Birth control: The Optum Store Guide
There are many contraceptive methods, from daily pills to devices you can forget about for years. Our guide will help you understand your options.
- What are the main types of birth control?
- What exactly is a barrier method? How many options are there?
- How does the birth control shot work?
- What are long-acting reversible birth control options?
- What is short-acting hormonal birth control?
- What about sterilization? When is that a good choice?
- Are there any new birth control options?
- Which form of birth control is most effective at preventing pregnancy?
- Which birth control option is easiest to use?
- What if you’re not sure which method is best for you?
If you want to prevent pregnancy, you’ve got a lot of birth control options. There are many contraceptive medications and devices, from the pill to a diaphragm to condoms. Contraception can be a personal decision, too. Many factors might impact your choice, including how often you have sex and if you’re finished having kids.
Nearly all women in the U.S. use birth control at some point in their lives. About 65% of women ages 15 to 49 currently use contraception. That’s per the most recent survey from the Centers for Disease Control and Prevention (CDC). The remaining 35% don’t use it for reasons that make a lot of sense: They’re trying to conceive, they’re pregnant, they just had a baby or they’re not sexually active.
Whether you’re currently on birth control or need to find a method to use, our go-to guide will walk you through the basics. We’ll help you get a better view of the best option for you.
What are the main types of birth control?
There are 5 main types of medicines and devices that prevent pregnancy. They work in different ways to prevent an egg from being fertilized by a sperm. Those categories are:
- Barrier methods (such as condoms and diaphragms)
- Birth control shot
- Long-acting reversible birth control (such as IUDs and implants)
- Short-acting hormonal birth control (such as the pill)
- Permanent sterilization
Read on to learn more about each type of birth control.
What exactly is a barrier method? How many options are there?
These methods create a literal physical barrier, blocking sperm from reaching an egg. They do not contain hormones. Here are details about your options.
What it is: This device is a shallow cup made of soft silicone. Each time you have sex, you add spermicidal jelly, cream or foam to the cup. You bend the diaphragm in half and place it inside your vagina for up to 24 hours.
How it works: The diaphragm covers the cervix (the long, narrow end of your uterus). It blocks sperm from swimming up into your uterus. The spermicide makes the diaphragm more effective. It works by damaging and killing any sperm cells in the vagina.
What to know: A diaphragm must be left in the vagina at least 6 hours after sex. Your doctor will fit you for a diaphragm and then give you a prescription. A diaphragm lasts about 2 years. It’s 88% effective in preventing pregnancy.
Birth control sponge
What it is: A small, round sponge made of soft plastic foam. It’s placed deep in the vagina before sex.
How it works: The sponge covers the cervix, blocking sperm. It also contains spermicide that damages and kills sperm.
What to know: You buy sponges over the counter (OTC) and throw them away after you use them. You need to leave a sponge in for at least 6 hours after you have sex and must take it out within 30 hours after you put it in. The sponge is 76% to 88% effective at preventing pregnancy.
What it is: This small, soft latex or silicone cup fits around the cervix. It looks like a sailor’s hat, according to Planned Parenthood.
How it works: Like with a diaphragm, you place spermicide inside the cap before inserting it deep into your vagina before sex. It blocks sperm from joining an egg.
What to know: You need a prescription for a cervical cap. You can leave it in for up to 48 hours and don’t need to use more spermicide each time. It’s 71% to 86% effective at preventing pregnancy.
What it is: This thin latex, polyurethane or lambskin sheath goes over an erect penis.
How it works: A condom catches sperm so that it can’t enter the vagina and uterus.
What to know: Condoms are inexpensive. You can buy them OTC at drugstores, grocery stores and online. Latex and polyurethane condoms are the most effective protection against sexually transmitted infections (STIs). That’s according to the American College of Obstetricians and Gynecologists (ACOG). Condoms are 85% effective at preventing pregnancy.
What it is: This is a thin lubricated pouch that you place in your vagina. (These are also called female condoms.)
How it works: It’s an alternative to a regular condom and basically works the same way. The pouch stops the sperm from reaching an egg. They can be inserted up to 8 hours before sex.
What to know: You can buy internal condoms over the counter at the drugstore. Internal condoms are also effective against STIs. But male condoms give you better STI protection, says ACOG. Internal condoms are 79% effective at preventing pregnancy.
What it is: Spermicide contains a chemical that comes in foam, gel or tablet form.
How it works: The chemicals stop sperm from reaching an egg. You place it in your vagina 5 to 90 minutes before sex.
What to know: You can use spermicide on its own. But it provides better birth control if you pair it with a condom, diaphragm or cervical cap. Depending on whether you use it alone or with a barrier, spermicide is 72% or 86% effective at preventing pregnancy.
How does the birth control shot work?
This birth control method (also called Depo-Provera®) is a shot that contains a hormone called progestin. It’s given every 3 months. Like all hormonal birth control methods, the shot works by preventing the ovaries from releasing eggs. It also thickens the cervical mucus so the sperm can’t swim up your uterus. It’s safe and convenient. But you need to remember to make your appointment every 3 months to get your next shot. The shot is 94% effective at preventing pregnancy.
What are long-acting reversible birth control options?
These options are highly effective and are the ultimate “set-it-and-forget-it” option, says Cindy M. Duke, MD. She’s an OB-GYN and the chief medical officer of Nevada Fertility Institute in Las Vegas. Long-acting reversible birth control devices prevent pregnancy for 3 to 10 years. But if you decide you want to conceive, you can have a device removed at any time. Options include:
What it is: An IUD (intrauterine device) is a small, flexible T-shaped piece of plastic. It’s inserted into the uterus by a health care provider. Hormonal IUDs contain the hormone progestin.
How it works: A hormonal IUD prevents pregnancy by making it hard for sperm to join with an egg. It thickens the cervical mucus so the sperm has a tough time getting through. It can also stop the ovaries from releasing eggs in the first place.
What to know: It can be used for 3 to 5 years, depending on the type. Side effects include irregular bleeding, no periods and abdominal/pelvic pain. Hormonal IUDs are 99% effective at preventing pregnancy. Four brands are approved for use in the U.S.:
What it is: Also called Paragard®, it’s a small plastic device shaped like a T and wrapped with copper wire. It’s placed in the uterus by a health care provider.
How it works: By preventing the sperm from reaching the egg. (Sperm don’t like copper, according to Planned Parenthood.)
What to know: It’s long-lasting and can be used for up to 10 years. The copper IUD is a little bigger than the hormonal IUD, says Shawn Tassone, MD. He’s a board-certified OB-GYN and integrative health practitioner in Round Rock, Texas. “It’s probably not the best choice for someone with a smaller uterus,” he says. It also might not be the best option if you have heavy, painful periods. That’s because side effects with the copper IUD can include cramps or heavier, longer periods with spotting between periods. It’s 99% effective at preventing pregnancy.
Birth control implant
What it is: This is a thin device, shaped like a match-stick rod, that contains progestin. A health care provider places it under the skin on the inside of the upper arm.
How it works: It prevents the ovaries from releasing eggs and thickens cervical mucus.
What to know: It can be used for up to 3 years. Side effects include changes in menstrual bleeding patterns, weight gain, headache and acne. It’s 99% effective at preventing pregnancy.
What is short-acting hormonal birth control?
These are among the most popular birth control options. They are:
What it is: This is a medication containing the hormones estrogen and progestin. You swallow a tablet daily. Birth control pills are also known as oral contraceptives.
How it works: The medication prevents the ovaries from releasing eggs. (If there is no egg to fertilize, you can’t get pregnant.) It also thickens cervical mucus so sperm gets trapped.
What to know: The pill is the most common hormonal method. About 14% of all women take this medication, according to the CDC. It requires a prescription. Side effects can include spotting or bleeding between periods, nausea, breast tenderness and headache. The pill also comes in a version with just progestin, called the mini pill. It’s nearly identical to the regular pill but mainly works instead by thickening cervical mucus. The pill is 91% effective at preventing pregnancy.
What it is: A skin patch that contains estrogen and progestin. It releases hormones through your skin. It’s worn on the lower abdomen, bottom, upper arm or upper back.
How it works: It stops the ovaries from releasing eggs.
What to know: You change patches once a week for 3 weeks (21 total days) and leave off a patch on the fourth week. It’s prescription only and 91% effective at preventing pregnancy.
What it is: This is a small, flexible device (brand names: NuvaRing®, Annovera®) that you place in your vagina.
How it works: The ring releases progestin and estrogen, 2 hormones that prevent the ovaries from releasing eggs.
What to know: You keep the ring in place for 3 weeks, then remove it for a week to have your period. (With NuvaRing, which is disposable, you can choose to skip your period by always keeping a ring in your vagina, but you need to swap it out for a new ring every 3 to 5 weeks, according to Planned Parenthood.) The ring’s side effects are similar to that of the pill. It’s 91% effective at preventing pregnancy.
What about sterilization? When is that a good choice?
If you’re definitely finished having children, sterilization is a good option to consider. According to the CDC, female sterilization is the most common method of birth control, at 18%. These are the surgical options:
For women: Sterilization surgery is sometimes called tubal ligation or “getting your tubes tied.” This is when the fallopian tubes are permanently tied and cut. It is safe and 99% effective at preventing pregnancy. As with any surgery, there is a risk of pain, bleeding and infection.
For men: Sterilization surgery is called a vasectomy. The small tubes in the scrotum that carry sperm are cut or blocked off. This permanent birth control option can be reversed, but the chances of reversal go down with time, according to the U.S. Food and Drug Administration (FDA). It’s safe and 99% effective.
Are there any new birth control options?
Yes. In 2020, the FDA approved a new prescription contraceptive gel called Phexxi®. This hormone-free option is 93% effective if used perfectly, according to Planned Parenthood. But that can be challenging in the real world, so it’s probably about 86% effective.
You put Phexxi in your vagina up to an hour before sex. It works by lowering the pH in the vagina so that it’s “basically inhospitable to sperm,” says Dr. Tassone. That means the sperm has a hard time moving, lowering its chance of reaching an egg. (Learn more about Phexxi.)
Ready to switch up your birth control? Check out the options, including Phexxi, available from the Optum Store. Fill out a quick assessment and get contraception delivered right to your door. Start now.
Which form of birth control is most effective at preventing pregnancy?
The IUD and birth control implant are the most effective birth control methods that can be reversed, according to ACOG. Sterilization surgery for women and men is also highly effective, but it is permanent.
Which birth control option is easiest to use?
The simple answer? The one you actually use. Or the one “you don’t have to remember, like an IUD,” says Kimberly Langdon, MD. She’s a board-certified OB-GYN and medical adviser at Medzino Health, which is based in Austin, Texas.
If you’re okay with a daily method, the pill might be the right birth control method for you. Or if you can remember to see your doctor every 3 months, the shot might be the one. If you don’t want to think about pregnancy prevention except for an initial quick insertion in your doctor’s office, an IUD is for you. For options that you can access just when you have sex, a barrier method such as a diaphragm or condom might be the better choice.
(Ready to rethink your birth control? Check out this article.)
What if you’re not sure which method is best for you?
It’s okay to not be sure about which option you want to try. That’s why it’s important to talk to your OB-GYN about it. In fact, changing birth control is actually quite common, with many women using different options.
Factors that could impact your birth control method include your age, health, reproductive goals, religious beliefs and other needs, according to the Mayo Clinic. You can list all the options you’re interested in, with pro and con columns. Take that list to your doctor for further discussion.
Our expert panel
Cindy M. Duke, MD, board-certified OB-GYN and founder and chief medical officer of Nevada Fertility Institute in Las Vegas
Kimberly Langdon, MD, board-certified OB-GYN and medical adviser at Medzino Health, a digital health company in Austin, Texas
Shawn Tassone, MD, board-certified OB-GYN and integrative health practitioner in private practice in Round Rock, Texas
Statistics on usage: Centers for Disease Control and Prevention (2020). “Current Contraceptive Status Among Women Aged 15-49: United States, 2017-2019”
Background on birth control methods: Planned Parenthood (n.d.). “Birth Control”
American College of Obstetricians and Gynecologists (2022). “Birth Control: FAQs for Teens”
U.S. Food and Drug Administration (2021). “Birth Control”
Mayo Clinic (2022). “Birth Control Options: Things to Consider”