The Short Answer
There is no single best birth control method. The right one depends on your body, your routine, and what matters most to you - whether that is set-and-forget convenience, hormone-free options, or something you can stop at any time. This guide covers every major method with honest effectiveness numbers, real side effects, and practical trade-offs so you can have a better conversation with your provider.
Key Points:
- IUDs and implants are the most effective methods (99%+), even with typical use
- Pills, patches, and rings are highly effective but depend on consistent use
- Non-hormonal options exist for people who want to avoid hormones
- Most side effects are temporary and improve within 2-3 months
- Track how your body responds to any method with the bloom app
Birth Control Comparison Table
Scan all methods at once, then read the sections that interest you.
| Method | Type | Typical Use | Perfect Use | Duration | Hormones | Requires Procedure | Reversibility |
|---|---|---|---|---|---|---|---|
| Combined pill | Hormonal | 91% | 99.7% | Daily | Estrogen + progestin | No | Immediate |
| Mini pill (progestin-only) | Hormonal | 91% | 99.7% | Daily | Progestin only | No | Immediate |
| Hormonal IUD (Mirena, Kyleena) | Hormonal | 99.8% | 99.8% | 3-8 years | Progestin only | Yes | After removal |
| Copper IUD (Paragard) | Non-hormonal | 99.2% | 99.4% | 10-12 years | None | Yes | After removal |
| Implant (Nexplanon) | Hormonal | 99.95% | 99.95% | 3-5 years | Progestin only | Yes | After removal |
| Patch (Xulane) | Hormonal | 91% | 99.7% | Weekly | Estrogen + progestin | No | Immediate |
| Vaginal ring (NuvaRing) | Hormonal | 91% | 99.7% | Monthly | Estrogen + progestin | No | Immediate |
| Shot (Depo-Provera) | Hormonal | 94% | 99.8% | Every 3 months | Progestin only | No | 6-12 months |
| Male condom | Barrier | 82% | 98% | Per use | None | No | Immediate |
"Typical use" reflects how most people actually use a method, including occasional mistakes. "Perfect use" assumes flawless, consistent use every time. The gap between these numbers tells you how forgiving a method is.
Long-Acting Hormonal Methods
Hormonal IUD (Mirena, Kyleena, Liletta, Skyla)
A small T-shaped device placed in the uterus by a provider. It releases a low dose of progestin locally, which thins the uterine lining and thickens cervical mucus.
- Effectiveness: 99.8% (typical and perfect use are nearly identical)
- Duration: 3-8 years depending on brand
- Hormones: Progestin only, mostly local (very little enters the bloodstream)
Insertion takes about 5 minutes. Periods often become lighter. About 20% of Mirena users stop getting periods entirely after one year. Common early side effects: cramping, spotting, and irregular bleeding for 3-6 months.
Compare hormonal vs copper IUDs in detail
Implant (Nexplanon)
A thin, flexible rod (about the size of a matchstick) inserted under the skin of the upper arm. Releases a steady dose of progestin.
- Effectiveness: 99.95% - the single most effective reversible method available
- Duration: 3-5 years
- Hormones: Progestin only
Insertion takes about one minute under local anesthesia. The most common side effect is irregular bleeding, which affects about 1 in 3 users.
Short-Acting Hormonal Methods
Combined Birth Control Pill
A daily pill containing estrogen and progestin. Prevents ovulation, thins the uterine lining, and thickens cervical mucus.
- Effectiveness: 91% typical, 99.7% perfect
- Duration: Daily
- Hormones: Estrogen + progestin
Must be taken at roughly the same time each day. Many formulations available. Benefits beyond contraception: can improve acne, reduce cramps, lighten periods, and manage PMS.
See how the pill compares to an IUD
Progestin-Only Pill (Mini Pill)
A daily pill containing only progestin. Works mainly by thickening cervical mucus. Must be taken within the same 3-hour window every day (stricter than combined pills). A good option for people who cannot take estrogen.
Patch (Xulane, Twirla)
A small adhesive patch worn on the skin that releases estrogen and progestin. Changed weekly (3 weeks on, 1 week off). May be less effective in people who weigh over 198 lbs (90 kg).
Vaginal Ring (NuvaRing, Annovera)
A flexible ring you insert into the vagina. It releases estrogen and progestin locally. Monthly action (3 weeks in, 1 week out). Lower systemic hormone levels than pills because hormones are absorbed locally.
Shot (Depo-Provera)
An injection of progestin given by a provider every 12-13 weeks. Most common side effect is irregular bleeding. Fertility return can take 6-12 months after the last injection.
Read the full Depo-Provera guide
Non-Hormonal Methods
Copper IUD (Paragard)
A hormone-free IUD that uses copper to prevent fertilization. The only highly effective, long-acting, hormone-free contraceptive available.
- Effectiveness: 99.2% typical, 99.4% perfect
- Duration: 10-12 years
- Hormones: None
Periods may become heavier and cramps stronger, especially in the first 3-6 months. Can be used as emergency contraception if inserted within 5 days of unprotected sex.
Compare copper vs hormonal IUD
Condoms
Barrier methods that physically block sperm. Male condoms: 82% typical / 98% perfect. Female condoms: 79% typical / 95% perfect. The only method that also protects against STIs. Can be combined with any other method for added protection.
Choosing the Right Method
These questions can help narrow it down:
- Do you want to avoid hormones? Consider the copper IUD or condoms.
- Do you want something you do not have to think about? IUDs and implants require no daily or weekly action.
- Do you want to control your period? Combined pills, hormonal IUDs, and the implant can lighten or stop periods.
- Are you breastfeeding? Progestin-only methods are safe while nursing.
- Do you want to get pregnant soon? Avoid the shot. All other methods allow rapid return to fertility.
If you are weighing two specific methods: Pill vs IUD | Hormonal vs non-hormonal birth control
Tracking Your Experience
Whichever method you choose, tracking how you feel in the first few months helps you and your provider spot patterns early. The bloom app lets you log symptoms, mood, and side effects privately on your device - no account required.
Frequently Asked Questions
What is the most effective birth control method?
The implant (Nexplanon) is the single most effective reversible method at 99.95%. Hormonal IUDs are a close second at 99.8%. Both work without any daily effort.
Which birth control has the fewest side effects?
The copper IUD is the only highly effective hormone-free option, so it avoids hormonal side effects entirely. However, it can cause heavier periods. Among hormonal methods, the hormonal IUD tends to have the fewest systemic side effects because most of the hormone stays local.
Can I switch birth control methods?
Yes. Most switches are straightforward, though timing matters to maintain continuous protection. Read our guide on switching methods.
How long do birth control side effects last?
Most side effects improve within 2-3 months as your body adjusts. If they persist beyond 3 months or significantly affect your quality of life, talk to your provider. More on side effects by method.