Method
Number of pregnancies per 100 women within their first year of typical use1
Side effects and risks*
*These are not all of the possible side effects and risks. Talk to your doctor or nurse for more information.
How often you have to take or use
Abstinence (no sexual contact)
Unknown
(0 for perfect use)
No medical side effects
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")
Less than 1
- Possible pain during recovery (up to 2 weeks)
- Bleeding or other complications from surgery
- Less common risk includes ectopic (tubal) pregnancy
No action required after surgery
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.
Less than 1
- Pain during the insertion of Essure; some pain during recovery
- Cramping, vaginal bleeding, back pain during recovery
- Implant may move out of place
- Less common but serious risk includes ectopic (tubal) pregnancy
No action required after surgery
Permanent sterilization surgery for men (vasectomy)
Less than 1
- Pain during recovery
- Complications from surgery
No action required after surgery
Implantable rod (Implanon®, Nexplanon®)
Less than 1
- Headache
- Irregular periods
- Weight gain
- Sore breasts
- Less common risk includes difficulty in removing the implant
No action required for up to 3 years before removing or replacing
Copper intrauterine device (IUD) (ParaGard®)
Less than 1
- Cramps for a few days after insertion
- Missed periods, bleeding between periods, heavier periods
- Less common but serious risks include pelvic inflammatory disease and the IUD being expelled from the uterus or going through the wall of the uterus.
No action required for up to 10 years before removing or replacing
Hormonal intrauterine devices (IUDs) (Liletta, Mirena®, and Skyla®)
Less than 1
- Irregular periods, lighter or missed periods
- Ovarian cysts
- Less common but serious risks include pelvic inflammatory disease and the IUD being expelled from the uterus or going through the wall of the uterus.
No action required for 3 to 5 years, depending on the brand, before removing or replacing
Shot/injection (Depo-Provera®)
6
- Bleeding between periods, missed periods
- Weight gain
- Changes in mood
- Sore breasts
- Headaches
- Bone loss with long-term use (bone loss may be reversible once you stop using this type of birth control)
Get a new shot every 3 months
Oral contraceptives, combination hormones ("the pill")
9
- Headache
- Upset stomach
- Sore breasts
- Changes in your period
- Changes in mood
- Weight gain
- High blood pressure
- Less common but serious risks include blood clots, stroke and heart attack; the risk is higher in smokers and women older than 35
Take at the same time every day
Oral contraceptives, progestin-only pill ("mini-pill")
9
- Spotting or bleeding between periods
- Weight gain
- Sore breasts
- Headache
- Nausea
Take at the same time every day
Skin patch
(Xulane®)
9
May be less effective in women weighing 198 pounds or more2
- Skin irritation
- Upset stomach
- Changes in your period
- Changes in mood
- Sore breasts
- Headache
- Weight gain
- High blood pressure
- Less common but serious risks include blood clots, stroke and heart attack; the risk is higher in smokers and women older than 35
Wear for 21 days, remove for 7 days, replace with a new patch
Vaginal ring (NuvaRing®)
9
- Headache
- Upset stomach
- Sore breasts
- Vaginal irritation and discharge
- Changes in your period
- High blood pressure
- Less common but serious risks include blood clots, stroke and heart attack; the risk is higher in smokers and women older than 35
Wear for 21 days, remove for 7 days, replace with a new ring
Diaphragm with spermicide (Koromex®, Ortho-Diaphragm®)
12
If you gain or lose than 15 pounds, or have a baby, have your doctor check you to make sure the diaphragm still fits.
- Irritation
- Allergic reactions
- Urinary tract infection (UTI)
- Vaginal infections
- Rarely, toxic shock if left in for more than 24 hours
- Using a spermicide often might increase your risk of getting HIV
Insert each time you have sex
Sponge with spermicide (Today Sponge®)
12
(among women who have never given birth before)
or
24
(among women who have given birth)3
- Irritation
- Allergic reactions
- Rarely, toxic shock if left in for more than 24 hours
- Using a spermicide often might increase your risk of getting HIV
Insert each time you have sex
Cervical cap with spermicide (FemCap®)
233
- Vaginal irritation or odor
- Urinary tract infections (UTIs)
- Allergic reactions
- Rarely, toxic shock if left in for more than 48 hours
- Using a spermicide often might increase your risk of getting HIV
Insert each time you have sex
Male condom
18
- Irritation
- Condom may tear, break or slip off
- Allergic reactions to latex condoms
Use each time you have sex
Female condom
21
- Irritation
- Condom may tear or slip out
- Allergic reaction
Use each time you have sex
Withdrawal — when a man takes his penis out of a woman's vagina (or "pulls out") before he ejaculates (has an orgasm or "comes")
22
- Sperm can be released before the man pulls out, putting you at risk for pregnancy
Use each time you have sex
Natural family planning (rhythm method)
24
- Can be hard to know the days you are most fertile (when you need to avoid having sex or use back-up birth control)
Depending on method used, takes planning each month
Spermicide alone
28
Works best if used along with a barrier method, such as a diaphragm
- Irritation
- Allergic reactions
- Urinary tract infection
- Frequent use of a spermicide might increase your risk of getting HIV
Use each time you have sex
