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Non-hormonal Birth Control Methods

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Jul 6, 2020.

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.

  • Some women cannot use hormones at all because of health reasons, breastfeeding, side effects or a host of other reasons.
  • Some may only need occasional pregnancy protection and prefer not to use a full-time birth control method.
  • Certain women prefer to avoid hormones in general based on personal beliefs.

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.

  • barrier methods, such as the condom, sponge, cervical cap, or diaphragm
  • spermicide
  • the copper IUD
  • natural family planning (fertility awareness methods or the rhythm method)

Be sure to review the effectiveness rates of these birth control methods (seen in this chart here). 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 latex condom is the best way to protect against any form of sexually transmitted disease (STD), including HIV and AIDS. A male latex condom or female 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

  • Can be used short-term if the need for birth control is only occasional.
  • For women who cannot use hormones (for medical, breastfeeding, or other reasons) the barrier methods, such as the cervical cap, condom, diaphragm, contraceptive sponge are available. Spermicide (best used with a condom) and copper IUD are also all hormone-free methods.
  • Many methods are inexpensive, but may not be covered by insurance because they are available over-the-counter (OTC).
  • Some methods are easily accessible without a prescription at retail stores, and can be packed easily for travel.

Disadvantages with non-hormonal birth control methods

  • Except for the copper IUD, these methods require careful and consistent use to prevent pregnancy. They may be associated higher failure rates when compared to birth control pills or other hormonal birth control options.
  • Some methods cannot be used during menstruation.
  • Some women may not like placing or leaving devices in the vaginal canal, or may find it uncomfortable.
  • Certain methods, such as a diaphragm or condom, may interfere with sexual spontaneity.

Side effects with non-hormonal birth control methods

Common side effects

Non-hormonal barrier method birth control has few side effects. The copper IUD can be linked with serious 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.

Serious side effects with the copper IUD may include: pelvic inflammatory disease (PID), uterine perforation, 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 Example brand: FemCap
  • Barrier method; flexible cap placed over cervix. Use every time.
  • Must be fitted and prescribed by a health care provider.
  • Used with spermicide; cap must stay in place 6 hours after intercourse, but do not leave in vagina for more than 48 hours.
  • Can last 1 to 2 years.
  • Do not use during menstrual period due to higher risk for toxic shock syndrome
  • 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.
  • 15% to 30% failure rate; failure rate higher in women who have already had children.
  • Does not protect against STDs.
Condom (male) Various options available without a prescription at retail stores and pharmacies.
  • Barrier method; placed over penis and prevents sperm from entering the uterus. Use every time. 
  • May be made of latex; allergies or irritation are possible.
  • 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.
  • 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.
Internal Condoms (also called female condoms but can be used by any gender) Example brand: FC2 Internal Condom
  • 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 every time.
  • In 2017, went to a prescription-only product in US called FC2.
  • May be able to get online or through a family planning or health clinic; insurance may pay with prescription; $2-$3 per condom (often in packs of 12). Pharmacist can order with prescription.
  • Can protect against STDs if used correctly; made of polyurethane and synthetic latex.
  • Do not use with a male condom due to a chance of tearing the condom.
  • About a 20% failure rate.
  • May cause irritation, burning, rash.
Diaphragm Example brand: KoroFlex, Ortho-Diaphragm
  • Barrier method; silicone cup placed over cervix prior to sex; reusable.
  • May cause vaginal irritation.
  • Must be fitted and prescribed by a health care provider.
  • 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.
  • Do not leave the diaphragm in place for more than 24 hours.
  • Costs $15 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
  • Barrier/spermicide method; do not use if sulfite allergy; 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.
  • $15 to $20 for package of 3 sponges.
  • Do not use during menstrual period due to higher risk for toxic shock syndrome; may cause irritation.
  • 20 to 40% failure rate; failure rate higher in women who have already had children.
  • Does not protect against STDs.
Spermicide Brand examples: Encare Vaginal Inserts, Gynol II, Conceptrol; available without a prescription at retail stores / pharmacies.
  • Spermicidal creams, jellies, foams, films, vaginal suppositories; usually contains nonoxynol-9, a chemical that kills sperm to prevent fertilization.
  • Spermicides are inserted into the vagina shortly before intercourse; may cause irritation.
  • Cost is roughly $5 to $20 for a multi-pack.
  • High failure rate 20% to 30% when used alone.
  • To increase effectiveness should always use with a condom or diaphragm.
  • Not covered by insurance (over-the-counter product).
  • Does not protect against STDs.
Copper Intrauterine Device (copper T 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.
  • 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.
  • 12-25%% rate of failure with typical use.
  • Does not protect against STDs.

Learn MorePermanent Birth Control Methods

See Also

Sources

Further information

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