Birth control is often thought of as the responsibility of the female, since she’s the one who could become pregnant after a sexual encounter. In reality, birth control options should be openly discussed between partners and between an individual and their doctor. Birth control can do more than prevent pregnancy, too. Condoms, for example, protect against sexually transmitted infections (STIs), and hormonal birth control can help control a female’s acne or mitigate irregular menstrual periods. Understanding your options and your responsibility early on will keep you, your partner, and your relationship healthy.
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Are there different types of birth control?
There are three major birth control methods: awareness, hormonal, and barrier.
- Awareness methods involve being aware of your actions and actively working to prevent pregnancy before, during, or after intercourse. This type of birth control includes abstinence (choosing to avoid sexual activity altogether), which is 100% effective at both pregnancy and STI prevention. Other awareness methods include withdrawal (pulling out before ejaculation), family planning (engaging in intercourse on low-risk days), emergency contraceptives (taking a pill shortly after intercourse to prevent pregnancy), and sterilization (permanently altering the body so that pregnancy becomes nearly impossible).
- Hormonal methods are currently only available to females and require a prescription from a doctor. (Hormonal birth control for males is undergoing clinical trials.) To prevent pregnancy, hormones are used long term to either stop ovulation all together or prevent sperm from reaching the egg during or after intercourse. While the way the hormones enter the body differs between methods (pill, injection, implant, patch, intrauterine device, or ring), all are quite effective when used properly. However, hormonal methods are not effective at preventing STIs, so a conversation should be had about safety and a barrier method should be considered also.
- Barrier methods work to prevent sperm from reaching the egg during or after intercourse. Some barrier methods (condom, diaphragm, cervical cap, sponge) physically block the sperm, while others (spermicide, copper intrauterine device) kill the sperm and render them unable to fertilize the egg. The efficacy of barrier methods at preventing pregnancy varies significantly, but only condoms are at all effective at preventing the spread of STIs.
No two of these methods are the same, either in how they’re used or how effective they are at preventing pregnancy. Furthermore, while awareness methods and barrier methods can be equally the responsibility of males and females, hormonal methods are only available for females at this time, shifting a large portion of the responsibility in a heterosexual relationship onto a woman.
What are my birth control options?
The chart below explains common types of birth control, their effectiveness, and other tips for use. For more exhaustive information on how to use each type and for personal stories from young users, visit Bedsider, a free support network for birth control, or Planned Parenthood, a reproductive health provider and educator.
Birth Control Method
|What Is It?||
Perfect use; typical use
|Hormonal?||Protection From STIs?||
|Abstinence||Choosing not to engage in sexual intercourse or sexual activities of any kind.||100%; 100%||No||Yes||Abstinence may be chosen or circumstantial, but either way, it is personal. Sometimes the choice is religious, and other times it isn’t.|
|Withdrawal (pulling out)||Separating from your partner before ejaculation.||96%; 78%||No||No||This method, while popular among college students, is extremely unreliable; if you plan to use this method safely to prevent pregnancy, couple it with a second form of birth control.|
|Fertility awareness (natural family planning)||Tracking fertility, basal body temperature, and cervical mucus to determine when to have intercourse with a partner with little chance of pregnancy.||95%–99%; 76%–88%||No||No||This method requires commitment and attention to detail; it is usually recommended for people who are in long-term relationships and can take on big responsibilities.|
|Emergency contraceptives (morning-after pills)||A backup method of birth control that females can take by mouth. It may be taken when their first birth control method fails or after unprotected intercourse. It prevents pregnancy before it happens. It is not an abortion pill.||More effective the sooner it is taken after unprotected intercourse||Yes||No||The hormone dosage in emergency contraceptives is high, which makes it difficult for an egg to be fertilized and properly implant in the fallopian tube.|
|Sterilization||A procedure, either surgical or non-incision, which blocks the fallopian tubes (usually in females) or vas deferens (usually in males), depending on your anatomy.||99%; 99%||No||No||Sterilization, while a method of birth control, is not recommended for the typical college student because you have to be completely sure that you never want to have children. The procedure is usually reversible in men, but irreversible in women.|
|Birth control pill (oral contraception)||A daily pill that releases estrogen and progestin, hormones to stop ovulation.||99%; 91%||Yes||No||Set a daily alarm on your phone to remember your pill; effectiveness decreases if you don’t take the pill at the same time every day.|
|Implant (Nexplanon)||A matchstick-sized rod inserted into your arm which releases progestin, a hormone to stop ovulation.||99%; 99%||Yes||No||The implant can stay in your body for up to four years.|
|Shot (Depo-Provera)||An injection, needed once every three months, which contains progestin, a hormone that prevents sperm from reaching the egg.||99%; 94%||Yes||No||Set an alarm on your phone to remember to see your doctor every three months for the next dose.|
|Vaginal ring (NuvaRing)||A bendable ring inserted into the vagina for three weeks every month that releases estrogen and progestin, hormones to stop ovulation.||99%; 91%||Yes||No||Occasionally, doctors recommend that the vaginal ring be refrigerated until use; ask your doctor about this, especially if you live in a dorm and do not have access to a refrigerator.|
|Patch (Xulane)||A square piece of plastic that adheres to your skin, much like a bandage, that gives off estrogen and progestin, hormones to stop ovulation.||99%; 91%||Yes||No||Set a weekly alarm on your phone to remember to change your patch.|
Hormonal or Barrier Methods, Depending on Brand
|IUD (intrauterine device)||A T-shaped device inserted in the uterus. Hormonal IUDs (Kyleena, Liletta, Mirena, Skyla) release progestin, a hormone that prevents sperm from reaching the egg. Copper IUDs (ParaGard) block or kill sperm before it reaches the egg.||99%; 99%||Hormonal and nonhormonal (copper) IUDs available||No||Hormonal IUDs can stay in the uterus for up to six years; copper IUDs can stay in for up to 10 or 12.|
|Condom||A barrier method (available in male and female versions) which prevents the exchange of bodily fluids during sexual activity.||
Male condoms: 98%; 82%
Female condoms: 95%; 75%
|No||Yes||Campus health centers and Planned Parenthood often provide free condoms.|
|Diaphragm (Caya or Milex) and spermicide||A dome-shaped cap, about the width of your palm, often filled with spermicide and fitted over the cervix to prevent sperm from reaching the egg.||94%; 88%||No||No||You may have to be fitted for a diaphragm by a doctor, but it can then work for up to two years.|
|Cervical cap (FemCap) and spermicide||A cup-shaped cap, about the diameter of a golf ball, often filled with spermicide and fitted on the cervix to prevent sperm from reaching the egg.||n/a; 71%–86%||No||No||You must be fitted for a cervical cap by a doctor, but it can then work for up to two years.|
|Sponge||A piece of foam which blocks the cervix and releases spermicide when moistened before insertion.||80%–91%; 76%–88%||No||No||A sponge is not reusable; it must be thrown out after a 30-hour period.|
*Effectiveness statistics from Bedsider
Which of the birth control methods prevent sexually transmitted infections?
Condoms (both male and female) and abstinence are the only forms of birth control that prevent the spread of infections. The rest of the above options simply work to prevent pregnancy. For condoms to be effective at preventing STIs, they must be used every time you have intercourse, whether it’s vaginal, anal, or oral.
Do I need birth control if I’m in a same-sex relationship?
Birth control, while not necessary to prevent pregnancy in same-sex relationships, may still be used to prevent sexually transmitted infections. Condoms, available in both male and female versions, are the only barrier birth control that can prevent the spread of STIs. Abstinence, in which both partners abstain from sexual activity, is the only other way to completely protect yourself from infection.
Please note that cisgender women (people who were born female and identify as women) are not the only people who can get pregnant. Transgender men (even those undergoing hormone replacement therapy and taking testosterone) and nonbinary individuals with a uterus may be fertile. If this describes you, you may want to talk to your doctor about the birth control method that is right for you.
Regardless of your sex or that of your partner, an open conversation about birth control is crucial to a healthy sexual relationship if you are planning to have intercourse. (Even if you’re not planning on having intercourse, having a conversation about what you both want out of the relationship is still healthy. For abstinence to work long term, both partners need to agree to comply.) If you elect to use a barrier method, decide who is going to purchase the products and how you are going to split the costs; it is equally your and your partner’s responsibility to prevent the spread of STIs.
How do I get birth control?
Depending on the form of birth control you want to use, you will either have to purchase it yourself or get a prescription from a doctor. If you want any form of hormonal birth control, an IUD, a diaphragm, or a cervical cap, visit your primary care physician or gynecologist or make an appointment at your local Planned Parenthood. Thanks to the Affordable Care Act, most health insurance plans will cover the majority or all of the cost of birth control that is approved and prescribed by a doctor.
Condoms, sponges, and the morning-after pill are available over the counter or online without a prescription. Anything you purchase over the counter will come with a cost. The one exception is if you obtain a prescription for the morning-after pill; with a doctor’s approval, this type of birth control should be at least partially covered by insurance. If you’re worried about cost, you may also be able to get free condoms from your school’s health clinic or your local Planned Parenthood.
What if I want to use birth control for something other than pregnancy or STI prevention?
Some forms of hormonal birth control, most notably the birth control pill, may be used for reasons other than to prevent pregnancy: namely to control irregular or heavy periods or to treat acne. Birth control pills can also help with endometriosis and polycystic ovarian syndrome. If you are suffering from one of these issues, talk to a doctor or gynecologist. A doctor will be able to determine if there is an underlying factor causing your symptoms or if you would benefit from taking birth control.
Page last updated: 03/2018