Non-Hormonal Birth Control Options

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 menstrual cycle

Non-hormonal birth control can be a better choice for those who have sex infrequently, as you do not need continuous contraception.

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 condoms, you’ll have better protection against STIs, such as HIV or chlamydia. However, not every type of non-hormonal contraception will protect you from STIs, so it’s important to do your research first.

Non-hormonal birth control works in different ways, such as:

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

As there are different types of non-hormonal birth control, you should be able to find the right one for you and your partner.

Male condoms are a barrier method of contraception, which means they physically 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, anal, 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. Latex and polyisoprene can be damaged by oil-based lubricants, making them less effective. If you use these types of condoms, avoid lubricants with these ingredients:

• oil
• butter, such as cocoa butter
• petroleum jelly

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?

Male condoms can be 98% effective in preventing pregnancy if you use them perfectly every time you have sex. To make sure a condom is as effective as possible, you should:

• check the use-by date to make sure it has 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
• use a new condom if you’re having sex for more than 20 minutes, as the current condom can split

You may find that you last longer during sex when using male condoms as it can make the penis feel less sensitive – this is completely normal. You should make sure that your condom is not too tight and is a good fit for the size of your penis. If you find it difficult to get or keep an erection, your condom may not be the correct size. If this happens frequently, you might have erectile dysfunction.

What are the advantages and disadvantages of using condoms?

If your partner does not want to use condoms, there are other options for contraception. However, 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.

Internal (female) condom

Internal or female condoms are similar to male condoms except they are inserted inside the vagina or anus before sex. They are usually made from latex or synthetic latex. You can use lubricants with female condoms, but make sure the lube is suitable for use with the material the condom is made from.

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.

Internal condoms will protect you against STIs, but you can only use them 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 at 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 and disadvantages of using an internal condom?

You will need to get emergency contraception, such as the morning after pill or copper coil, if you want to protect against pregnancy and your internal condom tears or splits during sex.

Diaphragms are another method of barrier contraception that work by blocking the entrance to the womb, stopping sperm from reaching an egg. A diaphragm looks like a little cup made of silicone or latex which covers your cervix. 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. They can also show you how to put it in and take it out safely.

Diaphragms must be used with spermicide and can be fitted inside your vagina up to 3 hours before sex. If you insert a diaphragm more than 3 hours before sex, you’ll need to take it back out and apply more spermicide.

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 womb. You’ll need to apply more spermicide on the diaphragm if 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 estimated to be around 92 to 96% effective at 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 and disadvantages of using a diaphragm?

Copper IUD

A copper intrauterine device (IUD) is inserted into your womb by a trained doctor or nurse. It releases copper into your womb, which affects how sperm move and thins the womb lining, making it difficult for an egg to attach to it. This prevents fertilisation and reduces your chances of getting pregnant.

Once inserted, the copper IUD can be left inside your womb for around 5 or 10 years (depending on the type). So, you will be protected from pregnancy all the time the copper IUD is in place, even during unplanned sex.

How effective is the copper IUD?

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

What are the advantages and disadvantages of using a copper IUD?

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.

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

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.

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, though, so check that the ingredients in your spermicide do not cause damage to condoms.

How effective is spermicide?

Spermicide is 82% effective on its own when perfect use is considered, though this drops to 72% in typical use.

Spermicide is best used along with a diaphragm or cap. Then, the effectiveness increases up to an estimated 92 to 96%. Spermicides are not effective at protecting you against STIs.

What are the advantages and disadvantages of using spermicide?

Cervical cap

The cervical cap is a similar non-hormonal birth control barrier method to the diaphragm. The cap is made of silicone or latex and should be used alongside spermicide. The cervical cap is smaller than the diaphragm and fits snugly to block the entrance to your womb.

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 are estimated to be 92 to 96% effective if you use them perfectly with spermicide.

What are the advantages and disadvantages of using a cervical cap?

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.

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. 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. You will need to use condoms to protect yourself against STIs if you use a birth control sponge.

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. It 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, so you will need a new one the next time you have sex.

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 and disadvantages of using a sponge?

While condoms can prevent STIs, no method is 100% effective. It’s recommended to get tested regularly if you’re sexually active, especially if you have multiple sexual partners or you do not know your partner's STI status.

You can request an STI test kit online from ZAVA discreetly, which you can take in the comfort of your own home before sending it to our partner lab. Our doctors will provide personalised guidance based on your results, and we can prescribe a range of STI treatments if required. You can also get tested at a sexual health clinic.

This table shows the effectiveness of each non-hormonal birth control method in typical (everyday) use vs perfect use, along with some important points to help you decide which is best for you.

There are some natural ways to prevent pregnancy, however, they are often not as reliable as other methods of contraception.

Withdrawal method

The withdrawal method, also known as pulling out, is when the penis is removed from the vagina before ejaculation. The withdrawal method is not recommended by the NHS as an effective way to prevent pregnancy because it relies on self-control and timing, so there is an increased risk of failure when practising this method.

The withdrawal method also does not protect against STIs, and although it’s a free, convenient, and natural form of contraception, it has a higher chance of failure compared to other methods.

Cycle tracking

Cycle tracking involves tracking your periods to see when you are most fertile and avoiding sex, or using protection, such as condoms, during that time. When used perfectly, cycle tracking can be between 91 to 99% effective at preventing pregnancy. However, if not done correctly, this falls to about 76% effective.

While tracking your cycle with an app or calendar, it can also be helpful to track your basal body temperature every day, which is your body's lowest resting temperature after resting (most commonly checked straight after waking up). Your temperature will rise slightly after ovulation, and this can help you identify your fertile window.

Herbal alternatives

Herbal birth control has not been proven to work, but some women may still choose to try it. Herbal medication uses one or more parts of a plant to help prevent disease or improve overall health. It’s believed that certain herbs may help to prevent an egg from implanting itself, cause periods, or affect sperm count and mobility if taken regularly, such as ginger root and thistle.