Non-Hormonal Birth Control Options

Dr. Babak Ashrafi

Medically reviewed by

Dr Babak Ashrafi

Last reviewed: 13 Jan 2022

There are plenty of options for non hormonal birth control. You may need non hormonal birth control if you cannot take medications with hormones, or maybe you’ve been getting side effects. It’s also good to know what’s out there as an alternative method of contraception.

Non hormonal birth control works in different ways depending on the type of product. You might need to try a few out and see which method is most comfortable for you and your partner. Most contraceptives are affordable and easily accessible either from a doctor or sexual health clinic.

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Why choose a non hormonal type of contraception?

You might choose a non hormonal type of contraception if:

  • hormonal birth control gives you side effects
  • you cannot use hormonal birth control due to a condition affected by hormones, like cervical cancer
  • you are breastfeeding and cannot take oestrogen
  • you do not want to interfere with your body’s natural cycle

If you do not have sex frequently you might not need continuous birth control. This makes non hormonal birth control methods more suitable for your situation.

If you already use hormonal contraception you can use a non hormonal method as a backup. This increases your contraceptive protection and lowers your chance of getting pregnant.

Hormonal birth control does not protect you from sexually transmitted infections (STIs). If you use a non hormonal method like condoms you’ll have better protection against STIs, such as HIV or chlamydia.

Different types of non hormonal birth control

There are different types of non hormonal birth control which means you should be able to find the right one for you. Non hormonal birth control works by either:

  • creating a barrier between the sperm and egg from meeting, such as a condom or diaphragm
  • reducing the movement of sperm, or killing them off
  • making it difficult for a fertilised egg to implant into the uterus

Condoms

Condoms are a barrier method of contraception which means they prevent the sperm from fertilising an egg. Condoms will also protect you against sexually transmitted infections (STIs), like chlamydia or HIV. You can use condoms if you’re having vaginal sex, anal sex or oral sex.

Both external (male) and internal (female) condoms are the only type of contraception that protects you against STIs. If you’re using a hormonal contraceptive, like the pill, you’ll still need to use a barrier method to protect yourself from STIs.

Male condoms are made from different materials, most commonly latex, polyurethane or polyisoprene. It’s important to know the type of condom that you’re using as latex and polyisoprene can be damaged by oil based lubricants. Check the packaging for any ingredients that say ‘oil’ or ‘butter’ (like cocoa butter), or petroleum jelly so you know to avoid these oil based lubricants.

Condoms need to be put on an erect penis. While you might think this will interrupt sex, you can turn this into part of your foreplay with your partner. Once ejaculation has occurred, you’ll need to take off the condom while the penis is still erect to prevent sperm from leaking out.

How effective are condoms?

Condoms can be 98% effective in preventing pregnancy if you use them perfectly every time you have sex. To get the most out of using condoms:

  • check the use by date of the condoms to make sure they have not expired
  • use a new condom each time you have sex
  • make sure that the penis does not come into contact with the vagina until you’ve put a condom on
  • if you’re having sex for more than 20 minutes, use a new condom as the current condom can split

If it’s your first time using female condoms, take some time to get used to them. Try to put them on yourself before you have sex so you can get used to the feeling.

Many men find that they last longer during sex when using male condoms as it can make their penis feel less sensitive. They may want to check that their condom is not too tight and is a good fit for the size of their penis. If a man finds it difficult to get or keep an erection, they might have erectile dysfunction.

What are the advantages of using condoms?

The advantages of using condoms include:

  • wide availability, as you can get them from most shops
  • easy to use
  • usually no side effects
  • you only need to use them when having sex, so you do not need to plan ahead
  • protect you and your partner against STIs

If your partner does not want to use condoms, there are other options for contraception. However, many of these options do not protect you against STIs. You can speak to a sexual health clinic for advice on how to discuss using condoms with your partner.

What are the disadvantages of using condoms?

There are a few disadvantages to using condoms:

  • if you’re allergic to latex or other ingredients that condoms are made from, you will not be able to use them
  • you might feel that condoms disrupt sex, but try and make this a part of your foreplay

condoms can split—if this happens, you might need emergency contraception

Diaphragms

Diaphragms are another method of barrier contraception that you can use inside your vagina. Diaphragms are used by fitting them inside your vagina up to 3 hours before sex.

A diaphragm looks like a little cup made of silicone or latex that covers your cervix. Diaphragms are usually used with spermicide but can also be used without. Spermicide can be a gel, cream or suppository that contains chemicals to kill sperm inside the vagina. Using a diaphragm with spermicide is much more effective at preventing pregnancy.

As your vagina and cervix size is unique to you, a doctor or nurse will need to find a diaphragm that’s the right fit for you. Once they advise you on the best size for you, they can show you how to put your diaphragm in and take it out safely.

After having sex, you’ll need to keep the diaphragm in for at least 6 hours before taking it out. This is to make sure no sperm can enter your uterus. You’ll need to apply more spermicide on the diaphragm if:

  • the diaphragm is inside you for longer than 3 hours before having sex
  • you have sex again

You should not keep a diaphragm inside your vagina for longer than 24 hours.

How effective are diaphragms?

When diaphragms are used with spermicide, they are around 92 to 96% effective in preventing pregnancy. Diaphragms do not protect against STIs, so you’ll need to use condoms to protect yourself. If used without spermicide, the effectiveness of diaphragms is much lower.

What are the advantages of using a diaphragm?

Here are the advantages of using a diaphragm:

  • you can put the diaphragm in before sex so there’s no interruption
  • highly effective in preventing pregnancy when you use it with spermicide
  • you only need to use the diaphragm when you want to have sex
  • they are reusable and last up to 1 year

What are the disadvantages of using a diaphragm?

The disadvantages of using a diaphragm comes down to your personal choice. When choosing your type of contraception, remember that:

  • diaphragms do not protect against STIs
  • it can take some time to learn how to use diaphragms
  • the latex material of the diaphragm or spermicide can cause you or your partner irritation, but you can get a silicone version instead
  • there is a small risk of a bladder infection (cystitis) if you use a diaphragm that is not the right size for you

a very small chance you get toxic shock syndrome if you use the diaphragm while on your period

Copper IUD

A copper IUD (intrauterine device) is an effective method of contraception. An IUD is inserted by a trained doctor or nurse to fit it inside your uterus (womb). The IUD releases copper into your womb which affects how sperm move and how your egg is transported through your ovaries. This prevents fertilisation and reduces your chances of getting pregnant.

Once inserted, the copper IUD can be left inside your womb for around 5 to 10 years (depending on the type). This allows you to always be protected against pregnancy even during unplanned sex.

How effective is the copper IUD?

The copper IUD is 99% effective in preventing pregnancy from the moment it’s put in. The IUD does not protect against STIs, however, so you’ll still need to use condoms too.

What are the advantages of using a copper IUD?

One of the advantages of using a copper IUD is that once it’s fitted you do not need to do anything else to maintain it. This makes the copper IUD one of the most convenient forms of contraception.

The copper IUD is not known to increase your weight or cause mood changes, unlike hormonal contraceptives. There is also no evidence to suggest that the copper IUD leads to cervical cancer or womb cancer.

If you want to get pregnant you can simply have the copper IUD removed. The effects of the copper IUD do not stay in your womb after removal, so there’s a chance you’ll get pregnant pretty soon after removal.

What are the disadvantages of using a copper IUD?

There are some disadvantages to using a copper IUD, mostly involving an increased chance of getting an infection. Signs of an infection include:

  • pain or discomfort in your tummy area
  • a fever
  • unusual vaginal discharge

If you think you have an infection after having an IUD fitted, speak to a doctor or nurse. They might prescribe antibiotics to heal the infection or they may suggest removing it.

You might be more likely to get thrush, a yeast infection. You can easily treat thrush by using a cream or taking a tablet.

After the copper IUD is inserted your periods can become more painful and heavy. Your menstrual cycles should get better after a few months. You can always consider a different form of contraception if you feel a copper IUD is not right for you.

Birth control sponge

The birth control sponge is another barrier form of contraception that sits inside your vagina. The sponge is usually made of polyurethane and is disc shaped. You will need to use condoms to protect yourself against STIs if you use a birth control sponge.

As the sponge covers your cervix, it prevents sperm from entering your womb and fertilising an egg. The sponge contains spermicide and will kill any sperm coming near your cervix.

Before you put the sponge in your vagina, you should wet it with water. This will activate the spermicide and also make it easier to insert it deep into your vagina.

The sponge can be used for up to 24 hours but should not be left inside your vagina for more than 30 hours. You can only use a birth control sponge once and you will need a new one the next time you have sex.

The sponge is no longer available in the UK but may be available in other countries.

How effective is the birth control sponge

The effectiveness of the birth control sponge will depend on whether you’ve given birth or not. If you’ve never had a baby, the birth control sponge is around 88% to 91% effective. If you have had a baby, the sponge is about 76% to 80% effective.

What are the advantages of using a sponge?

Here are some advantages to using a birth control sponge:

  • it can be inserted into your vagina up to 24 hours before you want to have sex
  • it does not contain any hormones
  • you only need to use it during sex

What are the disadvantages of using a sponge?

The main disadvantage of the sponge is that it’s not as effective as other methods of non hormonal birth control. But you can use a sponge as an ideal backup method of contraception if you want to add an extra layer of protection.

There is a chance you might get toxic shock syndrome when using the sponge. In addition, the sponge does not protect you against STIs, so you’ll need to use condoms for this.

Spermicide and gel

Spermicide is a type of chemical that kills sperm or reduces their ability to fertilise an egg. Spermicides are available in a variety of forms, such as gels, foams, vaginal suppositories or creams.

You can buy spermicide over the counter at a pharmacy and it may contain the ingredient nonoxinol. The chemical nonoxinol works by damaging the sperm cell membrane which decreases the movement of the sperm.

Spermicides are generally used with a diaphragm or cervical cap. Using them together makes them more effective at preventing pregnancy.

You can also use spermicides with external condoms (for males) as the chemicals in the spermicide will add protection. Condoms made from latex or polyisoprene will get damaged if used with oil based products, so check that the ingredients in your spermicide do not cause damage to condoms.

How effective is spermicide?

Spermicide is 72% effective on its own. When used along with a diaphragm or cap, this effectiveness can increase up to 96%. Spermicides are not effective at protecting you against STIs.

What are the advantages of using spermicide?

The advantage of using spermicide is that it does not contain any hormones, which is ideal if you want to avoid using hormonal contraceptives. Another advantage is that spermicides are available without prescription so you do not need to see a doctor to use them.

What are the disadvantages of using spermicide?

The main disadvantages of using spermicide include:

  • they can cause vaginal irritation
  • using spermicide alone can increase your chances of getting an STI or other infections

If you use spermicide alongside the diaphragm or cervical cap, make sure to use a condom as well. You can get STI test kits from your sexual health clinic or request an STI test kit from ZAVA Online Doctor.

Using spermicide on its own is a lot less effective at preventing pregnancy, so you should use it with a diaphragm or cervical cap.

Cervical cap

The cervical cap is a similar non hormonal birth control barrier method to the diaphragm. Both the cap and diaphragm are made of silicone or latex and require the use of spermicide alongside them. The cervical cap is smaller than the diaphragm and fits snugly to block your cervix, whereas the diaphragm covers a larger area.

Like the diaphragm, the cervical cap can be put inside your vagina at any time before you have sex. You’ll need to put more spermicide if the cap has been in your vagina for more than 3 hours. The cap should stay in place for 6 hours after you’ve had sex.

Cervical caps do not protect against STIs, so you’ll need to use condoms to give yourself the best protection.

How effective are cervical caps?

Cervical caps can be up to 96% effective if you use them perfectly with spermicide. As they take some time to get used to, cervical caps are realistically around 88% effective even with a spermicide.

What are the advantages of using a cervical cap?

The main advantages of using a cervical cap include:

  • you can insert the cap up to 3 hours before sex so there is no interruption
  • only needs to be used when you want to have sex
  • its reusable and easy to look after

What are the disadvantages of using a cervical cap?

The disadvantages of cervical caps are:

  • they can time to get used to
  • there’s a chance using one can lead to a urinary tract infection (UTI) or cystitis
  • have a small risk of toxic shock syndrome
  • cause irritation in your vagina or your partner’s genitals, especially when used with spermicide

Cervical caps are not the most effective contraceptive in comparison to other birth control methods. Remember that the best method is always down to what works best for you.

Internal (female) condom

Internal or female condoms are similar to male condoms. They are usually made from latex or synthetic latex and you insert one into your vagina before sex. You can use lubricants with female condoms but make sure the lube is suitable to use with the material the condom is made from.

Internal condoms will protect you against STIs. But you can only use an internal condom once, so if you want to have sex again you’ll need to insert a new condom. You should check the expiry date of an internal condom before you use it to check that it’s within its use by date.

How effective are internal condoms?

When used perfectly, internal condoms are 95% effective in preventing pregnancy. There is a small chance that the penis may go in between the side of the vagina and the condom during sex.

What are the advantages of using an internal condom?

Some of the advantages of using internal condoms are similar to male condoms:

  • there are no side effects when using condoms, unless you are allergic to what it’s made from
  • it protects you and your partner against STIs
  • you only need to use it when you want to have sex

What are the disadvantages of using an internal condom?

Internal condoms are not as widely available as male condoms are, which means they can be a bit more expensive. You might also find that putting an internal condom on can disrupt sex, or that it may tear or split.

You will need to get the morning after pill if your internal condom does tear or split during sex.

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Medically reviewed by:
Dr Babak Ashrafi Clinical Lead for Service Expansion
Accreditations: BSc, MBBS, MRCGP (2008)

Babak studied medicine at King’s College London and graduated in 2003, having also gained a bachelor’s degree in Physiology during his time there. He completed his general practice (GP) training in East London, where he worked for a number of years as a partner at a large inner-city GP practice. He completed the Royal College of GPs membership exam in 2007.

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Last reviewed: 13 Jan 2022




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