Tuune’s ultimate no-nonsense guide to birth control methods (yep, all 17 of ‘em)

It can be pretty darn confusing trying to figure out which birth control method is right for you. 

With hormonal options and non-hormonal options, long-acting or short-acting, regimens AND effectiveness to think about, it can feel, well... overwhelming.

We know it can be tough trying to get all of the information you need to make an objective, informed decision, especially as sex education is only mandatory in 22 US states (1). 

But don’t despair, we’ve got you covered. We put together this totally no-nonsense ultimate guide to give you all the basic information you need on all 17 different types of birth control.

So if you’re searching for answers to questions like ‘what is the most effective birth control method?’, or ‘which types of birth control stop periods’, you’ve landed in the right place. 

We’ll also be publishing detailed articles on each method over the next few months so remember to check back for more or let us know what you want to hear about.

Let’s get into it…

Types of hormonal birth control 

There are lots of different types of hormonal birth control, but each of them do preeetty much what they say on the label—they use hormones to prevent pregnancy. 

Hormonal birth control methods contain different types of synthetic hormones—which are essentially (wo)man made versions of our naturally occurring female sex hormones, estrogen and progesterone (2). 

There are two different categories of hormonal birth control: 

1. Combined Hormonal Contraceptives (CHCs): These can contain synthetic versions of both estrogens (like Ethinyl Estradiol) and progesterone (progestins), but some more modern CHC’s use natural forms of estrogen (like Estradiol) with progestins (3,4).
   
   

2. Progestogen-only Hormonal Contraceptives: You guessed it, progestogen-only methods only contain synthetic versions of progesterone, known as progestins (5).

Let’s take a look at each of these and their methods in turn.

Combined hormonal contraceptives (CHCs)

The pill

Combined oral contraceptives (COC’s), or simply, ‘the pill’, are one of the most common types of birth control and there are literally 100s of different COC brands.

Containing both synthetic versions of estrogen and progesterone, combined pills prevent pregnancy by suppressing ovulation, thickening  cervical mucus (making it harder for sperm to swim through) and thinning the lining of the womb (making it harder for eggs to attach) (6).

COCs can be taken on a whole loaaad of different types of regimen (how often you have a pill break...if at all). A common myth is that you need to have a withdrawal bleed on the pill— you don’t (and we’ve got the Pope to thank for that one…) (7).

The pill needs to be taken at around the same time every day (some have a more flexible window than others) which counts as ‘perfect use’. When used perfectly it’s pretty decent 99% effective (8), 91% when used ‘typically’ (give or take a few forgotten pills here or there). Pills offer no STI protection though, so be sure to use condoms if ya need to.

The combined patch 

The combined patch, or simply ‘the patch’, is a small (roughly 2”x2”) square patch that is applied to the skin (usually on the upper arms or leg) where it releases a steady dose of synthetic estrogen and progesterone into the blood every 24 hours.

Similarly to the pill, the synthetic hormones in the patch help to prevent pregnancy by suppressing ovulation, thickening cervical mucus and thinning the lining of the womb (6). Patches are 91% effective ( 9), but offer no STI protection.

If you’re thinking ‘but what if it falls off?’, rest assured, this is pretty rare (they’re very sticky). You’ll need to remove it every 3 weeks before a patch-free week (with a side order of withdrawal bleed) and then pop on a new one after the patch-free week. Bonus—you can do this yourself at home. 

The vaginal ring

A small silicone ring-shaped device that you insert into the vagina just below the cervix, where it releases a steady dose of synthetic estrogen and progesterone into the bloodstream every 24 hours.

Again, it works by suppressing ovulation, thickening cervical mucus and thinning the linings of the womb (6). Same as the patch, the ring lasts for 3 weeks before you need to take it out for a ring-free withdrawal bleed week before inserting it again for the next cycle.

There are two different types of vaginal rings available in the US. Annovera, which if you’re green is the more sustainable option as you can reuse it for up to a year, and Nuvaring, which you’ll need to replace each cycle.

The good news is, you can insert the ring yourself, so no need for those annoying trips to the nurse. If you’re thinking ‘but what if it falls out?’, don’t worry your cervix has got ya, it’s pretty sturdy up there. Also if you’re worrying ‘but won't I/my partner feel it during sex?’ If inserted properly you/your partner shouldn’t feel a thing.

It’s 91% effective (10), but again, sans STI safety—so wrap up.

Progestogen-only hormonal contraceptives

The mini pill

The progestogen-only pill (POPs) or ‘mini-pills', only contain synthetic versions of the hormone progesterone (progestins). POPs work in a similar way to COCs by thickening cervical mucus (keeping sperm away) and by suppressing ovulation (keeping eggs at bay) (8).

POPs containing older forms of progestin (like levonorgestrel) do not always completely suppress ovulation (11,12). But most modern POPs that contain a newer form of progestin (drospirenone) have been found to suppress ovulation in 97% of cycles (pretty poppin’) (11,13).

Most POPs are taken on a continuous regimen, meaning you take your pill packs back to back and don’t get a regular bleed (bingo)—but some newer POPs (like Slynd) can be taken on a 24/4 regimen if you still want a bleed.  POPs are also monophasic, so each pill contains the same amount of progestin, keeping your hormones at a constant, steady level.

Same as COCs, they’re 99% effective when taken perfectly, at around the same time every day (again the perfect use window varies depending on the brand) and 91% with typical use. (8). But same as COCs, no STI protection either. 

Progestogen-only intrauterine system (IUS)

The progestogen-only IUS, or the ‘hormonal coil’, is a small (about 1”x1”) T-shaped plastic device that is inserted into the uterus where it releases a synthetic version progesterone every 24 hours. There are 4 brands of IUS available in the US, Mirena, Kyleena, Liletta and Skyla.

Pretty much the same as all other progestogen-only methods, the synthetic progesterone (levonorgestrel) released from the IUS prevents pregnancy by thickening cervical mucus and completely suppressing ovulation (14).

Generally the IUS makes bleeds lighter, shorter or stops them completely and you shouldn’t get a regular withdrawal bleed (your ‘period’ on hormonal birth control) because progestogen levels are kept at a constant level. However, it’s common to experience spotting and breakthrough bleeds in the first few months after insertion.

The progestogen-only IUS is one of the most effective forms of birth control at 99% and is super low maintenance—once inserted it can last for up to 3-7 years (15). Lots of people worry about the insertion process being painful (although with a good healthcare practitioner and pain medication, you shouldn’t have anything to worry about) and it offers no STI protection.  

Progestogen-only implant

The implant is a small, flexible rod that’s inserted under the skin in the upper arm where it releases a synthetic form of progestogen every 24 hours. Similarly to the IUS and POPs, the implant suppresses ovulation and thickens cervical mucus (16).

Another low maintenance method—it only needs replacing every 3-5 years (depending on the brand) and is up to 99.9% effective (17,18). Nexplanon is the brand available in the US, which lasts up to 3 years and contains the progestin etonogestrel.

Bleeding is a little hit and miss, shorting or completely stopping altogether in some people, whereas others experience regular bleeds (19).  Again no STI protection.

If you’re thinking, ‘but won’t you be able to see it under the skin’, or ‘will I be able to feel it? It’s placed just under the skin, but don’t worry our skin is made of thick stuff—it shouldn’t be visible. You can usually feel it if you rub gently on the skin above it, but it shouldn’t cause discomfort.

Progestogen-only injection

The progestogen-only injection contains a synthetic version of progesterone which is administered via an injection shot every 8-13 weeks (depending on the brand). Depo-provera is the only brand of injection available in the US and only needs a top-up every 12-13 weeks.

The injection raises levels of progestin in contrast to estrogen, which thickens cervical fluid and suppresses ovulation (20).

It’s slightly less effective than the IUS or the implant, coming in at 94% effective (21). Again, bleeds can be hard to predict—lightning or leveling off for some, and regular bleeds for others (22). No STI protection.

Types of non-hormonal birth control

So now that we’re well and truly pally with what's on offer with hormonal birth control methods—let’s check out the flip-side to see what types of non-hormonal birth control are on the menu. 

Non-hormonal birth control is essentially any form of birth control that does not contain synthetic hormones. Non-hormonal birth control choices range from the good ole’ male condom right through to the copper IUD.

The copper intrauterine device (IUD)

The copper IUD, or the ‘copper coil’, is similar to the IUS (hormonal coil) in that it’s a small (1”x1”) T-shaped device that’s inserted into the uterus.

But instead of being made of plastic, it’s made of copper, and releases copper into the womb instead of progestogen. Now, sperm reaaally don’t get on well with copper (like at all), and it makes it near impossible for any sperm to get into the womb let alone anywhere near your eggs (23).

The copper released thickens cervical mucus, making it more difficult for sperm to swim through or survive (they literally drop dead on contact with the copper) (23).

Ovulation is not affected with the copper coil, so you’ll still have periods. For the first few months (up to 6) periods are likely to be heavier, longer and can be more painful (24).

The IUD is one of the most effective forms of birth control at an impressive 99.9% (25) and is one of the longest acting—you only need to get it replaced every 5-12 years (depending on the brand) (25). All in all a solid bit of birth control.

Again, many people worry about the insertion process—but with pain medication, a good caring physician and preparation, there shouldn’t be anything to worry about.

The copper intrauterine ball (IUB)

The copper IUD’s little sister, the copper IUB is the most recent birth control option to be released, making its debut in 2020. Made up of 17 copper pearls linked together within a frame, it forms a small spherical ball shape (about 6” in diameter) (26).

The IUB is inserted into the uterus, where it fits in snuggly and works pretty much in the same way as the copper IUD, by releasing a veery small amount of copper into the womb. The copper zaps any wayward sperms, thickens cervical mucus and suppresses ovulation, all in all preventing pregnancy with a 99.9% effectiveness rate for up to 5 years (27).

Similar to the copper IUD, ovulation is not affected so you’ll still have periods. For the first few months (up to 6) periods are likely to be heavier, longer and can be more painful, but this usually levels off with continued use.

This new ball on the block might be small, but it sure is mighty.

Fertility awareness methods (FAMs)

Also referred to as fertility awareness-based methods (FABs) or natural family planning, these are a collection of methods that work by identifying when in your menstrual cycle you are fertile.

By monitoring of different fertility signals like basal body temperature, thickness of cervical mucus and period tracking, you can identify your ‘fertile window’ and avoid sex or use barrier methods when your eggs are out to get sociable (28).

There are lots of different apps and digital technologies that can help you with fertility awareness, but the caveat is they only come in at 76-88% effective (29). They offer no STI protection, but your normal menstrual cycle isn’t affected—and you’ll bleed however you normally do.

The male condom

Now we’re into the big bad barrier methods. A barrier method of birth control works by physically blocking sperm from entering the womb, rather than relying on internal bodily processes and changes to prevent pregnancy.

The male condom is a tried and tested classic. An external condom made of a thin plastic or latex sheath that’s worn over the penis during sex. Condoms are great because they also protect against STIs (but not 100% of the time—cue condom break). They also don’t interfere with your menstrual cycle, so you’ll bleed like normal.

They come in at 85% effective (30), but can be used alongside other methods to double-dip for STI protection and pregnancy prevention.

The female condom

A little lesser known female alternative to the male condom, the female condom is another barrier method of birth control. A thin plastic lining that’s worn inside the vagina during sex, it also acts by blocking sperm from entering the womb.

You can insert a female condom up to 8 hours before sex but should remove it just after sex and they are single-use. 

Slightly less effective than it’s male counterpart 79% effective (30), but it also offers good STI protection with no change to your monthly menstruation. 

Cervical caps and diaphragms

These delightful sounding contraceptions are soft silicone cups or domes that are inserted into the vagina before sex. They cover the cervix to block sperm from entering the womb in true barrier method style.

They sit higher up than the female condom and need to be used with spermicide (which we’ll come to in a second). Both caps and diaphragms need to be left in for a minimum of 6 hours after sex but left in for no more than 30 hours for diaphragms or 48 hours for caps. 

Spermicides

Spermicides are gels containing a chemical that’s toxic to sperm. You insert them into the vagina, usually via a pessary (which is a kind like a tampon applicator) before sex. The gel blocks sperm from entering the womb by killing them upon contact.  Spermicides don’t protect against STIs and come in at 72- 86% effective (31).

The sponge

The birth control sponge is, well… a sponge that you insert into the vagina before sex. Small, round and made of plastic, the sponge contains spermicide and covers the cervix, zapping and blocking sperm from entering the uterus.

Only 76-88% effective, the sponge also doesn’t have additional STI protection, so it’s best to use a male condom with it if you need to. The only brand of sponge available in the US is the Today Sponge.

If you’re worrying about ‘but won’t it get stuck’, have no fear—the sponge has a fabric loop attached so you can easily take it out.

Withdrawal

Possibly the oldest birth control method in the books, the withdrawal method (often more eloquently referred to as ‘pulling out’) has been being used as far back as our ancestors go. This is when the penis is withdrawn prior to ejaculation, attempting to prevent sperm from entering the womb. Only 78% effective (32), the withdrawal method can be pretty hit and miss, and there is also obviously no protection against STIs.

Female sterilization

Although sterilization may sound like a severe method of preventing pregnancy, female sterilization is actually the most widely used method of birth control globally, making up 24% of all birth control users worldwide (33).

In female sterilization, the fallopian tubes are cut or blocked which prevents eggs from reaching the uterus. A common misconception is that after sterilization your periods stop. This isn’t the case and your monthly menstrual cycle won’t be affected because your hormones are still going with their monthly flux—any eggs you release just won't reach your uterus.

If you’re thinking ‘won’t all the eggs get backed up inside my tubes?!’ No, your body absorbs the egg and breaks it down by other means (an eggs-orcism).

Male sterilization (vasectomy,) on the other hand is less common, making up only 2% of all birth control users worldwide (33). The tubes from the testes are cut which prevents sperm being released.

Emergency birth control 

So we’ve covered birth control methods that you can plan for, but what happens when we’re caught short? It happens to everyone, the condom breaks, you miss a bunch of pills… you know the story. Luckily, there are a couple of really good options for emergency birth control, including both a hormonal and non-hormonal option. 

But it’s worth reminding that emergency birth control shouldn’t be used as a form of ‘everyday' birth control (the clue is in ‘emergency’).

The morning after pill

A one time use pill that can be popped after unprotected sex (or post the dreaded condom break). Depending on the brand (such as Plan B and Ella) the morning after pill needs to be used between 1-5 days after unprotected sex, but the longer after sex the less effective it becomes (34).

Brands vary slightly but most contain a very high dose of synthetic progesterone, which quickly suppresses ovulation, thickens up cervical mucus and destabilizes the uterine lining. This all acts to prevent an egg from reaching or attaching to the womb, or sperm from entering the womb.

Effective between 75-89% of the time (depending on the brand and time after sex)(35), UNLESS the sperm have already gotten friendly with your eggs and a fertilized egg has already implanted. The morning-after pill won’t terminate a pregnancy.

The emergency IUD

A copper coil can also be used as a form of emergency birth control, if it’s inserted up to 5 days post unprotected sex and offers up to 99.9% effectiveness (36). It works the same as any time you get it fitted in a non-emergency situation, but similarly to the morning after pill, it will not terminate a pregnancy if a fertilized egg has already implanted. 

And that’s a wrap!

So there you have it, our tour-de-force of the birth control methods menu. We’ve been through the 17 types (+ the emergency options) but we’ve not even scratched the surface of how many different brands there are. 

Choosing the right birth control doesn’t have to be a headache. If you want to find a birth control method that’s going to work well with your body and goals (yep, remember those matter too), then we're here to help.

Written by

Annalisa Hayes (she/her)

Copywriter at Tuune, Annalisa has worked for various pioneering health-tech startups and healthcare companies with purpose-led missions. Driven by empowering people to take control of their health, she helps make the science behind hormones accessible for our community, so they can make clued-up choices about their healthcare.

Medically reviewed by

Dr. Arushee Prasad, GP, MBBS (she/her)

Dr Arushee Prasad is a GP for NHS England with an MBBS in Medicine and Surgery, and an MRCGP from the Royal College of General Practitioners. Passionate about digital health and algorithmic medicine, Arushee was previously an Algorithmic Medical Doctor for Docly.

Scientifically researched by

Hannah Durrant (she/her)

Hannah is a Biomedical Content Writer at Tuune, with a BSc in Biomedical Sciences from University College London. She is passionate about bringing together the scientific community and the general public by disseminating modern science via digestible, engaging and thought-provoking content.