Contraception is highly personal and no one method is right for everyone. Your answers to these questions may help you choose a method:
The Association of Reproductive Health Professionals offers an online tool to help you choose the method that's right for you. Find a link to the tool, plus other sexual health resources, on our Health Links page.
A contraceptive method’s effectiveness is described in two ways: perfect use, for those whose use is always correct and consistent; and typical use, for those who may use the method incorrectly or inconsistently.
A higher effectiveness rating doesn’t necessarily make a method the best choice for you; if you’re unable or unlikely to use it properly, it’s not right for you.
Contraceptive effectiveness ratings
About the choices
- Male condom
- Female condom
- Contraceptive sponge
- Cervical cap
- Lea’s Shield
- Contraceptive pill
- Contraceptive patch
- Fertility awareness
When you don’t wish to have intercourse or aren’t prepared to use a reliable contraceptive, abstaining from intercourse is a positive choice.
A male condom is a thin sheath that fits over an erect penis. Male condoms are available in latex, polyurethane or animal skin. Most latex condoms are made with the milk protein casein, but vegan versions are available. Condomi Condoms are a vegan latex condom from Germany. These cost about 35 cents each and are available in many types, including flavored and XXL. The male condom prevents sperm from entering the vagina during ejaculation. Condoms are available over-the-counter at the UHS Pharmacy. Latex condoms are highly effective in preventing STI transmission; polyurethane condoms are thought to provide similar protection, while animal skin condoms aren’t effective. Condoms only protect areas they cover; protection against STIs transmitted by skin-to-skin contact is minimal.
Learn the right way to use a condom.
The female condom (brand names include Reality) is a soft, loose-fitting polyurethane sheath that lines the inside of the vagina; it’s available over-the-counter. The female condom has two flexible rings. One lies at the closed end of the sheath; this ring is squeezed and inserted into the vagina, where it anchors the condom in place. The second ring lies outside the vagina; the penis enters the sheath through the outside ring.The female condom is highly effective in preventing STIs. Because the outer ring partially covers the labia, it also protects against STIs transmitted by skin-to-skin contact.
Spermicides are available in foams, creams, gels, jellies, suppositories and film. They contain chemicals that immobilize and/or kill sperm, and can also form a barrier around the cervical opening and coat the vaginal lining. These are sold over-the-counter at the UHS Pharmacy. Insert spermicide into the vagina according to product directions. Do not douche after use. Spermicides do not provide STI protection. Some women may experience irritation of the vaginal lining, which may increase STI risk.
The contraceptive sponge is an over-the-counter method that can block the entrance to the uterus as well as absorb sperm; sponges contain the spermicide nonoxynol-9. Moisten the sponge with water to activate; then, fold it in half and insert high into the vagina. Intercourse can take place immediately after insertion. The sponge must be left in place for six hours after intercourse; to remove, pull on the soft cotton loop. Do not douche after use. Read the product’s instructions for complete information. Spermicides do not protect against STIs. Some women may experience irritation of the vaginal lining, which may increase STI risk.
The diaphragm is a soft, latex, dome-shaped device which is inserted in the vagina and covers the cervix. They must be used with spermicide and provide both a physical and chemical barrier. Diaphragms come in eight sizes and must be fitted by a clinician; they’re available at UHS. To use, spread spermicidal jelly or cream inside the dome and around the rim, then squeeze the diaphragm together and insert into the vagina, over the cervix. More spermicide is required for each additional act of intercourse. The diaphragm must stay in place for six to eight hours after the last act of intercourse; to remove, hook your finger over the rim and slide the device gently out of the vagina. Diaphragms offer some STI protection.
Cervical caps are prescription methods which are inserted in the vagina and cover the cervix. They must be used with spermicide, and provide both a physical and chemical barrier. Cervical caps come in various sizes and are fitted by a clinician. Fill the cap 1/3 full with spermicidal jelly or cream; do not spread over edges. Devices must be inserted prior to intercourse. This method offers some protection against STIs.
Lea’s Shield is a bowl-shaped silicone barrier which requires a prescription in the United States. It is inserted in the vagina and covers the cervix, and must be used with spermicide. This method provides a physical and chemical barrier. Spread spermicidal jelly or cream inside the bowl and around the rim, then squeeze the shield together and insert into the vagina, over the cervix. More spermicide is required for each additional act of intercourse. The shield must stay in place for eight hours after the last act of intercourse; to remove it, hook your finger into the removal loop and slide the device gently out of the vagina. The method offers some protection against STIs.
Oral contraceptives are a synthetic combination of the hormones estrogen and/or progesterone. The pill inhibits the release of an egg from the ovaries, thickens the cervical mucus, making it difficult for sperm to enter the uterus, and makes the conditions of the uterus unfavorable for implantation of a fertilized egg. Contraceptive pills are a prescription method and are available at UHS. Pills containing hormones are taken daily for 21 days; for the next seven days, a woman takes no pill or a placebo pill. Her period should begin during this time. The pill offers no protection against STIs; studies have shown it may increase susceptibility.
The patch (brand name Ortho Evra) is a synthetic combination of the hormones estrogen and progestin, which are absorbed through the skin. The hormones prevent ovulation, thicken cervical mucus and make the uterus unfavorable to implantation. The patch is a prescription contraceptive and is available at UHS. The 2” x 2” square patch is applied to the buttocks, upper outer arm, lower abdomen or upper torso (excluding breasts). Patches are changed on the same day of the week for three consecutive weeks, and are worn 24/7. No patch is worn during the fourth week; this is when a woman will get her period. The patch offers no STI protection.
The NuvaRing is a 2” flexible, transparent vaginal ring which releases a continuous low dose of estrogen and progestin over 21 days. The hormones prevent ovulation, thicken cervical mucus and make the uterus unfavorable to implantation. This method is available by prescription. Insert the ring high into the vagina by pressing the sides together and pushing it gently into the vagina. It’s left there for 21 days and then removed; a woman will have her period during the week the ring is removed. Most women don’t feel the ring once it’s in place. The ring does not protect against STIs.
Depo-Provera is an injected, progestin-only contraceptive which prevents ovulation, thickens the cervical mucus and makes the uterus unfavorable to implantation of a fertilized egg. This prescription method is injected by your provider every 11 – 13 weeks; it's available at UHS. Depo-Provera offers no protection against STIs.
Surgical contraceptive methods should be considered permanent. Tubal ligation cuts or blocks a woman’s Fallopian tubes, preventing the egg from leaving the tube. A vasectomy cuts and blocks the tubes which carry sperm from a man’s testicles, preventing the release of sperm during ejaculation. Once surgery is performed — and for men, semen is proven free of sperm — infertility results; no other contraception is needed. Sterilization offers no STI protection.
This non-prescriptive method incorporates factors which indicate the fertile and infertile periods of a woman’s monthly cycle, including include basal body temperature, cervical changes and cervical mucus observations. Daily recordkeeping and periodic abstinence are required. This method offers no STI protection.
Information adapted from Contraceptive Technology, 2004, 18th edition, Hatcher, et.al