Nonhormonal Birth Control: What Are the Options? – Healthline
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Birth control that doesn’t affect your hormones in any way is called nonhormonal birth control.
The various nonhormonal methods work to prevent pregnancy by making a physical barrier between the sperm and egg, surgically changing the body, or altering behavior leading up to or during sex.
Some people may not want to use hormonal birth control for many reasons. For some, hormonal birth control can have negative side effects on the body.
Other reasons why someone may avoid hormonal birth control include health concerns, mood changes, decreased libido, or simply a desire to avoid hormones.
Nonhormonal birth control is any method of preventing pregnancy that won’t affect your hormones. There are many types of nonhormonal birth control, like:
copper IUDcondomsdiaphragmspermicidecervical capbirth control spongevaginal gelvasectomypull out method (withdrawal)
For anyone with concerns or health issues around using hormonal birth control, like the pill or patch, nonhormonal birth control could be a great alternative.
Each type of nonhormonal birth control comes with its own particular set of benefits and considerations. Generally, it’s best to understand how well a given nonhormonal birth control method fits with your lifestyle, needs, and preferences, along with how confident and comfortable you are using it.
For example, a copper IUD can be effective against pregnancy for up to 10 years, which is great if you know you won’t want to conceive for the long term. But condoms are a good option if you’d prefer the flexibility to decide when you want to get pregnant, since they’re used as a barrier method each time you have sex.
Nonhormonal birth control is also helpful for people who:
don’t like to take a pill at the same time every daydon’t want to visit a doctor for prescriptionsare breastfeeding and don’t want to pass hormones to their babyare sensitive or intolerant to certain female hormones like estrogen
Best long-term method
Copper intrauterine device (IUD)
Price range: free to $1,300, depending on health insurance and coverageEffectiveness: 99 percent
The copper IUD (ParaGard) is a T-shaped plastic device wrapped in copper that gets inserted through the cervix into the uterus by a doctor. Copper is toxic to sperm. The device can also steer a fertilized egg away from the uterine wall.
Best barrier method
Condoms
Price range: varies; around $8 for a pack of 12Effectiveness: 98 percent with perfect use, 85 percent with typical use
There are two types of condoms: external and internal condoms.
An external condom goes over the penis to catch semen. While typically made of latex, there are other options, such as:
polyurethanepolyisoprene (a synthetic form of latex)
External condoms are available in a range of sizes, styles, textures, flavors, and colors.
Internal condoms, also called vaginal condoms, are a thin, strong covering that’s held in place by a ring on each side. They can be up to 95 percent effective but are about 79 percent effective with typical use.
Best reusable method
Diaphragm
Price range: free to $75 with insuranceEffectiveness: 94 percent with perfect use, 88 percent with typical use
A diaphragm is a small cup made of flexible silicone that can stop sperm from making contact with an egg. Its edges get covered in spermicide before it’s inserted into the vagina to cover the cervix.
While you’re able to insert it and take it out yourself, you’ll have to talk with a doctor and receive a prescription for one.
However, once you have your diaphragm, you can use it for multiple sessions before it’s taken out, and it can be inserted up to 1 day before having sex.
You can also safely use it when breastfeeding and stop using it at any time.
That said, a diaphragm is not an option if you have an allergy or sensitivity to silicone. It also doesn’t protect against STIs and can be pushed out of place during sex.
Don’t leave a diaphragm in for more than 24 hours, and don’t use petroleum jelly or other oil-based creams to insert it. Spermicide is the best lubricant for insertion.
Best low maintenance option
Spermicide
Price range: free to around $25Effectiveness: 82 percent with perfect use, 72 percent with typical use
Spermicide is a chemical that’s applied to the vagina before sex. It works by blocking the cervix or stopping sperm from entering the uterus. It’s available in a gel, cream, or suppository form. It’s most effective when combined with an additional birth control method, like a diaphragm or condom.
Best reusable option
Cervical cap
Price range: free with insurance to $275 without insurance, depending on coverageEffectiveness: 86 percent with perfect use, 71 percent with typical use
A cervical cap is a silicone cup that’s like a smaller diaphragm. It gets covered in spermicide and inserted in the vagina to cover the cervix. It’s a reusable barrier method but must be used with spermicide for maximum effectiveness.
It can be inserted in advance and used multiple times, but it doesn’t protect against STIs and isn’t the most effective form of birth control.
Best for as-needed use
Birth control sponge
Price range: about $15 for three spongesEffectiveness: 88 percent with perfect use, 76 percent with typical use
The birth control sponge is made from plastic foam. It gets inserted into the vagina and features a nylon loop to help remove it easier after intercourse. As with other nonhormonal birth control methods, the sponge contains spermicide and blocks the cervix from sperm fertilizing an egg.
You can use it on an as-needed basis. This means you can just insert it before having sex. It’s also safe to insert it up to a day before. However, avoid using it during your period. It’s also less effective if you’ve given birth.
You can purchase a birth control sponge at some Planned Parenthood health centers or family planning clinics.
Best prescription option
Vaginal gel (Phexxi)
Price range: may be free to $25 with insurance; around $316 for 60 grams without insuranceEffectiveness: 93 percent with perfect use, 86 percent with typical use
Phexxi is a contraceptive vaginal gel. It contains ingredients that alter the vagina’s pH level to be more acidic. This makes it harder for sperm to fertilize an egg. The gel is most effective when used with another nonhormonal birth control method, like condoms.
It comes in a prefilled applicator with one dose of gel. You insert it within an hour of having sex. Each time you have sex, you reapply it.
Best minor surgery
Vasectomy
Price range: between $0 to $1,000 with or without insurance. Under the Affordable Care Act, most insurance plans should cover birth control, excluding vasectomies—however, some networks will cover some or all of the costsEffectiveness: at least 99 percent
A vasectomy (also referred to as male sterilization) is the most effective nonhormonal birth control method for people with a penis. It involves cutting, sealing, or blocking the vas deferens tube, which moves sperm to the penis from the testicles.
There are two types of vasectomies:
Conventional vasectomy. A doctor makes small cuts to the scrotum to reach the vas deferens tube. They remove a small piece of the tube, leaving a small space between the two ends. Then, the doctor ties the two ends of the tube together or places some tissue between them. No-scalpel vasectomy. A doctor will feel for the vas deferens tube and hold it in place with clamps. They make a tiny hole in the scrotum to take out the tube, then cut and tie it closed before putting it back in place.
A vasectomy can be reversed up to 20 years after the initial procedure.
There are several factors to take into account when picking the best nonhormonal birth control option. Everyone is different. Your personal needs will impact the right choice for you.
You’ll need a solid understanding of the risks, considerations, and benefits of each birth control type. From there, you can assess whether it fits with your lifestyle and preferences.
Here are some of the most important things to consider in your research:
Effectiveness rate. The only guaranteed way to prevent pregnancy is to abstain from intercourse. But you have other options: Many nonhormonal birth control methods are highly effective at minimizing those chances. For instance, a copper IUD can be 99 percent effective.Price. Some methods are significantly more expensive than others, especially if you’re paying out of pocket without insurance. Before making a decision, consider your budget.Permanence. If you know for certain that kids aren’t ever an option in the future, you could consider options like a vasectomy. However, if you’d like the flexibility to get pregnant, condoms are a good option.How well it protects against STIs. Pregnancy isn’t the only thing you should think about avoiding; STIs are an important consideration, too. Many nonhormonal birth control types, like condoms, do a great job of preventing STIs. However, others, like a copper IUD, won’t prevent STIs.
If you’re on the fence about nonhormonal versus hormonal birth control, remember that hormones affect all of us differently. Consider hormone changes and side effects, protection against STIs, and how they can affect your menstruation and fertility.
How hormonal birth control works
The ovaries naturally produce the hormones estrogen and progesterone, but they can be synthetically made into contraceptives.
Higher than typical amounts of these hormones are used to cause the ovary to hang on to the egg. This way, there’s nothing for sperm to fertilize. Hormonal birth control also makes cervical mucus thicker and stickier, making it tougher for sperm to get to the uterus.
Hormonal birth control may cause many side effects. When your body acclimates to inserted, oral, or patch hormonal birth control, you could experience things like:
spotting between periods (this is most common with low or ultra-low dose hormonal birth control, like birth control pills, the implant, and hormonal IUDs)vaginal irritationbreast tenderness or enlargementweight fluctuationsnauseamood changesblood pressure increase
Since hormonal birth control affects many people in different ways, it’s good to remember that some types can cause your body to have extra or heavier periods or none at all. When making this decision, talk with your doctor about what you can expect.
And, though less common, more serious side effects can occur, such as:
blood clotsstrokecardiovascular diseasesdeep vein thrombosis
It’s crucial to remember that hormonal birth control does not protect against STIs. If you choose this method over a nonhormonal method and you’re unsure whether your partner is STI-free, you’ll want to use another method that reduces the risk of transmission, like a condom, until you both can screen for STIs.
Is nonhormonal birth control effective?
Nonhormonal birth control can be very effective. Like hormonal birth control, each method has its own effectiveness rate. For example, condoms are 85 to 98 percent effective. The diaphragm is 88 to 94 percent effective.
Is hormonal or nonhormonal birth control better?
Neither hormonal nor nonhormonal birth control is universally better or worse. The ideal option for you will depend on your body and health, needs and preferences, lifestyle, and budget.
How does nonhormonal birth control work?
Nonhormonal birth control works by:
creating a physical barrier between the sperm and eggsurgically altering the body to prevent pregnancy (e.g., a vasectomy)practicing behavioral methods like fertility awareness methods (FAMs) or pulling out
Nonhormonal birth control is one way to prevent pregnancy without affecting your hormones. Hormones affect everyone differently, so nonhormonal options can be a great option for many people.
There are many nonhormonal birth control options, which can be as effective as hormonal methods but without side effects. Of course, as with any birth control method, you’ll still need to weigh the pros and cons and consider your most important factors when deciding.
If you’re unsure about which option is right for you, speak with a doctor.
Emma Caplan is a writer and editor with over 10 years of experience in various content types and topics, like health and lifestyle, home and design, local events and news, travel, the outdoors, real estate, business, and tech. Emma edits marketing content, as well as fiction and non-fiction books. Her work has been featured in the Chicago Tribune and on Nexstar Media, Narcity Media, and BobVila.com.
