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There are at least a dozen types of birth control to choose from in the U.S. that prevent pregnancy. But it is important to understand which type of birth control fits your needs: Are you looking for hormonal or non-hormonal birth control; birth control that requires one appointment every few years or that you take every day; or birth control that also protects against sexually transmitted infections (STIs)? (You may need to use multiple kinds of birth control to meet all of these needs.) Another important factor is whether or not your insurance covers a particular form of birth control and how much it might cost you out of pocket.
The good news is that organizations like Planned Parenthood and other local nonprofit organizations can help you access birth control for free or at a very low cost. There is also now a variety of online services that offer virtual consultations with a doctor plus monthly delivery, including Hers, Favor, Lemonaid, Nurx, and Wisp. Plus, over-the-counter (not requiring a prescription) birth control pills may soon be a reality in the U.S. after decades of advocacy. In July, a Paris-based company filed an application with the FDA to bring a progestin birth control pill to market, which, if approved, would be the first of its kind in the U.S. (There are lingering questions, though, about whether this option will be affordable.)
To help you decide which option is best for you, we’ve created a comprehensive list of the kinds of birth control currently available in the U.S.
Birth control implant
The birth control implant (Nexplanon or Implanon) is a small rod, the size of a match, that a health care provider inserts under the skin in your upper arm. It releases progestin, a hormone that prevents you from getting pregnant. It is 99 percent effective and lasts up to five years. To get one, you need a prescription.
Intrauterine device (IUD)
An intrauterine device (IUD) is a small T-shaped device that’s inserted into your uterus—and it’s one of the most effective birth control methods at 99 percent. There are two types of IUDs: hormonal and non-hormonal. The hormonal one (with brand names including Mirena, Kyleena, Liletta, and Skyla) releases progestin into your body. Meanwhile, the non-hormonal one (ParaGard) uses copper, which is toxic to sperm. Hormonal IUDs, depending on the brand, can last up to eight years, while non-hormonal ones can last up to 12 years.
IUDs can also be used as emergency contraception if they’re inserted within 120 hours or five days after unprotected sex. (Some states are now trying to limit access to IUDs after the overturning of Roe v. Wade). A doctor, nurse, or other health care provider can insert the IUD. Talk to your gynecologist or local Planned Parenthood clinic to find out more.
Birth control pills contain hormones that help prevent pregnancy when you take them every day on a schedule. You can choose between combination pills—pills that include both estrogen and progestin—or progestin-only pills. Pills are 91 percent effective. To get birth control pills, you need a prescription from your health care provider or your local Planned Parenthood clinic, though over-the-counter birth control pills may be available soon.
Condoms are tubes, often made of latex, that are worn over the penis during sex or inserted in the vagina (these are often called internal condoms). These tubes serve as a barrier and prevent semen from entering the vagina. Besides helping to prevent pregnancy, they can also help to protect against STIs. Condoms are 85 percent effective at preventing pregnancy and 98 percent effective at preventing most STIs. You can get them easily at any grocery store, pharmacy, or community health center without a prescription.
The vaginal ring is a round, flexible plastic ring (branded Annovera or NuvaRing) that you can insert into your vagina and that prevents pregnancy by releasing hormones. Annovera lasts for a year, but you have to leave it inside for 21 days and then take it out for seven days every month to get a withdrawal bleed similar to your period. It’s 91 percent effective. NuvaRing lasts up to five weeks inside your vagina before you have to take it out for seven days and replace it with a new one.
The shot, mostly known by one of its brand names, Depo-Provera, is a birth control injection with progestin, administered every three months. You can either have a medical professional give you the injection, or you can do it yourself. To get it, you need a prescription. It’s 94 percent effective.
Small and sticker-like, the patch is a birth control that you attach to your skin. It releases both estrogen and progestin into your bloodstream to prevent pregnancy (similar to combination birth control pills). You can wear the patch 21 days at a time before you have to remove it for a week to get your period. To get it, you need a prescription. The patch is 91 percent effective.
A hormone-free birth control option, the sponge is a small, round, squishy plastic device that you can insert into your vagina up to 24 hours before sex. It protects against pregnancy by covering your cervix, which blocks the entrance of sperm into your uterus, and by slowing sperm down through its spermicide coating. You don’t need a prescription to get it, though Today Sponge—the only brand in the U.S.—says it’s having production issues, so the product is out of stock. The sponge is between 76 and 88 percent effective.
The diaphragm is a small cup made of silicone that you place inside your vagina to cover your cervix during sex and prevent sperm from entering. It’s 88 percent effective, but it should be used with spermicide to function properly.
Spermicide is a chemical that comes in the form of a foam, gel, cream, film, or suppository (an insert that dissolves in the vagina). Spermicide forces sperm to stop moving, preventing it from reaching an egg. You put it inside your vagina before sex. You don’t need a prescription to get it, and it’s 72 percent effective.
Similar to the diaphragm, the cervical cap is a small device made of silicone that you put inside your vagina before sex to cover your cervix and prevent sperm from entering. It is best to use it with spermicide to increase its effectiveness. A prescription is required to get one, and it’s between 71 and 86 percent effective.
Plan B or the morning-after pill
Plan B is an emergency contraceptive that can be used up to 72 hours (three days) after unprotected sex—the sooner you take it, the more effective it is. The most popular over-the-counter brand, Plan B One-Step, prevents the release of an egg or its fertilization. You don’t need a prescription to get Plan B One-Step (you only need one for ella, another brand of the morning-after pill). Plan B is about 87 percent effective, but it shouldn’t be used as a regular birth control method. Emergency contraceptives do not cause abortion; this is one of many debunked myths.