Birth control is a way for women and men to prevent and plan the timing of pregnancy. There are many different birth control methods, including hormonal contraception, non-hormonal contraception, and OTC methods. Birth control effectiveness is an important and common concern in your decision to choose a birth control method.
People have been using birth control for thousands of years. Today, we have many safe and effective birth control methods to choose from. Birth control effectiveness depends on different factors. As with any contraceptive, your chosen birth control method will be more effective if you use it consistently and correctly. This means that if you want high levels of birth control effectiveness, you must always use it and make sure that you are using it the right way.
When you are comparing birth control effectiveness, it is helpful that you understand what failure rates mean. This is where birth control comparison can become a little confusing. The birth control effectiveness rate is the opposite of its failure rate. So, let’s say that you are comparing the effectiveness of the birth control pill and the effectiveness of Depo Provera. You read that that the pill has an 8% failure rate and Depo Provera has a 6% failure rate. What does this tell you?
Well, failure rates refer to the number of pregnancies that take place when 100 women use that birth control method for one year. Another way to look at this birth control comparison is that the pill is 92% effective at preventing pregnancy and Depo Provera is 94% effective. So the birth control effectiveness rate is the number you get when you subtract its failure rate from 100.
Birth Control Comparison Based on Typical Use
Birth control methods can be grouped into different categories and some methods are more effective than others:
- Natural Methods (not including abstinence): Birth control effectiveness for these methods range from 77%-95%.
- Nonhormonal OTC Methods: Birth control effectiveness for these methods range from 72%-88%.
- Prescription Methods: Birth control effectiveness for these methods range between 86%-99.9%.
- Hormonal Methods: Birth control effectiveness for these methods range from 92%-99.9%.
- Permanent Methods: Birth control effectiveness for these methods range from 99.5%-99.9%.
Remember that some methods fall into more than one of these categories. For example, hormonal birth control pills are available both OTC and by prescription. And some people may opt to use more than one method at a time—such as a hormonal birth control pill and condoms—to achieve even higher effectiveness than one method alone.
In July 2023, the Food and Drug Administration (FDA) approved Opill (norgestrel), a progestin-only oral contraceptive, to be sold OTC. Opill is the first and only birth control pill available without a prescription. Before starting a birth control method, it's a good idea to speak with your healthcare provider, even if your method of choice doesn't require a prescription.
Factors That Can Lower/Increase Birth Control Effectiveness
Except for abstinence (which is 100% effective), no birth control method is completely guaranteed to prevent pregnancy. But there are things you might do to lower or increase your birth control effectiveness.
Things to keep in mind:
- Get the facts: If you have misconceptions about your method, like the pill or condoms, you can compromise your birth control effectiveness because you believe the wrong information.
- Use it correctly: If you want to make sure that your birth control is effective, it is important to use it the correct way. This includes putting on a condom properly, correctly inserting the sponge, using an internal condom, applying the patch correctly, and checking your IUD strings.
- Timing: You should also be aware of things like expiration dates, when it's time for a new diaphragm, or what to do when switching to a new pill.
- Have a plan for when something goes wrong: Birth control effectiveness could also be lowered if you do not know what to do if something goes wrong, like if your NuvaRing falls out or your patch falls off.
- Drug interactions; Certain medications and supplements can lower the effectiveness of hormonal birth control. It is important that you ask your pharmacist to double-check that any medications you are using do not interfere with the progestin or estrogen in these methods.
- Changes in your health: Did you know that almost half of all unintended pregnancies happen to women who were using birth control when they got pregnant? One possible reason for this is that obesity may lower your birth control effectiveness. This is especially true for overweight and/or women with obesity who use the pill.
- Plan for travel: Another time that you are at risk for lowering your birth control effectiveness is when you travel. Make sure you plan ahead when traveling.
- Store properly: How you store your contraception may also lower your birth control effectiveness. For example, it is very important that you are storing your condoms properly.
Make your contraception works for you by asking your doctor about how effective each method is and which method will work best for you.