How Effective Are Different Types of Birth Control?

Medically Reviewed by Traci C. Johnson, MD on May 30, 2024
Written by Paul Frysh
7 min read

There are many types of birth control. Some may fit better with your lifestyle or goals, but knowing which is most effective can help you make an informed choice. 

Birth control works best when used exactly as directed, known as “perfect use.” But if you’re like most people, you may not always use it perfectly each time. Experts refer to this as “typical use,” and it can make some forms of contraception less effective. 

Take birth control pills, for example. With typical use, effectiveness drops from 99% to 91%. So, instead of 1 out of every 100 people getting pregnant while on the pill each year, it’s closer to 9 out of 100. But certain kinds of contraception are more reliable – and harder to mess up – than others. 

Here’s how different forms of birth control stack up in their effectiveness, based on typical use.

Female and male sterilization can prevent pregnancy for the rest of your life. Reversals are challenging and not always successful, so you should consider this a permanent form of birth control. You can get it if you have a uterus or if you make sperm. 

Tubal ligation.This is a major surgery sometimes referred to as “getting your tubes tied.” The doctor typically cuts and closes off your fallopian tubes. After, an egg can’t get inside the uterus, and sperm can’t get to the egg to fertilize it.

Things to know about tubal ligation include: 

  • Your chances of getting pregnant are less than 1 in 100.
  • You’ll still get a menstrual cycle (until you go through menopause). 
  • You can get your tubes tied at the same time as childbirth or another belly surgery.
  • Your chances of ovarian cancer may go down, especially if you get your fallopian tubes removed.

Vasectomy.This is a minor surgery that usually takes less than a half-hour. During the procedure, the doctor makes a small cut in the top part of the scrotum. Then, they cut out part of the vas deferens, or the tubes sperm travel through to get into semen. The body absorbs sperm made by the testes.

Things to know about vasectomy: 

  • The odds you can get someone pregnant are less than 1 in 100 after the first year. 
  • It takes at least 2 to 4 months to work.
  • It’s slightly less effective than tubal ligation. 
  • Males can still ejaculate after a vasectomy.

Long-acting reversible contraception (LARC) offers the best protection against pregnancy outside of permanent birth control.

There are two types of LARCs: 

Implant. A doctor places a toothpick-sized rod under the skin of your upper arm. The implant releases a steady dose of the hormone progestin (Nexplanon), which can prevent pregnancy for up to 3 years. You have less than a 1 in 100 chance of getting pregnant with the implant. 

Some key facts about the implant include: 

  • You can get one right after an abortion, miscarriage, or childbirth. 
  • You can use it while breastfeeding. 
  • It works right away if you get it during the first 5 days of your period. 
  • You’ll need backup birth control for 7 days if you get it outside of your period. 
  • You’ll need a health care professional to put it in and take it out. 

Intrauterine device (IUD). This is a plastic, T-shaped device the doctor puts inside your uterus. IUDs can prevent pregnancy for 3-10 years, depending on which kind you get. Like an implant, your doctor can remove an IUD at any time if you decide you want to get pregnant.

IUDs include: 

  • Copper IUD (Paragard). A copper IUD can protect against pregnancy right away and works for up to 10 years. It’s 99% effective (less than 1 in 100 people who have one get pregnant per year) and changes little about the way your natural hormonal cycle works. 
  • Hormonal IUD. These release a steady dose of the hormone progestin. Hormonal IUDs include Kyleena (approved up to 5 years), Liletta (up to 8 years), Mirena (up to 8 years), and Skyla (up to 3 years). It takes about 7 days after you get a hormonal IUD for it to start working. Less than 1 in 100 people per year get pregnant with this type of birth control. 

Depot medroxyprogesterone acetate (Depo-Provera)shot. Your doctor injects progestin hormones into your muscle. You’re protected from pregnancy right away if you get the shot during the first 5 days of your period. But you’ll need to wait 7-10 days to have unprotected sex if you get the shot at another time of your menstrual cycle. 

Things you should know about the shot include:

  • It’s 99% effective if you get it every 3 months.
  • It’s 96% effective with typical use (you don’t get your shot on time). 
  • Chances of pregnancy go up if you wait a little longer than 12 weeks to get a new shot. 
  • It doesn’t protect against sexually transmitted infections (STIs). 

Birth control pills. You can take a combination of hormones (estrogen and progestin) or a progestin-only “minipill.” They’re both 91%-99% effective at preventing pregnancy. With typical use, around 9 in 100 people will get pregnant using the pill.

You’ll need a prescription for most birth control pills, except for the progestin-only Opill. It's available over the counter. 

Tips to make the pill more effective include:

  • Set a reminder to take your pill at the exact same time every day. 
  • Ask your doctor if medications or herbal supplements will interfere with the pill. 
  • Have a backup plan if you vomit or have diarrhea for at least 2 days.

Patch. This thin piece of material sticks to your arm, shoulder blade, butt, or lower belly. It sends a steady stream of estrogen and progestin into your blood through your skin. You change it weekly. Around 6 in 100 people may get pregnant with typical use. Perfect use lowers your odds to 1 in 100. 

Tips to make the patch more effective include: 

  • Change your patch on the same day each week. 
  • Make sure the patch sticks to your skin. 
  • Replace the patch with a new one if it comes loose or falls off. 

Vaginal ring. This is a flexible, ring-shaped device (Annovera, EluRyng, NuvaRing) that goes inside the vagina. You absorb estrogen and progestin through your vaginal wall. Like other kinds of hormonal birth control, the vaginal ring stops the ovaries from releasing an egg, thickens your cervical mucus, and thins the lining of your uterus. 

You can keep the ring inside your vagina for 3 weeks at a time before you change it. With typical use, your chance of pregnancy is about 9 in 100. But your odds go down to 1 in 100 if you use it perfectly.

Tips to make the vaginal ring more effective include: 

  • Replace the NuvaRing or EluRyng every 21 days (with or without a bleed week). 
  • Don’t keep it out for longer than 2 hours (Annovera) or 3 hours (NuvaRing, EluRyng). 
  • Keep it somewhere cool, away from direct sunlight. 

You can reuse the Annovera vaginal ring for up to 1 year. Talk to your doctor if you want to wear the ring continuously (meaning you don’t take it out for a bleed week) to prevent pregnancy and lighten your flow.

Some form of birth control is better than none, but certain kinds of contraception are less reliable than others. They include: 

Barrier methods: These options physically block sperm from getting to an egg. Some protect against sexually transmitted infections (STIs), but they don't work as well as hormonal contraception or the copper IUD.

Here are common kinds of barrier methods and how well they work with typical use: 

Male condom (88% effective). This is a thin layer of material that you put over a penis during sex. Condoms made from latex (rubber) or polyurethane (plastic) give you the best protection against STIs, such as HIV. 

Female condom (79% effective). You put this thin plastic pouch inside the vagina. It offers some protection against STIs.

Spermicide (72% effective). This is a chemical that kills sperm. You can use this with barrier methods like condoms or alone. 

Diaphragm (88% effective). This is a dome-shaped piece of silicone or latex that goes inside your vagina and covers your cervix. You’ll need a prescription for it and to use spermicide with it.

Sponge (76%-88% effective). You put this soft foam into your vagina before sex. It blocks sperm from getting into the uterus but also has spermicide in it.

Cervical cap (77%-83% effective). Like a diaphragm, this small device blocks sperm from getting into your uterus. You’ll need to use it along with spermicide. Ask a health care provider for a prescription.

Withdrawal (80% effective): Also known as “the pull-out method,” your sexual partner takes their penis out of your vagina before they ejaculate. Around 22 out of 100 (or about 1 in 5) people who use this method will get pregnant each year, making it less effective than some other forms of birth control. 

Natural family planning (76% effective): Sometimes called the “rhythm method,” this is a fertility awareness-based approach to birth control. You lessen the chances you’ll get pregnant by learning when you’re most fertile during your menstrual cycle, and then you avoid sex or use a barrier method during that window. 

Fertility awareness-based methods include: 

  • Standard days method
  • Cervical mucus method
  • Basal body temperature (BBT) method
  • Symptothermal method

If timed perfectly, only around 1 to 5 people out of 100 may get pregnant during the first year using fertility awareness. But with typical use, around 12-24 people out of 100 may become pregnant using these methods. Ask your doctor or another health care professional to learn more.