Originally published March 30, 2010. Updated October 6, 2026, to reflect current contraceptive options, effectiveness rates and terminology.
There are many types of contraceptives available today, from condoms and birth control pills to IUDs and implants. Some are available over the counter, while others require a prescription or a procedure from a healthcare provider.
Choosing the right birth control depends on factors such as effectiveness, convenience, side effects, medical history, whether you want to become pregnant in the future and whether you also need protection from sexually transmitted infections (STIs).
Here are the main types of contraceptives and how they work.
Barrier Methods
Barrier contraceptives physically prevent sperm from reaching an egg.
These include:
- External condoms
- Internal condoms
- Diaphragms
- Cervical caps
- Contraceptive sponges
External condoms are one of the most widely available forms of birth control. According to the CDC, about 13 out of 100 people relying on external condoms become pregnant during the first year of typical use.
Latex external condoms also reduce the risk of HIV and many other STIs when used correctly and consistently. Most other contraceptive methods do not provide STI protection.
Internal condoms may also provide some STI protection, although the evidence is more limited.
Diaphragms and cervical caps are inserted into the vagina before sex and are generally used with spermicide. Their effectiveness varies, and cervical caps are less effective for people who have previously given birth.
Spermicides and Vaginal Contraceptives
Spermicides are products placed inside the vagina before sex to make it more difficult for sperm to reach an egg. They are available in forms including gels, creams, foams, films, suppositories and tablets.
Used by themselves, spermicides are less effective than many other forms of contraception. The CDC estimates a typical-use failure rate of about 21%.
Spermicides are sometimes used with diaphragms, cervical caps or condoms.
Products containing nonoxynol-9 can cause genital irritation, particularly when used frequently. Nonoxynol-9 does not protect against STIs or HIV, and frequent use may damage genital tissue in ways that can increase susceptibility to HIV infection.
Condoms containing spermicide have not been shown to provide better STI or pregnancy protection than condoms without it.
Hormonal Birth Control
Hormonal contraceptives use progestin alone or a combination of estrogen and progestin to prevent pregnancy.
Depending on the method, they may work by:
- Preventing or suppressing ovulation
- Thickening cervical mucus so sperm have more difficulty reaching an egg
- Creating other changes in the reproductive system that reduce the likelihood of pregnancy
Hormonal methods include:
- Combined birth control pills
- Progestin-only pills
- Birth control patches
- Vaginal rings
- Contraceptive injections
- Birth control implants
- Hormonal IUDs
The effectiveness of hormonal birth control varies considerably by method.
With typical use, approximately 7 out of 100 users of birth control pills, patches or vaginal rings become pregnant during the first year. The contraceptive injection has a typical-use failure rate of about 4%.
Implants and hormonal IUDs are significantly more effective because they do not depend on remembering a pill or replacing a device regularly.
Hormonal birth control can cause side effects, but these vary by method and individual. Possible effects may include changes in menstrual bleeding, breast tenderness, headaches, nausea or mood changes.
Some estrogen-containing contraceptives also carry a small increased risk of blood clots and may not be appropriate for people with certain medical conditions or risk factors. A healthcare provider can help determine which hormonal method is appropriate for you.
Hormonal contraception does not protect against STIs.
IUDs
An intrauterine device, or IUD, is a small device placed in the uterus by a healthcare professional.
There are two main types:
Hormonal IUDs
Hormonal IUDs release a small amount of progestin and can remain effective for several years, depending on the product.
Their typical-use failure rate is approximately 0.1% to 0.4%.
Copper IUD
The copper IUD does not contain hormones. Copper interferes with sperm’s ability to fertilize an egg.
Its typical-use failure rate is approximately 0.8%. It can also be used as emergency contraception when inserted within the appropriate time after unprotected sex.
IUDs are among the most effective reversible forms of birth control.
Birth Control Implant
The contraceptive implant is a small flexible rod inserted beneath the skin of the upper arm.
It releases progestin and provides long-term contraception without requiring daily action.
The CDC estimates a typical-use failure rate of approximately 0.1%, making the implant one of the most effective reversible birth control methods available.
Fertility Awareness Methods
Fertility awareness-based methods involve tracking signs of fertility—such as menstrual cycle timing, cervical mucus or body temperature—to identify days when pregnancy is more likely.
Depending on the method and how consistently it is followed, effectiveness varies substantially. The CDC estimates typical-use failure rates ranging from approximately 2% to 23%.
These methods do not protect against STIs.
Permanent Birth Control
Permanent contraception may be appropriate for people who are certain they do not want a future pregnancy.
Options include:
- Tubal surgery
- Vasectomy
Tubal surgery prevents sperm and egg from meeting by closing or cutting the fallopian tubes.
A vasectomy prevents sperm from entering semen. It is not immediately effective; another method of contraception must be used until testing confirms that sperm are no longer present.
Both methods are highly effective, with typical failure rates below 1%.
Which Type of Contraceptive Is Best?
There is no single birth control method that is best for everyone.
When comparing contraceptive options, consider:
- How effective the method is
- How often you need to remember to use it
- Whether you want a hormonal or non-hormonal option
- Possible side effects
- Your medical history
- Whether you may want to become pregnant in the future
- Cost and accessibility
- Whether STI protection is important
If preventing pregnancy is a high priority and you don’t want to think about birth control every day, an IUD or implant may be worth discussing with your healthcare provider.
If STI protection is also important, condoms should be used even when another birth control method is being used.
The Bottom Line
Today’s contraceptive options range from condoms and birth control pills to highly effective long-acting methods such as IUDs and implants.
Effectiveness, convenience and potential side effects vary considerably from one method to another, so the best choice depends on your health, lifestyle and reproductive goals.
A healthcare provider can help you compare your options and choose a method that is safe and appropriate for you.
