Choosing a birth control method is a deeply personal decision that balances your lifestyle, health goals, and how you want to feel in your own body.
There are two main categories of birth control: hormonal and non-hormonal.
Hormonal birth control options include birth control pills, the patch, vaginal ring, progesterone implants and certain intrauterine devices (IUDs).
Non-hormonal birth control options include fertility awareness methods, such as Natural Cycles powered by Oura, the copper IUD, and barrier methods, such as condoms.
Whether you’re looking for “set it and forget it” convenience or a hormone-free approach, it’s essential to speak with your healthcare provider to find the method that’s right for you.
Below, find essential questions to ask yourself and/or your healthcare provider as you make your decision.
| Oura’s Cycle Insights experience now offers Hormonal Birth Control support, designed to help you track symptoms, predict bleeding, and better understand how hormonal birth control impacts your body on a personal level. |
1. How Effective Do I Need My Birth Control to Be?
What does “effective” mean when talking about birth control? Effective birth control prevents pregnancy. The metric to pay attention to is the “typical use” rate, which reflects how well that method prevents pregnancy in the “real world,” when a pill is sometimes forgotten.
“Perfect use,” on the other hand, is a measure of the technical effectiveness when used exactly as specified and consistently followed.
So if a typical use rate is 90%, that means that if 100 women used that type of birth control for a full year in the real world, that 90 would not be pregnant by the end of the year, and 10 would be pregnant.
With efficacy rates between 91% and 99%, hormonal birth control options are some of the most reliable ways to prevent pregnancy. However, the rate varies based on the specific option you choose, as well as how well you use it.
Birth Control Efficacy Rates |
||
|---|---|---|
| Method Name | Efficacy Rate (Typical Use)* | |
| Higher Efficacy
Lower Efficacy |
Sterilization Surgery (tubal ligation for women, vasectomy for men) | 99% |
| Hormonal IUDs | 99% | |
| Implant | 99% | |
| Copper IUD | 99% | |
| Injection (Progesterone Only) | 96% | |
| The Pill (Combined Hormones) | 93% | |
| Intravaginal Ring (Estrogen + Progesterone) | 93% | |
| Natural Cycles Powered by Oura | 93%** | |
| Mini Pill (Progesterone Only) | 91% | |
| Patch (Estrogen + Progesterone) | 93% | |
| Male Condom | 87% | |
| Cervical Cap | 86% effective for people who’ve never given birth
71% in people who have given birth |
|
| Sponge | 86% effective for people who’ve never given birth
78% effective for people who have given birth |
|
| Diaphragm | 83% | |
| Spermicide | 79% | |
| Withdrawal Method | 78% | |
| Fertility Awareness Methods (FAMs) | 77%–98% effective, depending on methods used | |
| *All typical efficacy rates based on data from Planned Parenthood **Source: https://www.naturalcycles.com/cyclematters/natural-birth-control |
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Ask yourself the following questions to figure out if you should consider a high-efficacy method.
Would I ever want to be a coparent with my sex partner(s)?
- If no, consider a high-efficacy method.
Would pregnancy have dangerous social consequences for me or my family?
- If yes, consider a high-efficacy method.
Would getting an abortion if I wanted one be safe, legal, and accessible?
- If no, consider a high-efficacy method.
Do I have a medical scenario where pregnancy is not recommended at this time for my safety?
- If yes, consider a high-efficacy method.
2. How Often Do I Want to Think About Birth Control?
When it comes to birth control, the efficacy of the method often depends on how easily a method fits into your actual life. This is often categorized by the level of daily effort required.
Continuous types of birth control, including the IUD, implant, or injection, require no daily effort, while cyclic methods, such as the pill, patch, and ring, require daily or periodic attention.
Consider the following questions:
Do I like bleeding on a mostly predictable schedule?
- If yes, consider cyclic.
- If no, consider continuous.
Am I good at remembering to do something every single day at the same time—no matter what?
- If yes, consider cyclic or continuous.
Do I dislike remembering to take something every day and/or don’t want to think about it?
- If yes, consider continuous.
Do I have concerns about losing insurance or ability to pay?
- If yes, consider continuous.
Am I safe to be seen taking contraception or having contraception in my possession?
- If no, consider continuous.
3. Do I Have Medical Conditions or Take Any Medications to Consider?
It’s crucial to understand how any current medical conditions you have or medications you’re taking may interact with hormones in birth control.
For instance, while estrogen can be helpful for cycle control, it can increase the risk of blood clots or interact with certain conditions.
Here’s the breakdown of hormones in typical hormonal birth control methods:
- Combined pill, patch, ring: Estrogen & progesterone
- IUD, implant, injection, mini-pill: Progesterone only
Consider the following questions:
Do I have medical conditions like hypertension?
- If yes, consider discussing your situation with your doctor. Depending on age and how well blood pressure is controlled, the recommendation is likely to be progesterone-only methods.
Do I smoke cigarettes regularly?
- If yes, consider progesterone-only methods. Smoking damages blood vessels and increases the risk of cardiovascular disease. When combined with estrogen, the risk of serious blood clots or heart attack rises significantly, especially as you age.
Do I take certain medications, such as anticonvulsants, HIV antiretrovirals, or treatment for TB (tuberculosis)?
- If yes, consider progesterone-only methods. Certain medications, which speed up your liver’s metabolism, can cause your body to process birth control hormones too quickly, potentially making your birth control less effective.
Do I have migraines with aura?
- If yes, consider progesterone-only methods. “Aura” refers to sensory disturbances—like seeing flashes, blind spots, or feeling tingling—that happen before a headache. Research suggests that combined hormonal contraceptives should generally be avoided in patients with migraine with aura due to the compounded stroke risk.
4. What Are My Future Fertility Plans?
First, it’s important to note that no association has been established between birth control and fertility problems. In a review of 22 studies that enrolled a total of 15,000 women who discontinued contraception, the rate of pregnancy was 83% within the first 12 months of contraceptive discontinuation. This research also showed that how long a woman used contraception did not significantly affect the time to fertility when you take into account the age of the woman.
However, when choosing a birth control method, consider if and when you may want to plan a pregnancy. Some methods you can discontinue on your own—you can decide to stop using your pills, patch or ring at any time. Other methods require a clinic visit to remove an IUD or take out an implant.
Some methods have a relatively short return to fertility after discontinuation. Others, most notably the injection, by design take longer to wear off, and so may have a longer time until return to ovulation.
Consider the following questions:
Am I hoping to become pregnant in the next year?
- If yes, consider a method you can discontinue on your own, or that wears off quickly.
Am I sure I do not want to have kids or I have completed my family?
- If yes, consider a long-term method or sterilization.
Do I want to start trying to get pregnant in the next 3 to 6 months?
If yes, consider these methods, which offer the fastest path back to your baseline based on your age and health status:
- Barrier Methods: Since these don’t alter your hormonal patterns or ovulation, your fertility remains exactly as it is. You are ready to start trying the moment you stop using them.
- IUDs (Hormonal and Copper): While an IUD is a “long-acting” device, its effects are local to the uterus. Once a provider removes it, most users return to their baseline fertility based on age and health status, usually within one to two cycles.
- The Implant: Much like the IUD, once the implant is removed, the hormone clears your system rapidly, often allowing ovulation to resume within days.
| The birth control injection shot, commonly known as the brand name Depo-Provera, works a little differently. Because the shot is a high-dose, slow-release progestin, it can stay in your system long after the 12-week “protection” window ends. On average, it can take up to 10 months for regular ovulation to return after the last shot. |
5. Am I At Risk for STIs?
Trick question: the answer is yes. Everyone is at risk for sexually transmitted infections (STIs).
Hormonal birth control does not protect against infections. If you are sexually active, STI prevention is a separate but equally important pillar of your reproductive well-being.
An STI is an infection passed from one person to another through sexual contact, including vaginal, anal, and oral sex. These can be caused by bacteria (like chlamydia), viruses (like HPV or HIV), or parasites (like trichomoniasis).
The data over the last decade shows a concerning rise in infection rates. According to the CDC, in 2024, there were more than 2.2 million reported STIs in the U.S.—a 13% increase compared to a decade ago. The CDC has also cited a shocking 700% increase in rates of congenital syphilis, an STI passed from mother to baby during pregnancy.
It is important to note that many STIs are asymptomatic, meaning you can have one—and spread one—without ever feeling “sick.”
How to Reduce Your Risk of STIs
1. Stay abstinent until testing: The most effective way to prevent STIs is to practice abstinence until both you and your partner have been tested for STIs and received negative lab results. Consider testing at regular intervals in the future.
2. Use barrier methods: Barrier protection (like male or female condoms) is the only contraceptive method that physically blocks the transmission of many STIs. When used correctly, it dramatically lowers, but does not fully prevent, the risk of infections. Use barrier methods every time, especially with new or non-monogamous partners.
3. Be aware of STI symptoms: Avoid sexual contact if you or a partner have visible sores, rashes, or unusual discharge. However, keep in mind that “no symptoms” does not equal “no infection.”