9 Non-Hormonal Birth Control Options

Having access to reliable birth control is important for many people. While the birth control pill remains a popular option, more and more people are looking for hormone-free birth control, due to sensitivity to hormonal side effects or for other medical or personal reasons.

These days, there are many options for non-hormonal birth control. If you’re looking to avoid unplanned pregnancy and additional hormones, here’s what you should know about your birth control options.

Efficacy

For many people, the efficacy of birth control is the most important factor when choosing a method. Efficacy is how well a birth control method prevents pregnancy. This is measured as the number of people, out of 100, who will get pregnant during a year of using this birth control method and having penis-in-vagina sex.

When researchers calculate the failure rate of birth control, they give two numbers: how many people will become pregnant with perfect use of the birth control, and how many will become pregnant with typical use.

Typical use includes mistakes like missing an occasional pill. It is a better indicator of the efficacy of a method of birth control.

Here’s how effective popular non-hormonal birth control methods are, with typical use:

• Copper IUD: 99.2% effective
• Condoms: 85% effective with male condoms; 79% effective with female condoms
• Phexxi vaginal gel: 86% effective
• Cervical cap: 86% effective for people who have never had a baby; 71% effective for people who have had a baby
• Sponge: 86% effective for people who have never had a baby; 73% effective for people who have had a baby
• Diaphragm (with spermicide): 87% effective
• Spermicide: 79% effective
• Fertility awareness method: 77% effective to 98% effective
• Withdrawal: 78% effective

Copper IUD 

An intrauterine device (IUD) is inserted into your uterus to prevent pregnancy. There are two types of IUDs approved by the Food and Drug Administration (FDA) for use: hormonal and non-hormonal.

The only non-hormonal IUD, sold under the brand name Paragard, continuously releases a tiny amount of copper, which changes the chemical environment of the uterus so that it’s toxic to sperm and eggs.

In some cases, this can be used as emergency contraceptive: If Paragard is inserted up to five days after unprotected sex, it can be used to prevent pregnancy.

Pros

• Lasts for up to 12 years
• More than 99% effective
• No daily maintenance 
• Can be used as emergency contraceptive
• Discreet

Cons

• No protection from sexually transmitted diseases (STDs)
• May cause irregular or heavy periods
• Must be inserted by a doctor

Side Effects

• Pain or cramping on insertion
• Periods and cramping may be heavier, particularly in the first three to six months
• Irregular periods

Condoms

Condoms provide a physical barrier between the partners having sex. Male condoms are worn on the penis and are 85% effective with typical use. Internal condoms, also known as female condoms, are inserted into the vagina or anus. They’re 79% effective at preventing pregnancy.

Pros

• Provide STD protection
• Accessible without a prescription
• Can be used by partners of any sex

Cons

• Must be used each time you have sex
• Some people find them uncomfortable
• Have the potential for mistakes while using
• Have a higher failure rate compared to the copper IUD

Side Effects

Most people won’t experience any side effects from condoms. If you or your partner has a latex allergy, be sure to get latex-free condoms.

Phexxi

Phexxi is one of the newest methods of hormone-free birth control. It is a gel that is inserted into the vagina before having sex. The gel, which doesn’t have any hormones, changes the acidity of the vagina in order to make it difficult for sperm to reach an egg.

Phexxi was approved by the FDA in 2020 and is 86% effective at preventing pregnancy with typical use.

Pros

• On-demand use
• Easy to use, similar to tampon insertion

Cons

• Prescription required
• Must use each time, within an hour before having sex
• Doesn’t protect from STDs
• Less effective than the copper IUD

Side Effects

• Vaginal itching or burning
• Yeast infections
• Urinary tract infections
• Allergic reaction in partner
• Rarely, kidney or bladder infections

Cervical Cap

A cervical cap is a small piece of silicon that covers the entrance to the cervix, preventing sperm from reaching the egg. Cervical caps are smaller than diaphragms and can be left in place longer.

When used with spermicide, it’s 86% effective at preventing pregnancy for people who have never had a baby and 71% effective for those who have had a baby.

Pros

• Discreet
• Can be left in for two days

Cons

• Must be prescribed and fitted by a doctor
• Can be tricky to insert
• Must be used with spermicide for most effectiveness
• No protection from STDs
• Less effective than other non-hormonal options

Side Effects

Most people don’t experience side effects from cervical caps, but you might find the cap uncomfortable, particularly if it’s not inserted correctly or is bumped during sex. The spermicide used with caps can increase your risk for STDs.

Sponge

The sponge is a piece of plastic that blocks the entrance to the cervix, preventing sperm from meeting the egg. It also contains spermicide to kill sperm. It is 86% effective for people who have never had a baby and 73% effective for people who have had a baby.

Pros

• No prescription required
• Once inserted, effective for 24 hours
  

Cons

• Must be made wet before insertion
• Must be used every time
• May increase risk for STDs
• Less effective than the copper IUD

Side Effects

Some people using the sponge experience vaginal irritation. This can increase your risk for STDs, so it’s very important to practice safe sex while using the sponge.

Diaphragm

A diaphragm is a plastic cap that covers the opening to your cervix, blocking sperm from getting to the egg. Diaphragms are used with spermicide and are 87% effective.

Pros

• Lasts up to two years
• On-demand use

Cons

• Requires prescription and fitting
• Must be inserted within two hours of sex beginning
• Can be difficult to place
• Must be properly cared for and stored

Side Effects

People who use diaphragms are at increased risk for urinary tract infections (UTIs). The spermicide used with diaphragms can increase your risk of STDs.

Spermicide

Spermicide is a cream or gel that is inserted into the vagina where it slows down sperm, making it harder to reach the egg. Used on its own, spermicide is 72% effective. It is more effective when used with other contraceptives such as condoms, diaphragms, sponges, and cervical caps.

Pros

• Affordable
• Doesn’t require a prescription
• Doesn’t interrupt sex
  

Cons

• Has to be applied 15 minutes before sex and reapplied every time you have sex
• Can be messy
• Contains Nonoxynol-9, which can irritate the penis or vagina and increases the risk for HIV and other STDs
  

Side Effects

Spermicide can irritate the genitals, causing vaginal itching, burning, or a rash. It can also cause penile itching or burning urination, and increases the risk of HIV and other STDs.

Natural Family Planning

Natural family planning, also known as the fertility awareness method, involves tracking your natural cycles to avoid pregnancy.

With this method, you use indicators of fertility, like cervical mucus and basal body temperature, to identify your fertile window. During that window, you avoid sex or use a barrier method. Today, you can use a birth control app to make it easier to track your cycle and predict your fertility.

The effectiveness of this method varies widely, ranging between 77% and 98%. 

Pros

• Both partners can be involved
• May teach you about your body
• Birth control app can make it easier
  

Cons

• More difficult with irregular cycles
• Requires backup birth control or avoiding vaginal sex during the fertile window
• Requires daily tracking

Side Effects

There are no side effects to the fertility awareness method.

Withdrawal

Also known as “pulling out,” this birth control method involves removing the penis from the vagina before ejaculation occurs. It is 78% effective.

Pros

• Free
• Always available
  

Cons

• Can be hard to pull out in time (high margin of error)
• Precum can contain sperm
  

Side Effects

There are no side effects to withdrawal.

A Word From Verywell

Selecting birth control is a very personal choice. You should consider how long you want your birth control to last, whether you are OK with something that needs to be applied right before sex, and whether you need protection from STDs.

Today, more non-hormonal birth control options are available than ever before. Your healthcare provider can help you decide which is right for you.