Contraception: Your Options, Explained

How to think about it

Three questions tend to matter most: how effective do you need it to be, do you want hormones involved or not, and how much day-to-day effort do you want to put in. There's no wrong answer — just a method that fits better or worse for where you are right now, and that can change over time.

Long-acting methods (LARCs)

IUDs (hormonal or copper) and the arm implant are the most effective reversible options available — over 99% effective, because once they're placed there's nothing to remember day to day. Hormonal IUDs often lighten periods substantially or stop them altogether; the copper IUD is hormone-free and can also work as emergency contraception if placed within 5 days of unprotected sex.

Short-acting hormonal methods

The pill, patch, and ring all work similarly — suppressing ovulation with hormones you take or wear on a schedule. With perfect use they're over 99% effective, but typical-use effectiveness is closer to 91–93%, because it's easy to miss a pill or forget to swap a patch. If consistency is hard for your schedule, that gap is worth factoring in honestly.

Barrier methods

Condoms are the only method that also protects against STIs, and are worth using alongside another method for that reason even if pregnancy prevention isn't your only goal. Diaphragms are another hormone-free barrier option, used with spermicide and fitted by a provider.

Fertility awareness-based methods (FABMs)

FABMs are a family of methods — the symptothermal method, cervical mucus monitoring (like the Billings method), and hormone-monitor-based approaches (like the Marquette Method) — that track daily fertility signs (basal body temperature, cervical mucus, and sometimes urine hormone levels) to identify the fertile window each cycle. They're often confused with the old “rhythm method,” which just counted calendar days and was genuinely unreliable — modern FABMs are a different, more precise approach, hormone-free from start to finish.

Correctly taught and consistently used, some FABMs have published effectiveness rates much closer to hormonal methods than their reputation suggests — but “correctly taught” is doing real work in that sentence. Effectiveness depends heavily on training from a certified instructor and daily consistency, and typical-use rates (accounting for real-world inconsistency) are meaningfully lower than perfect-use rates, same as with the pill.

The same charting used to avoid pregnancy can be used to try to conceive, just by flipping the strategy on fertile days — part of why some people choose FABMs specifically: one skill set serves both goals, and it gives you real insight into your own cycle along the way, not just a yes/no answer each month.

What they don't do: protect against STIs, or work well without real training — a period-tracking app guessing your fertile window is not the same thing as a taught FABM. FACTS About Fertility (factsaboutfertility.org) is a physician-education organization that maintains detailed, method-by-method effectiveness data if you want to go deeper before choosing one — we've also added it to our Resources page.

Permanent options

Tubal ligation (or salpingectomy) and a partner's vasectomy are options for people who are certain they're done building their family. Vasectomy is simpler, safer, and more easily reversible than tubal procedures, worth knowing if it's on the table as a couple's decision.

Emergency contraception

The morning-after pill (levonorgestrel or ulipristal acetate) works best the sooner it's taken after unprotected sex. The copper IUD, if you can get it placed within 5 days, is actually the most effective emergency option — worth knowing if you're near a clinic that can place one quickly.