Birth Control Methods Chart

Designed for providers to help clients consider their birth control options, this chart takes client autonomy into account and presents methods that clients can start and stop on their
own and those that require provider involvement (prescription or procedure). The chart highlights method characteristics, including use & frequency, so clients can make informed
decisions, based on their own preferences. Note: Within each table, the methods are listed in order of number of pregnancies expected, and side effects are alphabetized within each
method. Not all risks and benefits for each method are included on this chart.

CLIENTS CAN START AND STOP ON THEIR OWN

Number of
Method Use & Frequency Period Changes Potential Side Effects Other Considerations
Pregnancies Expected1
Fertility 2–23 out of 100 Client tracks signs of fertility Must have regular cycles and be
Awareness-based (depends on specific FAB daily and abstains from sex on None None comfortable tracking basal body
(FAB) method) fertile days. temperature and cervical mucus.
Spotting or bleeding
Available OTC. Safe for people with
Pill (progestin-only), Client takes by mouth same time between periods. May not Acne, breast tenderness,
7 out of 100 high blood pressure, blood clot history,
Opill every day. have traditional withdrawal headache, nausea, weight gain
and those who can’t take estrogen.
bleeding
Client rolls onto erect penis Allergic reactions, vaginal Method prevents STIs. Requires a
Condom (external) 13 out of 100 None
(external) every time has sex. irritation cooperative partner.
21–28 (spermicide alone) or
Spermicide or Client inserts into vagina before
17 (sponge w/ spermicide) None Vaginal irritation Pair with another method for back-up.
vaginal sponge penile-vaginal sex every time.
out of 100
Client inserts into vagina (internal) Allergic reactions, vaginal Method prevents STIs. Requires a
Condom (internal) 21 out of 100 None
every time has sex. irritation cooperative partner.
Partner with penis ejaculates
Withdrawal 25 out of 100 None None Requires a cooperative partner.
outside of and away from vagina.

REQUIRES PROVIDER TO START WITH A PRESCRIPTION (CLIENTS CAN STOP ON THEIR OWN)—CONTINUED ON OTHER SIDE
Number of
Method Use & Frequency Period Changes Potential Side Effects Other Considerations
Pregnancies Expected1
Provider administers shot (IM), or
Shot (IM/SC) Spotting, lighter Bone density loss, Delay in fertility return. Not visible
4 out of 100 the client self-administers shot (SC)
progestin-only period, or no period headache, weight gain to others.
every 12–15 weeks.
Client places patch on back, butt, or
Patch Breast tenderness, headache, May be less effective in people with
belly. Every month, changes patch Temporary spotting
(transdermal system 7 out of 100 nausea, skin irritation, a BMI of 30 or over.
weekly for 3 weeks and no patch or lighter period
estrogen + progestin) stomach pain Extended/continuous use option.*
for 1 week.
May reduce acne, cramping, and PMS.
Pill (combined Temporary spotting Breast tenderness, headache, Routine blood pressure checks
7 out of 100 Client takes by mouth daily.
estrogen + progestin) or lighter period nausea, risk for blood clots recommended.
Extended/continuous use option.
Client places ring into vagina. Every Two types: monthly and yearly. May
Ring Lighter period or
7 out of 100 month, keeps ring in vagina for 3 Breast tenderness, nausea reduce acne, cramping, and PMS.
(estrogen + progestin) temporary spotting
weeks and then removes for 1 week. Not visible but can be felt by partners.
Spotting or bleeding
Safe for people with high blood
Pill (progestin-only, Client takes by mouth at the same between periods. May not Acne, breast tenderness,
7 out of 100 pressure, blood clot history, and
“the mini pill”) time every day. have traditional headache, nausea, weight gain
those who can’t take estrogen.
withdrawal bleeding
REQUIRES PROVIDER TO START WITH A PRESCRIPTION (CLIENTS CAN STOP ON THEIR OWN)—CONTINUED
Number of
Method Use & Frequency Period Changes Potential Side Effects Other Considerations
Pregnancies Expected1
Diaphragm or Client inserts into vagina with
17 (diaphragm) and 22–23 Allergic reactions, UTI, Same device may be used for
cervical cap spermicide before every instance None
(cap) out of 100 vaginal irritation two years.
(both w/spermicide) of penile-vaginal sex.

Vaginal contraceptive Client inserts into vagina before Allergic reactions, UTI,
28 out of 100 None May act as lubricant for dryness.
gel (Phexxi) each act of penile-vaginal sex. vaginal irritation

REQUIRES PROVIDER FOR CLIENTS TO START AND STOP (REVERSIBLE METHODS)

Number of
Method Use & Frequency Period Changes Potential Side Effects Other Considerations
Pregnancies Expected1
Provider inserts rod under skin in Acne, depressed mood,
Implant Unpredictable spotting, Mild pain with placement. Not visible
<1 out of 100 upper arm. Lasts up to 5 years* and headache, mood swings,
(progestin-only) lighter period, or no period but can be felt by partners.
can be removed earlier. weight gain
Provider inserts device into uterus.
Levonorgestrel IUD Spotting, lighter period, or Cramping pain with
<1 out of 100 Varies by type, up to 8 years, and Not visible but can be felt by partners.
(progestin-only) no period placement
can be removed earlier.
Provider inserts device into uterus. Effective as EC within 5 days* of
Non-hormonal Cramping pain with
<1 out of 100 Lasts up to 12 years* and can be Spotting or heavier period unprotected sex. Not visible but
copper IUD placement
removed earlier. can be felt by partners.

REQUIRES PROVIDER TO PERFORM PROCEDURE (PERMANENT METHODS)

Number of
Method Use & Frequency Period Changes Potential Side Effects Other Considerations
Pregnancies Expected1
Single surgical procedure done at a Requires anesthesia and up to
Tubal ligation <1 out of 100 None Bleeding, surgical pain
hospital. 2 weeks of recovery.

Vasectomy <1 out of 100 Single outpatient surgical procedure. NA Bleeding, surgical pain Up to 2 days for recovery.

EMERGENCY CONTRACEPTION (EC)

Number of
Method Use & Frequency Period Changes Potential Side Effects Other Considerations
Pregnancies Expected1
Non-hormonal Provider inserts device into uterus Cramping pain with Lasts up to 12 years* and can be
<1 out of 100 Spotting or heavier period
copper IUD* within 5 days of unprotected sex. placement removed earlier.
Client takes by mouth as soon as
Ulipristal 7 out of 10 who would have Spotting or period Abdominal pain, dizziness, Requires prescription. May be less
possible within 5 days of
acetate (ella) become pregnant will not at new time headache, nausea effective in people over 194 pounds.
unprotected sex.

Last Updated August 2024

Breast tenderness, dizziness,
Levonorgestrel 7 out of 8 who would have Client takes by mouth within 120 May induce spotting Available OTC. May be less effective
headache, nausea, stomach
1.5mg pill (Plan B) become pregnant will not hours (~5 days)* of unprotected sex. or period in people over 165 pounds.
pain, tiredness, vomiting
*Use of this product for an extended duration has not been approved by FDA. Use of the non-hormonal copper IUD for EC has not been approved by FDA. Cason P, Cwiak C, Edelment A, et al.[Eds.] Contraceptive
Technology. 22nd edition. Burlington, MA:Jones-Bartlett Learning, 2023.
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This job aid was supported by the Office of Population Affairs (Grant FPTPA006030). The views expressed do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names,
commercial practices, or organizations imply endorsement by the U.S. Government.