Birth Control18 min readUpdated October 2026

The complete guide to birth control

Choosing birth control can feel overwhelming — there are a lot of options, and it's not always easy to find straight answers. This guide covers every major method: how it works, how well it works, and what it's actually like to use. No judgment, no shame, just information.

Note: This guide is for educational purposes. Talk to a healthcare provider before starting any birth control method — many clinics offer confidential appointments for teens.

The Pill

91–99% effective

Daily hormonal contraception

99% with perfect use; 91% with typical use · Daily

How it works

The pill contains synthetic hormones (estrogen and progestin, or progestin only) that prevent ovulation. Without ovulation, there's no egg for sperm to fertilize. It also thickens cervical mucus, making it harder for sperm to reach an egg, and thins the uterine lining.

How to use it

Take one pill at the same time every day. Most packs have 21 active pills and 7 placebo pills — you get your period during the placebo week. Some people skip the placebo pills to skip their period entirely, which is safe.

Pros

Highly effective when taken consistently
Can reduce cramps, acne, and PMS symptoms
Makes periods lighter and more predictable
Fertility returns quickly after stopping
Can be prescribed confidentially at many clinics

Cons

Must be taken every day at roughly the same time
Does not protect against STDs
Some people experience side effects like nausea, mood changes, or headaches
Requires a prescription
Less effective if you miss pills or take certain medications

Good to know: There are two main types: combination pills (estrogen + progestin) and progestin-only pills (the "mini pill"). The mini pill is often recommended for people who can't take estrogen. If you're under 18, many Planned Parenthood and Title X clinics can prescribe the pill confidentially.

Condoms

STD protection85–98% effective

Barrier protection — the only method that also prevents STDs

98% with perfect use; 85% with typical use · Per use

How it works

Condoms are a physical barrier that prevent sperm from reaching the egg. External (male) condoms fit over a penis; internal (female) condoms are inserted into the vagina. Both work by blocking sperm and — unlike hormonal methods — also block the transmission of most STDs.

How to use it

For external condoms: check the expiration date, open carefully (no teeth or scissors), pinch the tip to leave space, and roll it down before any genital contact. Use a new condom for every act of sex. For internal condoms: insert before sex, making sure the inner ring sits against the cervix.

Pros

The only contraceptive that significantly reduces STD transmission
No hormones — no systemic side effects
Available without a prescription at pharmacies, clinics, and many schools
Often free at Planned Parenthood and health departments
Can be used alongside other methods for extra protection

Cons

Must be used correctly every single time
Can break or slip if used incorrectly
Some people find they reduce sensation
Latex allergies exist — non-latex options (polyurethane, polyisoprene) are available
Less effective than long-acting methods when used alone

Good to know: Using condoms alongside a hormonal method (like the pill or IUD) gives you the best of both worlds: very high pregnancy prevention plus STD protection. This is sometimes called "dual protection" and is recommended by most sexual health organizations.

IUD

99%+ effective

Long-acting, set-it-and-forget-it protection

Over 99% — one of the most effective methods available · 3–12 years depending on type

How it works

An IUD (intrauterine device) is a small T-shaped device inserted into the uterus by a healthcare provider. Hormonal IUDs (like Mirena, Kyleena, Liletta) release progestin to prevent ovulation and thicken cervical mucus. Copper IUDs (Paragard) are hormone-free — copper is toxic to sperm and prevents fertilization.

How to use it

A provider inserts the IUD during an office visit — the procedure takes a few minutes. You may feel cramping during and after insertion. Once it's in, you don't have to do anything. Check the strings monthly to confirm it's in place. Removal is also done by a provider.

Pros

Extremely effective — over 99%
Lasts 3–12 years but can be removed anytime
Hormonal IUDs often make periods lighter or stop them entirely
Copper IUD is completely hormone-free
Copper IUD can also be used as emergency contraception if inserted within 5 days
Fertility returns quickly after removal

Cons

Insertion can be painful — cramping is common for a day or two after
Requires a provider visit for insertion and removal
Copper IUD can make periods heavier and more painful, especially at first
Does not protect against STDs
Rare risk of expulsion (the IUD moving out of place)

Good to know: IUDs are safe for teens and people who haven't been pregnant. The upfront cost can be high without insurance, but Title X clinics offer them on a sliding scale — sometimes free. Over time, an IUD is often the most cost-effective option.

The Implant

99%+ effective

A matchstick-sized rod, up to 3 years of protection

Over 99% — among the most effective methods available · Up to 3 years

How it works

The implant (brand name Nexplanon) is a thin, flexible rod about the size of a matchstick that's inserted under the skin of your upper arm. It releases a steady low dose of progestin that prevents ovulation and thickens cervical mucus.

How to use it

A provider numbs your arm and inserts the rod in a quick office procedure. You can feel it under the skin but it's not visible. It works immediately if inserted in the first 5 days of your period. After 3 years, a provider removes it and can insert a new one at the same time.

Pros

Over 99% effective — nothing to remember
Lasts up to 3 years
Often makes periods lighter or stops them
Fertility returns quickly after removal
Good option if you can't take estrogen
Discreet — not visible under the skin

Cons

Irregular bleeding or spotting is common, especially in the first year
Does not protect against STDs
Requires a provider for insertion and removal
Some people experience hormonal side effects like mood changes or headaches
Upfront cost without insurance can be high

Good to know: Irregular bleeding is the most common reason people have the implant removed early. It's unpredictable — some people stop having periods entirely, others spot frequently. If that's a concern, talk to a provider about what to expect before getting it.

The Shot

94–99% effective

Hormonal injection every 3 months

99% with perfect use; 94% with typical use · Every 3 months

How it works

The shot (Depo-Provera) is an injection of progestin given by a healthcare provider every 12–13 weeks. It prevents ovulation, thickens cervical mucus, and thins the uterine lining.

How to use it

Visit a clinic every 3 months for your injection. The shot is given in the arm or buttocks. If you get your first shot within the first 7 days of your period, it works immediately. Otherwise, use a backup method for 7 days.

Pros

Nothing to remember between appointments
Often reduces or eliminates periods
Private — no packaging at home
Good option if you can't take estrogen
Can be used while breastfeeding

Cons

Must visit a clinic every 3 months — missing the window reduces effectiveness
Fertility can take 6–18 months to return after stopping
Does not protect against STDs
Irregular bleeding is common, especially in the first year
Long-term use may affect bone density (usually reverses after stopping)
Side effects can't be reversed immediately — the hormone stays in your system for months

Good to know: The delayed return of fertility is the biggest thing to know about the shot. If you think you might want to get pregnant within the next year or two, a different method may be a better fit. For people who want long-term pregnancy prevention and don't want to think about it every day, it can be a great option.

Emergency Contraception

75–99% effective

Not a regular method — but important to know about

Copper IUD: over 99%. Ella: ~85%. Plan B: ~75–89% (most effective within 72 hours) · Single use after unprotected sex

How it works

Emergency contraception (EC) prevents pregnancy after unprotected sex or contraceptive failure. It is not an abortion pill — it works by delaying or preventing ovulation, not by ending an existing pregnancy. There are three main types: levonorgestrel pills (Plan B, Take Action), ulipristal acetate (Ella), and the copper IUD.

How to use it

Plan B and generics: take as soon as possible, up to 72 hours after sex (still works up to 120 hours, but less effectively). Ella: requires a prescription, works up to 120 hours and is more effective than Plan B, especially later in the window. Copper IUD: inserted by a provider within 5 days — the most effective EC option and then works as ongoing contraception.

Pros

Provides a second chance after unprotected sex or a contraceptive failure
Plan B is available over the counter at pharmacies without a prescription or ID
Ella is more effective than Plan B, especially for people over 165 lbs
Copper IUD is over 99% effective as EC and provides ongoing contraception
No long-term effect on fertility

Cons

Not intended as a regular contraceptive method
Less effective than regular contraception used consistently
Plan B is less effective for people over 165–175 lbs — Ella or the copper IUD are better options
Does not protect against STDs
Can cause nausea, irregular bleeding, or headaches

Good to know: Having EC on hand before you need it means you can take it faster — and faster is more effective. Plan B is available at most pharmacies without a prescription. If cost is a barrier, many health departments and Planned Parenthood locations provide it free or at low cost.

Quick comparison

Effectiveness rates shown are with typical use. "Perfect use" rates are higher for all methods.

Method	Effectiveness	Duration	STD protection
The Pill	91–99%	Daily	No
Condoms	85–98%	Per use	Yes
IUD	99%+	3–12 years depending on type	No
The Implant	99%+	Up to 3 years	No
The Shot	94–99%	Every 3 months	No
Emergency Contraception	75–99%	Single use after unprotected sex	No

Common questions

Ready to talk to someone?

A healthcare provider can help you figure out which method fits your life. Planned Parenthood and Title X clinics see teens regularly and won't judge you.

Find a clinic near you