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How to Know if Non-Hormonal Birth Control is Right for You

by -

a couple laughing in bed

While the main job of any birth control method is to prevent pregnancy, some women may prefer an option that doesn’t affect their naturally occurring hormones. The good news is there are many different types of birth control without hormones to choose from. Dr. Ashley Peters, OB/GYN, explains what hormone-free options are available, how effective they are and what else to consider when choosing birth control to make sure it’s right for you. 

How Does Non-Hormonal Birth Control Work?

There are mainly two ways birth control prevents pregnancy. The first is by preventing ovulation, the process of when an egg is released from the ovary and can then be fertilized by sperm, which can lead to pregnancy. The second is by creating a barrier to prevent sperm from entering the vagina, which is how most non-hormonal birth control methods work.

When to Choose Non-Hormonal Birth Control vs. Hormonal

What’s right for someone else may not be right for you. Dr. Peters says there are several reasons someone might want non-hormonal birth control, outside of simply not wanting to change their natural hormones.

“Someone who’s breastfeeding, for example, may not want to take combination birth control pills that include the hormones estrogen and progestin, because estrogen may affect milk supply levels. Although a slight risk, blood clots are also more likely in someone who’s recently given birth and using hormonal contraception,” she says.  

While it’s generally safe, Dr. Peters says some medical conditions can be complicated by hormonal birth control, including: 

  • Uncontrolled diabetes

  • Uncontrolled high blood pressure

  • A history of having a heart attack, blood clot or stroke 

  • A history of breast, ovarian or liver cancer

  • Migraines with visual changes 

  • Significant shifts in your mood

“Most women don’t experience major side effects from using hormonal contraception. However, your doctor might recommend a non-hormonal birth control method if you start to notice changes in your mood outside of what’s normal for you, nausea, headaches or weight gain that won’t improve after three months of use,” says Dr. Peters. 

As far as the side effects of non-hormonal birth control, Dr. Peters says it really depends. 

“Each non-hormonal option can be different. For example, some people may find a diaphragm uncomfortable or difficult to insert. Another example would be a risk of a condom breaking. Some people can have allergic reactions to latex condoms or spermicides, too. There are pros, cons and side effects to every option.”

Is Non-Hormonal Birth Control the Right Choice for You?

Depending on your needs and the stage of life you’re in, it’s important to know if non-hormonal birth control checks all your boxes. Dr. Peters offers a few thought-starters for making your selection.

Non-Hormonal Birth Control Advantages

  • A prescription isn’t always needed. For some methods, you can skip the doctor’s office for insertion, too. 

  • It’s convenient. If remembering to take birth control is hard for you, non-hormonal options often don’t require a daily pill. 

  • There’s no big commitment. If you aren’t frequently sexually active, most non-hormonal birth control can be used as needed.  

  • They aren’t affected by other medications. Some supplements and medications, such as antibiotics, antiepileptics, antiretrovirals and St. John's wort, can decrease the effectiveness of hormonal birth control, while most non-hormonal options aren’t impacted. Dr. Peters says it’s best to talk with your doctor about any possible interactions.

Non-Hormonal Birth Control Disadvantages 

  • Results may vary. The effectiveness of this type of birth control depends on the method you use. 

  • They don’t always protect you against STDs. Some non-hormonal methods alone won’t keep you safe from sexually transmitted diseases (STDs). 

Types of Non-Hormonal Birth Control

Dr. Peters breaks down common types of non-hormonal birth control and how effective they are — ranked from most to least.  

Copper Intrauterine Device (IUD)

  • How it Works: A t-shaped plastic device with copper coils is placed inside the uterus during a procedure with your doctor. Once inserted, the IUD creates an environment unfavorable for sperm. You can use it for up to 10 years. 

  • Effectiveness: More than 99% of women don’t get pregnant in the first year following IUD insertion.

Vasectomy

  • How it Works: It’s a surgical procedure on a man’s scrotum and results in sperm being unable to leave the testes. 

  • Effectiveness: More than 99% of women don’t get pregnant within the first year of their partner’s vasectomy. 

Tubal Sterilization

  • How it Works: Both, or a portion of, the fallopian tubes are removed or blocked. The egg can’t reach the uterus, which prevents pregnancy. If a woman wants tubal sterilization, some studies suggest a decreased lifetime risk of ovarian cancer when both fallopian tubes are removed (known as a salpingectomy), making it commonly performed instead of removing just a portion of the fallopian tube — what most people call “getting your tubes tied.” 

  • Effectiveness: More than 99% of women don’t get pregnant in the first year following tubal sterilization. 

Diaphragm

  • How it Works: It’s inserted in the vagina to block semen from entering the uterus and is usually paired with spermicide. You’re typically fitted for a diaphragm by your doctor.

  • Effectiveness: 88% of women don’t get pregnant in the first year.  

Vaginal Gel

  • How it Works: The gel goes in the vagina and affects the pH, or vaginal acidity, which prevents sperm from reaching the cervix. 

  • Effectiveness: 86% of women don’t get pregnant in the first year.  

Sponge

  • How it Works: It fits against the cervix to block sperm and contains spermicide.

  • Effectiveness: 88% of women, who had not given birth, did not get pregnant in the first year. That number drops to 76% for women who have given birth. 

Male Condom

  • How to Works: It goes over the penis, creating a thin barrier that prevents semen from entering. 

  • Effectiveness: 82% of women don’t get pregnant in the first year.  

Cervical Cap

  • How it Works: It’s placed over the cervix to prevent sperm from entering and is usually paired with spermicide. It requires a fitting by your doctor. 

  • Effectiveness: 80% of women don’t get pregnant in the first year.  

Female Condom

  • How it Works: It’s placed inside the vagina and creates a barrier that’s a lubricated tube. It has flexible rings on both ends, with one end closed to prevent sperm from entering.

  • Effectiveness: 79% of women don’t get pregnant in the first year.  

Withdrawal Method

  • How it Works: A man "pulls out" of a woman's vagina before he ejaculates.

  • Effectiveness: 78% of women don’t get pregnant within the first year of using this method.

Natural Family Planning

  • How it Works: A woman tracks when she’s most fertile by monitoring her menstrual cycle and sometimes vaginal discharge and body temperature. She then avoids intercourse or uses a barrier, such as a condom, when she’s fertile. 

  • Effectiveness: 76% of women don’t get pregnant in the first year. 

Spermicide

  • How it Works: A solution is placed inside the vagina containing a chemical that kills or stops sperm from proceeding.

  • Effectiveness: 72% of women don’t get pregnant in the first year.

“Picking contraception isn’t a one-size-fits-all choice. It’s best to evaluate what goals you’re looking for when choosing an option,” Dr. Peters says.

“For example, are you looking for contraception just to prevent pregnancy? Do you want it for another reason, like helping with acne? Do you want an option that may lighten your period? Are you good at remembering to take medicine every day? What medical conditions may affect your choice? After answering some questions like these, I recommend discussing your personal health history with your doctor to decide which method is best for you.”