Method | How Well Does it Work? | How to Use | Pros | Cons |
The Implant (Nexplanon) | >99% | A healthcare provider places it under the skin of the upper arm. It must be removed by a healthcare provider | Long-lasting (up to 5 years)No pill to take dailyOften decreases crampsCan be used while breastfeedingYou can become pregnant right after it is removed | Can cause irregular bleedingAfter 1 year, you may have no period at allDoes not protect again HIV or other sexually transmitted infections (STIs) |
Progestin IUD (Lilleta, Mirena, Skyla, and others) | >99% | Must be placed in uterus by a healthcare provider. Usually removed by a healthcare provider | May be left in place 3-7, depending on which IUD you chooseNo pill to take dailyMay improve period cramps and bleedingCan be used while breastfeedingYou can become pregnant right after it’s removed | May cause lighter periods, spotting, or no period at allRarely, uterus is injured during placementDoes not protect against HIV or STIs |
Copper IUD (Paraguard) | >99% | Must be placed in uterus by a healthcare provider. Usually removed by a healthcare provider | May be left in place for up to 12 yearsNo pill to take dailyCan be used while breastfeedingYou can become pregnant right after it is removed | May cause more cramps heavier periodsMay causeSpotting between periodsRarely, uterus is injured during placementDoes not protect against HIV or other STIs |
The Shot (Depo-Provera) | 94% | Get a shot every 3 months | Each shot works for 12 weeksPrivateUsually decreases periodsHelps prevents cancer of the uterusNo pill to take dailyCan be used while breastfeeding | May cause spotting, no period, weight gain, depression, hair or skin changes, change in sex driveMay cause delay in getting pregnant after you stop the shotsSide effects may last up to 6 months after you stop the shotsDoes not protect against HIV or STIs |
The Pill | 91% | You must take the pill daily | Can be used while breastfeedingYou can become pregnant right after stopping the pills | May cause nausea, weight gain, headaches, change in sex drive – some of these can be relieved by changing to a new brand May cause spotting the first 1-2 monthsDoes not protect against HIV or other STIs |
Progestin-Only Pills | 91% | You must take the pill daily | Can be used while breastfeedingYou can become pregnant right after stopping the pills | Often causes spotting, which may last for many monthsMay cause depression, hair or skin changes, change in sex driveDoes not protect against HIV or other STIs |
The Patch (Ortho-Evra) | 91% | Apply a new patch once a week for 3 weeks, no patch in week 4 | Can make periods more regular and less painfulNo pill to take dailyYou can become pregnant right after stopping the patch | Can increase vaginal dischargeMay cause spotting the first 1-2 months of useDoes not protect against HIV or STIs |
The Ring (NuvaRing) | 91% | Insert a small ring into the vagina. Change ring each month | One size fits allPrivateDoes not require spermicideCan make periods more regular and less painfulNo pill to take dailyYou can become pregnant right after stopping the ring | Can irritate skin under the patchMay cause spotting the first 1-2 monthsDoes not protect against HIV or other STIs |
External Condom | 82% | Use a new condom each time you have sex, use a polyurethane condom if allergic to latex | Can buy at many storesCan put on as part of sex play/foreplayCan help prevent early ejaculationCan be used for oral, vaginal, and anal sexProtects against HIV and other STIsCan be used while breastfeeding | Can decrease sensationCan cause loss of erectionCan break or slip off |
Internal Condom | 79% | Use a new condom each time you have sex, use extra lubrication as needed | Can put in as part of sex play/foreplayCan be used for anal and vaginal sexMay increase pleasure when used for anal and vaginal sexGood for people with latex allergyProtects against HIV and other STIsCan be used while breastfeeding | Can decrease sensationMay be noisyMay be hard to insertMay slip out of place during sexRequires a prescription from your healthcare provider |
Withdrawal (Pull-Out) | 78% | Pull penis out of vagina before ejaculation (that is, before coming) | Costs nothingCan be used while breastfeeding | Less pleasure for someDoes not work if penis is not pulled out in timeDoes not protect against HIV or STIsMust interrupt sex |
Diaphragm (Caya, Milex) | 88% | Must be used each time you have sex, must be used with spermicide | Can last several yearsCosts very little to useMay protect against some infections, but not HIVCan be used while breastfeeding | Using spermicide may raise the risk of getting HIVShould not be used with vaginal bleeding or infectionRaises risk of bladder infection |
Fertility Awareness (Family Planning) | 75% | Predict fertile days by: taking temperature daily, checking vaginal mucus for changes, and/or keeping record a of your periods. It works best if you use more than one of these – avoid sex or use condoms/spermicide during fertile days | Costs littleCan be used while breastfeedingCan help with avoiding or trying to become pregnant | Must use another method during fertile daysDoes not work well if your periods are regularMany things to remember with this methodDoes not protect against HIV or STIs |
Spermicide (Cream, gel, sponge, foam, inserts, film) | 72% | Insert spermicide each time you have sex | Can buy at many storesCan be put in as part of sex play/foreplayComes in many forms: cream, gel, sponge, foam, inserts, filmCan be used while breastfeeding | May raise the risk of getting HIVMay irritate vagina, penisCream, gel, and foam can be messy |
Emergency Contraception Pills – Progestin EC (Plan B® One-Step and others) and ulipristal acetate (ella®) | 58% – 74% Ulipristal acetate EC works better than progestin EC if you are overweight | Ulipristal acetate EC works better than progestin EC in the 2-5 days after sex. Works best the sooner you take it after unprotected sex. You can take EC up to 5 days after unprotected sex. If pack contains 2 pills, take both together. | Can be used while breastfeedingAvailable at pharmacies, health centers, or health care providers: call ahead to see if they have itPeople of any age can get progestin EC without a prescription | May cause stomach upset or nauseaYour next period may come early or lateMay cause spottingDoes not protect against HIV or other STIsUlipristal acetate EC requires a prescriptionMay cost a lot |