. Plan B One-Step contains levonorgestrel and is available without a prescription. It comes in many generic versions including Next Choice One Dose, My Way, Take Action, AfterPill, and Next Choice. Ella uses ulipristal, a form of progestin, and is only available by prescription. The ParaGard IUD can also be used for emergency contraception.

As you can see, most of the available methods are for women. Except for withdrawal and abstinence, the only options for men are condoms and having a vasectomy. Male hormonal birth control is currently being researched, but there are no methods available yet.

How to Use Contraception

As stated, there are various types of birth control. But each method is designed to work in a certain way:

• Behaviorally: Actions such as monitoring changes in your body to figure out when you ovulate (such as the Billing’s Method).
• Injected: When birth control is put into your body through an injection (like using Depo-Provera).
• Orally: This includes methods like the mini-pill or combination birth control pills since they must be taken by mouth at the same time each day.
• Inserted: This type has to be placed into the vagina to block sperm from reaching an egg, such as the sponge, female condoms, diaphragm, and spermicide. It also includes the NuvaRing which is inserted into the vagina so it can release hormones.
• Implanted: Methods in which your healthcare provider must slide or embed a device, like an IUD (which is inserted into the uterus) and Nexplanon (which is implanted under the skin in your arm).
• Worn: Men can wear condoms on their penises to catch sperm and keep it out of the vagina. Women can wear the patch which releases hormones through the skin, or wear female condoms which also catch sperm.
• Surgically: These are typically permanent options like getting your tubes tied or having a vasectomy.

The most important thing about contraception is that you use it correctly and every time that you have sex. Also, although all these methods are very different, the one thing they have in common is that no method (except for abstinence) is 100% effective.

Choosing Birth Control

It is your right whether or not to use contraception and deciding which method to use is a personal choice.

There is no "best" birth control method. It is helpful to research each method, weigh the risks and benefits, consider the level of effectiveness you want, and choose the one that fits into your lifestyle, your comfort level, and/or religious beliefs.

Having an honest talk with your healthcare provider can also help you in your decision-making process.

Part of your decision about which contraception method to choose may be based on some of your values. For example, if you have chosen to live a greener lifestyle, you may want to use an eco-friendly method or a device that can be recycled. You may also want to consider how quickly your fertility will return once you stop using a particular method.

And even if you are already using birth control, don't feel like you are stuck with that specific method. If you are not satisfied, change your birth control. The more comfortable and pleased you are with your contraception, the more likely you will use it (and in the correct way). Allow yourself to be empowered over your health, your reproductive and sexual choices, and your birth control. You are in charge of your body.

A Word From Verywell

Contraception has far-reaching implications in life. It can allow you to decide how many children you may want to have as well as when you want to be pregnant. There is no "right" reason to use birth control, but it is your decision to make.

You may have your own reasons for wanting to use birth control, but choosing a method should be an informed decision. Do your research, have a truthful conversation with your partner, and talk to your healthcare provider.