What Is the Best Form of Birth Control for Me?

Birth control is any method used to prevent pregnancy. Birth control is different for each person, so the best or most effective birth control depends on your needs.

Birth control, also called contraception, refers to devices or methods used to prevent pregnancy.

The “best” form of birth control may depend on a person’s needs. If the “best” birth control is defined as that which can best prevent pregnancy, then the only 100% reliable method is abstinence, which means not having penile-vaginal intercourse and avoiding any sexual activity in which sperm can get on a vulva or into a vagina. 

The next best form of birth control in terms of effectiveness is surgical sterilization, either a tubal ligation (“tubes tied”), sterilization implant, or hysterectomy in women, or a vasectomy in men. 

For those who have vaginal sex and want a reversible method of birth control, the “best” birth control is to use a type of long-acting reversible contraception such as an intrauterine device (IUD) or implant plus a condom. IUDs and implants work the best to prevent pregnancy. 

Hormonal birth control methods are also quite effective in preventing pregnancy when used perfectly, but many people do not use them perfectly, which can result in pregnancy. 

Types of contraception include: 

• Long-acting reversible contraception (LARC) 
  • Considered the most effective form of reversible contraception
  • Provides long-term pregnancy prevention without requiring any effort on the part of the patient
    • Intrauterine devices (IUDs) (also called an intrauterine system, or IUS) are small, T-shaped devices inserted into the uterus by a health care provider. IUDs remain in place and prevent pregnancy for years. 
      • Hormonal IUDs release the female hormone progestin (levonorgestrel) into the uterus, thickening cervical mucus to prevent sperm from reaching or fertilizing the egg, thinning the uterine lining, and possibly preventing the ovaries from releasing eggs
      • Copper IUDs prevent sperm from reaching and fertilizing the egg, and prevent an egg from attaching in the uterus. If an egg does become fertilized, a copper IUD can prevent it from implanting into the uterine lining.
      • Implants are implantable rods surgically inserted by a physician under the skin of a woman’s upper arm that release a form of the female hormone progestin and may remain in place for up to 5 years
• Hormonal methods of birth control 
• Use hormones to regulate or stop ovulation and prevent pregnancy
  • Short-acting hormonal methods
    • Injectable birth control uses the female hormone progestin administered in the arm or buttocks once every 3 months
    • Progestin-only pills (POPs) are taken orally once daily, usually at the same time of day
  • Combined hormonal methods contain a combination of the female hormones estrogen and progestin 
    • Combined oral contraceptives (also called COCs or “the pill”) are taken orally once daily at the same time each day
    • Contraceptive patches are applied to the skin and release hormones through the skin into the bloodstream
    • A vaginal ring is a thin, flexible, ring that measures approximately 2 inches in diameter inserted into the vagina that continually releases a combination of hormones
• Barrier methods 
  • Prevent sperm from entering the uterus
  • Are removable and are an option for women unable to use hormonal methods of contraception
  • Barrier methods that do not require a health care provider visit include:
    • Male condoms cover the penis and collect and prevent sperm from entering the woman's body
    • Female condoms are thin, flexible plastic single-use pouches inserted into a woman's vagina before intercourse to prevent sperm from entering the uterus
    • Contraceptive sponges are disposable, soft, spermicide-filled foam sponges inserted into the vagina before intercourse to help block sperm from entering the uterus. The spermicide also kills sperm cells.
    • Spermicides kill sperm cells and may be used alone or in combination with a diaphragm or cervical cap. 
  • Barrier methods that require a health care provider visit include the following:
    • Diaphragms are shallow, flexible cups made of latex or soft rubber inserted into the vagina before intercourse, blocking sperm from entering the uterus. A spermicide should be used with a diaphragm.
  • Cervical caps are similar to diaphragms but are smaller and more rigid. 
     
• Emergency contraception 
  • Intended for use after unprotected intercourse or if a condom breaks
    • Copper IUDs can be inserted within 5 days (120 hours) of unprotected intercourse and are a highly effective method of contraception for as long as the device remains in place
    • Emergency contraceptive pills (ECPs, or “morning after pills”) are hormonal pills, taken either as a single dose or two doses 12 hours apart, used in the event of unprotected intercourse. They should be taken as soon as possible after unprotected sex and are not intended to be used as a regular method of contraception. Emergency contraception is not the same as “the abortion pill.”
• Sterilization 
  • Surgical procedures that are permanent forms of birth control
  • Sterilization either prevents a woman from getting pregnant or prevents a man from releasing sperm
  • For women
    • A sterilization implant is a nonsurgical method for permanently blocking the fallopian tubes 
    • Tubal ligation (“tubes tied”) is a surgical procedure in which a doctor cuts, ties, or seals the fallopian tubes so sperm cannot reach an egg to fertilize it, and an egg cannot reach the uterus
    • Hysterectomy is the surgical removal of the uterus making pregnancy impossible. It is usually performed for reasons other than contraception. 
  • For men
    • Vasectomy is a surgical procedure that cuts, closes, or blocks the vas deferens, so sperm cannot leave the testes and cannot reach the egg

• “Natural” birth control 
  • Does not require medication, devices, or surgery
  • These methods are the least effective
    • Withdrawal
    • Fertility tracking
    • Breastfeeding (lactational amenorrhea method, or LAM)