There are more contraceptive options today than ever, and the "right" one depends on your goals, your medical history, and your life stage. Here is a clear, evidence based guide to the categories.
The five main categories
1. Hormonal methods
These prevent ovulation. They include the pill, the contraceptive patch, the vaginal ring, and the injection (Depo Provera). Used correctly, hormonal pills are about 91 percent effective; the injection is about 94 percent effective.
2. Long acting reversible contraception (LARC)
This is the IUD and the implant. Both are over 99 percent effective. IUDs can be hormonal (3 to 8 years depending on type) or copper (up to 10 years, no hormones). The implant is a small rod placed under the skin of the upper arm, effective for 3 to 5 years. Both are completely reversible.
Source: ACOG Committee Opinion on LARC, 2018.
3. Barrier methods
External and internal condoms, diaphragms, cervical caps, and spermicidal foams or films. Condoms are about 80 percent effective on their own and are the only method that also reduces STI risk. They pair well with another method.
4. Permanent contraception
Tubal ligation is a surgical option that's effectively permanent. It's appropriate for people who are certain they are done with childbearing.
5. Emergency contraception
Used after unprotected sex or contraceptive failure. A copper IUD inserted within 5 days is the most effective option (over 99 percent). Oral emergency contraception (like Plan B or ella) is less effective but more accessible.
Source: CDC Effectiveness of Contraceptive Methods, 2024.
How to choose
The right method depends on a few honest questions:
- How long do you want to delay pregnancy? If years, LARC is ideal. If a year or two, pills or the ring fit.
- Do you want to think about it daily or rarely? Pills require daily attention. IUDs and implants don't.
- Are you breastfeeding? Progestin only options are usually preferred.
- Do you have heavy or painful periods? Hormonal IUDs and combined pills often make periods lighter and cramps better.
- Do you have a history of blood clots, certain cancers, or migraines with aura? Some methods may not be safe; this is a conversation with your clinician.
- Do you also need STI protection? Add condoms to any other method.
What about side effects?
Every method has trade offs. Hormonal methods can cause breast tenderness, mood changes, or breakthrough bleeding, especially in the first few months. Copper IUDs can make periods heavier. Condoms can break. Many side effects fade within 3 months of starting a method.
Switching methods is normal
Most women switch methods at different life stages. What worked at 22 might not fit at 35. Coming in for a conversation is the easiest way to find what fits now.
Ready to talk it through?
Our team can walk you through the trade offs in plain language, no rush. We also place IUDs and implants in office. Read more about our birth control services or request a consultation.
This article is educational only and does not replace personal medical advice. For questions about your situation, please contact our office or call (973) 782 5577.
Ready when you are.
Request a visit. New patients welcome at our Totowa office.