Alternative Birth Control Methods

Alternative Birth Control Methods
Medically Reviewed by Brunilda Nazario, MD on August 04, 2020
Nonhormonal birth control is any method that doesn’t affect a woman’s hormones. Condoms are a well-known type, but there are many others.
Hormonal contraceptives , like the birth control pill and hormonal implants, change a woman’s hormone levels to keep her body from getting pregnant. They can be convenient and reliable. But they might not be ideal choices for some people for reasons like:
Your chances of getting pregnant in a given year vary widely depending on the birth control method, from less than 1 in 100 for copper T IUDs to more than 1 in 4 for spermicides .
These kinds physically come between a woman’s egg and a man’s sperm.
Outercourse and the pull-out method
Guttmacher Institute: “Contraceptive Use in the United States.”
Options for Sexual Health: “Barrier Methods,” “Hormonal Methods.”
Kidshealth.org: “Birth Control Methods: How Well Do They Work?”
The New England Journal of Medicine: “Contemporary Hormonal Contraception and the Risk of Breast Cancer.”
CDC: “Effectiveness of Family Planning Methods.”
Familydoctor.org: “Urinary Tract Infections.”
American Pregnancy Association: “Cervical Cap.”
Cleveland Clinic: “Birth Control Options.”
Mayo Clinic: “Spermicide,” “Diaphragm,” “Cervical Cap,” “Mirena (hormonal) IUD,” “Contraceptive Implant.”
Cornell Health: “Non-hormonal Methods of Contraception.”
U.S. Department of Health and Human Services Office of Population Affairs: “Male condom.”
American College of Obstetricians and Gynecologists: “Barrier Methods of Birth Control: Spermicide, Condom, Sponge, Diaphragm, and Cervical Cap.”
UpToDate: “Patient education: Birth control; which method is right for me? (Beyond the Basics),” “Patient education: Permanent birth control for women (Beyond the Basics),” “Patient education: Vasectomy (Beyond the Basics.”
American Journal of Public Health : “Outercourse as a safe and sensible alternative to contraceptives.”
Nemours/TeensHealth: “Withdrawal,” “Fertility Awareness.”
U.S. Department of Health and Human Services Office on Women’s Health: “Birth control methods.”
What you should know to prevent pregnancy.
© 2005 - 2022 WebMD LLC. All rights reserved.
WebMD does not provide medical advice, diagnosis or treatment.

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Birth control methods

Centers for Disease Control and Prevention. (2016). U.S. Selected Practice Recommendations for Contraceptive Use, 2016. Morbidity & Mortality Weekly Report; 65(RR-4): 1–66.
Curtis, K.M., Tepper, N.K., Jatlaoui, T.C., et al. (2016). U.S. Medical Eligibility Criteria for Contraceptive Use, 2016. MMWR Recomm Rep; 65(RR-3):1–104.
Food and Drug Administration. (2016). Birth Control: Medicines to Help You.
Food and Drug Administration. (2013). FC2 Female condom .
National Cancer Institute. (2012). Oral Contraceptives and Cancer Risk .
Wright, K.P., Johnson, J.V. (2008). Evaluation of extended and continuous use oral contraceptives . Therapeutics and Clinical Risk Management; 4(5): 905-911.
Fraser, I.S. (2012). Added health benefits of the levonorgestrel contraceptive intrauterine system and other hormonal contraceptive delivery systems. Contraception; 87(3): 273-279.

The Office on Women's Health is grateful for the medical review by:

Food and Drug Administration (FDA) Center for Drug Research and Evaluation (CDER), Division of Bone, Reproductive and Urologic Products (DBRUP) medical staff and Center for Devices and Radiological Health staff
Tessa Madden, M.D., M.P.H., Obstetrician and Gynecologist, Women's Health Center, Center for Advanced Medicine, and Associate Professor, Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri

All material contained on these pages are free of copyright restrictions and maybe copied, reproduced, or duplicated without permission of the Office on Women’s Health in the U.S. Department of Health and Human Services. Citation of the source is appreciated.

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Birth control (contraception) is any method, medicine, or device used to prevent pregnancy. Women can choose from many different types of birth control. Some work better than others at preventing pregnancy. The type of birth control you use depends on your health, your desire to have children now or in the future, and your need to prevent sexually transmitted infections . Your doctor can help you decide which type is best for you right now.
There is no "best" method of birth control for every woman. The birth control method that is right for you and your partner depends on many things, and may change over time.
Before choosing a birth control method, talk to your doctor or nurse about:
Learn about types of birth control that you or your partner can use to prevent pregnancy.
Keep in mind that even the most effective birth control methods can fail. But your chances of getting pregnant are lower if you use a more effective method.
Women can choose from many different types of birth control methods. These include, in order of most effective to least effective at preventing pregnancy:
Number of pregnancies per 100 women within their first year of typical use 1
*These are not all of the possible side effects and risks. Talk to your doctor or nurse for more information.
No action required, but it does take willpower. You may want to have a back-up birth control method, such as condoms.
Permanent sterilization surgery for women (tubal ligation, "getting your tubes tied")
Permanent sterilization implant for women ( Essure® )
The Essure® birth control device will no longer be sold or distributed in the United States after December 31, 2018.
Permanent sterilization surgery for men (vasectomy)
Implantable rod (Implanon®, Nexplanon®)
No action required for up to 3 years before removing or replacing
Copper intrauterine device (IUD) (ParaGard®)
No action required for up to 10 years before removing or replacing
Hormonal intrauterine devices (IUDs) (Liletta, Mirena®, and Skyla®)
No action required for 3 to 5 years, depending on the brand, before removing or replacing
Oral contraceptives, combination hormones ("the pill")
Oral contraceptives, progestin-only pill ("mini-pill")
May be less effective in women weighing 198 pounds or more 2
Wear for 21 days, remove for 7 days, replace with a new patch
Wear for 21 days, remove for 7 days, replace with a new ring
Diaphragm with spermicide (Koromex®, Ortho-Diaphragm®)
If you gain or lose than 15 pounds, or have a baby, have your doctor check you to make sure the diaphragm still fits.
Sponge with spermicide (Today Sponge®)
(among women who have never given birth before)
(among women who have given birth) 3
Cervical cap with spermicide (FemCap®)
Withdrawal — when a man takes his penis out of a woman's vagina (or "pulls out") before he ejaculates (has an orgasm or "comes")
Natural family planning (rhythm method)
Depending on method used, takes planning each month
Works best if used along with a barrier method, such as a diaphragm
Only two types can protect you from STIs, including HIV: male condoms and female condoms. 4
While condoms are the best way to prevent STIs if you have sex, they are not the most effective type of birth control. If you have sex, the best way to prevent both STIs and pregnancy is to use what is called "dual protection." Dual protection means you use a condom to prevent STIs each time you have sex, and at the same time, you use a more effective form of birth control, such as an IUD, implant, or shot.
You can buy these types of birth control over the counter at a drugstore or supermarket:
You need a prescription for these types of birth control:
You will need surgery or a medical procedure for:
Please note that Essure® will not be sold or distributed in the United States after December 31, 2018.
Birth control works to prevent pregnancy in different ways, depending upon the type of birth control you choose:
Yes, hormonal birth control methods, such as the pill, are safe for most women . Today's birth control pills have lower doses of hormones than in the past. This has lowered the risk of side effects and serious health problems.
Today's birth control pills can have health benefits for some women, such as a lower risk of some kinds of cancer. 5 Also, different brands and types of birth control pills (and other forms of hormonal birth control) can increase your risk for some health problems and side effects. Side effects can include weight gain, headaches, irregular bleeding, breast tenderness, and mood changes.
Talk to your doctor about whether hormonal birth control is right for you.
It can, depending on your health and the type of birth control you use. Talk to your doctor to find the birth control method that is right for you.
Different forms of birth control have different health risks and side effects. Some birth control methods that increase your risk for health problems include:
If you smoke and are 35 or older, you should not use hormonal birth control. Smoking tobacco and using hormonal birth control raises your risk for blood clots and high blood pressure. Smoking and high blood pressure are risk factors for a heart attack or stroke . The risk for a heart attack or stroke also goes up as you age.
Maybe. Research shows that hormonal birth control, such as the pill, patch, shot, ring, implantable rod, and hormonal IUD, may help with heavy, painful, or long-term bleeding. These methods can also help you have lighter, shorter periods. 6
Research shows that other benefits of hormonal birth control may include: 6,7
Read more about how birth control can help with the following health problems:
Follow the instructions that came with your birth control about using back-up birth control (such as a condom and spermicide). You also can follow these recommendations from the Centers for Disease Control and Prevention. 1
If you are late or miss a day taking your pill:
If you miss two or more days in a row:
Talk to your doctor if you continue to miss taking your birth control pill or find it hard to take the pill at the same time each day. You may want to consider a different type of birth control, such as an IUD, an implant, shot, ring, or patch that you don't have to remember to take every day.
Not very! About 22 out of 100 women who use withdrawal as their only form of birth control for a year will get pregnant. See the chart above for how this number compares to other methods of birth control.
Withdrawal is when a man takes his penis out of a woman's vagina ("pulls out") before he ejaculates or "comes" (has an orgasm). This lowers the chance of sperm from going to the egg. "Pulling out" can be hard for a man to do. It takes a lot of self-control.
Even if you use withdrawal, sperm can be released before the man pulls out. When a man's penis first becomes erect, some fluid may be on the tip of the penis. This fluid has sperm in it, so you could still get pregnant. Withdrawal also does not protect you from STIs, including HIV.
Breastfeeding can be a short-term method of birth control in very specific situations. The risk of pregnancy is less than 2 in 100 if all three of these describe you: 1
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Alternative Birth Control Methods

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