What birth control has least side effects

There are dozens of hormonal and non-hormonal forms of birth control. Keep in mind that some have a higher effectiveness rate than others (note that all effectiveness rates listed below are according to Planned Parenthood unless otherwise indicated).

Hormonal Birth Control Pills (Oral Contraceptives)

One of the most common types of birth control are hormonal birth control pills, or oral contraceptives. There are two types: combination birth control pills and progestin-only birth control pills, or the mini pill. The hormones in these pills taken every day work to prevent pregnancy by either stopping ovulation and/or by thickening cervical mucus and preventing sperm from reaching an egg. If you take them as guided, every day at the exact same time, they have a 99% effectiveness rate.

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IUDs

An intrauterine device (IUD) can be inserted into the uterus by a healthcare provider, and is effective for anywhere from three to 12 years, touting an effectiveness rate of 99% on its own. There are two types: a hormonal IUD, typically made of plastic that releases a progestin hormone slowly over time, and a non-hormonal IUD, made of plastic and copper. Both types work similarly, by essentially blocking sperm from reaching an egg, either through thickening cervical mucus (hormonal) or creating an inhospitable environment for sperm inside the uterus (non-hormonal).

Vaginal Rings

There are two different types of vaginal rings. One is left in for three weeks before it is removed and replaced with a new ring one week later. A newer version of the vaginal ring allows the user to use the same vaginal ring for one year, 13 cycles total, by inserting the soft, squishy ring each cycle directly into the vagina for 21 days and removing it for seven days (in order to have a menstrual period), explains Yen Hope Tran, D.O., an OB-GYN at Memorial Care Orange Coast Medical Center in Fountain Valley, California. It also works 99% of the time if used exactly as directed, and functions by both preventing ovulation and thickening cervical mucus, making it more difficult for sperm to enter the uterus.

Hormonal Patches

The hormonal patch works similarly to the vaginal ring and hormonal birth control pills: It releases hormones that prevent the release of eggs and prevent a sperm meeting an egg by thickening cervical mucus. You stick one new patch directly on your skin (you can apply it anywhere other than the breasts) weekly, and it’s considered 99% effective at preventing pregnancy if you do not apply it late, meaning that you must apply it on the exact same day each week.

Hormonal Birth Control Implants

A hormonal implant is placed under the skin by a health care provider in order to prevent pregnancy for up to three years. It releases a progestin-only hormone to stop ovulation from occurring and also thicken cervical mucus, similar to other hormonal options of birth control. The implant is highly effective at preventing pregnancy with efficacy of 99%.

Depo-Provera Shots

Another option is an injection called Depo-Provera which is given every three months. Like other hormonal methods, the shot prevents pregnancy mainly by stopping ovulation and thickening cervical mucus to prevent sperm from reaching an egg. If you follow up with the shots and get them in a timely manner, the effectiveness rate is 99%. Currently the shots are only approved for administration by a health care provider but research is being done to test whether patients can safely give one type of the shot to themselves at home, similar to insulin or other subcutaneous (under the skin) self-injections.

Barrier Methods

Barrier methods are non-hormonal methods of birth control that do not involve taking any pills, shots or any insertion procedures by a health care provider. These include external condoms, internal condoms (previously known as “female condoms,” which are inserted into the vagina prior to intercourse), diaphragms or cervical caps. All barriers work by keeping sperm from reaching an egg. These methods are between 86% and 98% effective at preventing pregnancy when used consistently and correctly every time you have sex, and condoms are the only birth control method that can also protect against sexually transmitted infections (STIs).

Non-Hormonal Gel

A newer form of non-hormonal contraception is Phexxi, a gel you can use right before or up to an hour before sex, without having to take any kind of daily, weekly or monthly birth control. Here’s how it works: “When semen enters the vagina, it raises the vagina’s pH levels from its typical range of 3.5 to 4.5 to a range of 6.5 to 7.2.,” explains Dr. Tran. “This increase in pH is what allows sperm to move and swim up the reproductive canal [in order to reach an egg and cause pregnancy].” Phexxi keeps the vaginal pH at its normal level, even when semen is introduced, making the environment of the vagina inhospitable to sperm. To insert the gel into the vagina, there’s a tampon-like device for one-time use. The gel then starts working immediately and lasts up to an hour for each act of vaginal sex, adds Dr. Tran. Phexxi is 93% effective when used consistently and correctly. Phexxi can also be used with barrier methods or any method other than the vaginal ring to increase effectiveness and has lubricating properties, so additional lubrication is not needed.

Withdrawal

Cycle Tracking

Tracking your monthly cycle—also known as natural family planning or fertility awareness—is another form of birth control that involves tracking menstruation, cervical mucus and/or basal body temperature to predict ovulation and peak fertility days in order to avoid sexual activity, and therefore pregnancy, on those days. Effectiveness is highly dependent on the methods of cycle tracking (tracking menstruation, cervical mucus and/or basal body temperature) and ranges from 76-99%.

Vasectomy or Tubal Ligation

Permanent forms of birth control include surgical procedures like a vasectomy or tubal ligation. A tubal ligation involves blocking or tying off the fallopian tubes so that eggs will not be able to be fertilized or transported to the uterus. A vasectomy is a surgery that blocks the vas deferens, the tubes that carry sperm, preventing sperm from being released into the ejaculate and potentially meeting with an egg. While a tubal ligation is often not successfully reversible, a vasectomy reversal is possible and typically has successful outcomes. Both methods should only be considered if you are certain you do not want future pregnancies.

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