Pros and Cons of Different Contraceptive Methods – Center for Young Women's Health (2024)

Posted under Health Guides. Updated 8 May 2022.

Pros and Cons of Different Contraceptive Methods – Center for Young Women's Health (3)

Here’s a list of the many available types of contraception, and the pros and cons of using each.

Hormonal Implants
Success Rate with Typical Use: 99%
ProsCons
  • Long-term method of birth control (protects against pregnancy for 3 years after insertion–it can be removed by a health care provider when you want to, or you can wait for 3 years when it’s time for a change of implant)
  • Very effective against pregnancy
  • May cause light or no menstrual periods
  • Doesn’t protect against STIs
  • Requires minor surgery and insertion of the tiny rod(s) underneath the skin
  • Requires minor surgery to remove device
  • Can cause side effects such as irregular menstrual periods, depression, nervousness, hair loss, and weight gain
  • Could get infection at area where rod is implanted

Intra-Uterine Device: Two types- LNG-IUS (Levonorgestrel hormone-releasing intrauterine system) and Copper IUD (no hormones)

Success Rate with Typical Use: 99%
ProsCons
  • Very effective against pregnancy
  • Provide protection against pregnancy when in place in your uterus- protects as soon as inserted (so don’t need to remember to use contraception if you have sexual intercourse)
  • Doesn’t need daily attention
  • Comfortable- you and your partner cannot feel the IUD, although you partner may feel the string
  • The levonorgestrel IUD (Mirena®, Skyla®, Lilleta®, Kyleena™) lessens menstrual flow and can be used to treat heavy periods
  • Both types do not protect against STIs. Other methods should be considered if high risk for STIs. Needs to be inserted by a health care provider.
  • Slightly higher risk of infection in the first 20 days after insertion
  • Cannot be placed in patients with known uterine anomalies
  • Can fall out or can rarely puncture the uterus
  • Slightly higher risk for infection in the first 20 days after insertion
  • TheCopper IUDcan have side effects such as menstrual cramping, longer and/or heavier menstrual periods, and spotting between menstrual periods.
Depo-Provera Hormonal Injection
Success Rate with Typical Use: 96%
ProsCons
  • Each injection provides 3 months of protection against pregnancy
  • Very effective against pregnancy if used correctly
  • Many women stop getting their menstrual period while getting injections. (This is not a medical problem and menstrual periods usually return 6-18 months after you stop taking injections)
  • Helps protect against uterine cancer
  • Doesn’t interrupt sexual activity
  • Doesn’t protect against STIs
  • Need to see your health care provider every 3 months for an injection
  • Depending on your insurance, your birth control may be free or there may be a co-pay
  • May have side effects such as weight gain, tiredness, and possibly a decrease in bone density
  • Many women have very irregular menstrual bleeding or spotting for the first 3 to 6 months and sometimes longer
Birth Control Pills
Success Rate with Typical Use: 93%
ProsCons
  • Very effective against pregnancy if used correctly
  • Makes menstrual periods more regular and lighter
  • Decreases menstrual cramps and acne
  • Makes you less likely to get ovarian and uterine cancer, pelvic inflammatory disease, ovarian cysts, and anemia
  • Doesn’t protect against STIs
  • Depending on your insurance, your birth control may be free or there may be a co-pay.
  • Need to remember to take every day at the same time
  • Can’t be used by women with certain medical problems or by women taking certain medications
  • Can occasionally cause side effects such as nausea, increased appetite, headaches, and, very rarely, blood clots
  • Need a prescription
Hormone Patch (Ortho-Evra)(Xulane)
Success Rate with Typical Use: 91%
ProsCons
  • Very effective against pregnancy if used correctly
  • Makes menstrual periods more regular and lighter
  • Decreases menstrual cramps and acne
  • Makes you less likely to get ovarian and uterine cancer, pelvic inflammatory disease, ovarian cysts, and anemia
  • Doesn’t interrupt sexual activity
  • Doesn’t protect against STIs
  • Still need condoms to lower the risk of STIs
  • Can’t be used by women with certain medical problems or by women taking certain medications
  • Can occasionally cause side effects such as nausea, increased appetite, headaches, and irregular bleeding in the first few cycles
  • Increased risk of blood clots
  • Need a prescription
Vaginal Hormonal Ring (NuvaRing®, Annovera™)
93% (NuvaRing),-97% (Annovera™)
ProsCons
  • Very effective against pregnancy if used correctly
  • Makes menstrual periods more regular and lighter
  • Decreases menstrual cramps and acne
  • Makes you less likely to get ovarian and uterine cancer, pelvic inflammatory disease, ovarian cysts, and anemia
  • Doesn’t interrupt sexual activity
  • Doesn’t protect against STIs
  • Still need condoms to lower the risk of STIs
  • Can’t be used by women with certain medical problems or by women taking certain medications
  • Can occasionally cause side effects such as nausea, increased appetite, headaches
  • Increased risk of blood clots
Diaphragm
Success Rate with Typical Use: 83%
ProsCons
  • Can be put in place right before intercourse or 2-3 hours before intercourse
  • Don’t need to take out between acts of sexual intercourse (protects against pregnancy for about 6 hours, but need to reapply spermicide)
  • Doesn’t protect against STIs
  • Need to get fitted by a health care provider and need a prescription
  • May be difficult to find
  • Can’t take out until 6 hours after intercourse
  • Cost $25-$45, plus the cost of spermicidal gel
  • May get moved out of place during sexual intercourse
  • Some women may be allergic to the diaphragm or to the spermicide
  • Need to be re-fitted after a 10 pound weight gain or loss and after pregnancy
  • Can be messy
  • Need to reapply spermicide with each act of sexual intercourse
  • Can cause an increase in urinary tract infections
Cervical Cap
Success Rate with Typical Use: 83%
ProsCons
  • Can insert several hours before sexual intercourse
  • Can leave in place 24-48 hours, will give protected sex for up to 48 hours
  • Use less spermicide with the cap than with the diaphragm, no need to apply more spermicide with each act of intercourse
  • Doesn’t protect against STIs
  • Cost $30-$50, plus the cost of spermicidal gel
  • Need to be fitted by a health care provider and need a prescription
  • Limited sizes available
  • Can’t take out until 6-8 hours after intercourse
  • May get moved out of place
  • Some women may be allergic to material of cap or to spermicide
  • Can’t be used by women with a history of abnormal Pap tests
  • Can cause increased urinary tract infections
External (Male) Condom
Success Rate with Typical Use: 87%
ProsCons
  • Lowers risk of STIs
  • Contraception that provides the most protection against sexually transmitted infections (latex condoms are best)
  • Don’t cost much (50 cents each), can buy at almost any drug store (don’t need a prescription)
  • Men feel they can “last longer” when using a condom
  • Allow men to have an active part in preventing pregnancy
  • Have to use a new one every time you have sexual intercourse (can only be used once)
  • May disrupt/interrupt sexual activity as it needs to be put on just before penetration
  • Can break
  • Women may be allergic to latex
Internal (Female )Condom
Success Rate with Typical Use: 79%
ProsCons
  • Provide protection against STIs (new product, so not clear how much protection given) and pregnancy
  • Can be inserted well before intercourse so less interruption of sexual activity
  • Male does not need to withdraw right after ejaculation, as he does with a male condom
  • May move or be uncomfortable
  • Can only use for one act of sexual intercourse
  • Cost about $2.50 each
Withdrawal
Success Rate with Typical Use: 80%
ProsCons
  • Natural, so no side effects
  • Doesn’t cost anything
  • Allows men to be an active part of preventing pregnancy
  • Doesn’t protect against STIs
  • Not very effective method of contraception
  • Difficult for male to always predict ejaculation
  • May decrease sexual pleasure of woman since need to always be thinking about what is happening during sexual intercourse
  • No control by women- need to rely completely on men to prevent pregnancy
Contraceptive Sponge
Success Rate with Typical Use: 76-83%
ProsCons
  • Can insert right before or several hours before sexual intercourse and will provide protection against pregnancy for a total of 24 hours
  • Don’t need a prescription
  • Doesn’t protect against STIs and may increase the risk of HIV infection in women who have sex multiple times daily because of irritation from the spermicide
  • Can’t take out until 6 hours after sexual intercourse
  • Can’t be used by women who are allergic to nonoxynol-9 (in the spermicides)
  • Increases urinary tract infections
Lactational Amenorrhea Method (LAM)
Success Rate with Typical Use (only applies if you meet all conditions): 98%
ProsCons
  • Natural
  • Costs nothing
  • No side effects
  • Only effective in women who have given birth in last 6 months, who have not had a menstrual period after childbirth and are feeding their babies only breast milk
  • Doesn’t protect against STIs
  • Only effective until menstrual period returns
  • May need to use a lubricant with sexual intercourse because of vaginal dryness
Fertility Awareness Based Methods
Success Rate with Typical Use: 75-86% depending on method
ProsCons
  • Natural
  • Approved by many religions
  • Woman gets to know her body and menstrual cycles
  • Can be helpful for partners who are very careful and don’t have sex during ovulation period and several days before and after
  • Doesn’t protect against STIs
  • Need to figure out when ovulating for each month, which may be difficult in those with irregular periods
  • Requires a lot of work- need careful instruction and the woman needs to figure out when ovulating
Spermicide
Success Rate with Typical Use: 79%
ProsCons
  • Doesn’t cost much, available at many drug stores, don’t need a prescription
  • Doesn’t protect against STIs and may increase the risk of HIV infection in women who have sex multiple times daily because of irritation from the spermicide
  • Effectiveness usually lasts only one hour (need to reapply each time have sexual intercourse)
  • Some women and men may be allergic to spermicides
  • May interrupt sexual activity (some forms need to be inserted at 10-20 minutes before intercourse)
  • Has a lower effectiveness against pregnancy than many other types of contraception- should use with another form of contraception to increase effectiveness
Tubal Ligation (Female Sterilization)
Success Rate with Typical Use: 99%
ProsCons
  • Very effective against pregnancy
  • One time decision that will provide protection against pregnancy forever
  • Need to have minor surgery
  • Permanent (although it is possible to undo sterilization with major surgery, it’s not always successful)
  • Only should be used by women who are absolutely sure that they do not want any or any more children
  • Expensive- ranges from $1000-$2500- but cost for contraception spread over rest of life
  • No protection against STIs

https://www.cdc.gov/reproductivehealth/contraception/index.htm#Contraceptive-Effectiveness

Our health guides are developed through a systematic, rigorous process to ensure accuracy, reliability, and trustworthiness. Written and reviewed by experienced healthcare clinicians from Boston Children's Hospital, a Harvard Medical School teaching hospital and consistently ranked as a top hospital by Newsweek and U.S. News & World Report, these guides combine clinical expertise, specialized knowledge, and evidence-based medicine. We also incorporate research and best practices from authoritative sources such as the CDC, NIH, PubMed, top medical journals, and UpToDate.com. Clinical specialists and subject matter experts review and edit each guide, reinforcing our commitment to high-quality, factual, scientifically accurate health information for young people.

Pros and Cons of Different Contraceptive Methods – Center for Young Women's Health (2024)
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