Thanks to Bedsider.org and the National Campaign to Prevent Teen and Unplanned Pregnancy for providing key information, text and image elements, and Dr. K.

Birth control (aka contraceptives) can come in handy for a whole bunch of reasons. Maybe you are—or will be—intimate with a partner of the opposite sex and need to prevent pregnancy. Maybe your priority is regulating your period. Maybe you are looking for a form of birth control that can help you avoid sexually transmitted infections (STIs) or one that is particularly discreet.

You may not need it this instant, but it’s good to know what’s out there and to bank some knowledge for the future. Regardless of your reasons for using birth control, all partners are responsible and need to know the options.

Our expert “Dr. K.” is Dr. Colleen Krajewski: practicing OB-GYN; assistant professor at the University of Pittsburgh Magee-Women’s Hospital, Pennsylvania; and medical advisor to Bedsider.org, an online birth control support network for women, operated by the National Campaign to Prevent Teen and Unplanned Pregnancy.

Dr. K.’s 4 steps for birth control decisionsGirl talking to her doctor

1. Identify your priorities

  • Each method has pluses and minuses. There isn’t one best method in the world for everyone.
  • Going into discussions about birth control with your partner and health care provider, know what your priorities are and where you’d be willing to sacrifice. For example:
    • Is pregnancy prevention your number one priority?
    • Do you care about regulating your period or preventing STIs?

2. Be ready, whatever your relationship status

  • Even if you’re not in a long-term relationship, it can still make sense to think about long-term birth control.
  • Being protected and safe, and taking control of your body is empowering.
  • The IUD (intrauterine device) and implant are great long-term birth control options for many girls and women.
  • Keeping condoms and emergency contraception on hand can save you (or a friend) a whole lot of stress and inconvenience later.

“Know where your immediate resources are, such as local clinics, nearby places that sell contraceptives, and someone who can support you or help you out in an emergency,” suggests Carissa, a senior in Winnetka, Illinois.

3. Make conversation, not assumptions

  • Conversations with your partners, not assumptions, are key to healthy sexual and nonsexual relationships.
  • For example, if your partner observes a particular religion, don’t make assumptions about their feelings and beliefs. You still need to talk about birth control, sexuality, boundaries, and other topics. Everyone is different.

4. Make sure you get the facts

Happy couple

Think about what you’re looking for in a contraceptive. For example…

  • I need to not get pregnant.
  • I need to take control of my period.
  • I need to know I’m protected against STIs.
  • I need to avoid a medical appointment.
  • I need something that doesn’t use hormones.
  • I need something that’s easy to hide.
  • I need something I don’t have to think about in the heat of the moment.
  • I need help NOW. I had unprotected sex.

How to get it

Birth control is covered by most health insurance plans, but the laws for getting it are varied based on your age and where you live.

Some states require permission from a parent to get birth control if you are under 18. This doesn’t necessarily mean your parent has to go with you to the appointment, but the doctor may need to contact your parent for permission. Find out about the laws in your state. 

Many states have health clinics, such as Planned Parenthood, that offer free or reduced-cost birth control options. You can make an appointment on your own and your medical records will remain confidential. Depending on where you live, some services, such as abortions, may require permission from a parent or guardian.

There may also be other clinics available in your area. See where they are located. 

Everything you need to know about the top contraceptives out there

 

Male condom

MALE (EXTERNAL) CONDOM

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Works best for:

“I need to know I’m protected against STIs”

“I want to avoid a medical appointment”

I need something that doesn’t use hormones”

pros

  • STI protection
  • Widely available
  • No medical visit
  • Easy to use
  • No hormones
  • Few or no side effects*

* Unless you have a latex allergy, but there are non-latex versions available

cons

  • Limited pregnancy prevention
  • Need to use a new one every time
  • Best with a backup method

Effectiveness at preventing pregnancy with typical use
82 percent

The Bedsider guide to the male condom.

What it is and how it works

Male condoms are one of the most popular forms of birth control out there. They slip over a guy’s penis to prevent pregnancy and lower the risk of STIs by keeping the guy’s sperm inside the condom and limiting skin-to-skin contact.

Use condoms for STI protection with other methods of birth control. Condoms aren’t the most effective method for birth control. But unlike most forms of contraception, they can often prevent transmission of STIs.

Find the best fit in advance

Condoms are not one size fits all. The wrong size of condom might not be as effective or comfortable. It’s important for guys to explore their options ahead of time.

Choose lubricated condoms or add lubrication to make the experience more comfortable and pleasurable for both parties. For comfort, pick a lubricant that is water-based, unscented, and isn’t “warming” or “cooling.”

Helpful hint

Stick with water-based lubricants to reduce chances of condom breakage. Oil-based lubricants can degrade latex condoms, making them more likely to tear.

Girls are responsible for condoms, too

Dr. K.: “Women should feel empowered to buy male or female condoms. It’s not always the guy’s responsibility. If you want to have sex, you should have a condom too.”

 

The pill

THE PILL

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Works best for

I need to take control of my period”

“I need something that I don’t have to think about in the heat of the moment”

pros

  • Lightens period
  • Hidden
  • Choice of products
  • Reversible

cons

  • Medical visit
  • No STI protection
  • Need to remember to take it at the same time every day
  • Possible side effects

Effectiveness at preventing pregnancy with typical use
91 percent

The Bedsider guide to the pill

“I don’t take my birth control pills in public places anymore. A lot of people will ask you what you are taking and then will judge you for it, instead of applauding you for being smart and responsible. I’ll stick to taking the pill in my bathroom because I don’t feel like I need to explain my life to everyone.”
—Katie, Carrollton, Georgia

“I’d been with a guy for many months and [I once had to tell him]: ‘Just because I am on the pill doesn’t mean I’m safe from STDs,’ so I continued to make him use a condom.”
—Name and school withheld

What it is and how it works You take the pill once a day, at the same time every day. The pill releases hormones that keep your ovaries from releasing eggs. The hormones also thicken your cervical mucus, which helps to block sperm from getting to the egg in the first place.

Sign up for a daily reminder to take your pill here.

Periods? The pill comes in 21-day or 28-day packs. Some types give you a regular period every month. Others let you have your period more rarely.

Keep emergency contraception somewhere accessible—in case you forget your pill and then have sex without a condom or other barrier method (i.e., anything that prevents the sperm from reaching an egg, such as a diaphragm, cervical cap, or sponge).

Also use condoms for protection from STIs.

 

IUDs

IUDs (INTRA-UTERINE DEVICES)

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There are two types of IUDs: hormonal and copper.

Hormonal IUD

Works best for

I need to not get pregnant”

I need to take control of my period”

“I need something that’s easy to hide”

“I need something that I don’t have to think about in the heat of the moment”

pros

  • Easy to use
  • Long-term protection
  • Hidden
  • Lightens periods (hormonal types)
  • Few or no side effects
  • Choice of products
  • Reversible

cons

Effectiveness at preventing pregnancy with typical use
99 percent

 

Copper IUD

COPPER IUD

+ More

Works best for

“I need something that doesn’t use hormones”

I need to not get pregnant”

“I need something that’s easy to hide”

“I need something that I don’t have to think about in the heat of the moment”

“I need help NOW. I had unprotected sex.”

pros

  • Long-term protection
  • Hidden
  • Few or no side effects
  • Reversible
  • Very effective in emergencies

cons

Effectiveness at preventing pregnancy with typical use
99 percent

The Bedsider guide to the IUD

Relief from anxiety and phone alarms

“I was nervous at first to get an IUD. But reassurance from the nurse helped. I am so happy I did it because now I don’t have an embarrassing alarm going off on my phone. And I never have to worry about remembering the pills.”

—Liz, Fremont, California

What it is and how it works

This small, T-shaped piece of plastic sits in your uterus to mess with the way sperm can move and prevent them from fertilizing an egg. Sounds odd, but it works like a charm.

Insertion is OK

Dr. K.: “Lots of people hear stories about IUD insertion being scary. Everybody’s experience is different. The scariness will go away, but your birth control stays in place. Most patients that I place the IUD in say, ‘Oh, that wasn’t nearly as bad as I thought!’”

Your IUD options:

  • Mirena and Skyla last for three to five years. They contain hormones. These IUDs can make your periods much lighter or stop completely.
  • ParaGard lasts for up to 12 years and does not contain hormones. Some women may experience increased blood flow or cramping while using this type of IUD.

Long-acting and reversible contraception (LARC)

IUDs and implants are two types of long-acting and reversible contraception (LARC). LARC methods are very low maintenance and can provide protection from pregnancy for years.

Also use condoms for protection from STIs.

 

Implant

IMPLANT

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Works best for

I need to not get pregnant”

“I need something that’s easy to hide”

“I need something that I don’t have to think about in the heat of the moment”

pros

  • Easy to use
  • Long-term protection
  • Hidden
  • Lightens period for some
  • Choice of products
  • Reversible

cons

Effectiveness at preventing pregnancy with typical use
99 percent

The Bedsider guide to the implant. 

Three stress-free years

“I started out with the Depo shot, but I was too busy to remember every three months. My doctor said the implant was convenient and a one-time insertion and would last for three years, worry free. Why not? It was very effective and very convenient. You don’t need reminders or alarms to take a pill or change a patch or switch a ring. You also don’t have to worry about it being misplaced or getting ‘lost.’”
—Ka, Manitowoc, Wisconsin  

What it is and how it works

The implant is a teeny-tiny rod (about the size of a matchstick) inserted under the skin of your upper arm. It releases hormones that keep your ovaries from releasing eggs and thicken your cervical mucus, which helps to block sperm from getting to the egg in the first place. It prevents pregnancy for three years.

The most effective method

The implant is more effective than the IUD or any other method, with a failure rate of five out of 10,000.

Period drama

Dr. K.: “The effect on [menstrual] bleeding is unpredictable. My patients who love the implant say, ‘I don’t mind what happens with my period: I want to know I’m not pregnant.’”

Love it or hate it

Dr. K.: “Just like with the ring, the women who love it love it, and the women who hate it hate it. If you think this method will work for you, then by all means try it out.”

Also use condoms for protection from STIs.

 

Adstinence

“NOT RIGHT NOW” OR ABSTINENCE

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Works best for

“I need to know I’m protected against STIs”

“I need to not get pregnant”

pros

  • STI protection
  • Few or no side effects
  • No hormones

cons

  • Harder to use

Effectiveness at preventing pregnancy with typical use
100 percent, if consistently done right

The Bedsider guide to “Not right now.”

Faith in waiting

“Growing up in a relatively conservative Muslim family, from a very young age I was told not to have a girlfriend. As I grew older and began to critically analyze the people around me, I came to understand how I’d much rather remain celibate until the right person came along.”
—Dan, Alberta, Canada

Is anyone worth it?

“I choose not to be sexually active because I have not yet found someone worth all the risks. I haven’t met someone that I know would love and support me through an STI or pregnancy, so therefore I have not found anyone worth losing my virginity to.”
—Caroline, New Albany, Indiana

What it is and how it works

Here, we’re using “not right now” to mean “no penetrative sex.” You can still be sexual in other ways—but be mindful that those other ways might introduce the risk of STIs.

You can always say “no” or “not right now”—for any reason. If you are feeling apprehensive or intimidated, this may not be the right time or partner. Even if you’ve been intimate with that person before, you always have the right to say “no.”

Make conversation, not assumptions

Dr. K.: “If your partner observes a particular religion, don’t assume that you don’t need to talk about birth control, sexuality, boundaries, or other topics. Conversations, not assumptions, are key to healthy relationships.” 

 

Emergency contraceptives

EMERGENCY CONTRACEPTIVES AKA “THE MORNING-AFTER PILL” OR PLAN B

+ More

Works best for

“I need help NOW. I had unprotected sex.”

EC pill (Ella)

pros

  • Very effective in emergencies

cons

  • Protection after the fact
  • Medical visit
  • Most pharmacies need to order it
  • Not effective as a regular method
  • No STI protection
  • Possible side effects

Effectiveness at preventing pregnancy with typical use
95 percent up to five days after sex 

 

Male condom.jpg

EC PILLS (LEVONORGESTREL-BASED)

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pros

  • Very effective in emergencies
  • Choice of products

cons

  • Protection after the fact
  • Medical visit
  • Not effective as a regular method
  • No STI protection
  • Possible side effects

Effectiveness at preventing pregnancy with typical use
95 percent first 24 hours, then declines slightly

The Bedsider guide to emergency contraception.

Pulling an all-nighter

“The one time a condom broke, my boyfriend and I had a panic attack immediately. We literally stayed up all night just so we could walk into a CVS to get the ‘morning-after pill.’ I don’t think I have ever been so nervous in my life.”
—Heather, Coral Gables, Florida

What it is and how it works

Emergency contraception (EC) pills, such as Plan B One-Step and Ella, stop a pregnancy before it starts. This means they are not the same as the abortion pill.

Copper IUD

ParaGard is the most effective EC. Have a provider insert it within five days of a misstep and lower your chance of pregnancy by 99.9 percent.

Buy emergency contraception in advance

Dr. K.: “A common theme in students’ stories is that everyone had to rush out to get Plan B in the morning. There’s no reason not to just buy it and stick it in your cabinet. In a stressful time, things would have been easier if these students had it on hand.”

Over-the-counter EC pills

These are available without a prescription at pharmacies and online. They include Plan B One-Step, Next Choice One Dose, Next Choice, My Way, and Levonorgestrel.

Prescription EC pill

Ella is a newer EC pill that is available only by prescription. It works for up to five days after unprotected sex and does not decrease in effectiveness over those five days.

Find an emergency contraception locator here.

 

The ring

THE RING

+ More

Works best for

I need to take control of my period”

“I need something that I don’t have to think about in the heat of the moment”

pros

  • Easy to use
  • Medium-term protection
  • Lightens period
  • Reversible

cons

Effectiveness at preventing pregnancy with typical use
91 percent

The Bedsider guide to the ring.

Birth control talk still shocks

“I discuss my birth control options openly with people. Whenever I tell anyone that I’m on the vaginal ring, I receive a shocked look. I don’t blame them; it’s not a popular option. Most people only know about the pill. Then they say, ‘Wait, you mean, you stick it up there?’”
—Rebecca, Ontario, Canada

What it is and how it works

The NuvaRing is a small, flexible ring that you insert into your vagina. It contains hormones that stop your ovaries from releasing eggs. It works in a similar way to the pill but is much lower maintenance.

Don’t knock it till you try it

Dr. K.: “All methods work for some and not others. In a study of satisfied pill users randomly assigned to the patch or the ring, 71 percent of women in the ring group planned to continue using it after the study was completed.”

Three weeks in, one week out

The Ring stays in place for three weeks. You take it out for the fourth week, which is usually when you get your period. After the fourth week you put a new ring in and start over.

Insertion diversion

If you’re not OK with putting your fingers inside yourself, the ring probably isn’t for you. It’s a lot like putting in a tampon: If you can do that, you’re good to go.

Also use condoms for protection from STIs.

About Rebecca’s experience

Dr. K.: “It’s problematic that people feel OK asking women about their birth control choices, but then as soon as a woman mentions her vagina, they get grossed out.” 

 

Female condom

FEMALE (INTERNAL) CONDOM

+ More

Works best for

“I need to know I’m protected against STIs”

“I want to avoid a medical appointment”

I need something that doesn’t use hormones”

pros

  • STI protection
  • No medical visit
  • More control for females
  • Easy to use
  • No hormones
  • Few or no side effects
  • Safe with latex allergies

cons

  • Limited pregnancy prevention
  • Use one every time
  • Not widely available
  • Best with a backup method

Effectiveness at preventing pregnancy with typical use
79 percent

The Bedsider guide to the female condom.

Develop your insertion skills

“Young women: Be the one to protect yourself. Using female condoms lets you be in control. Practice putting one in at home. Don’t wait till the heat of the moment then get aggravated because you can’t get it in right. Practice, practice, practice!”
—Jennifer, Tulsa, Oklahoma

What it is and how it works

The female condom is a pouch you insert into your vagina. It keeps the guy’s sperm inside the condom and out of your vagina. Unlike most male condoms, it doesn’t contain latex.

Practice in advance

Dr. K.: “If you’re feeling apprehensive or intimidated, practice inserting it ahead of time. Be sure to read the instructions! Also, don’t be shy with using lubrication. With a bit of practice, you’ll be a pro.”

Use condoms for STI protection with other methods of birth control. Male and female condoms aren’t the most effective method for birth control. But unlike most forms of contraception, they’re great for STI prevention.

Girls are responsible for condoms, too

Dr. K.: “Women should feel empowered to buy male or female condoms. It’s not always the guy’s responsibility. Unfortunately, the female condom is not widely available in drugstores but is available at Amazon.com and Walgreens.com.”

Choose lubricated condoms or add lubrication to make the experience more comfortable and pleasurable for both parties. For comfort, pick a lubricant that is water-based, unscented, and isn’t “warming” or “cooling.” 

 

The shot

THE SHOT (DEPO-PROVERA)

+ More

Works best for

“I need something that’s easy to hide”

“I need something that I don’t have to think about in the heat of the moment”

pros

  • Easy to use
  • Medium-term protection
  • Hidden
  • Lightens period

cons

Effectiveness at preventing pregnancy with typical use
94 percent

What it is and how it works

It’s just what it sounds like, a shot (like the ones you got as a kid). You go to your health care provider once every three months to have it injected. The shot contains the hormone progestin, which stops your ovaries from releasing eggs and thickens the cervical mucus to help prevent sperm from getting through to an egg.

A lot to like

This is an easy method of birth control that you only have to think about four times a year. As long as you can make it to your health care provider for those four appointments, you’re good to go.

Fear of needles

Some people just don’t like needles. If that’s the case, the shot may not be right for you. Bedsider.org asks, “But what’s a little prick compared to a pregnancy?”

Also use condoms for protection from STIs.  

 

Withdrawl

WITHDRAWAL: WHAT’S THE DEAL?

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What it is and how it works

The guy pulls out before he ejaculates. The hope is that he’ll be quick enough to do this successfully, before any sperm have entered the vagina. The reality is that humans make mistakes.

No protection from most STIs

Withdrawal without the use of other barrier methods does not offer STI protection from the majority of STIs. You’re better off using another form of birth control that includes a barrier method, such as the male or female condom.

Higher risk of pregnancy

Even when done correctly every time, there is a four percent chance of pregnancy, research shows. But most people aren’t able to withdraw perfectly every time, so the risk of pregnancy is much higher. Dr. K.: “Withdrawal is less effective than some other methods, so as primary pregnancy prevention, it’s not acceptable to many couples.”

The Bedsider guide to withdrawal.

Withdrawal symptoms

“I was not using protection but attempted the withdrawal method. Later a friend told me my former partner was pregnant. I had to quickly search on Facebook to find her. I didn’t have to ask her ‘Is the baby mine?’ because she was only a few months along, which didn’t match up to when we were last together. However, it was a wake-up call to always use protection.”
—Paul, Newark, New Jersey

No pressure, please

“We used condoms, but sometimes he would complain that they were too expensive, then later there wasn’t time or we forgot. So we would use withdrawal. I felt like he was making excuses to not use condoms. Girls shouldn’t feel pressured into using withdrawal.”
—Name withheld, Lawrence, Kansas

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Article sources

Bedsider.org provided images and elements of the text.

Colleen Krajewski, MD, MPH, assistant professor at the University of Pittsburgh Magee-Women’s Hospital, Pennsylvania; medical advisor to Bedsider.org.

Joleen Nevers, MA Ed, CHES, AASECT Certified Secondary Education, sexuality educator, health education coordinator, University of Connecticut, Storrs.

P. Davis Smith, MD, director of health services, Westminster School, Simsbury, Connecticut.

Pierre-Paul Tellier, MD, director of student health services, McGill University, Montreal, Quebec.

Bedsider.org. (n.d.). The National Campaign to Prevent Teen and Unplanned Pregnancy.
Retrieved from https://bedsider.org/

Centers for Disease Control and Prevention. (2013). Reproductive health.
Retrieved from https://www.cdc.gov/reproductivehealth/unintendedpregnancy/contraception.htm

Planned Parenthood. (n.d.). IUD.
Retrieved from https://www.plannedparenthood.org/health-info/birth-control/iud