Non Hormonal Birth Control Methods

The copper IUD is a small device that a health care provider inserts into the uterus of a person who can get pregnant. You can have it removed any time. It is effective for up to 3, 5, or 10 years, depending on the model. There is evidence showing that some models designed to be used for 5 or 10 years can be effective for up to 12 years (if inserted after age 25). 

The IUD being inside the uterus changes the chemistry of the uterus to be unfriendly to sperm. The copper IUD also contains copper, which changes the chemistry even further, making it extremely unfriendly to sperm and to unfertilized eggs. 

You can also have the copper IUD inserted as emergency contraception. It is 98% effective at preventing pregnancy up to 7 days after sperm has gotten into the vagina of a person who can get pregnant. You can have it removed after your next period once you are sure you didn’t get pregnant or leave it in as ongoing birth control for several years.

Things to consider

• Once it is in place, you don’t have to do anything to make it work for several years. 
• It doesn’t cause hormonal side effects.
• It allows the person who can get pregnant to be fully in control of birth control.
• It is effective as emergency contraception.
• You need a prescription for the IUD, and a health care provider needs to insert it.
• The insertion process can feel invasive and is usually painful.
• It can make periods heavier and more painful, especially in the first 3 to 6 months of using it.
• It does not reduce the chance of getting or passing STIs.
• It can be more expensive all at once than other methods.

Effectiveness

The copper IUD is 99.4 to 99.9% effective depending on the model. Because you do not need to do anything to make it work once it is inserted, perfect use and typical use are the same.

An external condom is a latex, polyisoprene, or polyurethane sheath that you can roll onto the erect penis* of a person who produces sperm before having sex that could result in a pregnancy. 

It prevents pregnancy by preventing sperm from getting into the vagina* of a person who can get pregnant. 

You can often get external condoms for free at sexual health clinics or you can buy them at pharmacies, corner stores, sex shops (including online), and sometimes in vending machines.

Things to consider

• You don’t need a prescription to use them.
• They lower the chances of getting pregnant and of getting or passing STIs.
• They are often free or low-cost.
• They don’t cause hormonal side effects.
• They allow a person who produces sperm to take responsibility for birth control.
• You have to have one with you when you have sex.
• It can add an extra step to put it on during or just before sex.
• Some people don’t like the way external condoms feel.
• Latex condoms can cause an allergic reaction, if you are allergic to rubber. Non-latex condoms are available but may be harder to find or more expensive. 
• Condoms expire over time and need to be stored in a cool place. 
• A person’s penis has to be erect in order to put an external condom on. 
• One condom is only good for one ejaculation.

Effectiveness

External condoms are 98% effective with perfect use and 85% effective with typical use. Perfect use means using it exactly as directed every time you have sex that could cause a pregnancy. Typical use is the average effectiveness for people who use it, taking into account that some people don’t use a condom every time, or they can break, slip off, or leak.

Learn more about making external condoms as effective as possible at reducing the chances of pregnancy and of getting or passing STIs here. 

The internal condom is a nitrile or polyurethane sheath with a flexible ring at each end that you can insert into the vagina* of a person who can get pregnant before having sex that could result in a pregnancy. The internal condom can also be used like an external condom if you take the inner ring out and put the condom directly onto a penis*. 

It prevents pregnancy by preventing sperm from getting into the vagina of a person who can get pregnant. 

You may be able to get internal condoms for free at sexual health clinics, or buy them at sex shops (including online).

Things to consider

• They can be highly effective at preventing pregnancy, if used as directed.
• You don’t need a prescription to use them.
• You can insert it ahead of time so you don’t have to stop to put it in while having sex. 
• They lower the chances of getting pregnant and of getting or passing STIs.
• You can use it if you have an allergy to latex.
• A person’s penis doesn’t need to be erect in order to use it.
• You have to have one with you, and do something every time you have sex that could cause a pregnancy.
• You have to make sure the condom stays in place or the penis could slip out and enter the vagina outside the condom. 
• Condoms also expire over time and need to be stored in a cool place.
• Internal condoms can be more expensive or harder to find than external condoms.

Effectiveness

The internal condom is 95% effective with perfect use and 79% effective with typical use. Perfect use means using it exactly as directed every time you have sex that could cause a pregnancy. Typical use is the average effectiveness for people who use it, taking into account that some people don’t use a condom every time, or they can break, slip out of place, or leak.

Learn more about making external condoms as effective as possible at reducing the chances of pregnancy and of getting or passing STIs here. 

A Caya diaphragm is a soft, shallow, teardrop-shaped cup made of silicone, with a flexible lip around the edge. You fill it with a spermicide (gel with a chemical that kills sperm) or barrier gel (gel that traps sperm), fold it lengthwise, and insert it into the vagina* of a person who can get pregnant before sex that could result in a pregnancy. The diaphragm covers the cervix and prevents pregnancy by preventing sperm from getting into the uterus. You can leave it in for multiple ejaculations for up to 24 hours total. 

It’s most effective if:

• You use an applicator to squirt in more spermicide or barrier gel between each ejaculation or if it has been 2 hours since you put it in or last added more gel. 
• You leave it in for at least 6 hours after the last ejaculation to give any sperm time to die. 

You may have to find a specialty shop to buy the diaphragm or the spermicide or barrier gel, or order it online.

Older varieties of diaphragm came in various sizes and were fitted by a health care provider but the only type of diaphragm currently available in Canada is the Caya diaphragm, which comes in one size that fits most people.

Things to consider

• You can insert it ahead of time so you don’t have to stop to put it in while having sex. 
• You don’t need a prescription to use it.
• It’s reusable. 
• It does not cause hormonal side effects.
• It allows the person who can get pregnant to be fully in control of birth control.
• You can leave it in for up to 24 hours and use it for multiple acts of sex during that time.
• You have to have it with you and do something every time you have sex that could cause a pregnancy.
• You need to be able to reach deep inside your vagina (or have someone do it for you) to insert and remove it. You have to learn how to insert it. Some people find the diaphragm difficult to insert correctly.
• You have to remember to take it out at least 6 hours after the last ejaculation.
• You or your partner(s) may develop irritation from the spermicide or barrier gel.
• It can make some people more likely to get urinary tract infections (UTIs).
• It comes in one size that fits most people but there is a chance it will not fit you well.
• It can be difficult to find places that sell the diaphragm and the spermicide or barrier gel.
• It does not reduce the chance of getting or passing STIs.

Effectiveness

The diaphragm is 94% effective with perfect use and 84% effective with typical use. Perfect use means using it exactly as directed every time you have sex that could cause a pregnancy. Typical use is the average effectiveness for people who use it, taking into account that some people don’t use the diaphragm every time, or you can insert it incorrectly, not leave it in long enough, or otherwise not use it as directed.

The FemCap cervical cap is a small, flexible, fitted silicone cap that you fill with a spermicide (gel that kills sperm) or barrier gel (gel that traps sperm) and insert into the vagina of a person who can get pregnant before having sex that could result in a pregnancy. It fits over the cervix and prevents pregnancy by preventing sperm from getting into the uterus. You can leave it in for multiple ejaculations for up to 48 hours total. 

It’s most effective if

• You use an applicator to squirt in more spermicide or barrier gel between each ejaculation or if it has been 2 hours since you put it in or last added more gel. 
• You leave it in for at least 6 hours after the last ejaculation to give any sperm time to die. 

You may have to find a specialty shop to buy the cervical cap or the spermicide or barrier gel, or order it online.

Things to consider

• You can insert it ahead of time so you don’t have to stop to put it in while having sex. 
• You don’t need a prescription to use it.
• It doesn’t cause hormonal side effects.
• It’s reusable.
• It allows the person who can get pregnant to be fully in control of birth control.
• You can leave it in for up to 48 hours and use it for multiple acts of sex during that time.
• You have to have it with you and do something every time you have sex that could cause a pregnancy.
• You need to be able to reach deep inside your vagina (or have someone do it for you) to insert and remove it. You have to learn how to insert it. Some people find the cervical cap difficult  to insert correctly. 
• You have to remember to take it out at least 6 hours after the last ejaculation.
• You or your partner(s) may develop irritation from the spermicide or barrier gel. 
• It comes in three sizes and you have to figure out which one will fit you. Some people will not find one that fits well.
• It can be difficult to find places that sell the cervical cap and the spermicide or barrier gel.
• It can be less effective if you have given birth vaginally.
• It does not reduce the chance of getting or passing STIs.

Effectiveness

The FemCap cervical cap is estimated to be 96% effective with perfect use and 92% effective with typical use but this is based on very small studies so may not be as accurate a measure as the effectiveness of other methods. Perfect use means using it exactly as directed every time you have sex that could cause a pregnancy. Typical use is the average effectiveness for people who use it, taking into account that some people don’t use the cap every time, or you can insert it incorrectly, not leave it in long enough, or otherwise not use it as directed.

** We have used the brand name FemCap to help people find places that sell cervical caps, but the name can carry implications of femininity. Not everyone who can get pregnant identifies with femininity or as a woman.

Spermicides are contraceptive foams, jellies, tablets, suppositories, or films that you insert into the vagina* of a person who can get pregnant before having sex that could result in a pregnancy. Spermicides contain a chemical called nonoxynol-9 that kills sperm. They prevent pregnancy by preventing sperm from surviving long enough to get into the uterus. You can often buy spermicides at pharmacies.

Things to consider 

• You do not need a prescription to use them.
• They don’t cause hormonal side effects.
• You have to have one with you and do something every time you have sex that could cause a pregnancy.
• They allow the person who can get pregnant to be fully in control of birth control.
• You or your partner(s) may develop irritation from the spermicide. Irritation from the spermicide can make it easier to get or pass some STIs. 
• Some forms of spermicides, like foam, can be messy.
• Spermicides containing nonoxynol-9 have a bitter chemical taste. 
• They do not reduce the chance of getting or passing STIs.

Effectiveness

Spermicide is 94% effective with perfect use and 72% effective with typical use. Perfect use means using it exactly as directed every time you have sex that could cause a pregnancy. Typical use is the average effectiveness for people who use it, taking into account that some people don’t use it every time, or do not use it as directed.
 

Withdrawal is when a person who produces sperm withdraws or “pulls out” their penis* from a partner’s vagina* before ejaculating (cumming) and ejaculates/cums away from a partner’s vagina. It prevents pregnancy by avoiding getting sperm in the vagina of a person who can get pregnant. It is most effective at doing this if (for the person who produces sperm):

• You are aware of when you are going to ejaculate/cum and pull out well before it happens.
• You ejaculate/cum away from your partner’s vulva*.
• You pee between any previous ejaculation and putting your penis in contact with a partner’s vagina, to reduce the chance that there is sperm left in your urethra that could be picked up by pre-ejaculate/precum.

Things to consider

• You do not need a prescription or anything besides your bodies to use it.
• It’s free.
• It allows a person who produces sperm to take responsibility for birth control.
• It doesn’t have hormonal side effects.
• You may not always know when you are going to ejaculate or be able to pull out in time.
• You or your partner may worry you won’t pull out in time.

Effectiveness

Withdrawal is 96% effective with perfect use and 81% effective with typical use. Perfect use means using it exactly as directed every time you have sex that could cause a pregnancy. Typical use is the average effectiveness for people who use it, taking into account that some people don’t use withdrawal every time, or you can misjudge when to pull out or otherwise not use it as directed.
 

Using the kind of sex you have as birth control involves avoiding kinds of sex that could result in a pregnancy, including penis* in vagina* sex and any other kind of sex that would get semen (cum) on the vulva* or in the vagina of someone who can get pregnant. This prevents pregnancy by avoiding getting sperm in a partner’s vagina.

Some types of sex that have no risk of pregnancy include:

• Oral sex.
• Handjobs or fingering.
• Masturbating near each other (unless a person who produces sperm ejaculates on or near the vulva of a person who can get pregnant).
• Kissing.
• Grinding or rubbing genitals or other body parts together through clothes.
• Anal sex with fingers, toys, mouths, or penises (unless a partner who produces sperm ejaculates on or near a partner’s vulva).
• Any other kind of sex where sperm does not have a way of getting onto the vulva or into the vagina of a person who can get pregnant.

Things to consider

• You can explore lots of different kinds of sex and pleasure. 
• You do not need a prescription to use it.
• It does not have hormonal side effects.
• It’s free.
• You have to avoid penis in vagina sex.
• Some types of sex that typically have no risk of pregnancy could lead to a person who produces sperm ejaculating on or near a partner’s vulva, which could result in a pregnancy.
• Depending on what types of sex you have, it may or may not lower the chance of getting or passing STIs. For more information on the chances of getting or passing STIs with different types of sex, see our STIs section.

Effectiveness

While having sex that has no risk of pregnancy is theoretically 100% effective, there are limited studies on its effectiveness.
 

Fertility awareness methods involve a person who can get pregnant keeping track of specific symptoms in their body to understand their fertility cycle and know when they are likely to be fertile (able to get pregnant). You can then use another non-hormonal birth control method, like condoms, or avoid sex that could result in a pregnancy during those times.

There are two main ways to go about it: 

• Retrospective methods track the length of your fertility cycle and assume that some days of the cycle will be fertile for most people. They can be simpler to learn and use, but are only effective if your cycle length falls within a specific range, and may require you to use another method of birth control or avoid sex that could result in a pregnancy for more days out of your cycle. These methods are less effective.
• Symptom tracking methods involve examining your cervical mucus ( vaginal discharge) daily for its color and texture and may involve taking your resting body temperature each morning. These methods can be more tailored to your specific cycle and may allow you to use another method of birth control or avoid sex that could result in a pregnancy for fewer days out of your cycle.

Things to consider

• You learn about your body and fertility cycle. 
• You do not need a prescription to use them.
• FAMs do not have hormonal side effects.
• They allow the person who can get pregnant to be fully in control of birth control.
• Some instruction manuals or books are free, low-cost, or available at public libraries, or you may have to find and pay for tracking supplies, an app, a class, or coaching to learn how to use your method effectively.
• You have to use another method of birth control or avoid sex that could result in a pregnancy for a few days out of every cycle.
• If you use a symptom tracking method, you have to do something every day.
• If you have an irregular cycle or your cycle is much longer or shorter than average, it’s still possible to use some FAMs effectively, but it may be more difficult, and some FAMs may not work for you.
• It does not reduce the chance of getting or passing STIs.

Effectiveness

Different types of FAMs have different effectiveness rates. Symptom tracking methods that track both cervical mucus and resting body temperature are 99% effective with perfect use. The Standard Days Method, an example of a retrospective method, is 95% effective with perfect use. FAMs may be 76-80% effective with typical use. Perfect use means using it exactly as directed all the time. Typical use is the average effectiveness for people who use it, taking into account that some people don’t follow their method strictly all the time, and you can miscalculate fertile days or otherwise not use it as directed, or a method you use during fertile times (e.g., condoms) can also fail.

Chest or breast feeding as birth control involves a person who can get pregnant who is lactating (producing milk) making sure to feed a baby or babies consistently enough that the hormones produced from chest or breast feeding reliably prevent the ovaries from releasing an egg (ovulation).

Chest or breast feeding can be effective as birth control during the first 6 months after giving birth, if: 

• You have not yet started getting your period again;
• You are feeding or pumping very regularly (no more than 4 hours apart); AND
• The baby is not eating or drinking much or anything else. 

Things to consider

• You might already be doing it to feed a baby.
• You do not need a prescription to use it.
• You may not need any special equipment to use it.
• It is only effective for 6 months after delivery, with specific conditions. 
• It can be unpredictable when you might stop feeding as consistently and consistent chest or breast feeding or pumping can be inconvenient or difficult for some people.
• It is possible for the ovaries to release an egg (ovulate) in the cycle before you get your first period after a birth.
• It does not reduce the chance of getting or passing STIs.

Effectiveness

The lactational amenorrhea method is at least 98% effective with perfect use (when used exactly as directed). It gets much less effective when not done exactly as directed.