In the United States, 65% of individuals use some type of birth control throughout their reproductive years (age 18-49).
The Centers for Disease Control and Prevention (CDC) reports that birth control pills are one of the most commonly used forms of contraception, used by 14% of people.
The birth control pill is a generally safe, affordable way for people to prevent unwanted pregnancies.
There are two types of birth control pills: combination pills that contain estrogen and progestin and the minipill, which contains progestin only.
Combination pills are the more commonly used pills, but the minipill is a good choice for those who cannot take estrogen due to health issues, like cardiovascular disease or a history of stroke.
In this article, we’ll review the effectiveness of birth control.
We’ll discuss the factors that impact how effective the various birth control methods are, which method is most effective and why, and how long it takes for birth control to work.
Birth Control Effectiveness
The chart below explains the different forms of birth control, their effectiveness with the range of typical-to-perfect use, how often they should be taken or replaced, and how each method should be used for maximum protection.
|Birth Control Method||Effectiveness||How Often Taken or Replaced and How Used|
|Sterilization for men||99% or more||One in-office procedure|
|Sterilization for women||99% or more||One surgical procedure|
|ParaGardⓇ copper IUD||99% or more||Replace in 10-12 years|
|MirenaⓇ hormonal IUDLilettaⓇ hormonal IUD||99% or more||Replace in 5-7 years|
|KyleenaⓇ hormonal IUD||99% or more||Replace in five years|
|SkylaⓇ hormonal IUD||99% or more||Replace in three years|
|Progestin injection||94% or more||Injection every three months—some people learn to do injections themselves|
|Contraceptive arm implant||99%||New implant needed every three years|
|Oral contraceptives:Monophasic or multiphasic||91% or more based on consistency of use||Take every day for three weeks, then take placebo pills for one week|
|Hormone patch||91% or more based on consistency of use||Apply a new patch to your body each week on the same day for three weeks in a rowRotate location on skin to avoid irritationTake one week off|
|Vaginal ring||91% or more based on consistency of use||Remove ring every three weeks and replace it one week later|
|Vaginal sponge||76%-91%||Insert in vagina up to 24 hours before intercourse|
|Diaphragm||71%-98% with spermicide||Must be inserted with spermicide no more than six hours before intercourse|
|Cervical cap||71%-98% with spermicide||Must be inserted with spermicide no more than six hours before intercourse|
|External condom||82%-98%||Must be put on before intercourse and stay on throughout|
|Internal condom||79%-95%||Must be inserted before intercourse and remain in place throughout|
Factors that Influence Birth Control Effectiveness
There is no single method of birth control—even sterilization—that is guaranteed to be 100% effective, but certain factors can increase or decrease the level of effectiveness for some forms of birth control.
Both partners in a sexual relationship need to be vigilant about using their chosen method of birth control every time they have sex to reach the highest level of effectiveness.
Additionally, using two or more methods of birth control will increase their effectiveness.
Long-Acting Reversible Contraceptives
Although no birth control method is 100% effective, long-acting reversible contraceptives (LARCs), such as intrauterine devices (IUDs) and implants injected under the skin, are far less likely to fail than other methods.
This is because the user doesn’t have to do anything for those products to work once they are inserted in the vagina or implanted in the arm.
LARCs include hormonal and non-hormonal forms of birth control. For example, MirenaⓇ is a hormonal IUD, whereas ParaGardⓇ is a non-hormonal IUD.
Other Hormonal Methods
The birth control pill—just like any other birth control that isn’t a LARC—is up to 99% effective, depending on the consistency of use.
The pill must be taken every day, without any missed days, to reach maximum effectiveness.
The same level of responsible use is needed for the other hormone-based birth control methods, including the patch and the vaginal ring.
For most users, it is common to miss a day or two each month, making the pill approximately 91% effective at preventing pregnancy.
It’s for this reason that many physicians recommend long-acting birth control options for young people under the age of 18 who may have trouble remembering their scheduled pill doses or patch or ring replacements.
Be aware that some antibiotics can reduce the effectiveness of the birth control pill.
Ask your doctor about this if you are prescribed antibiotics while taking the pill.
It’s important to understand that barrier methods of birth control, including diaphragms, cervical caps, and condoms, have to be used not only every time there is sexual intercourse, but also with the correct spermicide and within the right time frame.
For example, you can’t insert a diaphragm more than six hours before sex because the spermicide will not work as effectively.
It also must remain in place for six to eight hours after sex to prevent pregnancy.
Condoms must stay in place for the entire sexual encounter as well.
Diaphragm and cervical cap users should be checked by their physicians every year to ensure their method of birth control still fits properly.
Doing so will offer the best protection they can get from unwanted pregnancy.
When used correctly versus incorrectly, the difference in failure rates for barrier methods can be as high as 17%.
Which Method Is Most Effective?
Statistically, the most effective methods are sterilization and LARCs, which each have 99% reliability for protection.
Still, sterilization is permanent, and many people choose not to commit to a long-acting reversible contraceptive, since they may decide to have children soon or prefer not to use an implanted device.
All other birth control methods are potentially over 90% effective if used reliably and correctly.
The birth control pill, patch, or vaginal ring offers hormonal protection from pregnancy by preventing ovulation.
The birth control pill and the other hormonal options have to be used as prescribed, or there’s a higher chance of failure.
Overall, however, the pill is highly reliable at a 91% prevention rate when used as most people typically do.
Barrier methods, including the diaphragm, cervical cap, or sponge, are used with spermicide to kill the sperm before they reach the cervix and create a barrier to protect the cervix from the sperm entering it to fertilize the egg.
Barrier methods can fail if they are dislodged from their place in the vagina or if there’s insufficient spermicide.
Also, if they’re removed from the vagina too soon, it can result in pregnancy. However, when used correctly and as most people typically use them, barrier methods are 90% effective.
Some people will develop urinary tract infections (UTIs) due to the spermicide used with barrier methods.
You may need to try different brands if this happens to you, and be aware that there are different types of spermicides which you may or may not have a sensitivity to.
Condoms prevent sperm from entering the vagina because of the impenetrable material used to make them.
They also offer protection from sexually transmitted diseases, which no other birth control methods do.
But using condoms for birth control is far less secure than other methods for a variety of reasons, including:
- Condoms can break
- Condoms may not always be available when sex is initiated
- Some people find condoms uncomfortable and may resist wearing them
- Condoms are sometimes removed too soon
How Long Does it Take for Birth Control to Work?
Birth control start working at different times depending on when you start it and which oney you’re using.
For example, suppose you start taking the combination pill within five days of your period starting.
In that case, you’ll be protected within five days.
So if your period starts on a Monday and you begin taking the pill five days later on Saturday, you’ll be protected the following week on Thursday.
If you’re taking the minipill, you’re protected after 48 hours.
The vaginal ring or patch takes five to seven days to begin protecting you from pregnancy.
The LARC methods vary slightly: Hormonal IUDs and implants are effective immediately if they are inserted or implanted within five days of your period starting.
Otherwise, they take five to seven days to start working. Non-hormonal IUDs (ParaGardⓇ) are always effective immediately.
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Frequently Asked Questions
K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
Barrier Methods of Birth Control: Spermicide, Condom, Sponge, Diaphragm, and Cervical Cap. (2018)
Tubal Ligation. (n.d.)
The Economic Benefits of Birth Control and Family Planning. (2020)