These days, there are many options for non-hormonal birth control. If you’re looking to avoid unplanned pregnancy and additional hormones, here’s what you should know about your birth control options.
Efficacy
For many people, the efficacy of birth control is the most important factor when choosing a method. Efficacy is how well a birth control method prevents pregnancy. This is measured as the number of people, out of 100, who will get pregnant during a year of using this birth control method and having penis-in-vagina sex.
When researchers calculate the failure rate of birth control, they give two numbers: how many people will become pregnant with perfect use of the birth control, and how many will become pregnant with typical use.
Typical use includes mistakes like missing an occasional pill. It is a better indicator of the efficacy of a method of birth control.
Here’s how effective popular non-hormonal birth control methods are, with typical use:
Copper IUD: 99. 2% effectiveCondoms: 85% effective with male condoms; 79% effective with female condomsPhexxi vaginal gel: 86% effectiveCervical cap: 86% effective for people who have never had a baby; 71% effective for people who have had a babySponge: 86% effective for people who have never had a baby; 73% effective for people who have had a babyDiaphragm (with spermicide): 87% effectiveSpermicide: 79% effectiveFertility awareness method: 77% effective to 98% effectiveWithdrawal: 78% effective
Copper IUD
An intrauterine device (IUD) is inserted into your uterus to prevent pregnancy. There are two types of IUDs approved by the Food and Drug Administration (FDA) for use: hormonal and non-hormonal.
The only non-hormonal IUD, sold under the brand name Paragard, continuously releases a tiny amount of copper, which changes the chemical environment of the uterus so that it’s toxic to sperm and eggs.
In some cases, this can be used as emergency contraceptive: If Paragard is inserted up to five days after unprotected sex, it can be used to prevent pregnancy.
Pros
Lasts for up to 12 yearsMore than 99% effectiveNo daily maintenance Can be used as emergency contraceptiveDiscreet
Cons
No protection from sexually transmitted diseases (STDs)May cause irregular or heavy periodsMust be inserted by a doctor
Side Effects
Pain or cramping on insertionPeriods and cramping may be heavier, particularly in the first three to six monthsIrregular periods
Condoms
Condoms provide a physical barrier between the partners having sex. Male condoms are worn on the penis and are 85% effective with typical use. Internal condoms, also known as female condoms, are inserted into the vagina or anus. They’re 79% effective at preventing pregnancy.
Pros
Provide STD protectionAccessible without a prescriptionCan be used by partners of any sex
Cons
Must be used each time you have sexSome people find them uncomfortableHave the potential for mistakes while usingHave a higher failure rate compared to the copper IUD
Side Effects
Most people won’t experience any side effects from condoms. If you or your partner has a latex allergy, be sure to get latex-free condoms.
Phexxi
Phexxi is one of the newest methods of hormone-free birth control. It is a gel that is inserted into the vagina before having sex. The gel, which doesn’t have any hormones, changes the acidity of the vagina in order to make it difficult for sperm to reach an egg.
Phexxi was approved by the FDA in 2020 and is 86% effective at preventing pregnancy with typical use.
Pros
On-demand useEasy to use, similar to tampon insertion
Cons
Prescription requiredMust use each time, within an hour before having sexDoesn’t protect from STDsLess effective than the copper IUD
Side Effects
Vaginal itching or burningYeast infectionsUrinary tract infectionsAllergic reaction in partnerRarely, kidney or bladder infections
Cervical Cap
A cervical cap is a small piece of silicon that covers the entrance to the cervix, preventing sperm from reaching the egg. Cervical caps are smaller than diaphragms and can be left in place longer.
When used with spermicide, it’s 86% effective at preventing pregnancy for people who have never had a baby and 71% effective for those who have had a baby.
Pros
DiscreetCan be left in for two days
Cons
Must be prescribed and fitted by a doctorCan be tricky to insertMust be used with spermicide for most effectivenessNo protection from STDsLess effective than other non-hormonal options
Side Effects
Most people don’t experience side effects from cervical caps, but you might find the cap uncomfortable, particularly if it’s not inserted correctly or is bumped during sex. The spermicide used with caps can increase your risk for STDs.
Sponge
The sponge is a piece of plastic that blocks the entrance to the cervix, preventing sperm from meeting the egg. It also contains spermicide to kill sperm. It is 86% effective for people who have never had a baby and 73% effective for people who have had a baby.
Pros
No prescription requiredOnce inserted, effective for 24 hours
Cons
Must be made wet before insertionMust be used every timeMay increase risk for STDsLess effective than the copper IUD
Side Effects
Some people using the sponge experience vaginal irritation. This can increase your risk for STDs, so it’s very important to practice safe sex while using the sponge.
Diaphragm
A diaphragm is a plastic cap that covers the opening to your cervix, blocking sperm from getting to the egg. Diaphragms are used with spermicide and are 87% effective.
Pros
Lasts up to two yearsOn-demand use
Cons
Requires prescription and fittingMust be inserted within two hours of sex beginningCan be difficult to placeMust be properly cared for and stored
Side Effects
People who use diaphragms are at increased risk for urinary tract infections (UTIs). The spermicide used with diaphragms can increase your risk of STDs.
Spermicide
Spermicide is a cream or gel that is inserted into the vagina where it slows down sperm, making it harder to reach the egg. Used on its own, spermicide is 72% effective. It is more effective when used with other contraceptives such as condoms, diaphragms, sponges, and cervical caps.
Pros
AffordableDoesn’t require a prescriptionDoesn’t interrupt sex
Cons
Has to be applied 15 minutes before sex and reapplied every time you have sex Can be messy Contains Nonoxynol-9, which can irritate the penis or vagina and increases the risk for HIV and other STDs
Side Effects
Spermicide can irritate the genitals, causing vaginal itching, burning, or a rash. It can also cause penile itching or burning urination, and increases the risk of HIV and other STDs.
Natural Family Planning
Natural family planning, also known as the fertility awareness method, involves tracking your natural cycles to avoid pregnancy.
With this method, you use indicators of fertility, like cervical mucus and basal body temperature, to identify your fertile window. During that window, you avoid sex or use a barrier method. Today, you can use a birth control app to make it easier to track your cycle and predict your fertility.
The effectiveness of this method varies widely, ranging between 77% and 98%.
Pros
Both partners can be involvedMay teach you about your bodyBirth control app can make it easier
Cons
More difficult with irregular cyclesRequires backup birth control or avoiding vaginal sex during the fertile windowRequires daily tracking
Side Effects
There are no side effects to the fertility awareness method.
Withdrawal
Also known as “pulling out,” this birth control method involves removing the penis from the vagina before ejaculation occurs. It is 78% effective.
Pros
FreeAlways available
Cons
Can be hard to pull out in time (high margin of error) Precum can contain sperm
Side Effects
There are no side effects to withdrawal.
A Word From Verywell
Selecting birth control is a very personal choice. You should consider how long you want your birth control to last, whether you are OK with something that needs to be applied right before sex, and whether you need protection from STDs.
Today, more non-hormonal birth control options are available than ever before. Your healthcare provider can help you decide which is right for you.
