It varies by the type of contraception you use—from birth control pills to sterilization
Maybe you want to avoid getting pregnant, or you want both contraception and protection from STDs. Either way, you may be considering what form of birth control is best for you. While only condoms (male or female) protect against some sexually transmitted diseases (STDs), certain forms of birth control are better at pregnancy prevention than others. Considering the timing of your chosen birth control is also important in order to reduce your chances of conceiving accidentally. Here’s what you need to know about the different types of birth control options to take charge of your reproductive health.
What is birth control?
Birth control, or contraception, is any method, device, or surgical intervention that prevents pregnancy, says Erika Gray, Pharm.D., chief medical officer and co-founder of Toolbox Genomics, a DNA and epigenetic testing company. Some forms of birth control are reversible while others are permanent.
Types of birth control
There are many forms of contraception available, each with its own use guidelines, says Dr. Gray. Some are more effective than others, but it’s still possible to get pregnant with all types of birth control, including sterilization. Birth control can be grouped into the following categories:
- Barrier methods include condoms, cervical caps, spermicides, contraceptive sponges, and diaphragms
- Hormonal methods include oral contraceptives, vaginal rings, contraceptive patches, implants, IUDs, and injections
- Long-acting reversible contraceptives (LARCs) include intrauterine devices (IUDs) that are hormonal or nonhormonal.
- Sterilization includes vasectomy and tubal ligation
Birth control pills
There are two types of birth control pills (oral contraceptives):
- Progestin-only (progestin is a synthetic form of the hormone progesterone)
- Combination pills that contain progestin and estrogen
Birth control pills work best when taken at the same time every day, says Monte Swarup, MD, a board-certified OB-GYN in Chandler, Arizona, and founder of HPV HUB.
How long do birth control pills take to work?
When combination birth control pills are started within five days of starting your period, you’ll be protected immediately, according to Planned Parenthood. Otherwise, combination pills take up to seven days to work, so be sure to use a backup method of birth control (like a condom) for the first week to prevent pregnancy. Use condoms every time to decrease the risk of sexually transmitted infections.
Most progestin-only pills, also called minipills, are effective within 48 hours, but ask your healthcare provider to be sure.
How effective are birth control pills?
With perfect use, contraceptive pills are up to 99% effective, but because of user error (taking a pill late, vomiting up a pill, or accidentally skipping a pill or two), effectiveness is closer to 91%.
RELATED: Could progestin-only birth control be right for you?
IUD (hormonal and copper)
IUDs are devices that are inserted into the uterus by a healthcare provider to prevent pregnancy. This procedure is usually done in the office and takes about 10 minutes. There are two types, with various FDA-approved brands:
- Copper IUDs: Paragard (effective for 10 years)
- Hormonal IUDs: Mirena (effective for eight years), Liletta (effective for six years), Kyleena (effective for five years), Skyla (effective for 3 years), and Paragard (effective for 10 years)
How long do IUDs take to work?
Copper IUDs work to prevent pregnancy immediately, whereas hormonal IUDs take seven days, advises Dr. Gray.
How effective are IUDs?
Both types are 99% effective at preventing pregnancy, but how long they are effective varies by brand. IUDs do not protect against sexually transmitted infections.
RELATED: What you should know about IUD birth control
The birth control implant (Nexplanon) is a thin, matchstick-sized flexible rod that is placed beneath the skin of the upper arm, where it releases a steady stream of progestin to prevent pregnancy.
How long does the implant take to work?
If the implant is inserted during the first five days of your menstrual cycle, you are protected from pregnancy immediately. Otherwise, use a backup method of birth control for seven days until the hormones kick in.
How effective is the implant?
The implant is one of the most effective forms of birth control, providing a pregnancy prevention rate of over 99%, says Dr. Gray. The implant is effective for up to three years.
RELATED: Everything you should know about the birth control implant
Birth control shot
Depo-Provera, also called the “depo-shot,” is a form of birth control that is injected (usually by the patient) into the upper arm or buttocks every 12 weeks. It contains the hormone progestin, which prevents ovulation.
How long does the birth control shot take to work?
If you get the shot during your period (the first five days of menstruation), there’s immediate protection from pregnancy. Otherwise, use a backup form of birth control for 10 days to allow the hormones to take effect. It’s important to give yourself the injection every 11 to 13 weeks to avoid lapses in protection.
How effective is the birth control shot?
The birth control shot is 96% effective at pregnancy prevention.
RELATED: The Depo shot 101: Everything you need to know
Like combination birth control pills, the transdermal contraceptive patch (Xulane or Twirla) contains the hormones progestin and estrogen. The patch is worn on the skin of the back, belly, or butt. One patch is placed weekly for three weeks. This is followed by a one-week break for a menstrual period. A new birth control patch should be applied each week, on the same day.
How long does the patch take to work?
It takes seven days for the patch to work, so be sure to use a backup method of birth control for the first week.
How effective is the patch?
With normal use (the patch comes loose or you forget to change it on time), the patch is 93% effective. It is 99% effective with perfect use. The patch is less effective for women with a BMI > 30.
The birth control ring is a form of hormonal birth control that’s inserted in the vagina. The thin, flexible ring stays in place for three weeks each month followed by a one-week break when menstruation occurs. Three vaginal rings are currently FDA approved: NuvaRing and EluRyng (both are one-time use), and Annovera (which is reusable monthly for one year).
How long does the vaginal ring take to work?
When inserted on the first day of your period, the ring is effective immediately. Otherwise, it takes seven days to take effect. If you are switching from combination birth control pills or the patch directly to the ring, it is also effective right away.
How effective is the vaginal ring?
The ring has an efficacy of about 93% with regular use, and up to 99% with perfect use.
There are several types of barrier birth control methods that prevent sperm from reaching an egg. The time each method takes to work and the effectiveness varies by type. They include:
- Condom: A male condom is a thin sheath made of latex, polyurethane, or natural animal membrane, and is worn over an erect penis. A female condom is a plastic pouch that lines the vagina; it has a closed inner ring covering the cervix and an open outer ring that stays outside of the vagina. Both offer protection immediately. Male condoms are 87% effective with normal use; that number jumps to 98% with perfect use. Female condoms are 72%-82% effective with normal use and up to 95% effective with perfect use.
- Spermicide: Made from chemicals that inactivate sperm, spermicide is inserted into the vagina 10-15 minutes prior to penis-in-vagina sex and works for up to an hour. This method is about 79% effective and works best along with condoms or withdrawal during ejaculation.
- Sponge: This is rarely used. A round device made of soft foam, the sponge contains spermicide and is worn over the cervix. It can be placed in the vagina up to 24 hours before sexual intercourse and must be kept in place for six hours afterward. If you’ve never given birth, the sponge is 88% effective; if you have, it’s 80% effective.
- Diaphragm: This is rarely used. Made of silicone or latex, the diaphragm is a round device that covers the cervix. It is meant to be used along with spermicide and must be fitted by your healthcare provider. It’s best to have sex within two hours of inserting your diaphragm, which must remain in place for a minimum of six hours after intercourse (and up to 24). Under ideal conditions, diaphragms are 94% effective, and 87% effective with typical use.
- Cervical cap: This is rarely used. Similar to the diaphragm, the cervical cap is a round device that fits over the cervix and is meant to be used with spermicide, but it is smaller and can stay in place for up to 48 hours with the help of suction. If you haven’t given birth, the cervical cap is about 86% effective, but if you have, that number drops to 71%.
Sterilization (vasectomy in men and tubal ligation in women) is permanent birth control.
- Vasectomy: This surgery involves cutting the vas deferens, the tube that carries sperm in males. The surgery is permanent. Although in some cases it can be reversed, there’s no guarantee. That’s why it’s important to be sure you don’t want children in the future before having the procedure.
- Tubal ligation: Also known as “getting your tubes tied,” this surgery involves blocking or cutting both of the fallopian tubes so that when an egg is released from one of the ovaries, it does not come in contact with sperm. Although it can sometimes be reversed, you may not be able to get pregnant afterward, so it’s not a good idea to undergo this procedure if you might want to have children in the future. This is an abdominal surgery that sometimes is done at the time of a Cesarean section.
How long does sterilization take to work?
Sterilization works immediately after surgery, although you will need time to heal before engaging in sexual intercourse.
How effective is sterilization?
Sterilization is 99% effective at preventing pregnancy.
Guidelines for using birth control
When starting a new birth control it is important to follow your healthcare provider’s instructions and read the accompanying information carefully, advises Dr. Gray. “You can get pregnant while on birth control, but the chances are low when you use it correctly and consistently,” she says. “No method is 100% effective, so it’s important to follow the instructions and take precautions to minimize the risk of pregnancy.”
If you’re unsure whether your birth control has started working, use a backup method (like condoms) to prevent pregnancy until you can get medical advice from your healthcare provider, Dr. Gray recommends.
Consider having your healthcare provider prescribe oral emergency contraception, Plan B or Ella, to have available as a backup in case you do not take your birth control method on time. This is not considered an abortion pill. Emergency contraception destabilizes the endometrial lining so that implantation of a pregnancy does not occur.
If you have unprotected sex or your regular birth control fails—like when a condom breaks or you forget to take the pill on time—ask your provider if emergency contraception (the morning-after pill) is an option.