Over the Pill? Facts About Nonhormonal Birth Control

Are you thinking about switching to an IUD after being on the pill? Wth the intrauterine device's rise in popularity, you're not the only one with questions about nonhormonal birth control options.

Hormonal options range from the ring to the patch to the pill, but what if you want to avoid the consequences, including mood swings, weight gain, decreased sex drive, or other side effects? You're in luck — different methods of hormone-free birth control exist. And if you have health insurance, almost all forms of birth control are free under the Affordable Care Act, aka "Obamacare."

I've rounded up some basic info — including effectiveness rates and pros and cons — on several different nonhormonal options that will let you enjoy freedom from pregnancy. If one or more sparks your interest, talk to your gynecologist about whether it will work for you.

01
IUD
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IUD

How it works: A doctor inserts the small t-shaped device into the uterus, which affects the way sperm moves and prevents it from joining an egg. It also alters the lining of the uterus.

Success rate: Less than one out of 100 women will get pregnant while using an IUD.

Pros: It's safe, effective, and reversible, and it won't impact your hormones. While an IUD costs between $500 and $1,000 up front, it can last up to 12 years. If you have insurance, it's covered for free under the Affordable Care Act. It might also protect women from endometrial cancer.

Cons: An IUD does not protect against STIs. The common myth that it can cause infertility is not true. However, if you have an IUD inserted while you have an STI, you could increase your chance of infertility.

02
The Sponge
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The Sponge

How it works: The Today Sponge, the only brand available, is a plastic foam sponge that contains spermicide. It covers the cervix while also continuously releasing spermicide. You know it from Seinfeld.

Success rate: Among women who have never given birth, nine out of 100 of them will become pregnant using the sponge. If these same women do not always use it correctly, 16 out of 100 will become pregnant. It will not impact your hormones.

Pros: You can buy it over the counter, and you can have sex as many times as you like during the first 24 hours of wearing it. It's also included in the Affordable Care Act's free birth control mandate.

Cons: It does not protect against STIs, and it can be expensive bought over the counter ($17 for a package of three). Plus, it can be difficult to insert or cause messy or dry sex.

03
Male Condom
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Male Condom

How it works: A condom prevents sperm from entering the vagina.

Success rate: If used correctly, only two out of 100 women will become pregnant. Among women whose partners do not always use them correctly, 15 out of 100 will become pregnant.

Pros: Condoms are simple, easy to get, and cheap (free under Obamacare) and prevent STIs. They can also keep your partner erect longer.

Cons: They might dull sensation or interrupt intercourse.

04
Female Condom
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Female Condom

How it works: Placed inside the vagina, the female condom collects semen when a man ejaculates.

Success rate: If used correctly, only five out of 100 women will become pregnant. Among women who do not always use it correctly, 21 out of 100 will become pregnant.

Pros: It protects against STIs and can be used for vaginal or anal intercourse. If you're allergic to latex condoms, these can be a good option. They cost $6 for a three-pack at the drugstore but are included in the free birth control mandate of Obamacare.

Cons: It could cause irritation, slip into the vagina during intercourse, reduce feeling, or cause some noise, much like the male condom.

05
Diaphragm
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Diaphragm

How it works: The dome-shaped cup is inserted into your vagina to cover the cervix. You should use spermicide to increase effectiveness.

Success rate: Of women who always use the diaphragm correctly, six out of 100 become pregnant. If it's not used correctly, 16 out of 100 will become pregnant.

Pros: It usually cannot be felt by a partner, can be inserted hours before sex, and has no impact on your hormones. It also falls under Obamacare's free birth control mandate.

Cons: It does not protect against STIs and requires a fitting by your doctor. It cannot be used during your period, can be difficult to insert, which you have to do each time you have sex, and may move around during sex.

06
Cervical Cap
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Cervical Cap

How it works: A cervical cap (FemCap is the only brand available in the US) is a silicone cup you insert over your cervix along with spermicide.

Success rate: Of women who have never given birth, 14 out of 100 will become pregnant. For those who have given vaginal birth, 29 out of 100 will become pregnant.

Pros: It works similar to a diaphragm, and for $60-$75, a cervical cap will last up to two years. It's also covered by the Affordable Care Act.

Cons: It has similar drawbacks as the diaphragm: it cannot be used during menstruation, might be hard to insert, and does not protect against STIs. Plus, it requires a prescription.

07
Spermicide
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Spermicide

How it works: Spermicides are chemicals that kill sperm, which you insert deep into the vagina right before sex. It can be used along with other forms of birth control.

Success rate: When used alone, studies suggest that six to 26 percent of women will become pregnant.

Pros: It's easy to get and included in the free birth control mandate.

Cons: It's best to use it along with another form of contraception, and it can be somewhat difficult to use correctly.

08
Surgical Sterilization
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Surgical Sterilization

How it works: By sealing the fallopian tubes, surgical sterilization permanently prevents an egg from getting to the uterus.

Success rate: It could take up to three months before it is completely effective.

Pros: It's safe and lasts forever. It also does not impact your hormones, and most women still have normal periods. Plus, it's included in the free contraception mandate.

Cons: You might change your mind, plus it requires surgery.

09
Vasectomy
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Vasectomy

How it works: While this is technically birth control for men, if you're in a committed long-term relationship, you might consider it. A vasectomy cuts the tubes through which a man's sperm travels, making it impossible for sperm to travel out of the testes and make a woman pregnant.

Success rate: It's nearly 100 percent effective after about three months.

Pros: It lasts for life and is less intrusive than female sterilization. It also may be possible to reverse, although men should not count on that.

Cons: You might change your mind, as could he.