Your choice of birth-control method is a personal one and depends on a number of variables, including medical history, cost, associated risks, and whether you're looking for a temporary, long-term, or permanent solution. It can feel overwhelming, but we've done some of the work for you. Below, find a quick breakdown of the various contraception methods available now:
Male Contraception
Condom
Cost: $1-10
Failure rate: 18%
Duration: One-time use
Availability: Over the counter
Advantages: Helps prevent STIs; no hormonal side effects; easily disposable; temporary
Disadvantages: Irritation and allergic reaction; possible breakage; weaken when stored at too long or in high temperatures
Vasectomy
Cost: $500-1000
Failure rate: 0.2%
Duration: Permanent
Reversible: Yes, but not guaranteed
Availability: Outpatient surgical procedure
Advantages: Does not affect sexual experience or sex drive, no hormonal side effects
Disadvantages: Does not protect against STIs, not easily reversed, sterilization is not instantaneous; surgical side effects include inflammation, swelling, bruising, and blood clots
Female Contraception
Female condom
Cost: $2-4
Failure rate: 21%
Duration: One-time use
Reversible: Yes
Availability: Over the counter
Advantages: Protects against STIs; easily disposable; can be used during menstruation or after childbirth
Disadvantages: Can be challenging and uncomfortable to insert; may reduce clitoral stimulation and lubrication; can cause irritation or allergic reaction; possible breakage; weakens when used with oil-based lubricants
Spermicide
Cost: $5-10
Failure rate: 28%
Duration: One-time use
Reversible: Yes
Availability: Over the counter
Advantages: May provide additional lubrication; can be used with other forms of contraception; hormone-free
Disadvantages: Does not prevent STIs; must be applied ahead of time; side effects include irritation, urinary tract infections, and allergic reaction
Sponge
Cost: $3-5
Failure rate: 24%
Duration: One sponge lasts for up to 24 hours
Reversible: Yes
Availability: Over the counter
Advantages: Pretreated with spermicide; typically cannot be felt by either partner; hormone-free; can have intercourse multiple times within a 24-hour period without removal or reinsertion
Disadvantages: Irritation; allergic reaction; can be difficult to remove and insert; toxic shock; does not protect against STDs; yeast infection; cannot be used during menstrual cycle
Diaphragm
Cost: $50-300
Failure rate: 5-20% (depending on use)
Duration: Reusable; should be replaced every 1 to 2 years
Reversible: Yes
Availability: Prescription required
Advantages: Protection lasts 24 hours; can have intercourse multiple times without removing or reinserting; reusable
Disadvantages: Can be challenging and uncomfortable to insert; may reduce clitoral stimulation and lubrication; can cause irritation or allergic reaction; weakens when used with oil-based lubricants
Cervical cap
Cost: $50-75
Failure rate: 14 - 30% (Lower for women who have never given birth, higher for women who have)
Duration: Reusable; should be replaced annually
Reversible: Yes
Availability: Prescription required
Advantages: Can protect against pregnancy for 48 - 72 hours (longer than a diaphragm); can have intercourse multiple times without removing or reinserting
Disadvantages: Can cause abnormal pap smears; toxic shock syndrome; does not prevent STIs; cumbersome to insert; side effects include urinary tract infections, pain, swelling, redness, rash, cervicitis; cannot be used during menstruation
Birth Control Pill
Cost: $15-50/month
Failure rate: 9%
Duration: Takes up to 1 month for full effect, then for as long as it is taken daily
Reversible: Yes
Availability: Prescription required
Advantages: Can regulate menstrual cycle and reduce cramps; reduces risk of ovarian cysts; does not impact future fertility
Disadvantages: Must be taken daily; does not prevent STIs; may increase risk of blood clots, stroke, breast cancer, heart attack, high blood pressure, and depression; may decrease sex drive; other side effects include weight gain, chloasma, and allergic reaction
Vaginal ring
Cost: $15-80/month
Failure rate: 9%
Duration: Worn continuously for three weeks out of four weeks then replaced
Reversible: Yes
Availability: Prescription required
Advantages: Easy to insert and remove; can regulate menstrual cycle and reduce cramps; may reduce risk of ovarian cysts; does not impact future fertility
Disadvantages: Must be taken daily; does not prevent STIs; hormones may increase risk of blood clots, stroke, breast cancer, heart attack, high blood pressure, and depression; may decrease sex drive; other side effects include weight gain, chloasma, and allergic reaction
Contraceptive Patch
Cost: $15-80/month
Failure rate: 9%
Duration: Takes up to 1 month for full effect; must be replaced weekly
Reversible: Yes
Availability: Prescription required
Advantages: Can regulate menstrual cycle and reduce cramps; may reduce risk of ovarian cysts; does not impact future fertility
Disadvantages: Does not prevent STIs; may increase risk of blood clots, stroke, breast cancer, heart attack, high blood pressure, and depression; may decrease sex drive; other side effects include weight gain, chloasma, and allergic reaction
Birth Control shot
Cost: $35-75/injection
Failure rate: 6%
Duration: Must be repeated every 3 months
Reversible: Yes
Availability: Doctor's visit required
Advantages: Only four shots required per year; reduces menstrual cramps; may reduce risk of ovarian cysts, ovarian cancer, and pelvic inflammatory disease
Disadvantages: Fertility may take up to 8 months to return; does not prevent STIs; may increase risk of blood clots, stroke, breast cancer, heart attack, high blood pressure, and depression; may decrease sex drive; other side effects include weight gain, anxiety, breast lumps, and hair loss or excessive growth
Intrauterine device (IUD)
Cost: $500-1000
Failure rate: 1%
Duration: Non-hormonal up to 12 years; hormonal up to 5 years
Reversible: Yes
Availability: Doctor's visit required
Advantages: Fertility returns after first ovulation cycle; immediately effective when placed; can last at least five years; copper (non-hormonal) IUD is hormone-free
Disadvantages: Does not prevent STIs; may get stuck in the uterus or migrate outside it and cause injury; side effects include ovarian cysts, pelvic inflammatory disease; ectopic pregnancy, and infection
Hormone Implants
Cost: $400-800
Failure rate: 1%
Duration: Three years
Reversible: Yes
Availability: Doctor's visit required
Advantages: No impact on fertility once removed; may protect against pelvic inflammatory disease; may reduce menstrual flow and cramping
Disadvantages: Does not prevent STIs; causes tenderness and bruising when inserted and removed; can cause loss of bone density, loss of sex drive, and mood swings; additional side effects include weight gain, breast and abdominal pain, and allergic reaction
Tubal Ligation
Cost: $1500-6000
Failure rate: 1%
Duration: Permanent
Reversible: No
Availability: Outpatient surgical procedure
Advantages: Permanent and immediate; does not impact sex drive; does not cause symptoms of menopause
Disadvantages: Does not protect against STIs; recovery from surgery involves pain, bleeding, potential for infection; increases risk of ectopic pregnancy; more complicated, extensive, and invasive than male sterilization surgery
Essure
Cost: $1500-6000
Failure rate: 1%
Duration: Permanent
Reversible: No
Availability: Outpatient surgical procedure
Advantages: Less invasive than tubal ligation, with no open surgery required; procedure takes less than an hour
Disadvantages: Does not protect against STIs; increases risk of ectopic pregnancy; requires three months to take effect; more extensive than male sterilization surgery; side effects include cramping, vaginal bleeding, irregular menstrual cycle, nausea, vomiting, and infection
Reviewed November 12, 2012, by Edward Kim, MD - Urologist
References
Birth Control Guide. (2012). Food and Drug Administration Office of Women's Health.
