Birth Control and Contraception Options: An A-to-Z Guide

It’s a fact: As a woman, if you have sex with a man, it’s possible toget pregnant。But if you don’t want to get pregnant, there are many forms of birth control to help prevent pregnancy.

Birth Control: A Definition and Overview

Also called contraception, birth control has several different options. While abstinence, or refraining from intercourse, is the only way to prevent pregnancy with 100 percent certainty, there are both nonhormonal and hormonal methods of contraception.

Nonhormonal methods generally create a physical barrier between the sperm and the egg. There are also two permanent methods requiring surgery: sterilization, ortubal ligation, for women, and vasectomy for men.

Hormonal methods generally make it less likely that a woman will release an egg, that an embryo will form, or that an embryo will be implanted.

“It varies, and it depends on you and your lifestyle,” says Keosha T. Bond, doctor of education, an assistant professor of epidemiology at New York Medical College in Valhalla, New York. “I try to explain there’s no 'one size fits all.' It’s more, ‘What can I do, and how does my body react?’ There are so many contraceptive methods out there, but every one won’t fit every person.”

Learn More About The Best and Worst Birth Control Options

除了to the many methods detailed in the list of contraception options, today women have access toemergency contraception（（EC). Sometimes called next-day birth control or the morning-after pill, EC is a safe way to prevent pregnancy up to five days after unprotected sex.

Learn More About Emergency Contraception

Choosing the Right Birth Control Method for You

Birth control methodsare measured based on perfect use — meaning when they are used correctly every single time — and actual use, which is a more typical basis. For example, if birth control pills are supposed to be taken at the same time every single day, perfect use means the person is taking those pills exactly as directed. Typical use would mean that the pills were perhaps taken most of the time, but not every single day, or not at the same time every single day.

Available Birth Control Methods: All Your Contraception Options

Here’s a look at every kind of birth control available today:

避孕的类型：荷尔蒙节育

Contraception based on hormones help alter how your body works to get and stay pregnant. These range from daily use options, such as birth control pills, to long-term use approaches, such as hormone-based IUDs, which stay in place for several years, says Dr. Bond.

Hormonal Contraception Option: Birth Control Pills

There are many different kinds of birth control pills available, including high and low doses of hormones, some that change dosages based on a woman’s cycle, and others that give the same amount all month long, says Bond.

Some important facts:

• Pills need to be taken every day, typically at the same time each day.
• How effective are they? Perfect use: 99 percent; typical use: 91 percent.
• Depending on health insurance coverage, birth control pills may cost nothing or up to $113 per month, according to Bedsider. (1)

Hormonal Birth Control Side Effects

Some people don’t do well on hormonal contraception, which typically includes eitherestrogen, a form ofprogesteronecalled progestin, or a combination of the two. “Each woman is different, and you have to understand your body,” says Bond. If you notice one or more of these side effects, let your doctor know:

• Nausea
• Weight gain
• 改变月经周期，包括发现

谁不应该接受荷尔蒙节育措施？

对于某些人来说，不建议使用激素。“药丸很容易且很棒，但是如果您有migraineswith aura (vision changes during a bad headache), or have a history ofdeep vein thrombosis, stroke, or other cardiac changes,” talk to your doctor to learn if you should consider anotherbirth control option, says克里斯汀·卡兰·格雷夫斯（Christine Carlan Greves），医学博士, an ob-gyn based in Orlando, Florida. “If you have a blood clotting disorder, or breast cancer, you don’t want to take progesterone,” she added. Smokers, and those considered overweight or obese, should talk to their doctors about which contraceptives are recommended for them.

When the birth control pill was first introduced in 1960, it changed everything, especially for women.

一百年前，可靠的避孕是稀缺的。对于女性，发生性交意味着冒着怀孕的危险。在药丸到达之前，戒断和戒酒是可用的主要避孕方法。并且还有其他风险和障碍与使用节育措施进行空间或预防怀孕有关。一个大障碍是1873年的《康斯托克法案》，该法案使节育非法。

According to Planned Parenthood, fully one-third of the wage gains made by American women since the 1960s can be traced back to oral contraceptives. Between 1970 and 1990, hormonal birth control accounted for some 30 percent of the increase in the rate of women entering skilled careers like medicine and law. The birth control pill has also been the most influential factor enabling women to stay in college.

Learn More About Birth Control in America: A Brief History of Contraception

Hormonal Contraception Option: The Shot, Depo, or Depo-Provera

以上述名称知道的注入Depo-Provera可以帮助防止怀孕三个月。这是孕激素的镜头，可以通过防止卵巢释放鸡蛋，并使颈粘膜变稠，从而使精子无法有效旅行。

• Getting injections is private and done at your doctor’s office regularly every quarter. It also doesn’t require a monthly prescription or regular pharmacy trips.
• 它有多效果？With perfect use: 99 percent; typical use: 94 percent
• 根据计划生育，它无需花费或最高100美元。（（2)

荷尔蒙避孕措施：手臂植入物，Nexplanon或Implanon

这个is a small rod about the size of a matchstick that is placed into the upper arm. It releases progestin, which prevents your body from releasing eggs, and makes it tougher for sperm to move. It’s good for up to four years of pregnancy protection.

• It needs to be inserted in a healthcare provider’s office.
• It is 99 percent effective for both perfect and typical use.
• Most of the time it is covered for free but it can be expensive if not. Still, over the course of four years, it will end up costing about $10 per month, per Bedsider. (3)

Hormonal Birth Control Option: Vaginal Ring or NuvaRing

Like many birth control pills, the vaginal ring contains bothprogestin and estrogen。Unlike oral pills, a woman inserts the ring into hervagina（（similar to inserting a tampon) and the hormones work to prevent ovulation and pregnancy. It is worn each month and needs to be changed on a specific schedule, typically after three weeks, with a week off for a period. Then a new ring is inserted for the next cycle.

• You can use the ring to skip your period every month if you want, which is considered safe to do.
• 它有多效果？完美使用：99％；typical use: 91 perfect.
• 它的价格可能在$ 0到$ 200之间。（（4)

Hormonal Birth Control Option: The Patch

Resembling a small square Band-Aid, the beige contraceptive patch is worn on the skin and infusesestrogen and progestinso that ovulation doesn’t happen. It needs to be changed out every week and is available in generic form known as Xulane. (5)

• 它有多效果？完美使用：99％；典型用途：91％。
• It can cost between $0 and $150. (6)

避孕的类型：宫内装置或宫内节育器

IUDs (short for intrauterine device) are one of the most effective forms of birth control — they're more than 99 percent effective against pregnancy. Once recommended only for women who've already had children, experts now say that women who haven’t had children can effectively use an IUD.

IUDs are inserted into the uterus by a healthcare professional, and can work for 3 to 12 years, depending on which one you choose. They can also be removed any time if a woman wants to try to get pregnant.

Different IUDs on the Market

There are five kinds of IUDs available in the United States. Four of these work with a small amount of pregestin, which thickens cervical mucous and prevents sperm from reaching an egg. Known by the brand namesMirena，Kyleena，Liletta和Skyla，这些宫内节育器可以插入三到六年。它们还可以使您的周期更轻或完全消失。与您的医生谈谈哪一个可能适合您。

The fifth kind of IUD is made with plastic and a small amount of copper and is called the ParaGard. It prevents sperm from reaching an egg because sperm dislike copper. It does not affect your period and can be worn for up to 12 years.

• 尽管许多健康保险计划全部涵盖了宫内节育器，但对于那些从口袋里支付的妇女来说，宫内节育器的费用可能高达1,300美元，尽管摊销了几年，但每周或使用的费用很低。（（7)
• 它有多效果？All IUDs are 99 percent effective both for perfect and typical use.

避孕的类型：屏障方法

Barrier Method Options: Diaphragm, Sponge, and Cervical Cap

这些都是老的避孕方法still available, but aren’t as effective or as easy to use as other methods. “Sponges or a diaphragm? I don’t want to say they are outdated, but they aren’t talked about as much today by healthcare providers,” says Bond. All three methods need to be inserted into the vagina before having sex, so “they took away from the romance and the whole aspect of engaging in sex,” she says.

Similarly, “a diaphragm doesn’t work that great,” says Greves. “It’s better than nothing, but I don’t remember the last time I recommended it for someone.”

The Quick Diaphragm Details

• Diaphragms are a small silicone saucer that fits over the cervix and acts as a barrier for sperm to reach an egg.
• It’s inserted manually.
• 它有多效果？Perfect use: 94 percent when coated in spermicide (a lubricant that kills sperm); typical use: 88 percent.
• Costs vary from $0 to $90. (8)

The Quick Sponge Details

• 在药店的柜台上有海绵，看起来像带有尼龙手柄的白色泡沫圆。在性爱前三个小时，它插入阴道中。
• It works by blocking the cervix as well as continuously releasing spermicide while it is inserted.
• It costs from $0 to $15.
• 它有多效果？Perfect use: 80 to 91 percent. Typical use: 76 to 88 percent effective. (9)

快速宫颈盖细节

• Like a diaphragm, the cervical cap is a silicone circle inserted into the vagina up to six hours before intercourse to cover the cervix and prevent sperm from reaching an egg in the uterus. It’s also more effective when used with spermicide.
• It can be left in for up to 48 hours.
• Effectiveness at preventing pregnancy is between 71 and 86 percent. There are no stats available for perfect use.
• It costs between $0 and $200 to be fitted in a healthcare provider’s office, then from $0 to $89 for the cap itself, plus ongoing costs for spermicide. (10)

Barrier Method Contraception Option: Condoms

There are condoms available for men to use as a sheath over the penis as well as for women to use internally in the vagina or anus. Both are used to avoid pregnancy as well as to reduce the transmission ofsexually transmitted infections (STIs)from person to person. While male condoms are made from latex, plastic, or lambskin, female condoms are made only from plastic, which helps people with a latex allergy.

• Male condoms are available in most drugstores, grocery stores, and health clinics. They can be $0 to $2 apiece and are not typically covered by health insurance.
• Female condoms are also found in many drugstores, grocery stores, and health clinics, costing from $0 to $5 apiece. When used with spermicide, they are most effective.
• Male condom effectiveness rates are around 98 percent for perfect use and 85 percent with typical use; female condoms are about 95 percent effective for perfect use, 79 percent effective for typical use. (11,12)

There are several variations of this kind of birth control, also known as therhythm method或自然Family Planning。Overall, they work when a woman notices her most fertile days of her menstrual cycle by the kind of cervical secretions in her vagina, as well as measuring basal body temperature (the body’s temperature upon waking) — these are collectively known as symptom-based methods. If a woman is trying to determinefertilitybased on the length of several menstrual cycles, it is called a calendar-based method. It is used for birth control when a woman actively avoids sex during her most fertile times of her menstrual cycle.

Related:Some Fertility Tracker Apps Are Useful, Study Says

FAM选项：标准日方法

这个is only effective for women with two or more menstrual cycles that are between 26 and 32 days. (It doesn’t work when cycles are shorter or longer). Generally, the first fertile day is day 8 of a woman’s menstrual cycle, beginning with day 1 when the period first arrives. The last fertile day is day 19. Unprotected sex is avoided starting on day 8 and continuing through the end of day 19.

FAM Option: Two Day Method

这个is when a woman checks her cervical secretions twice a day to determine her fertility. If there are no secretions, it is unlikely she is fertile and therefore is less likely to get pregnant, as sperm cannot move toward an egg easily and live up to five days in the vagina without such secretions. If she feels secretions, both on one day and the day after, she is likely in her most fertile period, and therefore more likely to get pregnant.

FAM选项：宫颈粘液法

Cervical mucushas different consistencies throughout the menstrual cycle. Learning the differences can help you understand what's happening in your ovaries and in your cycle. There are several ways to check cervicalmucus, and it can be done first thing in the morning. Wipe the vagina before urinating, observe mucus on the underwear upon waking, or reach into thevaginal opening用干净的手指看和感觉粘液。

Decoding Your Body's Fertility Signals and Patterns

Recording the description of the mucus on a calendar or app will help you see patterns during the menstrual cycle. Menstrual blood may hide cervical mucus, so consider period days fertile ones. Once the period ends, there are typically dry days that may be considered less-fertile days depending on the length of your cycle. As an egg begins to get ready for ovulation, cervical mucus will appear, typically yellow, white, cloudy, and more or less sticky.

湿滑的宫颈粘液意味着生育能力

Right before the egg is released (ovulation), mucus gets slippery so it can best help sperm move to meet an egg. This is the most fertile time and when it is best to avoid unprotected vaginal sex. After several days, cervical secretions get more cloudy and sticky, and then disappear. When there are no secretions, this time is considered infertile. This phase continues until the period begins again and the cycle starts over.

FAM Option: Cervical Mucus Plus Basal Body Temperature tracking

Another method often used along with cervical mucus tracking involves taking your temperature upon first waking up in the morning. The body temperature rises slightly when you ovulate, so tracking the rates for at least three months can help predict when you are most fertile (and when to avoid unprotected vaginal sex).

It is recommended to take your temperature at the same time in the morning every day, yet it is important to understand that sickness, stress, fatigue, and other factors can affect the body’s temperature. Consult a healthcare provider or counselor about tracking your observations and how to best interpret your chart for contraception purposes.

FAM Option: Combined or Sympto-Thermal FAM

您可以将其称为最终组合：使用两种或三种FAM方法，例如宫颈粘液观测，以及一个日历或基础温度图表以预测排卵，症状 - 热生育意识法与使用一个FAM method独自的。

Learn More About Natural Family Planning and Fertility Awareness-Based Methods of Birth Control.

FAM Option: Lactational Amenorrhea Method (LAM) or Exclusive Breastfeeding

这个methodis when new mothers exclusively breastfeed their new babies for a period of up to about six months. Exclusive breastfeeding means the baby is nursed on demand (during the day and at night), does not use any bottles or pacifiers, is not eating any formula or other foods, and the mother hasn’t had her period return yet,not even spotting, since six weeks after delivery.

LAM功效率are about 98 to 99 percent if the mother follows all the above conditions, but start to decline as soon as an infant eats more than breastmilk, nurses less than on demand, or the mother’s period returns. In these cases, using a second form of contraception, such as a condom, is a good idea to prevent an unplanned pregnancy.

自然计划生育和生育意识方法的底线

Fertility awareness methods在几个月内跟踪变化，以及在最肥沃的情况下避免阴道性别（或使用避孕套），都需要进行很多奉献精神。

• 它有多效果？FAM is not the most effective at pregnancy prevention: 76 to 88 percent.
• It can cost $20 for supplies (a basal rate thermometer, pen and paper for tracking). (13)

“I don’t think FAM is reliable,” says Bond. “There is pre-ejaculation that can contain sperm that you can become pregnant by. If you are not sure about having some kind of pill, or other hormonal contraception, you should consider using condoms, because they are easy and don’t require that much change in the body.”

世界卫生大会t makes one method more effective than another? Failure rates are one factor taken into account when public health experts look at reliability and viability. Other important factors include perfect use versus typical use, accessibility, and cost.

Learn More About Contraception Speak: What Is Perfect Use of Birth Control?

Type of Contraception: Pulling Out, or Withdrawal

这个is when the man removes his penis from the vagina just before ejaculating. It’s tricky, because pre-ejaculate can form before withdrawal. Avoiding pregnancy means keeping all sperm away from the vagina, and even a small amount of sperm can get into the vagina and lead to pregnancy. This method is best used when combined with condoms.

• 它有多效果？With perfect use: 96 percent. With typical use, 78 percent. The man needs to withdraw every time during sex.
• 使用此方法没有成本。（（14)

Type of Contraception: Abstinence and Outercourse

Avoiding any kind of vaginal, anal, or oral sex is called abstinence, and activities such as kissing, dry-humping, masturbating, massage, and talking about fantasies are considered outercourse. The whole idea is to keep sperm away from the vagina to avoid pregnancy.

• 这个method is free, but requires a lot of dedication and willpower. It’s 100 percent effective at pregnancy prevention. (15)

避孕的类型：永久方法

For women, sterilization or tubal ligation is a way to permanently stop ovulation so you cannot ever get pregnant.

• 它有效99％，需要手术才能封闭输卵管，以使卵永远无法达到精子并受精。
• According to Planned Parenthood, it can cost anywhere from $0 to $6,000. (16)
• 这并不妨碍我对性传播nfections; condoms would still need to be used to reduce the chances of contracting an STI.

Learn More About How To Get Your Tubes Tied: What To Know About Permanent Birth Control

For men, vasectomy is the option for永久节育。

• It is 99 percent effective, and while vasectomy reversal procedures exist, they are pricey and not guaranteed. Choose vasectomy if you are sure you don’t want to get anyone pregnant.
• Planned Parenthood reports vasectomy costs from $0 to $1,000. (17)

Goodsexual healthis about a whole lot more than avoiding pregnancy or性传播疾病。Sexual health is about how you see yourself as a sexual being, your ability to embrace and enjoy your sexuality, and your sense of truly owning your sexual actions and choices.

Learn More About Healthy Sex: The Ultimate Guide

避孕访问和负担能力

世界卫生大会t is an affordable contraceptive option today may not be available tomorrow.太频繁，节育选择are determined by health insurance coverage. When the Affordable Care Act was introduced in 2010, it mandated birth control coverage, and helped American women get contraception, such as birth control pills, IUDs, and sterilization, at no cost. Yet with the change in federal government administrations since 2017, laws around birth control may change, too.

Learn More About The Politics of Contraception in Modern America

Knowing what all your birth control options are will help you and your partner choose what works best for you, wherever you are in your life. “I think it’s awesome to be talking about it. A lot of people just don’t know” about birth control, Greves says. “Birth control is always important.”

Resources We Love

关于节育及其工作原理的信息来源很多 - 但是，由著名的生殖健康组织，政府办公室或卫生政策小组提到的值得信赖的网站可能比口口相传更准确。

Favorite Resources on Birth Control Options

Planned Parenthood

www.plannedparenthood.org/learn/birth-control

Dedicated to reproductive health, this nonprofit offers a guide to all forms of birth control, including each method’s pros and cons, safety considerations, and a link to find the nearest Planned Parenthood healthcare clinic based on your ZIP code.

卧床不起Birth Control Support Network

www.bedsider.org

这个is a visual, interactive guide on birth control and where to get it. You can compare choices on the site side by side and watch video testimony from users.

节育服务服务

Alpha Medical

www.helloalpha.com

对于居住在加利福尼亚，佛罗里达州，伊利诺伊州，俄亥俄州和德克萨斯州的人们，将有更多州，Alpha Medical可以开处方并提供某些形式的节育形式。

Pandia Health

www.pandiahealth.com

这个organization also offers a birth control delivery service for people in certain areas in the United States, with low-cost or free options depending on your insurance coverage.

Contraception to Prevent Pregnancy After Unprotected Sex

Emergency Contraception Website

www.not-2-late.com

Operated by the Office of Population Research at Princeton University, this site offers information onemergency contraception (aka, next-day birth control)methods, how to find a provider, and frequently asked questions.

研究节育的医学协会

Federal Sources of Contraception Information

• Centers for Disease Control and Prevention查找有关该政府现场的有效避孕方法的详细信息。
• 食品和药物管理局到这里消费的信息均nt types of contraception available for women.
• HealthFinder.gov这份关于节育的常见问题解答和情况说明书来自美国卫生与公共服务部（HHS）的一个部门。
• HHS Office on Women’s HealthInformation about contraception, from another division of the HHS.

Contraception Policies by State

• Kaiser Family FoundationThese webpages, from a leader in health policy and health journalism, list contraception benefits policies by state, as well as how state and federal insurance policies cover contraception, and对妇女和雇主的影响。截至2018年7月，此信息是当前的。
• Guttmacher InstituteAn organization that aims to advance sexual and reproductive health and rights, Guttmacher Institute offers detailed info, likefact sheets on contraceptive use in the United States, including who uses contraceptiion and what methods they use, as well as news and policy updates related to reproductive health.

Science-Based Sites

• Medline PlusProduced by the National Library of Medicine and considered the world’s largest health library, MedlinePlus provides information from the National Institutes of Health about diseases, conditions, and wellness issues.
• Power to DecideA nonprofit whose aim is to end unplanned teen pregnancy runs this site, which includes a variety of useful resources, including a list of contraceptive deserts in the United States.
• Reproductive Health Access Project这个fact sheet charts different birth control choices by how effective they are and lists common side effects.

Learn More About Birth Control Resources