Everyone can use nonhormonal birth control
Although many birth control methods do contain hormones, other options are available.
Nonhormonal methods can be appealing because they are less likely to carry side effects than hormonal options. You may also want to explore nonhormonal forms of birth control if you:
- don't have frequent intercourse or don't need ongoing birth control
- don't want to change your body's natural cycle for religious or other reasons
- have had changes in your health insurance, making hormonal methods no longer covered
- want a backup method in addition to hormonal birth control
Keep reading to learn more about each method, including how it works, how effective it is at preventing pregnancy, and where to get it.
An intrauterine device (IUD) is a T-shaped device that's placed into the uterus by your doctor. There are two types of IUDs available - hormonal and nonhormonal - and each prevents pregnancy in a different way.
The nonhormonal option contains copper and goes by the name ParaGard. The copper releases into the uterus and makes the environment toxic to sperm.
Copper IUDs are over 99 percent effective at preventing pregnancy. Although the IUD can protect against pregnancy for up to 10 years, it can also be removed at any time, giving you a fast return to your normal fertility.
Many insurance carriers cover the cost of the IUD and insertion. So does Medicaid. Otherwise, this form of birth control may cost you up to $932. Patient assistance programs are available, so talk to your doctor about your options.
Common side effects include heavy bleeding and cramps. These typically decrease over time.
Sometimes, IUDs may become expelled from the uterus and need to be replaced. This is more likely to happen if:
- you haven't given birth before
- you're younger than 20 years
- you had the IUD placed too soon after childbirth
Barrier birth control methods physically prevent the sperm from reaching the egg. Although condoms are the most common option, other methods are available, including:
- cervical caps
You can typically purchase barrier methods over-the-counter at your local drugstore or online. Some may also be covered by your health insurance, so talk with your doctor.
Due to the chance of human error, barrier methods aren't always as effective as some other birth control methods. Still, they are convenient and worth exploring if you don't want to use hormones.
Condoms are the only birth control method that protects against sexually transmitted infections (STIs). They also happen to be one of the most popular and widely available methods. You can find condoms easily, and they don't require a prescription. They can cost as little as $1 each, or you may be able to get them for free at your local clinic.
Male condoms roll onto the penis and keep sperm inside the condom during sex. They come in a wide variety of options, including nonlatex or latex, and spermicide or nonspermicide. They also come in an array of colors, textures, and flavors.
When used perfectly, male condoms are up to 98 percent effective at preventing pregnancy. “Perfect use” assumes that the condom is put on before any skin-to-skin contact and that it doesn't break or slip off during intercourse. With typical use, male condoms are about 82 percent effective.
Female condoms fit into the vagina and prevent sperm from reaching your cervix or uterus. They're mostly made from polyurethane or nitrile, which is great if you have an allergy to latex. However, they're slightly more expensive and can cost up to $5 each.
As far as effectiveness goes for female condoms, perfect use is around 95 percent and typical use dips down to 79 percent.
Spermicide is a chemical that kills sperm. It usually comes as a cream, foam, or gel.
Some popular brands include:
- Encare Vaginal Contraceptive Inserts
- Gynol II Contraceptive Gel
- Conceptrol Contraceptive Gel
When used alone, spermicide fails around 28 percent of the time. That's why it's a good idea to use it along with condoms, sponges, and other barrier methods.
On average, using spermicide can cost up to $1.50 each time you have intercourse.
You may not experience any side effects with spermicide, but some people get skin irritation. All spermicides sold in the United States contain what is called nonoxynol-9. Nonoxynol-9 may cause changes in the skin in and around your genitals, making you more likely to contract HIV.
Talk with your doctor if you experience redness, itching, or burning or have concerns about HIV.
The contraceptive sponge is made from plastic foam. It's inserted into the vagina before sexual intercourse, acting as a barrier between sperm and your cervix. This single-use method is meant to be used with spermicide, which kills sperm.
You can leave a sponge in for up to 24 hours and have sexual intercourse as many times as you want during this time period. The important thing to remember is that you need to wait at least six hours after the last time you had sexual intercourse before you take it out. You shouldn't leave a sponge in for any longer than 30 hours total.
With perfect use, the sponge is 80 to 91 percent effective. With typical use, that number drops a bit 76 to 88 percent.
Sponges cost anywhere from $0 to $15 for three sponges, depending on whether or not you can find them for free at a local clinic.
You shouldn't use the sponge if you're allergic to sulfa drugs, polyurethane, or spermicide.
A cervical cap is a reusable silicone plug that can be inserted into the vagina up to six hours before intercourse. This prescription-only barrier method blocks the sperm from entering the uterus. The cap, which goes by the name FemCap in the United States, can be left in your body for up to 48 hours.
There's a wide range in efficacy, with a failure rate between 14 and 29 percent. As with all barrier methods, the cap is more effective when used with spermicide. You'll also want to check the cap for any holes or weak points before using it. One way you can do this is by filling it with water. Overall, this option is more effective for women who haven't given birth before.
Caps can cost up to $289. Payment is split between the actual cap and getting fit for the correct size.
A diaphragm is shaped like a shallow dome, and it's made of silicone. This reusable barrier method is also inserted into the vagina before intercourse. Once in place, it works by keeping the sperm from entering the uterus. You'll need to wait at least six hours to take it out after the last time you have sex, and you shouldn't leave it in for more than 24 hours overall.
With perfect use, a diaphragm is 94 percent effective at preventing pregnancy. With typical use, it's 88 percent effective. You'll want to fill the diaphragm with spermicide for the most protection against pregnancy. You'll also want to inspect the silicone for any holes or tears before inserting it into your body.
The two brands of this device on the market in the United States are called Caya and Milex. Depending on whether your insurance covers it, a diaphragm may cost up to $90.
Natural family planning
If you're in tune with your body and don't mind spending some time tracking your cycles, natural family planning (NFP) may be a good option for you. This option is also referred to as the fertility awareness method or rhythm method.
A woman can only get pregnant when she's ovulating. To practice NFP, you identify and track your fertile signs so that you can avoid having sex during ovulation. Most women find that their cycles are between 26 and 32 days long, with ovulation somewhere in the middle.
Timing intercourse away from ovulation can help prevent pregnancy. Many women experience a lot of cervical mucus in the most fertile time of their cycles, so you may want to avoid intercourse on the days when you see lots of cervical mucus. Many women also experience a spike in temperature around ovulation. You must use a special thermometer to track, and best results are obtained often from the vagina, not the mouth.
With perfect tracking, this method can be up to 99 percent effective. With typical tracking, it's closer to 76 to 88 percent effective. Using an app to help you track your cycles, like Fertility Friend or Kindara, may be beneficial.
How to choose the right birth control for you
The type of nonhormonal birth control you choose to use has a lot to do with your own preferences, its affordability, and factors like time, health status, and culture and religion.
Your doctor may be a good resource if you're not sure which form of birth control is right for you. You may even want to call your insurance carrier to discuss which options are covered and their associated out-of-pocket costs.
Other questions to ask as you assess your options include:
- How much does the birth control cost?
- How long does it last?
- Do I need a prescription or can I get it over the counter?
- Does it protect against STIs?
- How effective is it with protecting against pregnancy?
- What about effectiveness rates when using it perfectly versus typically?
- What are the side effects?
- How easy is the method to use long-term?
If you know you don't want kids, ask your doctor about sterilization. This permanent birth control method doesn't contain hormones and is over 99 percent effective. For men, sterilization involves a procedure called a vasectomy. For women, it means tubal ligation.