Home / Teen / Sex and Relationships / Contraception Contraception What is contraception? Contraception (also known as birth control) lowers the chances of unplanned pregnancy by preventing the sperm from meeting the egg, resulting in pregnancy. Some forms of contraception/birth control also help protect against sexually transmitted infections (STIs). Contraception will block sperm and an egg from meeting and a pregnancy occurring. Some contraception uses hormones to do this while others are just barrier methods. For teens, this is especially important. According to the Centers for Disease Control and Prevention, pregnancy and birth commonly lead to increased high school dropout rates among girls. Only about 50% of teen mothers receive a high school diploma by 22 years of age, whereas approximately 90% of women who do not give birth during adolescence graduate from high school. In fact, only 61% of working teen dads obtain a high school diploma by the age of 26 compared to 97% of their counterparts. How does pregnancy happen? In order for a pregnancy to happen, a sperm cell must fertilize an egg – most commonly through vaginal intercourse. Once the sperm has been released in the vagina, they will travel through the cervix into the uterus and eventually to the fallopian tube where an individual sperm can fertilize an egg. Following fertilization, the egg will travel into the uterus and embed itself into the uterine lining. Choosing contraception that’s right for you means talking with your health care provider. Just remember to always protect yourself in the event you become sexually active. Knowledge prepares you to make healthy decisions for the future. For more information on teen pregnancy and reproduction click here. Check out this Amaze.org video called Pregnancy and Reproduction Explained: https://www.youtube.com/watch?v=OejdOS4IqeE&list=PLwKLUKhFLWhYoU638Q_oJz4SVOuhQT8JH&index=10&t=0s Types of contraception: There are different types of birth control to choose from. Remember, because there are multiple options, you want to choose what is best for you! Check out this Amaze.org video called Birth Control: The Final Frontier https://www.youtube.com/watch?v=QUCe1xrm7OU Over the counter (no prescription required): This type of contraception does not require an appointment with a health care provider or prescription to purchase. Over-the-counter contraceptives can be found in drug stores, convenience stores and health departments/clinics. The prices of these contraceptives can vary by state, so check your local store or health department for pricing. Most health departments provide forms of contraceptives for free. For a full list of health departments near you, visit The National Association of County and City Health Officials. External Condoms (Use every time): This form of contraception provides a barrier method of protection made of latex (rubber), polyisoprene or polyurethane. It covers the penis and collects semen and other fluids, preventing them from entering a person’s vagina. An external condom should be used for oral, anal and vaginal sex. When used correctly and consistently from beginning to end, condoms protect against both pregnancy and STIs, including HIV. Condoms can leak or break if not used correctly. Oil-based lubricants (like Vaseline or massage oil) should not be used due to possibly breaking down the latex on the condom. You should always use water or silicone based lubricants with external condoms. On average, condoms last about five years after their manufacturing date. This expiration date is printed on the condom label. Always be sure to check this expiration date before using a condom. A condom’s material degrades over time. Also, things like lubricant or spermicide can dry up which means that an expired condom is more likely to break during use. It is super important to check a condom prior to its use. If the condom is expired, has no air in its packaging or appears dry/brittle when removed from the package — use a different condom! If no other condoms are available, an expired condom can still help reduce your risk, but it will not be as effective or safe as an unexpired condom. The effectiveness rate for external condoms is 85% with typical use but 98% if used perfectly every time. Here is a link for a short video on proper instructions to use a condom every single time: https://www.youtube.com/watch?v=rrW-0wam5QY Internal Condoms (Use every time): The internal condom, prevents sperm from entering a person’s uterus. You can also use internal condoms for anal sex by inserting into the anus. This form of contraception comes packaged with a lubricant and may be obtained in most drug stores and family planning clinics. The internal condom can be inserted up to eight hours before sexual intercourse so you are able to plan ahead with this type of contraception. The CDC recommends not using an internal condom with an external condom because it can cause tearing. As a note: internal condoms may cause irritation of skin surrounding the genitals and does require commitment. In other words, this form of birth control must be used consistently and correctly to be effective every time. The effectiveness rate for an internal condom for perfect use is 95% but typical use is 79%. Withdrawal Method (Use every time): The withdrawal method is also known as the pull out method. This is when a person removes the penis from the vagina before ejaculation occurs. This is most effective when using another type of birth control method, such as a condom since this provides no protection against STIs by itself. When done correctly every time the effectiveness rate for typical use is 78%. There is something called pre-ejaculate which comes out of the penis before it’s time to ejaculate and that contains enough sperm to start a pregnancy, which is why it’s important to use another form of birth control with the withdrawal method. If done perfectly, while using other types on contraception the effectiveness rate is 96%. Spermicide (Use every time): Spermicide has chemicals that stop sperm from reaching an egg to fertilize. This will come in different types of creams, gels, foams, film and suppositories. A person will insert this into the vagina right before sex. This works by blocking the cervix and stopping the sperm from being able to move. Spermicide may irritate the vagina. This method works best with using a barrier method such as an external condom. Spermicide does not provide protection for STIs. When used correctly this has a 71% effective rate for preventing pregnancy if used alone. If used with a condom it has an effective rate of 97%. The Sponge (Use every time): The sponge is a small round sponge that is made out of soft flexible plastic. The sponge contains spermicide. The sponge will cover the cervix; this will prevent sperm from being able to enter the cervix and the spermicide in the sponge will make the sperm unable to move. Once the sponge is in it can be used multiple times, for up to 24 hours. It’s small and easily carried around. This is unsafe to use while on your period. It may irritate the vagina and increase your risk of contracting an STI. The sponge only provides protection from pregnancy and not from STIs. The effectiveness rate for typical use for a sponge is 80% but for perfect use it’s 91%. Dental Dam (Use every time): A dental dam is a flexible, thin piece of latex that is laid over the vulva or anus during oral sex. Dental dams are only to protect against STIs and should not be used for contraception/to prevent pregancy. If you don’t have access to a dental dam, you can cut an external condom and make one to use. Always check the expiration date on the outside of the package before use. Abstinence (Free): Abstinence is defined as not engaging in any type of sex (oral, anal or vaginal). It can feel difficult to wait sometimes, but waiting until you are mature enough to handle the outcomes of sex is your safest option when trying to prevent unplanned pregnancy and STIs. Abstinence is the only method that offers 100% protection against pregnancy and STIs, assuming no sexual contact of any kind has occurred (including genital touching). Abstinence can be hard to maintain, so make sure you’re always communicating with your partner about your boundaries. Prescribed (Requires a prescription from a medical professional): Birth Control Pill (On a schedule): Commonly referred to as “birth control” for a person with a uterus, the contraceptive pill can be provided by a health care provider. Like all hormonal methods, the pill releases hormones that prevent ovulation and thicken the cervical mucus. If taken correctly, the pill provides non-stop protection from pregnancy; it can make periods more regular, reduce cramps and shorten/lighten a menstrual cycle. The pill is most effective when taken at the same time every day. Birth control pills offer no protection against STIs. Each type of pill is different, so check with your doctor to learn more and figure out what is best for you. When starting a birth control pill it is not immediately effective. For the first month at least, you would need to still use an alternate form of birth control such as a condom to protect yourself from pregnancy. The birth control pill may cause side effects such as weigh gain, headaches, nausea, etc. If these symptoms occur, talk to your medical provider. The effectiveness rate of the birth control pill for typical use is 91% in preventing pregnancy but for perfect use it’s 99.7%. The Patch (On a schedule): The patch helps prevent pregnancy but offers no protection against STIs. To use the patch, you will put it on once a week on the same day every week for three weeks and then take a week off; so it’s not a form of contraception that you have to remember every day or every use. Some people have skin reactions, nausea, headaches and breast discomfort. The small adhesive patch is available through a prescription from a health care provider. The effectiveness rate for the birth control patch for typical use is 91% for preventing pregnancy but for perfect use it’s 99%. The Shot (On a schedule): The shot, also known as the Depo shot, needs to be administered by a medical provider the first time you receive it. You will need to get the shot again every three months, roughly every 12 weeks, but this can be done at a medical provider’s office or at your house if prescribed. Unlike the birth control pill, the shot becomes effective one week after receiving it, so you would still need to use other types of protection such as a condom during this time to prevent pregnancy. If administered on time in the future, it is always effective after that first week. Some side effects of the shot are irregular periods or no periods at all, headaches, depression, acne, weight gain, etc. Ask your medical provider for a full list of side effects. The shot (Depo shot) has an effectiveness rate for typical use of 94% for preventing pregnancy.(This may be if people miss a shot or do not get their shots on time). The effectiveness rate for perfect use is 99%. Diaphragm (Use every time): Diaphragms are dome-shaped silicone or latex cups with a flexible rim and can be obtained through a prescription from a health care provider. It won’t effectively protect against STIs including HIV. It can increase the risk of urinary tract infections and toxic shock syndrome if not cleaned/left in too long. It can be inserted into the vagina six hours prior to sexual activity and must be left in for six hours after. It can be left it in up to 24 hours and you can have intercourse multiple times with same use. You can reuse the same diaphragm for up to a year. The diaphragm is 88% effective against preventing pregnancy for typical use and has a 94% effectiveness rate for perfect use. The Cap (Use every time): This device, made of silicone, can be obtained through a prescription from a health care provider. A person with a uterus uses spermicide to coat the inside of the cap, then inserts it into the back of the vagina so that it covers the cervix to block sperm from entering. It won’t effectively protect against STIs. There is an increased risk of urinary tract infections and toxic shock syndrome (if it’s not cleaned properly/left in too long). You can use the same cap for up to a year with proper care in between use. You can insert it up to six hours prior to having sex and leave it in for up to 48 hours after sex. The Cap is 71-86% effective depending on usage to prevent pregnancy depending on if you have previously given birth or not. If you have never given birth, it has a higher effectiveness rate. The Ring (On a schedule): A person with a uterus can place the vaginal ring (NuvaRing) in the vagina for three weeks, followed by a ring-free week. It releases hormones to prevent ovulation and thickens the cervical mucous. If used correctly, the ring provides non-stop protection from pregnancy. It can make menstrual cycles more regular, reduce cramps and shorten or lighten a menstrual cycle period. The ring only needs to be changed once a month. It offers no protection against STIs. Some people experience vaginal discomfort, nausea, headaches and breast tenderness. The ring has a 91% effectiveness rate for preventing pregnancy with typical use and an effectiveness rate of 99% for perfect use. IUD (Low maintenance): IUD stands for intrauterine device, a long acting reversible contraceptive (LARC). There are two kinds of IUDs, one that contains copper and one that releases the hormone progestin. A health care provider inserts this t-shaped device into the uterus to provide effective pregnancy protection. A copper IUD can stay in place for up to 12 years, and a progestin IUD lasts 3-6 years depending on brand. Some possible side effects of IUDs are headaches, acne, irregular bleeding (this normally improves after six months of use), mood changes, cramping and pelvic pain. While IUDs offer no protection against STIs, they are more than 99% effective at preventing pregnancy. The Implant (Low maintenance): A health care provider inserts a small plastic-like rod under the upper arm skin of the person with a uterus. This long acting reversible contraceptive (LARC) device can protect against pregnancy for up to three years, can shorten or lighten a menstrual cycle and reduce cramps. It may cause irregular periods, nausea, headaches and weight gain. Some people may be able to see the rod under the skin. While the implant offers no protection against STIs, it is more than 99% effective at preventing pregnancy. PrEP (Taken Daily): PrEP stands for Pre-exposure prophylaxis. According to the Centers for Disease Control and Prevention, PrEP is for people who are at risk of contracting HIV. A person would take PrEP every day at the same time for it to be most effective at preventing HIV. “Studies have shown that PrEP reduces the risk of getting HIV from sex by about 99% when taken daily. Among people who inject drugs, PrEP reduces the risk of getting HIV by at least 74% when taken daily.”(CDC) PrEP will become effective anywhere from 7-21 days after first taking it. Currently no long term side effectives have been known. Some people experience headaches while taking PrEP but report they have gone away after using for a period of time. PrEP only helps protect against HIV, this method does not help prevent pregnancy or other STIs. It is best used with a barrier method. For more information specifically on PrEP and where to find PrEP in your area click Emergency Contraception (Used after sex): Check out this video from Amaze.org called: What should you do if you’ve had unprotected sex? https://www.youtube.com/watch?v=48zdZ6x3SK4 The emergency contraception pill (sometimes known as the morning after pill) can reduce the chance that a person with a uterus will get pregnant if they have unprotected sex or if another method of protection failed. It must be taken within 3-5 days; the sooner the pill is taken, the higher its effectiveness. Some brands are less effective depending on a person’s weight. Most of these options are available over the counter (Do NOT require a prescription). The copper IUD can also be used if inserted by a medical professional within five days of unprotected sex or birth control failure. The emergency contraception pill doesn’t protect against STIs and may cause nausea and/or breast tenderness. If a person does not get their period within three weeks, they should take a pregnancy test. Depending on different factors the effectiveness rate for this is anywhere from 75-99%. What method of birth control or contraception should I use? When deciding on which method of contraception fits you best, it’s a good idea to talk to someone you trust. It could be a parent, a friend, a doctor or even a counselor. It’s okay to ask questions. Have you ever heard “There’s no such thing as a stupid question?” Guess what? When it comes to contraception, not knowing is understandable. However, when we seek answers and educate ourselves, studies show that we’re more likely to make informed decisions. For more information visit the Centerstone sexual healthcare section. Frequently Asked Questions: Is tracking my period an effective way to prevent pregnancy? It can be if you menstruate on a regular cycle. Not everyone menstruates on a regular cycle (especially teens). So this is not a reliable way to prevent pregnancy without using another form of protection. If I have sex during my period does that prevent pregnancy? No, sperm can live in the female reproductive system for up to five days so if you have sex during your period, sperm can still be present when you ovulate. If I use two condoms will it better protect myself from STIs and unplanned pregnancies? No, using more than one condom at a time actually lessens your protection; it can cause friction and possibly cause the condom to break. Can I use plastic wrap or a balloon if I don’t have condoms? Plastic wrap or balloons aren’t a good idea to use because these do not fit around the penis well and are more likely to come off during sex or tear, leading to a chance of pregnancy and STI transmission. Key takeaways: To reduce the risk of unwanted pregnancy and STIs, choose the most effective methods to lower your risk. A condom is the only birth control method that also reduces the risk of spreading/contracting STIs including HIV. Abstinence, or not having sex, offers 100% protection against the spread of STIs and can prevent a pregnancy. Sperm can stay alive inside the female reproductive system for up to five days. Additional resources Did you know health departments offer free forms of contraception? The National Association of County and City Health Officials created a tool to help you search for local health departments in your area. Want to learn more about sexually transmitted infections? Get the facts by visiting our page on STDs and STIs. The statistics surrounding teen pregnancy are interesting. Learn more on our prevention page where we take a closer look at teen pregnancy prevention. Additional resources: https://www.hhs.gov/opa/pregnancy-prevention/birth-control-methods/index.html https://www.plannedparenthood.org/learn/birth-control https://www.cdc.gov/reproductivehealth/contraception/index.htm Birth Control & Emergency Contraception via online/telehealth/apps: NURX https://www.nurx.com/ PP Direct https://plannedparenthooddirect.org/ Pill Club https://thepillclub.com/ Ella- Emergency contraception (Rx) for people 165lbs+ https://www.prjktruby.com/products/ella/ Minor’s access to birth control and sexual/reproductive health rights by state: https://www.guttmacher.org/state-policy/explore/minors-access-contraceptive-services Bedsider- Birth control methods info, locators, reminders https://www.bedsider.org/ A Step Ahead- How to access free LARC methods in TN https://www.astepaheadmiddletn.org/ What if I need birth control help? Contact your medical provider or local health department if you have any questions about the different types of contraception. Refer to resources listed above.