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Non-hormonal Methods of Birth Control

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Jan 25, 2024.

Birth control options for women who can't use hormones

Although they are popular, not every woman can use - or wants to use - the pill or other hormonal contraceptive for birth control.

There are several birth control options that do not contain hormones, that are effective if used correctly, and that are usually affordable, or even free.

What is hormone-free birth control?

There are several hormone-free methods of birth control, but their effectiveness can vary widely.

Be sure to review the effectiveness rates of these birth control methods (seen this example chart). Discuss which option might be best for your personal situation with your doctor.

In general, spermicide should always be used with a condom or diaphragm to increase its effectiveness.

A male condom (latex or plastic, not lambskin) or internal condom is the best way to protect against any form of sexually transmitted disease (STD), including HIV and AIDS. A male latex condom or internal condom should be used in combination with other birth control options (i.e., pill, patch, shot, IUD, sponge) if protection against STDs is needed.

Advantages with non-hormonal birth control methods

Disadvantages with non-hormonal birth control methods

Side effects with non-hormonal birth control methods

Common side effects

Non-hormonal barrier method birth control has few side effects. 

Some women or men may have irritation, dryness, or allergies associated with devices placed in vaginal canal, such as the condom, cervical cap, diaphragm, contraceptive sponge or spermicides. If side effects occur with use, contact your healthcare provider.

More serious side effects

Serious side effects are rare with the non-hormonal barrier method of birth control, like with the condom, diaphragm, or cervical cap; although allergies can rarely occur, especially if latex is present. Toxic shock syndrome may rarely occur with the contraceptive sponge.

The copper IUD (Paragard) can be linked with serious side effects and may include: pelvic inflammatory disease (PID), uterine perforation, embedment in wall of uterus, life-threatening infection, endometritis (inflammation of the uterine lining), ectopic pregnancy, and IUD expulsion.

Other warnings and side effects may occur with the use of non-hormonal birth control. It is important to review the specific consumer information for your birth control choice. Discuss these serious side effects with your healthcare provider. Tell your healthcare provider about all other medications you take, including prescription, over-the-counter, vitamin and herbal supplements.

Non-Hormonal Birth Control Options

Product Common Proprietary Names Description
Cervical Cap Brand: FemCap (2nd generation)
  • Barrier method; flexible cap placed over cervix. Use every time. Can be inserted 15 minutes to 40 hours prior to intercourse. May last 1 to 2 years.
  • Must be prescribed by a health care provider. Comes in 3 sizes based on your pregnancy history.
  • Used with spermicide; cap must stay in place 6 hours after intercourse, but do not leave in vagina for more than 48 hours.
  • Do not use during menstrual period due to higher risk for toxic shock syndrome (rare but serious). Use another form of contraception (like condoms) during your menstrual cycle.
  • May cause vaginal irritation or allergies if allergic to silicone
  • Cost $0 to $275 per cap (this includes the cost of the exam); insurance will probably cover your cost in the US. Spermicide is about $5 to $15 per package.
  • Failure rate for the 2nd generation FemCap is 7.6 per hundred women per year.
  • Does NOT protect against STDs.
Condom (male)

Various options available without a prescription at retail stores and pharmacies.

It’s best to use latex or plastic condoms, not lambskin, to help prevent both STDs and pregnancy.

  • Barrier method; placed over penis and prevents sperm from entering the uterus. Use new condom every time.
  • May be made of latex; allergies or irritation are possible. Latex or plastic (latex-free) condoms protect against pregnancy and STDs; lambskin condoms protect against pregnancy but NOT STDS like HIV.
  • Protects against STDs (like HIV/AIDs) if used correctly.
  • Do not use with a female (internal) condom due to a chance of tearing the condom. Can use a condom with a sponge, cervical cap, or spermicide for better protection.
  • Inexpensive, easily accessible at retail stores. Not covered by insurance; costs vary range from $5 to $20.
  • 15% to 20% failure rate; to increase effectiveness rate use with spermicide.
  • If the condom breaks, leaks, or slips consider emergency contraception use (Plan B, etc). Contact your pharmacist right away.
Internal (female) Condoms (can be used by any gender)

FC2 Internal Condom (prescription only)

Internal condoms can provide portable protection for all genders.

  • Barrier method; thin lining that goes into vagina to protect uterus from sperm; can place up to 8 hours prior to sex. Also used for HIV protection with anal sex. Use a new one every time.
  • Can protect against STDs if used correctly; made of polyurethane and nitrile (soft plastic) non-latex cover. People of any gender can use them for vaginal or anal sex.
  • About a 21% failure rate. Do not use with a male condom due to a chance of tearing the condom.
  • Can get online or through a family planning or health clinic. Pharmacist can order with prescription. Cost may be as little as $0. 
  • May cause irritation, burning, rash.
Diaphragm Example brand: KoroFlex, Ortho-Diaphragm
  • Barrier method; silicone cup placed over cervix prior to sex; reusable but use every time.
  • Used with spermicide; must remain in place 6 hours after intercourse; use additional spermicide if have intercourse again or more than 6 hours after diaphragm originally inserted.
  • May cause vaginal irritation.
  • Must be fitted and prescribed by a health care provider.
  • Do not leave the diaphragm in place for more than 24 hours.
  • Costs $0 to $75, plus cost of exam; can last up to 2 years.
  • 12-17% failure rate.
  • Does NOT protect against STDs.
Contraceptive Sponge Example brand: Today Sponge, no prescription needed
  • Barrier / spermicide method; do not use if sulfite allergy. A foam-like vaginal insert embedded with spermicide (nonoxynol-9); wet with small amount of water prior to use.
  • The sponge can be inserted up to 24 hours before sex, but sponge must remain in place for at least 6 hours after last intercourse; but do not leave in place longer than 30 hours total.
  • $15 to $20 for package of 3 sponges. Available in pharmacies, no fitting required.
  • May cause irritation due to nonoxynol-9. Use correctly and follow package directions.
  • Do not use during menstrual period due to higher risk for toxic shock syndrome (rare but serious).
  • 12% to 24% failure rate; failure rate higher in women who have already had children.
  • Does NOT protect against STDs.

Brand examples: Encare Vaginal Inserts, Gynol II, Conceptrol, Delfen Foam.

Available without a prescription at retail stores and pharmacies.

  • Spermicidal creams, jellies, foams, films, vaginal suppositories; usually contains nonoxynol-9, a chemical that kills sperm to prevent fertilization.
  • Spermicides are typically inserted into the vagina shortly before intercourse; may cause irritation and may not last more than one hours; read package directions.
  • Cost is roughly $5 to $20 for a multi-pack.
  • High failure rate 20% to 30% when used alone.
  • To increase effectiveness should use with a condom or diaphragm. Using spermicide plus a condom gives you extra protection from pregnancy and protects against STDs.
  • Not covered by insurance (over-the-counter product).
  • Does NOT protect against STDs.
Non-hormonal vaginal gel

Brand name: Phexxi (lactic acid, citric acid and potassium bitartrate)

Requires a prescription from your doctor.

  • Phexxi is a prescription product used for the prevention of pregnancy and as an on-demand method of birth control.
  • Gel is inserted in vagina before sex to help stop sperm getting to an egg. Phexxi prevents pregnancy by lowering the pH in your vagina and slowing sperm movement.
  • Phexxi is NOT effective for the prevention of pregnancy when administered after sex.
  • Comes in a pre-filled, single-dose applicator. Insert into the vagina immediately before (or up to one hour before) each episode of vaginal intercourse. Once inserted, effective only for one hour. Follow the directions for use on the package.
  • About 14% failure rate. To increase effectiveness can be used with a condom or diaphragm. Avoid using Phexxi with contraceptive vaginal rings (like the NuvaRing).
  • May be covered by insurance or the manufacturer may be able to offer financial assistance.
  • Does NOT protect against STDs.
Copper Intrauterine Device (copper IUD) ParaGard IUD; must be prescribed and inserted by a health care provider.
  • Non-hormonal IUD; inserted by healthcare provider within 7 days of menses onset; replace after 10 years.
  • Do not get if you have a copper allergy, Wilson's Disease, or a bleeding disorder.
  • Common side effects include longer and heavier periods or spotting; these may subside after 2 to 3 months.
  • Serious side effects may include pelvic inflammatory disease (PID), uterine perforation, IUD expulsion, ectopic pregnancy.
  • If a period is missed, promptly be evaluated for pregnancy; do not use in pregnancy, PID, postpregnancy or postabortion uterine infection in the past 3 months; cancer of the uterus or cervix; infection in the cervix.
  • <1% failure rate; highly effective type of birth control.
  • Can be expensive but insurance may pay. Requires doctor visit and insertion. Effective for up to 10 years.
  • Does NOT protect against STDs.
Natural Family Planning (also called fertility awareness methods) Not applicable
  • Must avoid sex when fertile and ovulating; known as the calender or rhythm method.
  • May monitor bodily changes such as cervical mucous changes or body temperature to determine most fertile time.
  • Involves no hormones or devices.
  • Inexpensive.
  • 12% to 25%% rate of failure with typical use.
  • Does NOT protect against STDs.

Learn More: Permanent Birth Control Methods

See also


Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.