Nonhormonal birth control methods can prevent pregnancy. They have to be used correctly to do so and don’t always protect against sexually transmitted infections.
Medically reviewed by Valinda Riggins Nwadike, MD, MPH
Hormonal and nonhormonal birth control are reversible contraception methods. This means you can stop using the method or have it removed if you want to try to become pregnant.
Hormonal birth control methods are some of the most effective ways to prevent pregnancy. Although nonhormonal methods also work most of the time, they have to be used correctly to avoid unplanned pregnancy.
Here’s a list of the most common types of nonhormonal birth control and what makes them different from hormonal options.
What’s the difference between hormonal and nonhormonal birth control?
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Hormonal birth control changes the way the body works for a short period of time. It causes hormone levels to change. This stops the body from doing what’s needed to start a pregnancy, such as ovulation.
Nonhormonal birth control works by stopping sperm from reaching an egg. Examples include barrier methods like condoms and diaphragms. Spermicides are also a nonhormonal method that works by killing sperm.
There are benefits and risks associated with each kind of contraception.
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Combined hormonal birth control helps protect against certain types of cancer, specifically endometrial and ovarian cancer, but it’s also associated with a higher risk of breast cancer in people who have used it in the past 6 months.
Hormonal birth control does not protect against sexually transmitted infections (STIs).
Nonhormonal birth control risks and benefits
Nonhormonal birth control carries fewer medical risks than hormonal methods. For example, there’s no increased risk of breast cancer — but there’s also no protection against other types of cancer.
Some barrier methods, such as latex condoms, can protect against STIs. However, others, like lambskin condoms and copper IUDs, do not offer this protection.
Nonhormonal birth control can also vary in its effectiveness in preventing pregnancy. For example, external condoms prevent pregnancy 98% of the time with perfect use. However, the rate drops to 87% with typical use. It’s important to use birth control correctly.
The right contraception method is a matter of personal choice. Some people combine a condom or other barrier method with a hormonal method, such as birth control pills, to protect against pregnancy and STIs.
Copper IUDs
A copper IUD is placed inside the uterus, where it can stay for up to 10 years. Copper makes sperm less mobile, so it can’t swim to an egg. The copper IUD does not use hormones and is 99% effective at stopping pregnancy.
The possible side effects of a copper IUD are heavier periods and cramping, which are most likely to happen during the first 3 to 6 months after you have it put in.
You can have a copper IUD removed if you decide you want to become pregnant.
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The male condom, also called an external condom, is placed over the penis before intercourse. The female condom, or internal condom, is inserted into the vagina. Both methods provide some protection against STIs. They should not be used at the same time.
Condoms can cause irritation or allergic reactions. If you have an allergy to latex, you may look for another brand made from a different material. Internal condoms can also cause burning, itching, or rash and may cause pain during sex.
Spermicide and vaginal gel
A spermicide comes in many forms, such as a jelly, cream, or foam. It works by making it hard for sperm to move and by blocking the cervix. It doesn’t provide STI protection.
Spermicides can also cause irritation, increasing the chances of contracting or transmitting an infection. It’s a good idea to use a spermicide with another kind of barrier protection, like a condom.
Spermicides are available without a prescription.
A vaginal gel called Phexxi is available only by prescription. It lowers the pH level inside the vagina, so sperm can’t move well. It comes as a gel in a single-use applicator.
Diaphragm
A diaphragm is often used along with a spermicide to prevent pregnancy. It is a flexible, bowl-shaped device that covers the cervix. You insert it before you have sex and cannot leave it in for more than 24 hours.
Since diaphragms come in different sizes, a healthcare professional can fit you for one. They are only available by prescription.
Cervical cap
A cervical cap is similar to a diaphragm in that it fits over the cervix and should be used with a spermicide. It’s shaped like a hat, and you can leave it in for up to 2 days.
As with a diaphragm, you’ll need a fitting and prescription from a healthcare professional to get a cervical cap.
Sponge
The birth control sponge is also placed inside the vagina. It has a built-in spermicide, so you don’t have to add one as you would with a cervical cap or diaphragm. You’ll have to wet and squeeze the sponge before you place it.
The sponge blocks the entrance to the uterus and stops sperm from moving, so there’s less chance of pregnancy.
Sponges are available without a prescription but are single-use only.
Types of hormonal birth control
Hormonal birth control is either combined, containing estrogen and progestin, or progestin-only. Progestin stops ovulation and makes the uterus less hospitable to sperm. Estrogen contributes to this process and also helps reduce irregular bleeding.
You can get hormonal birth control in different forms.
Choosing a contraceptive method is a matter of personal choice. Factors you may want to consider are effectiveness at stopping pregnancy, protection from STIs, ease of use, side effects, and health risks.
