Birth Control (Contraception): Types, Uses & Side Effects

Birth control (contraception) is any medicine, device, or method that you use to prevent pregnancy. There are many different types of birth control. All methods have pros, cons and side effects. Birth control is only effective when it’s used correctly.

Choosing a method of birth control can be hard. Know the options and how to pick the type of birth control that’s right for you.

Pregnancy can happen any time you have sex without birth control. Using birth control can help prevent pregnancy if you’re not planning to have a baby. A healthcare provider can help you pick a type based on your lifestyle, health history and desire to have children in the future.

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.

How does birth control work?

Different types of birth control work in different ways, including:

• Stopping sperm from reaching an egg
• Stopping your ovary from releasing an egg
• Damaging sperm so it can’t swim to an egg
• Thickening your cervical mucus so sperm can’t get through
• Changing the lining of your uterus so an egg can’t implant

Types of birth control

The main birth control methods are:

• Barrier methods
• Hormonal medication and devices
• Intrauterine and implantable devices
• Sterilization
• Fertility awareness
• Withdrawal
• Emergency contraception
• Abstinence

Barrier methods

Barrier methods are better for protecting against STIs. But they’re usually easier to misuse. Examples of barrier methods are:

• Condoms: A condom is a latex sleeve you roll over an erect penis. It blocks sperm from entering the vagina. Condoms can break, rip and slip off. They’re about 85% effective when used correctly.
• Spermicide: This is a gel, cream or foam you put inside your vagina at least 15 to 30 minutes before sex. It contains chemicals that stop sperm from moving. People usually use it to make a barrier method more effective.
• Vaginal diaphragm: This is a small, flexible cup that you insert into your vagina before sex and remove afterward. You need a provider to fit it. It’s about 87% effective, and up to 94% effective when used with spermicide.
• Cervical cap: This is a thimble-shaped cup that fits over your cervix. A provider must fit you for one. It’s about 78% effective. But it can be 85% effective if you use it with spermicide.
• Internal condom: This type works like a regular external condom but goes inside the vagina. It’s about 80% effective.
• Sponge: A sponge is a small, donut-shaped device that contains spermicide. It’s between 76% and 91% effective at preventing pregnancy.

Hormonal medications and devices

These birth control methods use hormones to prevent pregnancy. They’re between 91% and 99% effective. Examples are:

• Birth control pills: Pills use hormones to prevent pregnancy. Most contain estrogen and progestin. Some only contain progestin (the minipill).
• Birth control shot: This is an injectable form of birth control. It’s a shot of progestin that you get every three months.
• Vaginal ring: This is a small, flexible ring that you insert into your vagina. It releases hormones to stop ovulation. You keep it in place for three weeks and remove it for one week.
• Birth control patch: This is a type of birth control that sticks to your skin. You wear it for three weeks and remove it for one week.

Intrauterine and implantable devices

These forms of birth control are typically most effective. This is mainly because they don’t require you to remember to use them. They’re considered long-acting reversible contraception (LARC). Examples are:

• Birth control implant: This is a small, flexible rod that your provider places under the skin of your arm. It works for about three years.
• IUDs: An IUD is a small, flexible, T-shaped device that your provider puts in your uterus to prevent pregnancy. There are two types of IUDs: copper and progestin. They last between three and 12 years depending on the type.

Sterilization

Methods that involve sterilization are almost 100% effective in preventing pregnancy. But they’re mostly permanent. Options include:

• Salpingectomy: This is surgery to remove your fallopian tubes. This stops an egg from reaching your uterus.
• Tubal ligation: A tubal ligation blocks your fallopian tubes. A surgeon clamps, ties or blocks the tubes to prevent pregnancy.
• Vasectomy: This is a procedure to seal the vas deferens, the tubes that carry sperm in men. Pregnancy can’t occur without sperm.

Fertility awareness methods (natural family planning)

These methods don’t use medications or devices to prevent pregnancy. Instead, they rely on knowing your body and looking for signs of ovulation. You use this information to avoid sex on certain days. Natural family planning isn’t as effective at preventing pregnancy. Some examples are:

• Rhythm method: This form of birth control involves tracking your cycle on a calendar to predict ovulation.
• Cervical mucus method: This type involves looking for changes to the consistency of your cervical mucus. Thin, clear and stretchy vaginal discharge means you’re more likely to get pregnant.
• Basal body temperature: This involves taking your temperature before you get out of bed each morning. Your temperature rises after ovulation.

Pull-out method (Withdrawal)

Pulling out before ejaculation is hard to do and not very effective. Even a little bit of semen can cause pregnancy.

Emergency contraception

Morning-after pills can be up to 90% effective when taken within 72 hours (three days) after unprotected sex. Try to take them as soon as you can. The most effective morning-after pill contains ulipristal. It’s only available by prescription. Several over-the-counter brands are available and all contain levonorgestrel.

Abstinence

Abstinence is the only birth control that’s 100% effective. It’s also the best way to protect yourself from infection. Don’t let someone pressure you into having sex if you don’t feel ready.

Talk to your partner and/or healthcare provider before you choose a method. Birth control is only effective if you use it the right way. No method is perfect. In most cases, you can change which type you use if you don’t like it.

What are the most effective forms of birth control?

The most effective form of birth control is abstinence (not having sex at all). But this can be difficult.

Any form of birth control only works when you use it correctly. Methods that are easy to use and don’t need much effort are usually the most effective. For example, the birth control implant and intrauterine devices (IUDs) tend to be the most effective. Fertility awareness and pulling out are the least effective.

Using two types of birth control is often better than using only one — for example, using a condom and taking the pill. This helps prevent pregnancy and protects against STIs at the same time.

What is the best birth control with the least side effects?

Every method comes with its own side effects and risks. Condoms and diaphragms have fewer side effects. But they also aren’t super effective compared to other methods.

Don’t make a choice based on side effects alone. Choose a birth control based on effectiveness, risks and safety. Your healthcare provider can help you with this.

What is the best option to avoid weight gain?

The best birth control to avoid weight gain is usually a non-hormonal method, like condoms, a diaphragm or the copper IUD.

But most studies don’t show a definitive link between hormonal birth control and weight gain. The only exception is the birth control shot. On average, people gain around five pounds in the first year.

What is the healthiest birth control option?

It depends on the person. Each type has its own side effects, risks and level of effectiveness. The healthiest type is the one that’s safe for you based on your health history and lifestyle. A healthcare provider can help you decide.

What are the least effective forms of birth control?

The least effective types are:

• Pull-out method
• Natural family planning (fertility awareness)
• Spermicide (when used alone)

Remember, all birth control methods can be ineffective when you don’t use them correctly.

What are the side effects of birth control?

Birth control is highly effective at preventing pregnancy, but it can also have some downsides. Side effects can range from mild to serious.

It’s worth noting that many of these side effects often go away on their own, and not everyone has side effects. Talk to a healthcare provider if you are concerned about possible side effects from birth control.

Side effects can depend on the type of birth control you use. Some general side effects of birth control include:

• Cardiovascular issues (e.g., high blood pressure)
• Changes in libido (sex drive)
• Changes to your menstrual cycle
• Digestive issues (e.g., bloating, constipation, and nausea)
• Headaches
• Increased stress levels
• Mood changes
• Sleep problems
• Sore breasts
• Weight changes

Birth Control Patches 

Patches can irritate your skin and cause spotting, or bleeding between periods. This method can also raise your risk of blood clots and stroke.

Birth Control Pills 

The pill can cause side effects, such as:

• Headaches
• Nausea
• Sore breasts
• Spotting

Some types of pills that contain more than one hormone can increase your risk of blood clots and high blood pressure. These health conditions can lead to a stroke or heart attack.

Birth Control Shots 

Birth control shots can cause irregular bleeding. You may also have longer periods or spotting in the first year. Some people report weight gain as a side effect. Weight gain is usually less than five pounds on average.

IUDs 

IUDs come in two forms: copper and hormonal. The copper IUD may cause painful periods and bleeding for the first few months. You may see spotting, more days of bleeding, and heavier bleeding at first if you opt for a hormonal IUD.

Other side effects include:

• Headaches
• Mood changes
• Nausea
• Sore breasts

IUDs can increase the risk of an ectopic pregnancy or when the fertilized egg implants outside of the uterus. An ectopic pregnancy is a severe concern that requires immediate medical treatment.

Spermicide 

Spermicide can irritate the vagina. A healthcare provider might advise spermicide if you have sex with only one person and that person does not have human immunodeficiency virus (HIV).

Vaginal Rings 

Vaginal rings may cause side effects like:

• Changes in sex drive
• Diarrhea
• Headache
• Increased vaginal discharge
• Sore breasts
• Vaginal infection or irritation
• Vomiting
• Weight changes

More severe but uncommon side effects include chest pain, shortness of breath, and depression. Vaginal rings pose the same risks as the pill, namely an increased risk of blood clots and high blood pressure.

Choosing Birth Control

The best method of birth control for you is one that is safe, that you are OK using, and that you can use right all the time. Your chosen method of birth control may change over time. And the following factors affect your choice:

• Your age and health history.
• Whether you want to have children, how many you want, and when you want to get pregnant.
• The people you have sex with, including how many sexual partners you have, how often you have sex, and what a partner prefers.
• Your religious beliefs and cultural practices.
• How well a birth control method prevents pregnancy, side effects, cost, and whether the method prevents sexually transmitted infections.

To decide which type of birth control is right for you, know your choices, know yourself, and know your partner.

How to use birth control

You can buy condoms and some types of emergency contraception over the counter. Most other birth control methods require planning.

A healthcare provider will let you know how to use birth control based on the type:

• Birth control patch: A healthcare provider will place the patch on your upper body, lower abdomen, upper outer arm, or buttocks. You’ll change the patch once per week for three weeks, take a week-long break, and then apply a new patch.
• Birth control pill: You’ll take the pill every day, ideally at the same time, for 21 days. You’ll then get your period during the fourth week.
• Birth control shot: You’ll need to receive a shot every three months. A healthcare provider often gives the shot. Some shots are available to administer at home.
• IUD: A healthcare provider inserts the IUD during a quick procedure. A copper IUD is effective right away and will stay in place for up to 10 years. A hormonal IUD starts working in seven days and will be effective for three to seven years.
• Vaginal ring: A healthcare provider provides the ring. You’ll place the ring in your vagina and leave it for three weeks. You’ll take the ring out for seven days and then put in a new one.

The pill, patch, and vaginal ring give you the option of having a period. You usually use the method for three weeks and have your period the fourth week. You may use birth control continuously to skip your period. It’s best to run it by a healthcare provider first if you are considering using birth control to skip your period.

How To Prevent Pregnancy?

Birth control is not foolproof. You’ll need to know how to use birth control correctly for it to work as well as it’s supposed to. A healthcare provider can provide advice and guidance on how to use birth control properly.

Here’s how to avoid some of the most common mistakes:

• Birth control patch: Do not use tape or gauze to hold the patch in place if it comes even partially loose. Replace it with a new one right away. You’ll need to use a backup form of birth control for one week if the patch is loose for more than 24 hours.
• Birth control pill: Know when you last had your period. You’ll have instant protection against pregnancy if you start the pill within five days of your period. The pill will take about one week to start working if not.
• Condoms: Toss condoms if you have had them sitting in your wallet or purse for a long time. They can get damaged and become less effective.
• IUD: Use another type of birth control for seven days after a hormonal IUD insertion. You may feel a tiny, slippery string at the top of your vagina. Do not tug or pull it. The string is how a healthcare provider will remove the IUD when it’s time.
• Vaginal ring: Take out the ring right away if you accidentally leave it in for more than four weeks. Use condoms for the next seven days. Talk with a healthcare provider if you have had unprotected sex within the last five days. You may want to use emergency contraception.

Do the methods protect against sexually transmitted infections?

Condoms are the only methods of birth control that help protect against sexually transmitted infections. Use condoms unless you know that neither you nor your partner are having sex with anyone else and you’ve both been tested for sexually transmitted infections. Use a new condom every time you have sex. You can use condoms with any other method of birth control you use.

Will I be able to get pregnant when I want to?

If you want to get pregnant anytime soon, you may want a method that you can stop quickly. Such methods include short-acting hormonal methods or barrier methods. If you want to keep from getting pregnant for a longer time, you might choose a long-acting method, such as an IUD.

You might want different types of birth control at different times in your life. If you know that you don’t want to get pregnant ever, you may prefer a lasting method, such as sterilization.

Other Uses for Birth Control?

The main use of birth control is to prevent pregnancy, but some types can help you out in other ways. Hormonal methods, for example, like the pill, patch, shot, and some IUDs, can help with:

• Acne
• Anemia, or low iron levels
• Heavy or irregular periods
• Painful periods
• Premenstrual syndrome (PMS)

Latex condoms are the only type of birth control that offers protection against sexually transmitted infections (STIs). STIs include gonorrhea, chlamydia, and HIV. Condoms can also lower your risk of genital herpes, syphilis, human papillomavirus (HPV), and HPV-related diseases like cervical cancer.

Conclusion

Learning about birth control options can help you choose what works best for your needs. Some things to consider include how often you have sex, your overall health and your plans for children. Other important factors are convenience and cost. Certain birth control options require daily upkeep, like taking a pill, to be effective. Other methods, like an IUD, are “get it and forget it” because they last for years. A healthcare provider can help you compare your options and understand the benefits and risks of each.