Birth Control & Family Planning

Birth Control Options Compared: Effectiveness, Pros and Cons

By the Find Her Doctor editorial team · Updated November 1, 2026 · 6 min read

The most effective reversible birth control methods are the implant and IUDs, which prevent more than 99% of pregnancies. The shot, pill, patch and ring work well too, but only when you use them on time. Condoms are the only method that also lowers the risk of STIs. There's no perfect birth control, only the one that fits your health and your life right now.

People switch methods all the time, and that's normal. The method that worked in college may not fit when you're 34 and working night shifts. Use the chart below to narrow things down, then bring your top two choices to a clinician.

The comparison chart

The CDC groups methods by how often people get pregnant with typical use. Typical use means real life: the pill you took four hours late, the shot appointment you pushed back two weeks.

With perfect use, the pill, patch and ring are over 99% effective. The gap comes from how hard it is to be perfect every single day for years.

Set it and forget it: IUDs and the implant

Long-acting reversible contraception (LARC) is placed once by a clinician and keeps working with nothing for you to do. You can have it removed any time, and fertility comes back quickly.

• Hormonal IUD. A small T-shaped device that releases progestin into the uterus. Brands differ in size, dose and how long they last. Many users get lighter periods, and some stop having them.
• Copper IUD. Hormone-free. The copper makes the uterus unfriendly to sperm. Periods may get heavier or crampier, especially in the first few months.
• Implant. A thin rod about the size of a matchstick placed under the skin of your upper arm. It's the single most effective reversible method. Irregular, unpredictable bleeding is the most common complaint.

What placement is really like: an IUD insertion takes a few minutes, and most people feel a few strong cramps. Ask ahead about pain control options, and plan to take it easy for the rest of the day. The implant goes in after a numbing shot; afterward you'll have a small bruise and a bandage for a day or so.

More detail lives in our guides to hormonal vs. copper IUDs and the birth control implant.

The pill, patch, ring and shot

The pill

Combined pills contain estrogen and progestin. Progestin-only pills ("mini pills") have no estrogen, which suits people who should avoid it. Opill is a progestin-only pill sold without a prescription. The hard part isn't the pill, it's the habit. Tie it to something you already do every day, like brushing your teeth, set a phone alarm as backup, and keep a spare pack in your work bag. If you work rotating shifts, say so when you pick a pill, because some mini pills have a much tighter timing window than others.

The patch and the ring

Both contain estrogen and progestin. You change the patch weekly and can wear it on your belly, buttock, upper outer arm or upper back (not on your breasts). It's a beige square, so it can show with some clothes, and people often ask whether it falls off in the shower or the gym. It's made to stay on, but check it daily. The ring sits in the vagina and is changed monthly (or yearly, for one reusable brand). People who hate daily pills often like these. A common question: "Can my partner feel the ring?" Sometimes, and most couples say it isn't a problem. If you can feel it while walking around, it usually just needs to be pushed in a little farther.

The shot

A progestin injection every 3 months. It's private and needs no daily attention, but you do have to get back to the office (or give yourself the under-the-skin version, if your clinician offers it) on time. Book the next shot before you leave, and put a reminder in your phone that day. It can cause irregular bleeding, and fertility may take longer to return after the last shot than with other methods.

Barrier and other methods

• External and internal condoms protect against both pregnancy and STIs.
• Diaphragm, cervical cap, sponge and spermicide are hormone-free but less effective.
• Vaginal pH gel (Phexxi) goes in right before sex and needs a prescription.
• Fertility awareness methods mean tracking cycle signs. They work best with training and regular cycles.
• Withdrawal is better than nothing but has a high failure rate.

Permanent methods

If you're sure you don't want future pregnancies, options include tubal surgery (tubal ligation, or removing the tubes, called salpingectomy) and vasectomy for a partner. Vasectomy is the simpler procedure of the two.

Questions to ask yourself before you choose

• How much does effectiveness matter right now? If a pregnancy would upend your life, the implant or an IUD is hard to beat.
• Do you want to avoid hormones? Look at the copper IUD, condoms or fertility awareness.
• Would lighter or fewer periods be a bonus? The hormonal IUD, continuous pills, ring or patch, and the shot can all reduce bleeding.
• Any health conditions? Migraine with aura, a history of blood clots, smoking after age 35, and some heart conditions can make estrogen unsafe. The CDC's Medical Eligibility Criteria spell out which methods are safe for which conditions.
• When might you want to get pregnant? Most methods allow a quick return of fertility. The shot can delay it by several months.
• Do you need STI protection? Add condoms to anything.

Getting birth control in New York

You have more routes here than in many states:

• Over the counter: condoms, Opill and levonorgestrel emergency contraception, at any drugstore.
• From a pharmacist, no prescription: under a statewide standing order issued in 2024, participating pharmacists can dispense the pill, patch or ring after you fill out a self-screening form. Pharmacists must complete state training first, so call ahead and ask whether your pharmacy takes part.
• From a clinician: IUDs, implants, the shot and prescription pills come from OB/GYNs, family planning clinics, midwives and nurse practitioners.

New York Medicaid covers contraception, and state-regulated insurance plans are required to cover FDA-approved contraception without cost sharing. Check your plan's details, since self-funded employer plans follow federal rules instead.

Myth vs. fact

• Myth: "IUDs are only for people who've had a baby." Fact: ACOG and the CDC say IUDs are safe for most people, including teens and people who've never been pregnant.
• Myth: "Birth control causes infertility." Fact: fertility returns quickly after most methods. Only the shot can cause a temporary delay.
• Myth: "You need a break from the pill." Fact: there's no medical reason to take breaks from hormonal birth control.
• Myth: "The pill makes you gain a lot of weight." Fact: studies haven't found that most pills cause significant weight gain.

When to see a doctor

Talk to a clinician before starting a method if you have:

• A history of blood clots, stroke or heart disease
• Migraines with aura
• High blood pressure
• Breast cancer now or in the past
• Liver disease
• You smoke and are over 35

Call your provider if a new method causes very heavy bleeding, severe pain, signs of a blood clot (leg swelling or pain, chest pain, sudden shortness of breath) or a severe headache.

Find a birth control provider near you

General OB/GYNs and nurse practitioners place IUDs and implants every day. For complex medical situations, a Complex Family Planning specialist has extra training in contraception for people with medical conditions. Browse OB/GYNs, see which providers take Medicaid, or search the directory to find someone in your borough or county.

Frequently asked questions

Sources

• CDC — Contraception: How Effective Are Birth Control Methods?
• CDC — U.S. Medical Eligibility Criteria for Contraceptive Use, 2024
• ACOG — Birth Control (patient FAQ)
• FDA — Birth Control Chart
• New York State Department of Health — Standing order for pharmacist-dispensed hormonal contraception (2024)

This article is for general education and is not medical advice. It does not replace an evaluation by a licensed clinician who knows your history. If you think you have a medical emergency, call 911.