11 of the Best Nonhormonal Birth Control Options

Whether you’re on the pill, have a patch, or use a ring, hormonal birth control can be a total drag. It can cause annoying-AF side effects like bleeding between periods, boob pain, headaches, mood changes, and nausea.

There’s also a small chance that it could increase your risk of heart attacks, blood clots, or strokes.

You may want to opt for a nonhormonal method if you:

• have trouble remembering to take a pill every day
• don’t want to change your body’s natural cycle
• experience bad side effects from hormonal birth control
• have certain health conditions like severe hypertension, heart disease, vascular disease, certain liver diseases, or migraine with aura

• Effectiveness: 99%
• Cost: $$$

A copper IUD (aka Paragard) is a T-shaped piece of plastic that’s wrapped in copper. A doctor inserts the device into your uterus through your cervix. It’s more than 99 percent effective and gets to work right away. The copper is toxic to sperm, so it helps prevent fertilization. It can also prevent a fertilized egg from attaching to the uterine wall.

A copper IUD is a great choice if you want long-term protection — it can last up to 10 years! It can also be used as emergency contraception for up to 5 days after you have sex without a condom or other barrier.

One downside is that insertion can be uncomfortable. Discomfort can range from a slight sting to WHY IS THERE A WASP IN MY VAGINA? But the entire procedure usually takes just 5 to 15 minutes.

Another possible downside: Some folks have heavier periods for 6 months or more after insertion.

• Effectiveness: 85–98%
• Cost: $

Condoms aren’t just a great way to prevent pregnancy — they also help protect you against sexually transmitted infections (STIs). They act as a barrier to catch the semen. They’re cheap and easy to get, and they don’t require a lot of planning.

Condoms are 98 percent effective when used correctly — but that’s only if you use them perfectly every time. Because slip-ups happen, the real rate of effectiveness is closer to 85 percent.

FYI: Most condoms are made from latex, which is a no-go if you’re allergic. If that’s the case, you can opt for non-latex or lambskin versions.

• Effectiveness: 72–86%
• Cost: $–$$

Spermicide is a chemical you insert into your vag before you get your freak on. It works by paralyzing sperm or blocking the cervix. Both can prevent fertilization. You can get it in gel, foam, or suppository form.

Spermicide usually works best when combined with other forms of birth control (like condoms or diaphragms). It has only a 72 to 86 percent success rate when used on its own — and that’s if you use it perfectly.

The active ingredient in most spermicides is nonoxynol-9. While it does a good job at slowing sperm, it can trigger irritation. According to Planned Parenthood, this can increase your risk of STIs. Another con is that you can’t rinse out your vagina for at least 8 hours after using it.

• Effectiveness: 76–88%
• Cost: $

A birth control sponge (Elaine’s personal fave) is a round piece of foam that you push deep inside your vagina before each sex sesh. The sponge contains spermicide and covers the cervix to prevent an eggo from getting preggo. It’s 76 to 88 percent effective and can be used for up to 24 hours.

Each sponge has a soft fabric loop to help you take it out. But insertion is another story. It can take a lot of practice to get good at inserting the sponge correctly. And you have to leave it in for at least 6 hours after you have sex.

• Effectiveness: 86%
• Cost: $$

In 2020, the Food and Drug Administration approved a contraceptive gel called Phexxi. It contains lactic acid, citric acid, and potassium bitartrate, which changes the vagina’s pH, making it more acidic. This means it’s harder for sperm to fertilize an egg.

Phexxi is about 86 percent effective with typical use. Like spermicide, it works best when combined with another form of birth control. And you have to be careful with the timing. It works for about an hour after you put it in, but it won’t prevent pregnancy if you use it after sex.

PSA: You need a prescription to get Phexxi. If you can’t get it covered by insurance, expect to pay about $22 per use.

• Effectiveness: 99%
• Cost: $$$

Vasectomy is the most effective birth control method for peeps with peens. This common procedure involves cutting, sealing, or blocking the vas deferens tubes. These carry sperm from the testicles to the penis.

It doesn’t effect orgasms at all. There will still be ejaculation — there just won’t be sperm in the semen. But note that it takes about 3 months to kick in.

While a penis procedure def doesn’t sound pleasant, most folks say it’s not too bad. The average recovery time is less than a week, and it’s more than 99 percent effective.

Vasectomies can be reversed in many cases, but they’re meant to be a one-time thing. Make sure it’s what you want before you get it done. Also, expect to pay up to $1,000 if it’s not covered by your insurance.

• Effectiveness: 99% or higher
• Cost: $$$

Tubal ligation is a procedure that involves closing or removing pieces of the fallopian tubes. A hysterectomy involves removing the entire uterus (and sometimes the cervix, ovaries, or fallopian tubes too). Tubal ligation is more than 99 percent effective, and hysterectomy is 100 percent effective.

Both procedures require downtime, but a hysterectomy is *a lot* more extensive and expensive. Most folks bounce back from tubal ligation in a couple of days, while recovery from a hysterectomy can take 6 to 8 weeks. Also, a hysterectomy will kick-start menopause if your ovaries are removed.

• Effectiveness: 78%
• Cost: $

The pull-out method (aka withdrawal method) is when you pull the penis out of the vagina before ejaculation. It’s free, it’s convenient, and it doesn’t have any side effects. But even with these perks, it’s far from the best birth control out there.

The pull-out method is only 78 percent effective. That means about 1 in 5 folks who use this method get pregnant each year.

One of the main reasons this method fails is because it’s hard to pull out in time. Practicing with masturbation or other forms of birth control might come in handy, but accidents can still happen. And there’s a chance sperm can make its way into precum and still end up in the vagina.

• Effectiveness: 76–88%
• Cost: $

FAMs are methods of tracking your ovulation cycle to prevent pregnancy. This is also referred to as natural family planning or the rhythm method. There are a few ways to do this:

• Calendar method. You chart your menstrual cycle on a calendar and avoid having sex without birth control on or near your ovulation days.
• Cervical mucus method. You check for changes to your cervical mucus and avoid having sex during times when the mucus indicates ovulation.
• Temperature method. You monitor your ovulation by using a sensitive basal thermometer to take your temperature every morning before you get up. Higher basal temperatures might be a sign of ovulation.

Some folks like FAMs because these methods help them stay on top of their cycle. But FAMs are only 76 to 88 percent effective for birth control and require a lot of monitoring.

• Effectiveness: 88%
• Cost: $$

A diaphragm is a shallow, flexible cup that you insert into your vagina. It covers your cervix and can prevent sperm from reaching an egg. It’s 88 percent effective but works best when used in combination with spermicide.

Diaphragms are dope because you can put one in before you have sex and don’t have to interrupt sexy time. You’ll need a prescription to get one, but one can last up to 2 years, so it might be worth the hassle.

The downside is that a diaphragm can be hard to put in, and you have to be careful about keeping it in place during sex. Also, it won’t protect against STIs.

• Effectiveness: 71–86%
• Cost: $$

A cervical cap is sort of like a diaphragm. It prevents pregnancy by using spermicide and covering your cervix. But it’s smaller than a diaphragm, and you can leave it in longer. Since you put it in before sex, you don’t have to worry about it in the heat of the moment. When used correctly, cervical caps are 71 to 86 percent effective.

Like diaphragms, cervical caps can be tricky to put in. And you have to make sure the cap doesn’t slip off your cervix mid-sex. Also, some people have reported pain when using a cervical cap. Let your doctor know if you experience inflammation, weird discharge, or a bladder infection after using one.

BTW, you’ll also need an Rx to get a cervical cap.

Hormonal birth control has a lot of benefits, but it’s not for everyone. Talk with your doctor if you’re not sure which nonhormonal option is best for you. They can help you come up with a top-notch plan.

P.S. You know your body best. Your safety and comfort should *always* come first.