How well each method works
Effectiveness is measured as the number of pregnancies among one hundred users in a year of ordinary use. CDC figures sort the methods into tiers.
- The implant, hormonal and copper IUDs, vasectomy and tubal sterilization each result in fewer than one pregnancy per hundred users a year.
- The injection, given every three months, results in about four.
- The pill, the patch and the vaginal ring each result in about seven, mostly from missed or late doses.
- External condoms result in about thirteen, and withdrawal results in about twenty.
The top tier works best because it removes daily effort. An implant lasts three years or more, hormonal IUDs last three to eight years depending on the type, and the copper IUD lasts at least ten. All are reversible, and fertility returns quickly after removal.
Choosing a method
The right method depends on health, plans and preference, and the decision belongs to the person using the method, made with a partner's support. Methods containing estrogen, which include most pills, the patch and the ring, are not advised for people who smoke and are over 35, who have migraine with aura, or who have a history of blood clots. Progestin-only and copper methods avoid that problem. A progestin-only daily pill has been sold without a prescription since 2024. Vasectomy is a short office procedure that should be considered permanent, and it does not work until a semen test confirms it, about three months later. Most insurance plans must cover prescribed contraception without a copay. Rules on access for minors vary by state, and any clinic can explain yours.
Using condoms correctly
Condoms fail mainly through handling. Check the expiration date, and store them away from heat, which excludes wallets and glove compartments. Put one on before any genital contact, pinch the tip to leave space, and hold the rim while withdrawing. Use water-based or silicone lubricant, because oil-based products weaken latex. Use a new condom every time, and never two at once.
Emergency contraception
Emergency contraception prevents pregnancy after unprotected sex or a broken condom, and it does not end an existing pregnancy. A levonorgestrel pill is sold over the counter with no age limit and works best as soon as possible within 72 hours. A prescription pill, ulipristal, works for up to five days and holds up better at higher body weights. An IUD placed within five days is the most effective option, and it then stays as ongoing contraception.
Tip Buy one emergency pill before you need it, because the clock starts the moment something goes wrong.
