Birth Control: What to Know About the Pill, IUD, Ring, Arm Implant, and More

You know what birth control is and does. It can help you plan for your future — whether that involves kids or not. That said, navigating all the different methods out there can be overwhelming. So we broke them all down for you. 

Before we get to all the birth control options and how they work, let’s run through some basic sex-ed concepts. First, here’s how you can get pregnant, in less than 50 words: Sperm meets egg in one of the fallopian tubes. Sperm and egg unite to form the zygote (fertilized egg) which eventually finds a home in the lining of the uterus. If it all goes as planned, you get pregnant. Birth control methods can block parts of that process. 

We’re also going to be throwing around a lot of reproductive terms. As a refresher, here’s a brief list of them: 

• Ovulation: When an egg is released from an ovary, about halfway through a menstrual cycle. If you’re trying to get pregnant, this is the date you want to watch.  

• Contraception: Another way to say “birth control.” 

• Estrogen and Progesterone: Reproductive hormones that the ovaries (and other body tissues) make. Estrogen and progesterone power your period and get the body ready for pregnancy.

• Progestin: A synthetic progesterone-like hormone that can help suppress ovulation and prevent pregnancy. It’s in most hormonal birth control. More on that later.

• Period: The body’s (approximately) monthly way of telling you you’re not pregnant by shedding the lining of the uterus. Normally, it’s triggered by a drop in your estrogen and progesterone levels after ovulation if an egg isn’t fertilized. (Watch the video below for more on your menstrual cycle.)

• Sperm: Male reproductive cells. Millions of them are released in every milliliter of semen. 

• Fallopian Tubes: They connect the ovaries to the uterus. Think of them like pathways for your egg.

• Cervix: The lower part of the uterus that connects to the vagina.

So what are the different types of birth control?

Natural birth control methods

They go by a few different names: Fertility-based awareness methods, the rhythm method, the calendar method, or natural family planning. It’s when you can track your cycle by either using a calendar or app, charting body temperature, or monitoring changes in the consistency of your discharge. With that info, you determine when you’re least fertile and only get it on then. It's about 76% effective. 

• Pros: It doesn’t involve any medications and keeps you in touch with your body.

• Cons: It’s one of the least reliable methods of avoiding pregnancy  — as many as 24% of women get pregnant in the first year they try this. Also keep in mind that it works best on a cycle that functions like clockwork…and may require some major willpower during ovulation. 

The pull-out method 

It’s also called the withdrawal method. Another form of ‘natural’ birth control. The goal: to make sure sperm and egg never meet, by having your partner fire anywhere but inside the vagina. 

• Pros: It requires neither equipment nor chemicals, it’s free, and it doesn’t have any side effects.

• Cons: The pull-out method effectiveness is about 80%. Yep, that means 20% of the time, you could get pregnant. Plus, it requires that you (and your partner) time it right. 

Condoms

Old faithful. Most of the time. Versions of the condom have existed for thousands of years. Today, around 10% of women in their 20s and 30s use them. Both the male and female condom (which is significantly less popular) block sperm from getting through to the eggs. Other barrier options include the female birth control sponge, cervical cap, and diaphragm. Barrier methods are around 80% effective depending on the one you choose. 

• Pros: Condoms are a cheap birth control option. They’re available at most pharmacies and grocery stores, and can protect you from some STIs.

• Cons: They can rip or slip off. They can also cause irritation if you have a latex allergy. In that case, you can look for non-latex versions. 

Emergency contraceptive pill

You might know it as the “morning-after pill.” Important note: It is not the same as the abortion pill. Emergency contraception releases progestin that prevents or temporarily delays ovulation. Despite what its nickname implies, it can prevent pregnancy up to a few days after sex. But the sooner it’s taken, the better. EC pills can be up to 90% effective when taken within 72 hours of unprotected sex. 

• Pros: It’s usually available over the counter if plan A for birth control falls through. (How do you think Plan B got its name?) 

• Cons: Side effects include nausea, fatigue, headaches, a temporary change in your period, spotting, and cramps. Even though it typically doesn’t impact future fertility, it’s not recommended to be used as your primary BC method. Also, it’s less effective than other types of birth control — and not effective at all if you’re already ovulating at the time of unprotected sex. It also has weight restrictions. 

Birth control shot

It’s an injection that you get every three months, usually in the butt. It releases progestin to stop the ovaries from releasing eggs and thicken the cervical mucus so sperm can’t get to the egg. It’s about 94% effective. 

• Pros: You don’t have to think about your birth control on most days. 

• Cons: Similar to birth control pills, you have to get the shot regularly and on time for it to work. 

The patch or vaginal ring

The ones you stick in or on regularly. They release your favorite hormones, progestin and estrogen, to prevent pregnancy. The patch looks like a square bandage and stays on your arm for a week, before you replace it with a new one. Alternatively, the flexible ring goes into your vagina, typically for three weeks at a time, and then it’s out for a one-week break. (If it’s Nuvaring, it goes in the trash. Annovera rings are washed and put back in.) When they’re used correctly, the patch and ring are each about 99% effective.

• Pros: Once you get used to it, they’re easy to apply and remove yourself. You also don’t have to think about it daily and it’s less likely to cause irregular bleeding.

• Cons: They’re not recommended for smokers and women older than 35, and could cause headaches, irritation, and breast tenderness. 

The pill

The popular kid. It’s the most commonly prescribed contraceptive. If used perfectly, it can be 99% effective. There are two main kinds: the combination pill (estrogen and progestin) and the “minipill” (only progestin). The hormones in the pill can prevent your ovaries from producing an egg, thicken the mucus in the cervix, and thin the uterine lining. All to stop sperm from swimming to an egg. The mini pill is best for people who can’t take estrogen for health reasons. 

• Pros: Some pills are known to regulate your menstrual cycle and can reduce acne. Plus, all you have to do is stop taking it when you want to start trying to have a baby. You can start trying right away, though your cycle might not be totally regular at first. One more win: Women who have used the pill may be at lower risk for ovarian and endometrial cancer.

• Cons: If you don’t take it at the same time every day, it’s less effective. So set those phone alarms. As with other combined hormonal methods, it can increase your risk of blood clots. Some pills can cause side effects such as depression, weight gain, headaches, acne (it can go both ways), and decreased libido. 

IUD

It stands for intrauterine device. That’s because it hangs out in the uterus, where it releases progestin. That does a few things: Thickens mucus in the cervix to stop sperm from coming in, thins the lining of the uterus so eggs don’t stick around, and sometimes suppresses ovulation. There’s also a non-hormonal version of the IUD that is wrapped in copper, which is toxic to sperm. Both versions need to be implanted by a doctor, and can be removed once you want to start trying to conceive. About 14% of women in their 20s and 13% of women in their 30s have one.

• Pros: It’s more than 99% effective and it’s a LARC (long-acting reversible contraceptive). That means it’ll do its thing without much maintenance for three to five years for the hormonal IUD, and 10 years for the copper IUD. 

• Cons: IUD insertion and removal can be painful. They can also cause cramping, ovarian cysts, and changes to your period — in some cases stopping them completely (though some people may consider that a pro). In rare cases, the IUD can move and cause complications. 

The implant

A tiny rod that goes in your upper arm. It releases progestin to block pregnancy (sound familiar?). It halts ovulation, thickens cervical mucus, and thins the lining of your uterus. The implant stays in place for up to three years, and can be removed when you’re ready to get pregnant. 

• Pros: At over 99% effective, the implant is one of the most effective birth control methods out there. 

• Cons: Can cause headaches, dizziness, and breast pain. And it’s not recommended for women with a history of blood clots. 

Getting your (fallopian) tubes tied

It’s what doctors call tubal ligation or female sterilization. A surgeon removes or closes pieces of the fallopian tubes. That keeps eggs and sperm from meeting. According to a CDC survey, nearly 40% of women in their 40s choose this option. 

• Pros: It’s more than 99% effective, making it one of the most foolproof options. 

• Cons: Once you snip, you can’t really go back.

Other birth control options

There are a few new kids on the block. The FDA just approved a contraceptive gel. We are still waiting for something to happen with that remote-controlled contraceptive computer chip that was backed by Bill Gates, and the non-hormonal vaginal ring by the same company. Plus, we’ve still got a long wait before birth control for men is here. 

How much is birth control?

If you’re insured, good news: Most plans cover contraception. Having said that, in 2020, the Supreme Court upheld a ruling that “employers with religious and conscientious objections” didn’t need to provide free contraception to employees. President Biden has emphasized that he wants to expand access to contraception. 

If you’re not insured, you’ll likely have to pay out of pocket for a birth control pill prescription or procedure. Another option is to visit a health clinic or nonprofit like Planned Parenthood for discounted contraception (Power to Decide has a list of centers here). Without insurance, birth control may cost…

Condoms: $6-$12

Patch/vaginal ring: $150-$175

The shot: $200 for the initial injection and $40 or more for follow-up injections 

Birth control pills: Up to $50 per pack 

IUD: Up to $1,300

Implant: Up to $1,300 

Tubal ligation: Up to $6,000

Emergency contraception: Up to $50

Is birth control bad for you?

In general, birth control is considered a safe and effective way to prevent pregnancy for most people. Just like any medication, birth control methods may come with some side effects. ICYMI, you can scroll back up for the pros and cons of each birth control method. 

The reality is that not every method will work for everyone. That’s where you and your doctor come in. You can raise any questions and concerns you have, and choose the option that will work best for you. 

Can you get pregnant on birth control?

Unless your birth control is abstaining from sex, no birth control method is 100% foolproof. They all vary in effectiveness. Example: Natural birth control methods have an 80% effectiveness rate. Whereas birth control pills are 99% effective — and IUDs are even more effective. 

Getting pregnant on some birth control methods poses more of a health risk than others. Pregnancies with an IUD, tubal ligation, and the implant may increase the risk of an ectopic pregnancy. That means the zygote implants in a fallopian tube instead of the uterus. It’s not a viable pregnancy, and it requires immediate medical intervention. So if you think you might be pregnant while on birth control, it’s a good idea to make an appointment with your doctor ASAP. 

Should I be concerned about a potential birth control ban?

Birth control is still legal in the US. Since Roe v. Wade’s reversal in June 2022, there have been concerns of potential birth control bans. And that the same arguments used to overturn Roe v. Wade could be applied to birth control access. Some experts are concerned that IUDs and emergency contraception could be targeted because they can prevent implantation. But for now, birth control hasn’t been impacted by state or federal laws.

theSkimm

Birth control gives you (safe) control over your personal timeline and plans. No birth control method is 100% effective, but if you want to make love without making babies, it can help with that. 

Updated on Mar. 22 to reflect new information.