Hormonal Birth Control Options

Hormonal birth control methods tend to be very popular. You may wish to use hormonal contraception because:

Nonhormonal Birth Control

Nonhormonal birth control is any method that doesn’t affect a woman’s hormones. Condoms are a well-known type, but there are many others.

Why Choose Nonhormonal Birth Control?

Hormonal contraceptives, like the birth control pill and hormonal implants, change a woman’s hormone levels to keep her body from getting pregnant. They can be convenient and reliable. But they might not be ideal choices for some people for reasons like:

• You have to remember to take the pill at the same time every day.
• You need to see a doctor for prescriptions or to insert the device.
• They don’t protect you from sexually transmitted diseases.
• They may raise your chances for blood clots or breast cancer, or have side effects like mood swings or weight gain.
• You may not have sex often enough to need ongoing birth control.
• You may pass hormones to your baby if you’re breastfeeding.

Types of Nonhormonal Birth Control

Your chances of getting pregnant in a given year vary widely depending on the birth control method, from less than 1 in 100 for copper T IUDs to more than 1 in 4 for spermicides.

Barrier methods

These kinds physically come between a woman’s egg and a man’s sperm.

• What is it? A saucer-shaped silicone cup that you put into your vagina to block semen from entering your womb. You must be fitted for a diaphragm at first by your doctor.
• How well does it work? If you use the diaphragm correctly and add spermicide, you have a 6% chance of getting pregnant after a year’s use. But the odds double if you don’t always use it or don’t use it exactly right, the way a typical person does.
• Pros and cons. You can carry your diaphragm and put it in just before you have sex. It’s reusable for 12 months. If you decide you want to start a family, stop using it. A diaphragm won’t protect you from STDs. You have to leave it in for at least 8 hours after sex. You also may be more likely to get vaginal or urinary tract infections. Learn about the best ways to prevent a UTI.

Cervical cap

• What is it? It looks like its name: a little hat-shaped piece of silicone that you put over your cervix to keep out sperm. As with a diaphragm, you must be fitted by your doctor and should use it with spermicide.
• How well does it work? It can fail about 20% of the time, meaning 20 out of 100 women who use it will get pregnant in a year.
• Pros and cons. You can leave the cervical cap on for up to 48 hours after sex. You can try to get pregnant anytime. The cervical cap isn’t widely prescribed, and it can take practice to use it right. It won’t prevent STDs. It can raise your chances of bladder infections. It’s not recommended if you have sex at least three times a week or have a history of pelvic diseases. Read more on how a cervical cap works.

Sponge

• What is it? Made of foam, it works the same way as a diaphragm or cervical cap. The two big differences are that the sponge already contains spermicide, and you can buy it without a prescription.
• How well does it work? The sponge can be among the least reliable birth control for some people. It prevents pregnancy about 91% of time for women who’ve never given birth and who use it correctly and consistently every time. But that drops to just 76% for women who have had children and who use it the way most people do.
• Pros and cons. The polyurethane foam feels like your vaginal tissue. You can have sex multiple times in a 24-hour period with one inserted. You can stop using it and try to start a family right away. It won’t prevent STDs. Find out more on how to use the birth control sponge.

Copper IUD

• What is it? This T-shaped plastic piece is a nonhormonal type of intrauterine device. It goes into your uterus. It’s wrapped in copper, which is toxic to sperm and keeps them from swimming through the vagina to reach your egg. Failing that, it prevents the fertilized egg from attaching to your womb.
• How well does it work? IUDs are some of the best-working forms of birth control. Copper versions are less effective than hormone-based IUDs, but they still prevent conception more than 99% of the time.
• Pros and cons. You can leave a copper IUD in for 10 years. It can work as emergency contraception up to 5 days after you’ve had unprotected sex. If you decide you want to get pregnant, you’ll need a doctor to take it out. It doesn’t protect against STDs. The device can cause cramps or bleeding between periods. Get more information on the copper IUD and other intrauterine devices.

Spermicide

• What is it? You put this chemical into your vagina to kill or paralyze sperm. You can buy spermicide over the counter in several forms, including gels, foams, and suppositories.
• How well does it work? Spermicide alone can fail about 28% of the time. You can use it with condoms, diaphragms, and other contraceptives to boost their effectiveness.
• Pros and cons. Some people are allergic or sensitive to the main chemical used in spermicide, nonoxynol-9. You shouldn’t rinse out your vagina for at least 8 hours after using a spermicide, and some may leak out. It won’t protect you against STDs like HIV. In fact, infections might be more likely if the spermicide irritates your vagina. Know more about the effectiveness of spermicides.

Vaginal gel

• What is it? You use an applicator to put this gel in your vagina before sex. It keeps the pH level in the vagina from rising and allowing the sperm to move to the reproductive canal to get to the egg.
• How well does it work? It’s considered 86% effective. You might use it with condoms, diaphragms, or other contraceptives to boost their effectiveness.
• Pros and cons. It must be used before sex and reapplied within the hour if you don’t have sex. It also needs to be reapplied with each sexual encounter. Some people are allergic or sensitive to it, and it can cause infections or irritation. It won’t protect against STDs like HIV.

Male condom

• What is it? A thin sheath, often made of latex, that a man wears over his penis during sex to keep semen from getting into a woman’s body.
• How well does it work? It’s about 82% effective at preventing pregnancy.
• Pros and cons. Condoms are the only forms of birth control that guard against unplanned pregnancies and STDs, including HIV. They’re easy to find in stores or online. Some health clinics offer them for free. You don’t need a prescription to buy them. You can use them at any time and with little preparation. You must follow the instructions carefully for a male condom to be effective. Learn more about how to use a male condom.

Female condom

• What is it? A lubricated latex tube that you put inside your vagina. It has flexible rings on both ends. One end is closed to keep out sperm.
• How well does it work? In a given year, about 1 in 5 women who use female condoms get pregnant.
• Pros and cons. Female condoms also protect against STDs. You can buy them in drugstores or online. Allergies and side effects are rare. It may not be a good choice if you’re young or have a lot of sex and have a higher chance of getting pregnant. You have to use it every time and in the right way for it to work well. Find out more on how to use a female condom.

Surgical methods

Sterilization

• What is it? There are two types of sterilization surgeries. The first, called tubal ligation, blocks a woman’s fallopian tubes to prevent an egg from reaching her uterus. The second, called a vasectomy, seals the tubes that carry sperm out of a man’s testes.
• How well does it work? Both are almost 100% effective.
• Pros and cons. You may be able to “reverse” a vasectomy, but a tubal ligation is permanent. Sterilization doesn’t prevent STDs. As with any surgical procedure, there’s a risk of complications such as bleeding and infection. Get more information on birth control and sterilization.

Behavioral methods

Outercourse and the pull-out method

• What is it? “Outercourse” is sex in which the man’s penis doesn’t go into the woman’s vagina at all. In the withdrawal or “pull-out” method, he pulls out of her vagina before he ejaculates.
• How well does it work? There’s no risk of pregnancy with outercourse. But the pull-out method isn’t very reliable. Of 100 women who use it as their only birth control, about 22 will get pregnant.
• Pros and cons. Both methods are simple and free. If there’s no vaginal, oral, or anal penetration, outercourse carries a very low risk of STDs. The pull-out method doesn’t protect against STDs. It can also be difficult for the man to get the timing right. Read more about the withdrawal method.

Natural family planning

• What is it? A woman tracks her menstrual cycle, including her vaginal discharge and body temperature, so she can know which days she’s fertile. She then skips sex or uses a barrier method on those days. It’s also known as the rhythm method or fertility awareness.
• How well does it work? Of 100 women who use this method, up to 23 will get pregnant.
• Pros and cons. There are no side effects. It’s best for women who have very regular cycles, but it can still be hard to tell when exactly you’re ovulating. You have to be dedicated about monitoring your body and keeping records. It doesn’t protect against STDs. Know more about natural family planning methods for birth control.

Show Sources

Guttmacher Institute: “Contraceptive Use in the United States.”

Options for Sexual Health: “Barrier Methods,” “Hormonal Methods.”

Kidshealth.org: “Birth Control Methods: How Well Do They Work?”

The New England Journal of Medicine: “Contemporary Hormonal Contraception and the Risk of Breast Cancer.”

CDC: “Effectiveness of Family Planning Methods.”

Familydoctor.org: “Urinary Tract Infections.”

American Pregnancy Association: “Cervical Cap.”

Cleveland Clinic: “Birth Control Options.”

Mayo Clinic: “Spermicide,” “Diaphragm,” “Cervical Cap,” “Mirena (hormonal) IUD,” “Contraceptive Implant.”

Cornell Health: “Non-hormonal Methods of Contraception.”

U.S. Department of Health and Human Services Office of Population Affairs: “Male condom.”

American College of Obstetricians and Gynecologists: “Barrier Methods of Birth Control: Spermicide, Condom, Sponge, Diaphragm, and Cervical Cap.”

UpToDate: “Patient education: Birth control; which method is right for me? (Beyond the Basics),” “Patient education: Permanent birth control for women (Beyond the Basics),” “Patient education: Vasectomy (Beyond the Basics.”

American Journal of Public Health: “Outercourse as a safe and sensible alternative to contraceptives.”

Nemours/TeensHealth: “Withdrawal,” “Fertility Awareness.”

U.S. Department of Health and Human Services Office on Women’s Health: “Birth control methods.”

Hormonal Birth Control Options

Dawn Stacey, PhD, LMHC, is a published author, college professor, and mental health consultant with over 15 years of counseling experience.

Updated on March 28, 2020

Anita Sadaty, MD, is board-certified in obstetrics-gynecology. She is a clinical assistant professor at Hofstra Northwell School of Medicine and founder of Redefining Health Medical.

Hormonal birth control refers to birth control methods that contain synthetic forms of hormones. These contraceptives mimic the naturally-occurring hormones produced in a woman’s body. Hormonal birth control must be prescribed by your healthcare provider.

Types of Birth Control

There are two types of hormonal birth control:

1. Combination Hormonal Birth Control: Combination birth control is methods that contain both synthetic estrogen and some type of progestin.
2. Progestin-Only Birth Control: These methods are contraceptives that only contain progestin and are good options if you cannot use birth control that contains estrogen.

Hormonal birth control methods tend to be very popular. You may wish to use hormonal contraception because:

• These methods are reversible (with the exception of Depo Provera). This means that your fertility (or ability to get pregnant) quickly returns once you stop using them.
• Hormonal birth control is convenient and easy to use.
• Many of these methods have some of the lowest failure rates (when used correctly), so they are very effective.
• Hormone birth control can offer you many non-contraceptive health benefits as well (like helping with bad menstrual cramps or reducing acne).  

Here is a list of all of the available hormonal birth control methods for you to use. The first three are combination methods and the rest of the list are progestin-only hormonal birth control options.

Combination Birth Control Pills

Combo birth control pills must be taken every day, at the same time. They contain Ethinyl estradiol and one of the following types of progestin: norethindrone, norethindrone acetate, ethynodiol diacetate, levonorgestrel, norgestrel, desogestrel, norgestimate, or drospirenone. Each of these progestins has its own profile based on its progestational, estrogenic, and androgenic effects on your body. There is also a new combination birth control pill called Natazia—this is the only pill that contains estradiol valerate and the progestin, dienogest. Combination birth control pills are also categorized as monophasic, biphasic or triphasic—this is based on how the hormones are distributed over the weeks in each pill pack. There are also extended cycle combination pills.  

NuvaRing

The NuvaRing is a combination contraceptive that must be inserted into the vagina. Once inserted, it gradually releases Ethinyl estradiol and the progestin, etonogestrel. You insert NuvaRing and leave it in place for three weeks. On Week 4, you take it out—this is when you should have your withdrawal period.  

The Patch

The birth control patch is applied to the skin. It releases Ethinyl estradiol and the progestin, norelgestromin directly through the skin. You need to replace the patch every week (for three weeks). During Week 4, you keep the patch off.  

Nexplanon

Nexplanon is a progestin-only birth control insert that contains 68 mg of the progestin, etonogestrel. This single rod is inserted into your upper arm where the progestin is slowly released. The implant also contains radiopaque (this is so it can be easily seen on an X-ray to make sure that the rod has been properly placed). It is considered to be a long-acting, reversible contraceptive (LARC)—once Nexplanon is inserted, it provides pregnancy protection for up to three years.

Depo Provera and Depo-subQ Provera 104 Injection

Depo Provera and Depo-subQ Provera 104 are hormonal contraceptive injections. Both depo shots are similar—each injection slowly releases the progestin, medroxyprogesterone acetate. You must get a Depo Provera injection every 11 to 13 weeks (Depo-subQ Provera 104 injections must happen every 12-14 weeks). If you use Depo Provera, you basically need to have four injections each year. Like all hormonal birth control methods, Depo Provera does have some side effects. Many women stop using Depo Provera because of the side effects (like irregular or continuous bleeding). There is no way to know before starting Depo Provera if you will have any of these side effects. The good news about Depo Provera—it has been FDA-approved to help treat endometriosis.

Mirena IUD

Mirena is a type of IUD. Mirena releases the progestin, levonorgestrel (20 mcg a day). Mirena is inserted into your uterus by a healthcare provider. Once inserted, it can be left in place for up to seven years. All you need to remember to do is check the Mirena IUD strings—this will tell you that your Mirena is still in place. Because it has progestin, Mirena is a little more effective than the ParaGard IUD. Besides being used as contraception, Mirena has been FDA-approved to help treat heavy periods. You can also have your Mirena IUD removed at any time before the 7-year timeframe is over.

The Mini-Pill

The mini-pill is a progestin-only type of birth control pill. They are known to cause fewer side effects than combination pills. Because they do not contain estrogen, the mini-pill is a good birth control option for new moms who are breastfeeding. The mini-pill come in 28-day packs—you need to remember to take one of these pills every day for each 4-week pill cycle.  

Skyla IUD

Skyla is also known as the mini IUD. Once inserted, Skyla releases the progestin levonorgestrel (14 mcg a day)—Skyla lasts for three years. The Skyla IUD is considered a great hormonal birth control option for teenagers and women who haven’t given birth. The Skyla IUD (and the tube used to insert it) is smaller than Mirena and ParaGard. This makes Skyla a little bit easier and less painful to insert. Like any IUD, you can also have Skyla removed at any time.

A Word From Verywell

These birth control methods may not be the safest contraception for all women. That’s why it’s important to talk to your healthcare provider and review your medical history carefully.

Be honest during this conversation. Why? Because certain behaviors (like smoking) may put you more at risk for complications while using hormonal birth control.

Also, keep in mind that hormonal birth control:

• Does not provide any protection against sexually transmitted diseases
• May be less effective if you use certain medications
• Could possibly increase your risk of developing a blood clot
• May be less effective if you are very overweight

10 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. Petitti DB, Sidney S. Four decades of research on hormonal contraception. Perm J. 2005;9(1):29–34. doi:10.7812/tpp/04-129
2. Regidor PA. The clinical relevance of progestogens in hormonal contraception: Present status and future developments. Oncotarget. 2018;9(77):34628–34638. Published 2018 Oct 2. doi:10.18632/oncotarget.26015
3. Wieder DR, Pattimakiel L. Examining the efficacy, safety, and patient acceptability of the combined contraceptive vaginal ring (NuvaRing). Int J Womens Health. 2010;2:401–409. Published 2010 Nov 12. doi:10.2147/IJWH.S6162
4. Galzote RM, Rafie S, Teal R, Mody SK. Transdermal delivery of combined hormonal contraception: a review of the current literature. Int J Womens Health. 2017;9:315–321. Published 2017 May 15. doi:10.2147/IJWH.S102306
5. Thew M. Etonogestrel Implant-To Leave or Stay: A Case Series [published correction appears in Glob Pediatr Health. 2018 Apr 11;5:2333794X18770311]. Glob Pediatr Health. 2017;4:2333794X17738844. Published 2017 Nov 21. doi:10.1177/2333794X17738844
6. Halpern V, Combes SL, Dorflinger LJ, Weiner DH, Archer DF. Pharmacokinetics of subcutaneous depot medroxyprogesterone acetate injected in the upper arm. Contraception. 2014;89(1):31-35. doi:10.1016/j.contraception.2013.07.002
7. Bayer HealthCare Pharmaceuticals Inc. Mirena prescribing information.
8. Grimes DA, Lopez LM, Obrien PA, Raymond EG. Progestin-only pills for contraception. Cochrane Database of Systematic Reviews. 2010. doi:10.1002/14651858.cd007541.pub2
9. Nelson AL, Massoudi N. New developments in intrauterine device use: focus on the US. Open Access J Contracept. 2016;7:127–141. Published 2016 Sep 13. doi:10.2147/OAJC.S85755
10. National Research Council (US) Committee on Population. Contraception and Reproduction: Health Consequences for Women and Children in the Developing World. Washington (DC): National Academies Press (US); 1989. 4, Contraceptive Benefits and Risks.

By Dawn Stacey, PhD, LMHC
Dawn Stacey, PhD, LMHC, is a published author, college professor, and mental health consultant with over 15 years of counseling experience.