What Is the Most Effective Birth Control?

Birth control is not one size fits all. Some methods are more effective than others, but finding a method that fits with your budget, goals, and lifestyle is also important.

To find which birth control method is best for you, learn about how the different methods work, their effectiveness, the cost, and some of the pros and cons of each option.

Two young people comparing contraception against a turquoise background.


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Birth Control Methods

Birth control methods can be broken down into categories based on their mode of use, including:

  • Single use: These methods must be used for each episode of intercourse.
  • Scheduled: These methods involve planning outside of the act of intercourse, on an ongoing basis.
  • Low maintenance: These methods are long-acting and don't require regular planning or action.
  • Permanent: These are surgical procedures that permanently end a person's ability to become pregnant or to impregnate someone else.

Most birth control methods have two effectiveness rates. The first is how effective it is at preventing pregnancy when used exactly as intended, under ideal conditions. The second is how effective it is with typical use, taking into account human error and other factors that may lower the real-life effectiveness.

Contraception Does Not Mean Protection from STIs

With the exception of internal and external condoms, contraceptive methods do not protect against sexually transmitted infections (STIs).

If protection from STIs are needed in addition to the prevention of pregnancy, barrier methods (condoms) must be used, and may be combined with other forms of birth control.

Only latex and plastic condoms protect against STIs. Lambskin condoms help prevent pregnancy, but do not protect against STIs.

Single-Use Contraceptives

Condoms

External condoms are thin pouches that are slipped on over the erect penis right before intercourse. They are usually made of latex, but plastic condoms and lambskin condoms are available for people who are allergic to latex.

Internal condoms are thin pouches that create a barrier between the penis and the vagina. Internal condoms go inside the vagina (or anus) instead of on the penis.

Both condoms prevent skin-to-skin contact between the penis and the partner's skin. They also "catch" pre-ejaculate and ejaculate (semen), preventing sperm from reaching the egg.

How Effective Is It?

External condoms ideal use: 98% effective

Typical use: About 85% effective

Internal condoms ideal use: 95% effective

Typical use: About 79% effective

How Much Does It Cost?

External condoms cost about $2–$6 for a box of three. Packs of 12 or more often work out to about $1 per condom. Internal condoms cost $2–$3 each. Some places such as sexual health clinics will give out condoms for free.

Pros

  • Easy to access
  • Easy to use (once you get the hang of it; practice first if you are new to condom use)
  • Affordable, discreet, and portable
  • Effective against STIs (except for lambskin)
  • No side effects for either partner (if an allergy or irritation presents, non-latex options are available)
  • Can be used with most other birth control methods for added protection

Cons

  • Must be used correctly, every time you have sex, for the whole duration of intercourse
  • Can have a learning curve/take some time to get used to
  • Can only use water-based or silicone lubricant with latex condoms (anything with oil can damage latex condoms; check the condom package if you aren't sure)

Sponge

The birth control sponge is a small, round, squishy plastic sponge that is placed deep inside the vagina (to cover the cervix) before sex. The sponge blocks sperm from entering the uterus. It contains spermicide, which slows down sperm.

How Effective Is It?

Ideal use: About 91% effective. About 80% effective if you have given birth.

Typical use: About 88% effective. About 76% effective if you have given birth.

How Much Does It Cost?

A pack of three sponges costs about $15.

Pros

  • Can be put in up to 24 hours before sex
  • Unlimited sex during the 24 hours that the sponge is in
  • Easy to access over the counter
  • Discreet and portable
  • Not noticeable once it is in by wearer or partner

Cons

  • Can irritate the vagina or penis with its spermicide (nonoxynol-9), which can give infections an easier pathway into the body, increasing the risk for human immunodeficiency virus (HIV) and other STIs (using condoms along with the sponge can help prevent STIs)
  • Increased risk of toxic shock syndrome
  • Can be hard to use correctly
  • Must be left in for at least six hours after the last time you had sex (but no more than 30 hours total)

Diaphragm

A diaphragm is a soft, shallow, silicone cup that is inserted into the vagina to cover the cervix. It prevents sperm from entering the uterus by blocking the cervix.

A diaphragm is used with spermicide, which slows sperm and increases the effectiveness of the diaphragm. Spermicide also helps keep the diaphragm in place.

How Effective Is It?

Ideal use (with spermicide): 94% effective

Typical use (with spermicide): About 88% effective

How Much Does It Cost?

Diaphragms require a prescription and are fitted to the individual. They can cost up to $250. The cost may be covered by insurance, Medicaid, or other state programs.

Spermicide costs about $5–$15 a tube or kit.

Pros

  • Portable
  • Reusable and, with proper care, a diaphragm lasts up to two years
  • Doesn't interrupt sex
  • Is not usually noticed by the person or their partner

Cons

  • Does not protect against STIs
  • May cause urinary tract infections (UTIs)
  • Increased risk of toxic shock syndrome
  • Can be hard to use correctly
  • Must be left in for six hours after sex (no more than 24 hours total)
  • Must apply more spermicide if you have sex again during the same session
  • Has to be fitted to the individual, and may need to be refitted after pregnancy or a weight gain or loss of 10 or more pounds

Cervical Cap

A cervical cap is a small silicone cup that is inserted into the vagina before sex. It is similar to a diaphragm but smaller and shaped differently. It helps prevent sperm from meeting the egg. It must be used with spermicide to be at its most effective.

Cervical caps come in three sizes: Small (for people who have never been pregnant), medium (for those who have had an abortion, miscarriage, or cesarean delivery), and large (for people who’ve given birth vaginally)

How Effective Is It?

(With spermicide)

People who’ve never given birth: 86% effective

People who have given birth: 71% effective

How Much Does It Cost?

Cervical caps require a prescription and an exam to make sure the right size is used. It can cost up to $275 but may be covered by insurance or programs like Medicaid.

Spermicide costs about $5–$15 a kit.

Pros

  • Portable
  • Reusable and, with proper care, lasts up to a year
  • Can be inserted up to two hours before sex, so it doesn't interrupt the mood
  • Is not usually noticed by the person or their partner

Cons

  • Doesn't protect against STIs
  • Increased risk of toxic shock syndrome
  • Can be hard to use correctly
  • Must be left in for six hours after sex (no more than 48 hours total)
  • Must apply more spermicide in the vagina if you have sex again while it is still in
  • Has to be fitted to the individual, and needs to be refitted after birth, miscarriage, or abortion

No Sharing!

Diaphragms and cervical caps are single-user items only. Do not share with other people.

In addition to the hygiene factor, these barrier methods are not one size fits all. They must be fitted to the individual. Wearing the wrong size can make them ineffective.

Spermicide and Contraceptive Gel

Spermicide is an over-the-counter (OTC) product that comes in gel, cream, foam, or suppository. It is inserted deep in the vagina to prevent sperm from reaching an egg. There is also a prescription gel called Phexxi that works in a similar way to impair sperm mobility.

Spermicide or Phexxi can be used on their own but are more effective when used with other contraceptives such as condoms, diaphragms, cervical caps, or sponges.

How Effective Is It?

Spermicide used alone: 72% effective

Phexxi used alone: Ideal use is 93% effective. Typical use is about 86% effective

How Much Does It Cost?

Spermicide typically costs about $0.60–$3 per dose (about $8–$15 per kit). It can be found for free in some sexual health clinics. Phexxi requires a prescription and costs may vary depending on your insurance coverage.

Pros

  • Affordable
  • Portable
  • Can be used during breastfeeding if using spermicide (not known yet if Phexxi is safe to use while breastfeeding)
  • Can be used with other birth control methods (don't use Phexxi with the vaginal ring)

Cons

  • Has to be used every time you have sex
  • Contains nonoxynol-9 in spermicide, which can irritate the penis or vagina, increasing the risk for HIV and other STDs (Phexxi does not contain nonoxynol-9)
  • Can irritate the penis or vagina if using Phexxi
  • Does not protect against STIs
  • Can be messy

Do Not Eat

Spermicide is to be used on or in the genitals only. It is dangerous to ingest it.

Withdrawal

Also referred to as "pulling out," this method requires removing the penis from the vagina before ejaculation happens. Ejaculation happens away from the vulva and vagina.

How Effective Is It?

In practice, about 78% effective

How Much Does It Cost?

Free

Pros

  • Free
  • Always available

Cons

  • Doesn't protect against STIs
  • Can be hard to pull out in time (forget to, mistime, or change your mind)
  • Vulva cannot come into contact with ejaculate
  • Precum, or pre-ejaculate, can contain sperm
  • Must have a lot of trust with your partner

Scheduled Contraceptives

Birth Control Shot

The birth control shot (also called Depo-Provera) is a hormonal injection received every three months. The birth control shot contains the hormone progestin, which prevents ovulation. It also makes cervical mucus thicker, making it hard for sperm to get through.

How Effective Is It?

Ideal use: More than 99% effective

Typical use: About 94% effective

How Much Does It Cost?

Including an exam, it may cost up to $250. Each additional visit may cost up to $150. Costs are often covered by insurance or programs such as Medicaid or other state programs.

Pros

  • Convenient (only need to think about birth control four times a year)
  • Can make periods lighter and/or less frequent
  • May ease cramps and premenstrual syndrome (PMS)

Cons

  • Doesn't protect against STIs
  • Need to take shots on time or effectiveness may be affected
  • Can have side effects

Vaginal Ring

The birth control ring (also called the vaginal ring, or the ring) is a small, flexible ring that goes inside the vagina and releases estrogen and progestin into the body. These hormones prevent ovulation and thicken cervical mucus.

The two kinds of birth control rings are:

  • NuvaRing is put in the vagina for three weeks, then removed for one week a month to allow for a period. A new ring is used each month.
  • The ANNOVERA ring lasts for a year (13 cycles). It goes in the vagina for 21 days, then is taken out for seven days and stored in a case. After those seven days, the same ring goes back in.

How Effective Is It?

Ideal use: 99% effective

Typical use: 91% effective

How Much Does It Cost?

One NuvaRing can cost up to $200. One ANNOVERA ring can cost up to $2,200. They are usually covered by insurance or programs such as Medicaid.

Pros

  • Convenient (just need to think about it when inserting and removing it)
  • Can make periods lighter and more regular/easier to predict
  • Can be used to safely skip a period with NuvaRing
  • Can ease menstrual cramps

Cons

  • Doesn't protect against STIs
  • Have to stick to a strict schedule for putting the ring in and taking it out
  • Can have side effects

Birth Control Patch

The birth control patch is a patch that is worn on the belly, butt, back, or upper arm. The patch contains estrogen and progestin, which prevent ovulation. It also thickens cervical mucus, making it harder for sperm to get in.

How Effective Is It?

Ideal use: 99% effective

Typical use: About 91% effective

How Much Does It Cost?

One pack of three patches can cost up to $150. They are usually covered by insurance or programs such as Medicaid.

Pros

  • Convenient
  • Can make periods lighter and more regular/easier to predict
  • Can be safely used to skip periods
  • Can ease menstrual cramps

Cons

  • Doesn't protect against STIs
  • Can have side effects

Hormonal Birth Control Pill

The combination birth control pill contains estrogen and progestin. The progestin-only pill, or minipill, only contains progestin.

Both pills work to prevent ovulation and thicken cervical mucus (making it harder for sperm to get in). It is taken daily ideally at the same time. The minipill must be taken within the same three-hour window each day.

How Effective Is It?

Ideal use: 99% effective

Typical use: About 91% effective

The progestin-only pill is slightly less effective than the combination pill.

How Much Does It Cost?

A one-month pack can cost up to $50, but they are usually covered by insurance or programs such as Medicaid. They may also be available for a reduced price at Planned Parenthood.

Pros

  • Can make periods lighter or more regular
  • Can be used to safely skip a period
  • Can ease menstrual cramps

Cons

  • Doesn't protect against STIs
  • Can have side effects

Fertility Awareness (FAMs)

Fertility awareness methods (also called "natural family planning” or the rhythm method) are routines that track ovulation so that sex can be avoided on days most likely to result in pregnancy.

Tracking methods can include taking your temperature every morning before getting out of bed, checking cervical mucus (vaginal discharge) daily, and charting your cycle on a calendar or in a period tracking app.

How Effective Is It?

About 76%–88% effective. Most effective when multiple methods (such as temperature, mucus, and calendar) are used together.

How Much Does It Cost?

It's free except for equipment such as a thermometer.

Pros

  • Free
  • No side effects
  • Can be used with barrier birth control methods
  • Can help you gain a better awareness of your body and your fertility

Cons

  • Doesn't protect against STIs
  • Can be hard to do correctly
  • Less effective than other forms of birth control
  • Not effective for people with irregular menstrual cycles or abnormal vaginal discharge
  • Must avoid sex or use alternate birth control methods on fertile days (about nine days per month)

Low-Maintenance Contraceptives

Birth Control Implant

The birth control implant is a small rod that is implanted into the upper arm by a healthcare provider. The implant releases the hormone progestin, which prevents ovulation. It also thickens cervical mucus, which helps stop sperm from getting in.

The implant lasts up to five years.

How Effective Is It?

More than 99% effective

How Much Does It Cost?

The implant can cost up to $1,300. Implant removal can cost up to $300. The cost is usually at least partially covered by insurance or programs such as Medicaid.

Pros

  • Very effective
  • Convenient
  • Can ease period cramps and make periods lighter
  • Is long-term but reversible (the implant can be removed at any time)

Cons

  • Doesn't protect against STIs
  • Can have side effects
  • Infection in the arm is possible (this is rare)

IUD

What Is It?

An intrauterine device, or IUD, is a small, flexible T-shaped contraption that is inserted into the uterus by a healthcare provider. There are two types of IUDs: hormonal and nonhormonal. Both thicken the cervical mucus to keep sperm out.

Hormonal IUDs release a tiny amount of the hormone progestin (which prevents ovulation) into the uterus over a period of three to seven years, depending on which IUD is used.

The nonhormonal IUD releases a small amount of copper (which is toxic to sperm). It is effective for up to 12 years.

How Effective Is It?

More than 99% effective

How Much Does It Cost?

An IUD can cost up to $1,300, including medical exams, getting the IUD put in, and follow-up visits. This is often at least partially covered by insurance or programs such as Medicaid.

Pros

  • Very effective
  • Convenient
  • Can make your period lighter
  • Is long-term but reversible (the IUD can be removed at any time)
  • Can help treat people who suffer from severe cramps, really heavy periods, and anemia

Cons

  • Doesn't protect against STIs
  • Can have side effects and rare risks (talk to your healthcare provider)
  • Can be painful or uncomfortable to insert (like period cramps) but is temporary
  • Needs to be removed right away in the small chance a pregnancy occurs, to avoid complications such as ectopic pregnancy

Emergency Contraception

The nonhormonal copper IUD can also be used as emergency contraception. It is 99.9% effective at preventing pregnancy if it is inserted within 120 hours (five days) after having unprotected sex. It can remain in afterward to prevent future pregnancies.

Permanent Contraceptives

Vasectomy

A vasectomy is a surgery in which the small tubes (vas deferens) in the scrotum that carry sperm are cut or blocked off. It is performed by a healthcare provider in an office, hospital, or clinic. The procedure is very short (about 20 minutes) and heals within a few days. It permanently prevents pregnancy.

How Effective Is It?

Almost 100%

How Much Does It Cost?

A vasectomy can cost up to $1,000, including follow-up visits. Vasectomies may be fully or partially covered by some health insurance plans, Medicaid, and other government programs.

Pros

  • Very effective
  • Permanent

Cons

  • Doesn't protect against STIs
  • Not easily reversed, and a reversal may not work
  • Can have risks (discuss with your healthcare provider)
  • Is not immediately effective–takes about three months for there to be no sperm in the semen (after three months, this will be tested to make sure the semen is sperm-free)
  • Can be painful or uncomfortable procedure, which is temporary

Tubal Ligation

Tubal ligation (“getting your tubes tied”) is a surgical procedure in which a healthcare provider permanently cuts or seals off the fallopian tubes to prevent eggs from being released into the uterus. This keeps eggs and sperm from meeting.

It's usually a laparoscopic procedure (through one or two small cuts, using a tool with a light and a lens), with either local or general anesthesia. It takes about 20–30 minutes and leaves little scarring. Most people go home the same day.

How Effective Is It?

More than 99% effective

How Much Does It Cost?

Tubal ligation can cost up to $6,000, including follow-up visits. This may be fully or partially covered by some health insurance plans, Medicaid, and other government programs.

Pros

  • Very effective
  • Permanent

Cons

  • Doesn't protect against STIs
  • Not easily reversed, and a reversal may not work
  • Can have risks (discuss with your healthcare provider)
  • Can cause some pain or discomfort, but it is temporary
  • Can develop a pregnancy in your fallopian tube (ectopic pregnancy), which is dangerous but rare

Choosing the Best Birth Control

There are more factors to consider than effectiveness and cost when choosing birth control. The birth control that is best for you depends on things such as:

  • Do you want to get pregnant in the future?
  • Are STIs something you need to protect against?
  • Do you want a method you use every time or something that lasts longer?
  • Can you be sure that you will use that method correctly every time?
  • Do you or your partner have any health concerns or allergies that might affect which method you choose?
  • How often do you have sex?
  • How many sexual partners do you have?

Condoms plus another form of birth control is a good way to prevent pregnancy and STIs.

Start with Your Healthcare Provider

Before starting a birth control method, it's a good idea to speak with your healthcare provider, even if your method of choice doesn't require a prescription.

Your healthcare provider can help you decide what would best suit your needs, discuss any risks you should be aware of, and help make sure you are using the method correctly.

A Word From Verywell

If you are having penis-in-vagina sex and you don't wish to become pregnant or cause someone else to, you will need to find an effective birth control method.

There are many choices available, each with benefits and disadvantages. Talk to your healthcare provider about your options and which method or methods work best for you and your needs.

It's important to remember that the only birth control method that protects against STIs are condoms. Combining condoms with another form of birth control protects against STIs and gives extra protection from pregnancy.

Frequently Asked Questions

  • What birth control is best for me?

    Which birth control is the best depends on what your personal needs and comfort levels are. In general, using condoms along with another form of birth control helps protect against STIs and gives extra protection from pregnancy.

  • Which birth control is best for acne?

    Hormonal birth control methods such as the birth control pill or patch can help with acne.

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24 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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