Contraception refers to methods, medications, or devices used to prevent pregnancy. It gives you control over if and when to have children. There are many options, each with benefits, risks, and different levels of effectiveness. Below is a concise overview plus some non-contraceptive benefits.
Non-Hormonal Methods
These work by preventing sperm from reaching the egg. They’re often chosen by people who prefer to avoid hormones or have medical reasons to do so.
Fertility awareness–based methods (FABMs): Track cycles and avoid intercourse during the fertile window. Typical-use pregnancy rates vary widely (~2–23%).
Barrier methods (condoms, diaphragm, sponge): Male/external and female/internal condoms also protect against sexually transmitted infections (STIs).
Copper IUD (non-hormonal): Highly effective, long-acting (FDA-approved for up to 10 years). It can also be used as emergency contraception if placed within 5 days of unprotected sex.
Vaginal acidifying gel (e.g., Phexxi): Used as needed before sex; non-hormonal option.
Hormonal Methods
Estrogen + progestin methods prevent ovulation; progestin-only methods mainly thicken cervical mucus and may suppress ovulation.
Combined oral contraceptives (“the pill”), patch, vaginal ring: Benefits include more regular periods, lighter bleeding, less cramps, reduced PMS, clearer skin, and lower risk of ovarian and endometrial cancer. Estrogen-containing methods are not recommended for some patients (e.g., those with clotting risks).
Progestin-only options:
Progestin-only pill (daily)
Injection (every 3 months)
Etonogestrel implant (Nexplanon): FDA-approved for up to 3 years; placed under the skin of the upper arm.
Levonorgestrel IUDs: release progestin locally inside the uterus.
Long-Acting Reversible Contraception (LARC)
These “set and forget” methods are the most effective reversible contraception, with <1% failure rate.
Hormonal IUDs (Levonorgestrel):
Mirena® and Liletta®: FDA-approved for up to 8 years of pregnancy prevention; Mirena also approved for heavy menstrual bleeding.
Kyleena®: effective up to 5 years.
Skyla®: effective up to 3 years.
Benefits: Hormonal IUDs often lighten or eliminate periods and reduce heavy menstrual bleeding.
Copper IUD: FDA-approved for up to 10 years; also the most effective non-hormonal option.
Implant (Nexplanon): Up to 3 years; quick in-office placement and removal.
Emergency Contraception (EC)
Copper IUD: Most effective EC, placed within 5 days of unprotected sex.
Pills: Levonorgestrel (Plan B) or ulipristal acetate (Ella) — take as soon as possible within 5 days. These do not protect against pregnancy from future sex in the same cycle.
Choosing What’s Right for You
Choosing a method depends on effectiveness, convenience, side effects, your medical history, and whether STI protection is needed. Please remember – only condoms protect against STIs.
Updated U.S. CDC guidelines (2024) emphasize safety-based eligibility (U.S. MEC) and best practices for consistent use (U.S. SPR) to help patients and providers tailor contraception safely and effectively.