Having access to reliable birth control is important for many people. While the birth control pill remains a popular option, more and more people are looking for hormone-free birth control, due to sensitivity to hormonal side effects or for other medical or personal reasons.
These days, there are many options for non-hormonal birth control. If you’re looking to avoid unplanned pregnancy and additional hormones, here’s what you should know about your birth control options.
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For many people, the efficacy of birth control is the most important factor when choosing a method. Efficacy is how well a birth control method prevents pregnancy. This is measured as the number of people, out of 100, who will get pregnant during a year of using this birth control method and having penis-in-vagina sex.
When researchers calculate the failure rate of birth control, they give two numbers: how many people will become pregnant with perfect use of the birth control, and how many will become pregnant with typical use.
Typical use includes mistakes like missing an occasional pill. It is a better indicator of the efficacy of a method of birth control.
Here’s how effective popular non-hormonal birth control methods are, with typical use:
An intrauterine device (IUD) is inserted into your uterus to prevent pregnancy. There are two types of IUDs approved by the Food and Drug Administration (FDA) for use: hormonal and non-hormonal.
The only non-hormonal IUD, sold under the brand name Paragard, continuously releases a tiny amount of copper, which changes the chemical environment of the uterus so that it’s toxic to sperm and eggs.
In some cases, this can be used as emergency contraceptive: If Paragard is inserted up to five days after unprotected sex, it can be used to prevent pregnancy.
Condoms provide a physical barrier between the partners having sex. Male condoms are worn on the penis and are 85% effective with typical use. Internal condoms, also known as female condoms, are inserted into the vagina or anus. They’re 79% effective at preventing pregnancy.
Most people won’t experience any side effects from condoms. If you or your partner has a latex allergy, be sure to get latex-free condoms.
Phexxi is one of the newest methods of hormone-free birth control. It is a gel that is inserted into the vagina before having sex. The gel, which doesn’t have any hormones, changes the acidity of the vagina in order to make it difficult for sperm to reach an egg.
Phexxi was approved by the FDA in 2020 and is 86% effective at preventing pregnancy with typical use.
A cervical cap is a small piece of silicon that covers the entrance to the cervix, preventing sperm from reaching the egg. Cervical caps are smaller than diaphragms and can be left in place longer.
When used with spermicide, it’s 86% effective at preventing pregnancy for people who have never had a baby and 71% effective for those who have had a baby.
Most people don’t experience side effects from cervical caps, but you might find the cap uncomfortable, particularly if it’s not inserted correctly or is bumped during sex. The spermicide used with caps can increase your risk for STDs.
The sponge is a piece of plastic that blocks the entrance to the cervix, preventing sperm from meeting the egg. It also contains spermicide to kill sperm. It is 86% effective for people who have never had a baby and 73% effective for people who have had a baby.
Some people using the sponge experience vaginal irritation. This can increase your risk for STDs, so it’s very important to practice safe sex while using the sponge.
A diaphragm is a plastic cap that covers the opening to your cervix, blocking sperm from getting to the egg. Diaphragms are used with spermicide and are 87% effective.
People who use diaphragms are at increased risk for urinary tract infections (UTIs). The spermicide used with diaphragms can increase your risk of STDs.
Spermicide is a cream or gel that is inserted into the vagina where it slows down sperm, making it harder to reach the egg. Used on its own, spermicide is 72% effective. It is more effective when used with other contraceptives such as condoms, diaphragms, sponges, and cervical caps.
Spermicide can irritate the genitals, causing vaginal itching, burning, or a rash. It can also cause penile itching or burning urination, and increases the risk of HIV and other STDs.
Natural family planning, also known as the fertility awareness method, involves tracking your natural cycles to avoid pregnancy.
With this method, you use indicators of fertility, like cervical mucus and basal body temperature, to identify your fertile window. During that window, you avoid sex or use a barrier method. Today, you can use a birth control app to make it easier to track your cycle and predict your fertility.
The effectiveness of this method varies widely, ranging between 77% and 98%.
There are no side effects to the fertility awareness method.
Also known as “pulling out,” this birth control method involves removing the penis from the vagina before ejaculation occurs. It is 78% effective.
There are no side effects to withdrawal.
Selecting birth control is a very personal choice. You should consider how long you want your birth control to last, whether you are OK with something that needs to be applied right before sex, and whether you need protection from STDs.
Today, more non-hormonal birth control options are available than ever before. Your healthcare provider can help you decide which is right for you.
The most effective non-hormonal birth control is the copper IUD.
A contraceptive is a medication or device that is designed to prevent conception and pregnancy.