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Finding the right type of birth control is a lot like finding the right kind of shoe; you’re going to have to go through many until you find the one. Despite hormonal contraception being the most popular choice, there are many other options out there, one being the birth control sponge. 

This article details how the sponge works, whether or not it’s effective, and if it could be the right choice for you. 

Key Takeaways

• The vaginal sponge is a non-hormonal method of contraception.
• It prevents pregnancy 77-83% of the time.
• The sponge is available over the counter from planned parenthood clinics, pharmacies, and drug stores.
• You can use it to block sperm from the uterus for 24 hours without removing it. 
• It does not protect against STDs.

What Is the Birth Control Sponge?

The contraceptive sponge is a non-hormonal birth control method. It acts as a barrier in the form of a disk-shaped polyurethane foam sponge inserted into the vagina. The sponge works to prevent pregnancy by blocking the path of sperm to the uterus.

How Effective Is the Birth Control Sponge?

Physical barrier methods, like all contraceptive technology, are not 100% effective. Hormonal forms of contraception tend to prevent pregnancy more effectively [1]. 

Typically, the sponge is 77-83% effective, although this depends on whether or not a woman has gone through vaginal childbirth [2]. 

Giving birth to a child vaginally stretches the cervix and vagina, making the sponge far less effective [3].

A birth control sponge is more effective when used by a woman who hasn’t been pregnant before, though the contraceptive pill is still more successful

Vaginal Sponge and Spermicides

The contraceptive sponge contains a spermicide known as nonoxynol-9 that is gradually released over 24 hours and kills sperm before it reaches the egg [4]. 

Despite the spermicide inside, the sponge remains a relatively unreliable form of contraception and prevents pregnancy more effectively when combined with other birth control methods like the male condom.

Birth Control Sponge Advantages and Disadvantages

Below are the main pros and cons of the birth control sponge. 

Advantages

• Non-hormonal method of birth control: Avoids side effects of hormonal methods, such as weight gain, breakthrough bleeding, and nausea [5]
• It does not require a doctor’s prescription
• You only have to use it during sexual intercourse
• Safe to use while breastfeeding
• Won’t interfere with your menstrual cycle

Disadvantages

• It does not protect against sexually transmitted diseases (STDs)
• You cannot use it during your period
• Not reusable

How Do I Use the Sponge?

You must insert the contraceptive sponge into the vagina prior to sex. The sponge covers your cervix and blocks the path into your uterus, held in place by your vaginal muscles. It is essential to insert the sponge according to instructions. If you use the sponge incorrectly, it will dramatically reduce its effectiveness.

How Do I Insert the Sponge?

Before inserting the sponge, remove it from its packaging and wet it with about two tablespoons of clean water to activate the spermicide. 

To insert the sponge, position yourself with your legs slightly apart. Fold the sides of the sponge upward, and slide it folded side up, string side down, as far up into your vagina as it will go. Then, release it so that the edges unfold and cover your cervix.

When Can I Put the Sponge In?

It is essential to insert the contraceptive sponge before intercourse, even if it requires you to interrupt sex or foreplay to do so.

How Long Do I Leave the Sponge In?

To ensure maximum effectiveness, you must leave the sponge in for at least six hours after sex. However, you must remove it within 24-30 hours after insertion as leaving it in longer causes an increased risk of toxic shock syndrome.

How Do I Take the Sponge Out?

Most contraceptive sponges have a string attached to them to enable easy removal. Once you’re ready to remove the sponge, gently pull the string, or if you can’t find it, draw on the sponge itself. 

Bear down and try gently removing the sponge. If it is still held in place by your vaginal muscles, wait a while to allow them to relax and try again. 

Discard the used sponge after you’ve removed it.

Birth Control Sponge Side Effects

As with all contraceptive methods, there are possible side effects, including:

• Allergic reaction: The spermicide released by the sponge can cause itching, sores, or a rash inside the vagina or on your partner’s penis [6].
• Higher risk of toxic shock syndrome, causing fever, vomiting, diarrhea, and rashes, when misused [7]
• Vaginal dryness or irritation [8]

FAQ

We’re answering the most frequently asked questions about the birth control sponge below.

Is the Sponge Birth Control Still Available?

Yes, the contraceptive sponge is still available. However, the only brand currently on the market is the Today sponge, which is available over the counter at pharmacies, drug stores, family planning clinics, and planned parenthood centers. 

If you’re not sure how to get birth control, our article can help you find the best way for you.

Is the Birth Control Sponge Safe?

The contraceptive sponge is a safe barrier method when used according to its instructions. However, using it incorrectly could result in a greater chance of becoming pregnant or developing toxic shock syndrome.

Why Was the Birth Control Sponge Discontinued?

The vaginal sponge was mainly discontinued due to the development of the diaphragm, which was significantly more effective [9].  

The Today contraceptive sponge was temporarily taken off the market in 1994 due to bacterial contamination in the factories where it was manufactured. At the time, the company found the upgrades necessary for it to meet FDA approval would not be financially viable. 

The company was eventually taken over, and later the new, FDA-approved contraceptive sponge and spermicide barrier returned to the market and planned parenthood centers.

Can a Man Feel the Sponge?

No, you shouldn’t worry that your sex partner may feel the sponge. The material it is made of is soft and mimics the feel of the vaginal wall.

If you are unsure about using the sponge, there are various other methods of contraception, including birth control for men.

Conclusion

The birth control sponge is a non-hormonal form of contraception that you can use to prevent pregnancy for up to 24 hours. Despite it not being as effective as the diaphragm or cervical cap, using it combined with other forms of birth control prevents pregnancy up to 99% of the time. 

If you’re looking for an easy-to-use, barrier contraception method, the vaginal sponge could be the right choice for you.

References:

1. K;, Mansour D;Inki P;Gemzell-Danielsson. “Efficacy of Contraceptive Methods: A Review of the Literature.” The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/20136566/.
2. Commissioner, Office of the. “Birth Control.” U.S. Food and Drug Administration, FDA, www.fda.gov/consumers/free-publications-women/birth-control#BarrierMethods. 
3. B;, Trussell J;Strickler J;Vaughan. “Contraceptive Efficacy of the Diaphragm, the Sponge and the Cervical Cap.” Family Planning Perspectives, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/8354373/.
4. E;, Harrison C;Chantler. “The Effect of Nonoxynol-9 and Chlorhexidine on HIV and Sperm in Vitro.” International Journal of STD & AIDS, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/9506374/.
5. K;, Dawson. “Side Effects of Oral Contraceptives.” The Nurse Practitioner, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/503375/#:~:text=Some%20of%20the%20side%20effects,cancer%3B%20and%2C%20hepatic%20effects.
6. van Ulsen J;Stolz E;van Joost T;Geursen-Reitsma AM; “Allergy to Spermicidal Lubricant in a Contraceptive.” Contact Dermatitis, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/3652700/.
7. ; “Toxic-Shock Syndrome and the Vaginal Contraceptive Sponge.” MMWR. Morbidity and Mortality Weekly Report, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/6318070/.
8. SM;, Beckman LJ;Murray J;Harvey. “The Contraceptive Sponge: Factors in Initiation and Discontinuation of Use.” Contraception, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/2582772/.
9. B;, Trussell J;Strickler J;Vaughan. “Contraceptive Efficacy of the Diaphragm, the Sponge and the Cervical Cap.” Family Planning Perspectives, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/8354373/.

We women talk about anything and everything over drinks with friends. One of the things that I can bet that you don’t talk about is male birth control and the guy’s role in family planning, right? I mean, what is there to even talk about?

Apart from condoms, are there any other options? Let’s take a good look at what is on the table now as men’s birth control and dispel some of the ‘fake news’ that is out there. 

Key Takeaways

• Contraceptives such as vasectomy and condoms are the most effective. 
• The prototype pill for men is in development, but none have passed clinical trials and therefore have no FDA approval. 
• Outercourse and the withdrawal method are not forms of reliable birth control.
• Several topical gels are currently in clinical trials that offer a reliable and reversible male contraception option.

What Are the Options for Male Birth Control?

Pregnancy prevention is the name of the game, the prevention of unintended pregnancies. Let’s have a deep dive into the male contraceptive methods currently available. We can also dispel some of the myths and rumors you may have heard about with other products.

Vasectomy

We’ll start with the big one, known commonly as ‘The Snip’. As far as male birth control options go, this is the definitive procedure that is almost 100% (99.7%) effective [1]. It involves cutting the vas deferens, the tube that transports sperm from the testes to the penis and then out into the woman’s vagina [2]. 

A vasectomy only resulted in 0.15% of pregnancies, whereas male condom led to 18%

The operation can be done as minimally invasive surgery, through just a very small cut. Local anesthetic is used in the operation. It has the bonus of being an outpatient procedure so you can be back at home that same afternoon. 

You will generally have a consultation with your doctor to find out if it is right for you. There will also be a check of your ‘plumbing’ to ensure that there will be no complications for the procedure. 

Most operations will be carried out by a urologist with an assistant but may also be done as an outpatient in a clinic by a general surgeon. There is around a 1% risk of complications, additional bleeding, or discomfort, but your doctor will address all these issues pre-op [3]. 

The operation is referred to as irreversible, though there are possibilities if you change your mind later on—again your doctor will go through this with you. After the operation, sperm may still be produced, so testing post-op will be required to verify the success of the surgery. Until then, you must still use alternate methods of contraception to prevent pregnancy. 

This is the most common family planning option for older couples with children who have no plans to expand their brood. 

You should notice no difference in the sexual experience after the procedure [4]. There will be no change in the volume or aspect of your sperm. It is a myth that erectile dysfunction or low libido are side effects; everything will continue as usual. 

Condoms

Everyone will be familiar with these guys, the most common male birth control method. They have a number of benefits that other male birth control methods don’t. Condoms are cheap, readily available, and super easy to use. If used correctly, they are pretty effective too, around 98% [5]. 

This is the only male birth control option effective in pregnancy prevention and preventing sexually transmitted infections (STIs) [6].

Male condoms, when used correctly, are almost 90% effective at preventing the transmission of HIV and hepatitis B

 

If you have a latex allergy, plastic (aka latex-free) condoms are available [7]. You can use oil-based lubricants during sex as they do not affect the integrity of the sheath. 

Care must be taken with the care and storage of condoms. They shouldn’t be kept in wallets or billfolds. The friction and abrasion can damage the packaging and the condom. 

If you are using extra lubrication, you should not use oil-based lubricants with the standard (latex) condoms as they can weaken the material of the condom and cause it to break. You should choose water-based lubricants. Always check the condom packet for instructions if you are unsure.

Spermicides

Many over-the-counter spermicides are available. All are only recommended to be used in conjunction with condoms as they provide very poor protection on their own [8]. Their use isn’t classed as an official form of birth control. 

Outercourse

This covers a wide range of practices. As the name suggests, it does not involve penetrative sex. In theory, conception should not be possible, but there are pitfalls. 

Before ejaculation, sperm may be expressed, so any practices that involve close contact between the penis and vagina have some chance of pregnancy. Typically dry-humping and grinding are the riskiest practices. 

With oral or anal sex and even masturbation, pregnancy may occur if semen is expressed close to the vagina opening. Any further outercourse may introduce semen into the vagina and result in pregnancy. 

Behavioral Methods

Many forms of sexual activity can cause pregnancy. We all know several methods used to prevent it, typically the pull-out method (withdrawal contraceptive method based on pulling out of the vagina before ejaculation) being the most common [9]. As you can imagine, this is one of the least reliable forms of male contraception. 

As we have previously mentioned, sperm can be released before ejaculation, so it is easy to see why this method is ineffective (78% efficacy). 

The rhythm method is a contraceptive technique based on following the woman’s menstrual cycle to see when she is less likely to be fertile. This can be imprecise, as sperm can live for up to three days in the woman’s reproductive tract, and ovulation times may change from month to month. 

The human reproduction cycle can also be estimated with help from your female partner by finding slight changes in body temperature or by inspection of the vaginal mucosa. As discussed above, these are very imprecise methods and can not be relied upon to have a meaningful effect on preventing pregnancy.

If you take any medication that can potentially increase testosterone, such as Nugenix Total T or injectable testosterone, you should be aware of possible effects on fertility. If you are taking human growth hormone and having HGH side effects, you should also discuss this with your physician.

The Male Pill

No doubt you have seen and heard various things regarding the male birth control pill. The prototype male pill is being developed, but none have passed clinical trials and therefore have no FDA approval.

What Is the Male Birth Control Pill?

It is a form of hormonal birth control in pill form. Researchers are looking at the introduction of a combination of hormonal contraceptives into the body either by injection, implants, or an oral contraceptive pill. This is to stop sperm production or achieve a lower sperm count. 

It should be noted that although it will prevent pregnancy, it will not prevent sexually transmitted infections (STIs). If you are engaged in casual sex, you should also wear a condom to avoid any possible infection between you and your partner.  

How Does the Male Pill Work?

The male birth control pill will work similarly to the widely available female methods—a single daily pill. There are differing products currently in development that use a hormone or combination of hormones to suppress the production of sperm. 

Typically there is a mix of female and male hormones. Some, in pill form, contain follicle-stimulating hormone (FSH) and luteinizing hormone to prevent sperm production or a combination that reduces sperm production below fertile levels. 

Some contraceptive methods reduce free testosterone and overall testosterone levels in men to reduce sperm production. Your doctor may prescribe treatments to remedy this, as low testosterone in women and men can cause issues. 

Dimethandrolone undecanoate, or DMAU, is currently being tested as a new male birth control pill [10]. It is at the clinical trial stage, and as noted above, it is still a long way from the marketplace.

About 80% of subjects were satisfied with the method, whereas 54% would use it as their main contraceptive

 

A second, newer focus of contraception is an anti-fertility vaccine [11]. A number of US manufacturers are looking at targeting the way individual sperm attach to the egg to fertilize it. 

The vaccine would target the specific regions on the surface of the head of the sperm. Antibodies produced would bind to these regions preventing attachment of the sperm to the egg and stopping fertilization. 

As it stands, the pill would initially be for women as it would be easier to target the smaller amount of sperm in the fallopian tubes rather than all the sperm contained in the testes. As the efficacy of the treatments improved, a rollout of a male contraceptive pill would be on the cards. 

Clinical Trials for Male Birth Control

There are a number of trials (over 25) of various types of hormonal birth control underway [12]. They are at different stages, both animal and human clinical trials. As yet, none are close to the market; some estimates put the release dates between five and ten years. 

Trestolone is an anabolic steroid [13]. Studies are looking into subdermal implants for longer-term birth control. The results are quite promising. 

A compound called ouabain has some promising results [14]. It is from a plant that hunters in Africa use as arrow poison to stop the hearts of their prey. 

A non-hormonal treatment from the Chinese herb Tripterygium wilfordii is currently showing good results in animal trials [15]. It has reversibly inhibited sperm production in rats. 

A treatment targeting the production of sperm in the testes has shown impressive, reversible results, and work is still ongoing [16]. 

The message is, don’t hold your breath for a male birth control shot or pill just yet!

What Is the Male Contraceptive Gel?

There are a number of topical (applied to the skin) gels that are currently in preclinical or clinical trials. They offer a reliable (97% estimated efficacy) reversible male contraception option [17]. 

Most work in a similar way, akin to the female birth control pill. A hormone or hormones are introduced to suppress the sperm count to below fertile levels. 

Is Vasalgel Available in the US?

In short, no. Trials are not sufficiently advanced to allow for submission to the FDA for approval. It will be some time before it is on the market. 

Vasalgel is a new approach to male contraception. It involves blocking the vas deferens with a gel barrier rather than cutting it (vasectomy). The gel introduced to block the passage of sperm can be removed, so this will be reversible inhibition. There is no impact on sexual function; you will have a normal sex drive. 

Once again, don’t hold your breath!

FAQ

Why Isn’t There Male Hormonal Contraception? 

It takes a long time to go from the drawing board to FDA approval. Products are in human development, but male hormonal birth control is still a long way from being available. 

Why Was Male Birth Control Discontinued?

A common question and a common mistake. There have never been any products on the market to discontinue. 

There is a common misconception that a study on male birth control pills was put to a halt because the subjects were unable to tolerate the side effects, such as mood imbalances and acne. In fact, an independent safety board put a stop to the study [18].

How Effective Are Male Birth Control Pills? 

Currently, the estimates for efficacy are around 90% or slightly above. This isn’t easy to judge as clinical trials are not finished, and data isn’t fully available.

When Will Male Birth Control Pills Be Available?

Most estimates put the time frame between five and ten years. 

What Are Risks Associated With the Male Birth Control Pill or Similar Hormonal Treatments? 

For FDA approval, the risks must be minimal and manageable with consultation with your physician. No procedure or treatment is totally without risk. 

If you look at the possible side effects women accept when taking ‘The Pill,’ the list looks pretty terrible, with weight gain, blood clots, high blood pressure, and mood disorders being relatively common. In reality, the risks for healthy men are minimal across the cohort taking the pill. The male contraceptive pill will be similar. 

Conclusion

The male birth control pill or allied products will truly be a game-changer, a once-in-a-generation medical advance. For the first time, they will promote shared accountability for contraception, something that until now was not a viable option for men.

As it stands, there are only two reliable and safe methods for male birth control. These are vasectomy and condoms. Both have been available for decades, and yet the burden for birth control has always fallen squarely on the shoulders of women. 

When the options are finally presented, it will be up to men to take onboard these medical firsts and embrace them as fully as women did in the 60’s with ‘The Pill’. 

References

1. Stormont, Gavin. “Vasectomy.” StatPearls [Internet]., U.S. National Library of Medicine, 16 Apr. 2021, www.ncbi.nlm.nih.gov/books/NBK549904/. 
2. “Overview of the Male Anatomy.” Johns Hopkins Medicine, www.hopkinsmedicine.org/health/wellness-and-prevention/overview-of-the-male-anatomy. 
3. “Vasectomy.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 19 May 2021, www.mayoclinic.org/tests-procedures/vasectomy/about/pac-20384580. 
4. “Ejaculation after Vasectomy: What to Expect.” Medical News Today, MediLexicon International, www.medicalnewstoday.com/articles/326585. 
5. “How effective are condoms,” Planned Parenthood, https://www.plannedparenthood.org/learn/birth-control/condom/how-effective-are-condoms
6. “Sexually Transmitted Infections (STIs): Types and Symptoms.” Medical News Today, MediLexicon International, www.medicalnewstoday.com/articles/sexually-transmitted-diseases#chlamydia. 
7. Parenthood, Planned. “Condoms: How to Put On a Condom Video.” Planned Parenthood, www.plannedparenthood.org/learn/birth-control/condom. 
8. “Spermicide for Birth Control.” Spermicide for Birth Control | Michigan Medicine, www.uofmhealth.org/health-library/tw9509#:~:text=A%20nonprescription%20method&text=Spermicide%20and%20a%20condom%20used,sexually%20transmitted%20infections%20(STIs). 
9. “Birth Control for Men: 8 Options.” Medical News Today, MediLexicon International, www.medicalnewstoday.com/articles/birth-control-for-men#behavioral-methods. 
10. Nguyen BT;Farrant MT;Anawalt BD;Yuen F;Thirumalai A;Amory JK;Swerdloff RS;Bremner WJ;Liu PY;Blithe DL;Page ST;Wang C; “Acceptability of Oral Dimethandrolone Undecanoate in a 28-Day Placebo-Controlled Trial of a Hormonal Male Contraceptive Prototype.” Contraception, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/32298717/. 
11. A S V;Dhama K;Chakraborty S;Samad HA;Latheef SK;Sharun K;Khurana SK;K A;Tiwari R;Bhatt P;K V;Chaicumpa W; “Role of Antisperm Antibodies in Infertility, Pregnancy, and Potential ForContraceptive and Antifertility Vaccine Designs: Research Progress and Pioneering Vision.” Vaccines, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/31527552/. 
12. “Search of: Male+Contraception – List Results.” Home – ClinicalTrials.gov, clinicaltrials.gov/ct2/results?cond=male%2Bcontraception&term=&cntry=&state=&city=&dist=. 
13. Sinnesael, M., et al. “7α‐Methyl‐19‐Nortestosterone vs. Testosterone Implants for Hypogonadal Osteoporosis: a Preclinical Study in the Aged Male Orchidectomized Rat Model.” Wiley Online Library, John Wiley & Sons, Ltd, 26 July 2011, onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2605.2011.01198.x. 
14. “Heart-Stopping Arrow Poison Could Be the Key to Male Birth Control.” Smithsonian.com, Smithsonian Institution, 31 Jan. 2018, www.smithsonianmag.com/science-nature/arrow-poison-key-male-birth-control-180967985/. 
15. Chang, Zongliang, et al. “Triptonide Is a Reversible Non-Hormonal Male Contraceptive Agent in Mice and Non-Human Primates.” Nature News, Nature Publishing Group, 23 Feb. 2021, www.nature.com/articles/s41467-021-21517-5. 
16. Mruk, D., et al. “[PDF] A Male Contraceptive Targeting Germ Cell Adhesion: Semantic Scholar.” Undefined, 1 Jan. 1970, www.semanticscholar.org/paper/A-male-contraceptive-targeting-germ-cell-adhesion-Mruk-Wong/dcd92c9300aa8cd4fa93ca03863bc7b092f7ff6f. 
17. “Study of Daily Application of Nestorone® (NES) and Testosterone (T) Combination Gel for Male Contraception – Full Text View.” Full Text View – ClinicalTrials.gov, clinicaltrials.gov/ct2/show/NCT03452111. 
18. “Update on male hormonal contraception.” Giulia Gava, Maria Cristina Meriggiola, Ther Adv Endocrinol Metab. 2019; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419257/#bibr12-2042018819834846.

For many women, receiving ‘the pill’ for the first time is something like a rite of passage. However, birth control pills work by manipulating hormones and upsetting a woman’s natural rhythm. Some women aren’t comfortable with that for a whole variety of reasons.

There are many non-hormonal options when it comes to birth control. Each has its own advantages and disadvantages, so it’s usually possible to find one that meets your needs. All of them have one crucial advantage over hormonal birth control methods, as they leave your body chemistry alone as much as possible.

We’re going to look at the non-hormonal birth control options to see which are safe and which have the highest success rate.

Key Takeaways

• Behavioral methods of birth control are the least reliable.
• The most reliable birth control method is sterilization
• The most reliable, non-permanent birth control method is the copper IUD.
• The copper IUD is also effective as emergency contraception.
• Male condoms work best to prevent sexually transmitted infections.
• Male condoms work best for preventing pregnancy when paired with other birth control methods.
• All non-hormonal contraceptive methods have a risk of failure or side effects.

Non Hormonal Birth Control Options

Some hormone-free birth control methods are pretty common. Just about everyone has an embarrassing story about buying condoms, for example.

Many others aren’t as common or aren’t as popular as they once were. One reason the pill is so popular is that it’s a lot more convenient than fumbling for condoms mid-sexual encounter [1]. Frequently, the most effective method of birth control is the one you’ll use consistently and correctly.

When talking about the failure rate of birth control, health professionals may give two different figures. The first lists the failure rate of a method when it is used ideally, precisely as designed. The second gives the odds as observed in the field, where people may use a form of contraception incorrectly or inconsistently.

For men, non-hormonal methods are the only birth control methods available. Many people have tried to formulate male birth control pills without any success.

Barrier Methods

As the name implies, these methods use some type of barrier to prevent the sperm from meeting and fertilizing the egg [2]. The barrier can be either chemical or physical.

A barrier method may have to be put in shortly before sexual intercourse and removed shortly after. It’s generally not a good idea to leave a barrier method in place for an extended period.

Some barrier methods, such as a diaphragm or cervical cap, have been associated with toxic shock syndrome [3]. When barrier contraceptives are left in place for too long, an infection can develop. Toxic shock can be a complication of an infection and is very serious.

Both male and female condoms are considered barrier methods of contraception.

Male Condoms

A male condom is a tube that is closed on one end. A condom slips over an erect penis, forming a barrier between the penis and vagina, preventing sperm from entering the uterus.

Male condoms are considered the best way to prevent the transmission of STIs, as the barrier they form also works against viruses and bacteria.

When used in ideal circumstances, male condoms work 98% of the time. In real-world circumstances, 13 out of 100 women will become pregnant when using a condom on its own [4].

Adding another form of birth control, like spermicide, can reduce the odds of an unexpected pregnancy. Some male condoms come with spermicide.

Although not the least successful contraceptive method, male condoms still failed to prevent a pregnancy in 18% of women

Latex is the most common material used. However, some people are allergic to a male latex condom, so condoms made from other materials are also sold.

Diaphragms and Female Condoms

Though sometimes conflated, diaphragms and female condoms are actually two different barrier methods of birth control.

A female condom can be thought of as an internal condom. They consist of a pouch, usually stiffened somewhat with rings, closed on one end. This sort of condom is inserted into the vagina with the open end remaining outside the vagina.

A diaphragm is similar. However, diaphragms are smaller and go entirely into the vagina. They are placed over the cervix to prevent sperm from traveling up into the uterus.

Both methods have to be put in place immediately before intercourse, which can be awkward. Both also have to be placed correctly in order to work well. As a result, both have a slightly higher rate of failure.

A condom for a woman will fail about 5 times out of 100 when used in ideal circumstances but will fail over 20% of the time in real-world use.

When using a diaphragm with spermicide, 6 out of 100 women in ideal circumstances will become pregnant. In the real world, 17 out of 100 will become pregnant.

Cervical cap

Cervical caps are very similar to a diaphragm. It’s a small device that fits over the cervix. A cervical cap should be used with a spermicide.

This form of birth control will fail about 9 times in 100 in ideal circumstances. In real-world use, it will fail about 14 out of 100 times.

Cervical Sponge

This method is sometimes also called a birth control sponge. It’s used similarly to a diaphragm in that it is placed over the cervix. A contraceptive sponge has spermicide on it, preventing sperm from fertilizing an egg.

As with a diaphragm, proper placement is essential. However, the advantage of the sponge is that it will continue to work for about 24 hours. You don’t need to take it out and reapply spermicide during that time.

A sponge will work about 90% of the time in ideal circumstances, though sponges are half as effective if you’ve already had children. In the real world, it works about 90% of the time.

Spermicides

While spermicides may come as creams, gels, or tablets, they are all usually some form of a compound called nonoxynol-9 [5]. It has been in use for over 30 years as a safe, effective spermicide.

As the name implies, it’s a chemical that damages sperm or otherwise prevents them from moving. In other words, spermicide kills sperm. Spermicides are frequently paired with other forms of birth control [6].

When used on its own in ideal circumstances, about 1 in 5 women will become pregnant. In the real world, a little over 1 in 4 women will end up becoming pregnant.

Behavioral Methods

Family planning may be a newer term, but it isn’t a new concept. Most methods of birth control, particularly hormonal birth control methods, were invented in the second half of the 20th century.

Natural family planning, also called natural birth control, is a term for a few different methods of non-hormonal birth control. These methods don’t depend on a barrier device like a condom. Instead, these methods work with the body’s natural rhythms or have the man attempt to avoid ejaculating inside the vagina entirely.

In general, these methods tend to have a higher failure rate.

Withdrawal (Pull Out Method)

This form of natural birth control is relatively straightforward. As a man reaches climax, he removes his penis, preventing pregnancy. The concept is clear, but the execution is sometimes tricky. This method relies largely on the self-control and experience of the man.

In ideal circumstances, only 4 out of 100 women will conceive when using the withdrawal method. In real-world cases, the odds of failure are about 20%.

Fertility Awareness Method

This method is also sometimes known as the rhythm method. It uses a variety of fertility awareness methods to track a woman’s menstrual period, allowing partners to avoid sex during fertile periods.

Fertility awareness is not an exact science. Women have to monitor their basal body temperature, which can be challenging. Some methods of detecting ovulation include testing cervical mucus, which can also be difficult. A woman’s cycle also may vary naturally. This method works best if a woman’s menstrual cycle is fairly regular.

At around -5 days before temperature rise, the chances of pregnancy increase steadily before declining rapidly

The success rate of this natural family planning method is about the same as other behavioral, non-hormonal birth control options. In ideal circumstances, 3 women out of 100 would become pregnant using this method to prevent pregnancy. In practice, it’s a little over 20%.

Outercourse

The name says it all. This method prevents pregnancy as, during outercourse, the penis doesn’t actually enter the vagina. In terms of birth control options, this method is preferable as even a short amount of penetration can lead to pregnancy. Additionally, there isn’t the element of self-control to consider.

In theory, this method of birth control should be 100% effective.

Copper IUD

A copper intrauterine device (IUD) is a t-shaped piece of plastic with a thin copper wire wrapped around it [7]. Strictly speaking, this method is drug and hormone-free. Instead, copper is toxic to sperm, preventing them from moving. As a result, they can’t find the egg and fertilize it.

Copper IUDs also have a second line of defense [8]. If an egg is fertilized, the copper in the IUD will make it more difficult to implant in the lining of the uterus.

It is also one of the most effective forms of emergency contraception available. If a copper IUD is inserted within 5 days of having unprotected sex, there is a 99.9% chance of preventing pregnancy. Additionally, because it’s an IUD, you don’t have to worry about misusing it.

A copper IUD can sometimes shift out of proper placement, becoming less effective. It has also been associated with increased cramping, pain, and a heavier period flow, particularly in the first few months. However, it will continue to work for over 10 years. Copper IUDs have also been linked to a higher risk of pelvic inflammatory disease [9][10].

Permanent Sterilization

Sterilization is the most extreme of the non-hormonal options for birth control. It involves a surgical procedure for both men and women. It is considered permanent.

Male Sterilization

In a vasectomy, the tubes that carry sperm are sealed [11]. While a man can still get an erection and climax, no sperm is ejaculated.

Vasectomies can be reversed. However, it requires another procedure. Both procedures come with risks of impotence or other problems. It can also affect free testosterone levels.

Female Sterilization

Female sterilization can happen in a couple of ways. With each, the egg is prevented from reaching the sperm or uterus. All of these options are permanent.

Tubal ligation may be the most common [12]. The fallopian tubes are sealed so that eggs can’t travel to the uterus.

Because the uterus and fallopian tubes have been severed, an egg that may already have been fertilized can’t implant itself in the uterine lining. Instead, it may implant itself in the lining of the fallopian tube. This condition, called an ectopic pregnancy, can’t be brought to term and poses serious risks to women’s health.

Another form is called bilateral salpingectomy, in which the ovaries are removed [13]. This is less often done as a method of contraception than to prevent cancer or treat a condition. A hysterectomy, in which a woman’s uterus is removed, is sometimes done for similar reasons [14]. These procedures can lead to low testosterone in women.

A mini lap was the most common type of female sterilization surgery performed, followed by lap. An LSCS was fairly uncommon

Switching to Non-Hormonal Birth Control Methods: What to Expect

Hormonal methods of birth control trick a woman’s body into not releasing an egg each cycle. When you stop taking the pill, your body’s hormones may need a little bit of time to find a new equilibrium. That may mean that a cycle may be oddly timed, be particularly strong, or be different in other ways. Preparing for those changes can be a good idea.

It can also be helpful to overlap methods of birth control. Some methods may need a bit of time to become fully effective. During that period, the chances of pregnancy may rise dramatically.

How To Choose the Right Birth Control Method for You

Certain methods of birth control are more effective statistically. However, the best form of birth control is the one that best fits your needs. As this is a decision that can potentially have life-changing consequences, it can help to think through your options ahead of time.

Factors to consider might include:

• Future plans for children.
• Other health considerations.
• Comfort and ease of use.
• Frequency of use.
• Expense.
• Reliability.

FAQ

What Is the Best Non-Hormonal Birth Control?

The most reliable form of non-hormonal birth control is sterilization. The non-permanent method with the highest success rate was the copper IUD.

What Is the Healthiest Form of Birth Control?

This can depend on several factors. Hormonal birth control pills are sometimes used to treat other conditions, for example. Copper IUDs may have the best mix of reliability and a low chance of side effects. If you have concerns, your doctor is the best person to ask.

Does Non-Hormonal Birth Control Work?

When used correctly, all of the methods we’ve outlined will work much of the time. The reliability of any form of birth control can vary.

Conclusion

While the pill has become the standard for birth control methods, it’s far from the only effective method. Many non-hormonal options are just as easy to use and reliable as hormonal birth control. Additionally, many have fewer side effects.

As with any health decision, however, statistics only go so far. Bringing a new life into the world is a big decision, and it’s usually a good idea to plan ahead. Using a reliable method of preventing pregnancy is essential and not a choice that should be made lightly.

References:

1. “Estrogen and Progestin (Oral Contraceptives): MedlinePlus Drug Information.” MedlinePlus, U.S. National Library of Medicine, medlineplus.gov/druginfo/meds/a601050.html.
2. Barrier Methods of Birth Control, wa.kaiserpermanente.org/kbase/topic.jhtml?docId=hw138685.
3. “Toxic Shock Syndrome.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 18 Mar. 2020, www.mayoclinic.org/diseases-conditions/toxic-shock-syndrome/symptoms-causes/syc-20355384.
4. Posted under Health Guides. Updated 7 February 2020. +Related Content. “Contraception: Success and Failure Rates of Contraceptives.” Center for Young Women’s Health, 7 Feb. 2020, youngwomenshealth.org/2009/11/03/success-and-failure-rates-of-contraceptives/.
5. “Nonoxynol-9.” National Center for Biotechnology Information. PubChem Compound Database, U.S. National Library of Medicine, pubchem.ncbi.nlm.nih.gov/compound/Nonoxynol-9.
6. S;, Craig S;Hepburn. “The Effectiveness of Barrier Methods of Contraception with and without Spermicide.” Contraception, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/6759027/.
7. Parenthood, Planned. “IUD Birth Control: Info About Mirena & Paragard IUDs.” Planned Parenthood, www.plannedparenthood.org/learn/birth-control/iud.
8. “Copper IUD (ParaGard).” Mayo Clinic, Mayo Foundation for Medical Education and Research, 11 Feb. 2020, www.mayoclinic.org/tests-procedures/paragard/about/pac-20391270.
9. Kaneshiro, Bliss, and Tod Aeby. “Long-Term Safety, Efficacy, and Patient Acceptability of the Intrauterine Copper T-380A Contraceptive Device.” International Journal of Women’s Health, Dove Medical Press, 9 Aug. 2010, ncbi.nlm.nih.gov/pmc/articles/PMC2971735/.
10. “Pelvic Inflammatory Disease – CDC Fact Sheet.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 19 Nov. 2020, www.cdc.gov/std/pid/stdfact-pid.htm.
11. “Vasectomy.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 19 May 2021, www.mayoclinic.org/tests-procedures/vasectomy/about/pac-20384580.
12. “Tubal Ligation.” Johns Hopkins Medicine, www.hopkinsmedicine.org/health/treatment-tests-and-therapies/tubal-ligation.
13. “Prophylactic Oophorectomy: Preventing Cancer by Surgically Removing Your Ovaries.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 11 Aug. 2020, www.mayoclinic.org/tests-procedures/oophorectomy/in-depth/breast-cancer/art-20047337.
14. “Hysterectomy | Endometriosis | Fibroids.” MedlinePlus, U.S. National Library of Medicine, 26 May 2021, medlineplus.gov/hysterectomy.html.