There are more than a dozen distinct types of birth control available today, falling into seven broad categories: permanent sterilization, long-acting reversible contraceptives, the injectable shot, short-acting hormonal methods, fertility awareness-based approaches, barrier methods, and emergency contraception. The FDA uses these groupings, though the number of individual options within each category brings the total count well above 20 when you break them all out.
Understanding how these methods differ in duration, effectiveness, and what they ask of you day to day makes it much easier to find the right fit. Here’s a closer look at every category and the specific options within each.
Long-Acting Reversible Contraceptives (LARCs)
LARCs are the most effective reversible options available, and they require almost no ongoing effort after placement. Two types exist: intrauterine devices (IUDs) and the contraceptive implant.
Five IUDs are available in the United States. One is the copper IUD (ParaGard), which contains no hormones and is FDA-approved for up to 10 years of continuous use. It works by releasing copper ions that create an environment hostile to sperm. The remaining four IUDs release a small amount of a progestin hormone directly into the uterus. Two of these are approved for up to 5 years, one for up to 4 years, and one (the smallest) for up to 3 years. Hormonal IUDs often lighten periods significantly, while the copper IUD can make them heavier, especially in the first few months.
The contraceptive implant is a single small rod placed under the skin of the upper arm. It releases a hormone that prevents ovulation and lasts up to 3 years. With a typical-use failure rate of just 0.05%, it is the single most effective reversible contraceptive on the market. Copper and hormonal IUDs are close behind, with failure rates of 0.8% and 0.2% respectively in the first year of typical use.
Short-Acting Hormonal Methods
These methods all use synthetic hormones to prevent ovulation, thicken cervical mucus, or both. They require more regular attention than LARCs but offer flexibility since you can stop them at any time.
- The pill comes in two forms: combination pills (containing both estrogen and progestin) and progestin-only pills. Both have a typical-use failure rate of about 9%, mostly driven by missed doses. In 2024, the FDA approved the first over-the-counter daily oral contraceptive (Opill), a progestin-only pill available without a prescription.
- The patch sticks to the skin and delivers hormones through the bloodstream. You replace it weekly for three weeks, then go one week without. Its typical-use failure rate matches the pill at 9%.
- The vaginal ring is a flexible ring inserted into the vagina that releases a steady dose of estrogen and progestin. It stays in place for three weeks and comes out for one. Also 9% typical-use failure rate.
- The injectable shot is a progestin injection given every three months. Because you only need it four times a year, it performs slightly better in real-world use, with a typical failure rate of about 6%.
The main practical difference between these methods is how often you have to think about them. The shot is every 12 weeks, the ring and patch are weekly or monthly tasks, and the pill is daily. The closer a method’s schedule aligns with your routine, the more likely you are to use it consistently.
Barrier Methods
Barrier methods physically or chemically block sperm from reaching an egg. They are all non-hormonal and used only at the time of intercourse.
- Male condoms are the most widely used barrier method. With perfect use, only 2% of couples experience a pregnancy in the first year. In typical use, that rises to 18%. Condoms are also the only contraceptive that reduces the risk of sexually transmitted infections.
- Female (internal) condoms are pouches inserted into the vagina before sex. They have a 21% typical-use failure rate and a 5% perfect-use rate.
- The diaphragm is a shallow silicone cup placed over the cervix before sex, usually with spermicide. Typical-use failure rate: 12%.
- The cervical cap works similarly to the diaphragm but is smaller and fits more snugly over the cervix.
- The sponge is a soft, disposable foam disc containing spermicide. Effectiveness varies depending on whether someone has previously given birth. For those who haven’t, the typical-use failure rate is about 12%. For those who have, it jumps to 24%.
- Spermicides are gels, foams, or suppositories that kill or immobilize sperm. Used alone, they have a 28% typical-use failure rate, making them one of the least effective options. A newer prescription gel (Phexxi) works differently by keeping the vaginal environment acidic and has a typical-use effectiveness of about 86%.
Fertility Awareness-Based Methods
These approaches involve tracking your menstrual cycle to identify fertile days and then avoiding unprotected sex during those windows. There are several distinct techniques, and their effectiveness varies widely depending on which one you use and how consistently you follow it.
The calendar (rhythm) method estimates fertile days based on the length of past cycles. The standard days method is a simplified version that assumes fertility between days 8 and 19 of each cycle and has a perfect-use failure rate of 5%. The cervical mucus method asks you to observe changes in vaginal discharge throughout the month, since mucus becomes clearer and more stretchy near ovulation. Its perfect-use failure rate is about 3%. The temperature method involves taking your basal body temperature every morning to detect the slight rise that follows ovulation. The symptothermal method combines multiple signals, typically temperature, cervical mucus, and calendar calculations, and achieves the best results of any fertility awareness technique, with a perfect-use failure rate of just 0.4%.
As a group, though, fertility awareness methods have a typical-use failure rate of about 24%, reflecting how difficult it can be to track signs consistently and abstain or use backup methods on the right days. FDA-cleared contraceptive apps now exist to help automate some of this tracking, but they still rely on the user’s input and commitment.
Permanent Sterilization
For people who are certain they do not want future pregnancies, permanent methods are the most reliable option.
Tubal ligation (sometimes called “getting your tubes tied”) involves surgically cutting, blocking, or removing sections of the fallopian tubes. It has a first-year failure rate of about 0.5%. Vasectomy, the equivalent procedure for men, involves cutting or sealing the tubes that carry sperm. It has a first-year failure rate of 0.15%, and once a follow-up test confirms no sperm are present, the long-term risk of pregnancy drops to roughly 1 in 2,000. Both procedures should be considered irreversible, though reversal surgery exists and is sometimes successful.
Emergency Contraception
Emergency contraception is not a regular method but a backup option after unprotected sex or contraceptive failure. Three forms are available.
Levonorgestrel pills (sold over the counter as Plan B and generics) work best when taken as soon as possible and can be used up to 72 hours after intercourse, though effectiveness drops with each passing day. Ulipristal acetate (sold by prescription) maintains its effectiveness better between 72 and 120 hours, making it the stronger option when more time has passed. The copper IUD, when inserted within 120 hours of unprotected sex, is the most effective emergency contraceptive of all, preventing pregnancy more than 99% of the time, and it doubles as long-term birth control going forward.
Options Currently Available for Men
Right now, the only practical birth control options for men are condoms and vasectomy. That may change in the coming years. Two hormonal methods for men are in mid-stage clinical trials, including a daily gel applied to the skin that suppresses sperm production. A large international trial involving over 460 couples is testing one of these approaches. Several non-hormonal methods are also in earlier stages of development. None are expected to reach the market immediately, but male contraception is further along in the research pipeline than it has ever been.
How Effectiveness Numbers Work
You’ll notice two effectiveness figures for most methods: “perfect use” and “typical use.” Perfect use measures what happens when a method is used exactly as directed every single time. Typical use reflects how real people actually use it, including missed pills, late injections, and inconsistent condom use. The gap between the two numbers tells you how forgiving a method is. IUDs and implants have almost no gap because once they’re in place, there’s nothing to forget. Pills, condoms, and fertility tracking have large gaps because human error plays a bigger role.
Choosing a method often comes down to how much daily involvement you want, whether you prefer hormonal or non-hormonal options, how long you want protection to last, and how important maximum effectiveness is to you. There is no single best method, only the one that fits your body, your life, and your priorities.