Nonhormonal Birth Control

What Is Nonhormonal Birth Control?

Nonhormonal birth control is any method that doesn’t affect a woman’s hormones. Condoms are a well-known type, but there are many others.

Why Choose Nonhormonal Birth Control?

Hormonal contraceptives, like the birth control pill and hormonal implants, change a woman’s hormone levels to keep her body from getting pregnant. They can be convenient and reliable. But they might not be ideal choices for some people for reasons like:

Types of Nonhormonal Birth Control

Your chances of getting pregnant in a given year vary widely depending on the birth control method, from less than 1 in 100 for copper T IUDs to more than 1 in 4 for spermicides.

Barrier methods

These kinds physically come between a woman’s egg and a man’s sperm.

Diaphragm

  • What is it? A saucer-shaped silicone cup that you put into your vagina to block semen from entering your womb. You must be fitted for a diaphragm at first by your doctor.
  • How well does it work? If you use the diaphragm correctly and add spermicide, you have a 6% chance of getting pregnant after a year’s use. But the odds double if you don’t always use it or don’t use it exactly right, the way a typical person does.
  • Pros and cons. You can carry your diaphragm and put it in just before you have sex. It’s reusable for 12 months. If you decide you want to start a family, stop using it. A diaphragm won’t protect you from STDs. You have to leave it in for at least 8 hours after sex. You also may be more likely to get vaginal or urinary tract infections. Learn about the best ways to prevent a UTI.

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Cervical cap

  • What is it? It looks like its name: a little hat-shaped piece of silicone that you put over your cervix to keep out sperm. As with a diaphragm, you must be fitted by your doctor and should use it with spermicide.
  • How well does it work?  It can fail about 20% of the time, meaning 20 out of 100 women who use it will get pregnant in a year.
  • Pros and cons. You can leave the cervical cap on for up to 48 hours after sex. You can try to get pregnant anytime. The cervical cap isn’t widely prescribed, and it can take practice to use it right. It won’t prevent STDs. It can raise your chances of bladder infections. It’s not recommended if you have sex at least three times a week or have a history of pelvic diseases. Read more on how a cervical cap works.

Sponge

  • What is it? Made of foam, it works the same way as a diaphragm or cervical cap. The two big differences are that the sponge already contains spermicide, and you can buy it without a prescription.
  • How well does it work? The sponge can be among the least reliable birth control for some people. It prevents pregnancy about 91% of time for women who’ve never given birth and who use it correctly and consistently every time. But that drops to just 76% for women who have had children and who use it the way most people do.
  • Pros and cons. The polyurethane foam feels like your vaginal tissue. You can have sex multiple times in a 24-hour period with one inserted. You can stop using it and try to start a family right away. It won’t prevent STDs. Find out more on how to use the birth control sponge.

Copper IUD

  • What is it? This T-shaped plastic piece is a nonhormonal type of intrauterine device. It goes into your uterus. It’s wrapped in copper, which is toxic to sperm and keeps them from swimming through the vagina to reach your egg. Failing that, it prevents the fertilized egg from attaching to your womb.
  • How well does it work? IUDs are some of the best-working forms of birth control. Copper versions are less effective than hormone-based IUDs, but they still prevent conception more than 99% of the time.
  • Pros and cons. You can leave a copper IUD in for 10 years. It can work as emergency contraception up to 5 days after you’ve had unprotected sex. If you decide you want to get pregnant, you’ll need a doctor to take it out. It doesn’t protect against STDs. The device can cause cramps or bleeding between periods. Get more information on the copper IUD and other intrauterine devices.

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Spermicide

  • What is it? You put this chemical into your vagina to kill or paralyze sperm. You can buy spermicide over the counter in several forms, including gels, foams, and suppositories.
  • How well does it work? Spermicide alone can fail about 28% of the time. You can use it with condoms, diaphragms, and other contraceptives to boost their effectiveness.
  • Pros and cons. Some people are allergic or sensitive to the main chemical used in spermicide, nonoxynol-9. You shouldn’t rinse out your vagina for at least 8 hours after using a spermicide, and some may leak out. It won’t protect you against STDs like HIV. In fact, infections might be more likely if the spermicide irritates your vagina. Know more about the effectiveness of spermicides.

Vaginal gel

  • What is it? You use an applicator to put this gel in your vagina before sex. It keeps the pH level in the vagina from rising and allowing the sperm to move to the reproductive canal to get to the egg.
  • How well does it work? It’s considered 86% effective. You might use it with condoms, diaphragms, or other contraceptives to boost their effectiveness.
  • Pros and cons. It must be used before sex and reapplied within the hour if you don’t have sex. It also needs to be reapplied with each sexual encounter. Some people are allergic or sensitive to it, and it can cause infections or irritation. It won’t protect against STDs like HIV.

Male condom

  • What is it? A thin sheath, often made of latex, that a man wears over his penis during sex to keep semen from getting into a woman’s body.
  • How well does it work? It’s about 82% effective at preventing pregnancy.
  • Pros and cons. Condoms are the only forms of birth control that guard against unplanned pregnancies and STDs, including HIV. They’re easy to find in stores or online. Some health clinics offer them for free. You don’t need a prescription to buy them. You can use them at any time and with little preparation. You must follow the instructions carefully for a male condom to be effective. Learn more about how to use a male condom.

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Female condom

  • What is it? A lubricated latex tube that you put inside your vagina. It has flexible rings on both ends. One end is closed to keep out sperm.
  • How well does it work? In a given year, about 1 in 5 women who use female condoms get pregnant.
  • Pros and cons. Female condoms also protect against STDs. You can buy them in drugstores or online. Allergies and side effects are rare. It may not be a good choice if you’re young or have a lot of sex and have a higher chance of getting pregnant. You have to use it every time and in the right way for it to work well. Find out more on how to use a female condom.

Surgical methods

Sterilization

  • What is it? There are two types of sterilization surgeries. The first, called tubal ligation, blocks a woman’s fallopian tubes to prevent an egg from reaching her uterus. The second, called a vasectomy, seals the tubes that carry sperm out of a man’s testes.
  • How well does it work? Both are almost 100% effective.
  • Pros and cons. You can “reverse” a vasectomy later, but a tubal ligation is permanent. Sterilization doesn’t prevent STDs. As with any surgical procedure, there’s a risk of complications such as bleeding and infection. Get more information on birth control and sterilization.

Behavioral methods

Outercourse and the pull-out method

  • What is it? “Outercourse” is sex in which the man’s penis doesn’t go into the woman’s vagina at all. In the withdrawal or “pull-out” method, he pulls out of her vagina before he ejaculates.
  • How well does it work? There’s no risk of pregnancy with outercourse. But the pull-out method isn’t very reliable. Of 100 women who use it as their only birth control, about 22 will get pregnant.
  • Pros and cons. Both methods are simple and free. If there’s no vaginal, oral, or anal penetration, outercourse carries a very low risk of STDs. The pull-out method doesn’t protect against STDs. It can also be difficult for the man to get the timing right. Read more about the withdrawal method.

Natural family planning

  • What is it? A woman tracks her menstrual cycle, including her vaginal discharge and body temperature, so she can know which days she’s fertile. She then skips sex or uses a barrier method on those days. It’s also known as the rhythm method or fertility awareness.
  • How well does it work? Of 100 women who use this method, up to 23 will get pregnant.
  • Pros and cons. There are no side effects. It’s best for women who have very regular cycles, but it can still be hard to tell when exactly you’re ovulating. You have to be dedicated about monitoring your body and keeping records. It doesn’t protect against STDs. Know more about natural family planning methods for birth control.
WebMD Medical Reference Reviewed by Brunilda Nazario, MD on August 04, 2020

Sources

Guttmacher Institute: “Contraceptive Use in the United States.”

Options for Sexual Health: “Barrier Methods,” “Hormonal Methods.”

Kidshealth.org: “Birth Control Methods: How Well Do They Work?”

The New England Journal of Medicine: “Contemporary Hormonal Contraception and the Risk of Breast Cancer.”

CDC: “Effectiveness of Family Planning Methods.”

Familydoctor.org: “Urinary Tract Infections.”

American Pregnancy Association: “Cervical Cap.”

Cleveland Clinic: “Birth Control Options.”

Mayo Clinic: “Spermicide,” “Diaphragm,” “Cervical Cap,” “Mirena (hormonal) IUD,” “Contraceptive Implant.”

Cornell Health: “Non-hormonal Methods of Contraception.”

U.S. Department of Health and Human Services Office of Population Affairs: “Male condom.”

American College of Obstetricians and Gynecologists: “Barrier Methods of Birth Control: Spermicide, Condom, Sponge, Diaphragm, and Cervical Cap.”

UpToDate: “Patient education: Birth control; which method is right for me? (Beyond the Basics),” “Patient education: Permanent birth control for women (Beyond the Basics),” “Patient education: Vasectomy (Beyond the Basics.”

American Journal of Public Health: “Outercourse as a safe and sensible alternative to contraceptives.”

Nemours/TeensHealth: “Withdrawal,” “Fertility Awareness.”

U.S. Department of Health and Human Services Office on Women’s Health: “Birth control methods.”

CDC: “Contraception.”

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