Which Birth Control Is Right for You?

The most effective reversible methods are the ones you can't get wrong day to day: the contraceptive implant and the hormonal and copper IUDs. All three have a first-year pregnancy rate under 1% even in typical use — the implant is about 0.05%, and the IUDs sit around 0.1 to 0.8% — because once they're placed there's nothing to remember. That's the key idea behind 'typical use' versus 'perfect use': the pill, patch, and ring can be over 99% effective when used perfectly, but in real life around 7% of users get pregnant in a year because it's easy to be late or miss a dose. The implant and IUDs close that gap, which is why they're often called the most effective everyday options.

Four methods contain no hormones at all: the copper IUD, external and internal condoms, the diaphragm (used with spermicide), and fertility-awareness methods. They differ hugely in effectiveness — the copper IUD is one of the most effective methods there is (under 1% failure) and lasts up to a decade, while condoms (about 13% typical-use failure), the diaphragm (about 17%), and fertility-awareness methods (anywhere from 2% to 23% depending on how carefully they're followed) are more user-dependent. If avoiding hormones is your priority, the copper IUD is usually the standout for effectiveness, and condoms add the bonus of STI protection. A clinician can help you weigh them.

Plenty. The methods that contain estrogen are the combined pill, the patch, and the ring, and the CDC's U.S. Medical Eligibility Criteria advise against them for a handful of conditions — smoking at 35 or older, migraine with aura, high blood pressure, a history of blood clots, and the first weeks after giving birth. But those same conditions usually don't restrict the estrogen-free methods: the progestin-only pill (including over-the-counter Opill), the implant, the hormonal IUD, the copper IUD, and the shot all remain options for most people. So being unable to take estrogen rarely means being out of options — it usually just points you toward one of these. Your provider confirms what's safe for your specific history.

Only condoms — external or internal — meaningfully reduce the risk of sexually transmitted infections. Every other method on this list, from the pill and the ring to the implant and IUDs, is designed to prevent pregnancy and offers no protection against STIs whatsoever. That's why many people use condoms alongside a more effective pregnancy-prevention method, an approach called 'dual protection': the implant or IUD handles pregnancy, and the condom handles infection risk. If STIs are a concern, pairing your chosen method with condoms and staying current on testing is the way to cover both.

Perfect use is how well a method works when it's used exactly right every single time; typical use is how well it works for real people in everyday life, with the occasional late pill, forgotten patch, or condom used inconsistently. The gap can be large: the pill, patch, and ring are over 99% effective with perfect use but closer to 93% (about a 7% failure rate) in typical use, because they depend on you. Methods with nothing to remember — the implant and IUDs — have almost no gap between the two, which is what makes them so reliable. When you compare methods, the typical-use number is usually the more realistic one to plan around.

No, it's not a prescription or a diagnosis, and yes, it's private. This tool runs entirely in your browser — your answers are scored on your own device and are never sent to a server, saved, or shared, so closing the tab erases them. What it gives you is a ranked shortlist of methods that tend to fit your priorities and health flags, based on published CDC, Guttmacher, and ACOG guidance, to make your conversation with a clinician faster and better-informed. Only a provider can review your full history, check your blood pressure, and actually prescribe or place a method.