Contraceptive Pill Alternatives

Contraceptive Pill Alternatives

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Table of contents
OverviewUnderstanding your birth control optionsFactors to consider when choosing birth controlNuvaRingEvraSayana PressMaking an informed decisionSources
Navin Khosla NowPatientGreen tick
Medically reviewed by Navin Khosla, BPharm and written by Rajive Patel, BPharm - Updated on 26 Jan 2024
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Finding the right method of contraception can be a challenging decision. With so many contraception options available, it’s important to understand the different types of contraception and how they work. In this guide, we will explore the various birth control options and factors to consider when choosing the method that’s right for you.

Understanding your birth control options

There are several types of birth control methods available, each with its own advantages and considerations. Here are the main categories of birth control options:

Barrier methods

Barrier methods of birth control create a physical barrier between sperm and the egg, preventing fertilization. Examples include male condoms (external condoms) and female condoms (internal condom), diaphragms, cervical caps, and contraceptive sponges. These methods are easily accessible from pharmacies (over the counter), supermarkets, and sexual health clinics and offer some protection against sexually transmitted infections (STIs).

Hormonal methods

Hormonal methods of birth control use synthetic hormones to prevent ovulation, thicken cervical mucus to impede sperm movement, and thin the uterine lining to discourage implantation. Short-acting hormonal methods include birth control pills, the vaginal ring (NuvaRing), the skin patch (Xulane), and the contraceptive injection (Depo-Provera). Long-acting hormonal methods include the copper IUD (ParaGard), hormonal IUDs (Mirena, Skyla, Kyleena), and the contraceptive implant (Nexplanon).


Sterilisation is a permanent method of birth control that involves surgical procedures. Tubal ligation of the fallopian tubes is a commonly used method for women, while vasectomy is a permanent option for men. These procedures are highly effective but should be considered irreversible.

Spermicide or vaginal gel

Spermicide is a nonhormonal option for birth control that kills or immobilizes sperm. It is available in various forms, such as gels, creams, foams, and suppositories. Another nonhormonal option is the vaginal pH regulator gel (Phexxi), which prevents sperm from reaching the egg. These products are inserted into the vagina shortly before sexual intercourse.

Fertility awareness methods

Fertility awareness methods, also known as Natural family planning, involve tracking your menstrual cycle to determine when you are most fertile and avoiding intercourse during those times. These methods require careful monitoring of basal body temperature, cervical mucus, and other fertility indicators. They can be effective when used correctly but require commitment and consistency.

Withdrawal method

The withdrawal method is where the penis is withdrawn from the vagina before ejaculation. This method of birth control is not recommended due to the risk of not withdrawing the penis in time or sperm being present in the pre-ejaculate.

Emergency contraception

Emergency contraception, also known as the morning-after pill, can be used to prevent pregnancy after unprotected sex or contraceptive failure. Options include Plan B One-Step, Aftera, ella, and other emergency contraceptive pills. It is important to note that emergency contraception is not intended for regular use and does not protect against STIs.

Factors to consider when choosing birth control

When selecting a method of birth control, it is essential to consider several factors that may influence your decision. Here are some key considerations:


The effectiveness of a birth control method is a crucial factor to consider. Some methods, such as IUDs and implants, have higher success rates due to their long-acting nature and minimal user error. On the other hand, methods like fertility awareness and barrier methods may be less effective if not used consistently and correctly.


Consider your reproductive goals and whether you plan to have children in the near future. Short-acting hormonal methods and barrier methods offer more flexibility and can be easily stopped or are reversible. Long-acting methods like IUDs and implants provide extended contraception but may require a healthcare provider’s intervention for removal. Sterilization methods should only be considered if you are certain you do not want to have children in the future.

Compatibility with personal beliefs

Religious or cultural beliefs may influence your choice of birth control. Some methods, such as hormonal contraception or intrauterine devices, may conflict with certain religious or cultural practices. It is important to weigh the risks and benefits of each method and find an option that aligns with your personal convictions.

Convenience and affordability

Consider the convenience and cost of each birth control method. Some methods require daily or regular use, while others offer long-acting protection. Think about your lifestyle and how willing you are to follow a strict schedule or plan ahead. Additionally, consider the financial aspect and whether the method is covered by your insurance or fits within your budget.

Side effects

Different birth control methods may have varying side effects. Hormonal methods, such as the pill or the patch, may cause changes in menstrual patterns, breast tenderness, or mood swings. Nonhormonal methods, like barrier methods or fertility awareness, may have fewer side effects but may not be as effective for some individuals. Discuss any existing medical conditions or concerns with your healthcare provider to find the best option for you.

Protection against STIs

If protection against sexually transmitted infections (STIs) is a priority, condoms (male or female) are the only birth control method that provides reliable protection. Using a condom in addition to another form of contraception can offer both pregnancy prevention and STI protection.

Partner acceptance

Communication with your sexual partner is crucial when choosing a method of birth control. Discuss your preferences, concerns, and expectations to find a method that is acceptable to both of you. Mutual agreement and support can contribute to a more effective and satisfying contraceptive experience.


NuvaRing is a prescription birth control method that comes in the form of a flexible vaginal ring. It is designed to prevent pregnancy and is similar to the combined pill in that it releases a combination of hormones, namely etonogestrel and ethinyl estradiol, into the body. These hormones work together to suppress ovulation and thicken the cervical mucus, making it difficult for sperm to reach the egg.

How does NuvaRing work?

To use NuvaRing, you simply insert it into your vagina and leave it in place for three weeks. During this time, the hormones are continuously released to provide contraceptive protection. After three weeks, you remove the ring, have a one-week break, and then insert a new ring to start the next cycle. The convenience of NuvaRing lies in its long-lasting effectiveness. Unlike other birth control methods that require daily administration, such as the pill, NuvaRing only needs to be inserted once every three weeks. This means you don’t have to remember to take a pill every day, making it a convenient option for women with busy lifestyles.

Common side effects of Nuvaring

Like any hormonal birth control method, NuvaRing may cause some side effects. These side effects are typically mild and tend to improve over time as your body adjusts to the hormones. Here are some common side effects reported by users of NuvaRing:

  • Irritation inside the vagina or on the cervix
  • Headaches, including migraines
  • Mood changes, including depression
  • Discomfort or pain caused by the ring slipping out or causing discomfort
  • Nausea and vomiting
  • Vaginal discharge
  • Weight gain
  • Vaginal discomfort
  • Breast pain, discomfort, or tenderness
  • Painful menstrual periods
  • Abdominal cramping or pain
  • Acne
  • Decreased sexual desire

If you experience any side effects that are persistent or bothersome, it is important to consult your healthcare provider. They can provide guidance on managing these side effects or suggest alternative birth control options if needed.


The Ortho Evra Patch is a popular form of birth control that offers convenience and effectiveness to women who want to prevent pregnancy. This transdermal patch contains a combination of hormones, including a progestin called norelgestromin and an estrogen called ethinyl estradiol.

How does the Evra work?

The Ortho Evra Patch works by delivering a continuous and controlled dose of hormones through the skin. This transdermal patch is applied once a week and releases norelgestromin and ethinyl estradiol into the bloodstream. These hormones work together to prevent ovulation, thicken cervical mucus to block sperm, and thin the lining of the uterus to reduce the chances of implantation.

Common side effects of Evra

Common side effects of the Ortho Evra Patch may include:

  • Skin irritation: Some users may experience skin irritation at the application site. This can manifest as redness, itching, or rash. If you notice any skin irritation, consult your healthcare provider for guidance
  • Nausea and vomiting: Nausea and vomiting are common side effects of hormonal contraceptives. If these symptoms are severe or persistent, speak to your doctor about possible solutions
  • Headache: Headaches are a common side effect of hormonal birth control methods. If you experience severe or persistent headaches, consult your healthcare provider for evaluation
  • Bloating: Some women may experience bloating while using the Ortho Evra Patch. This side effect is usually temporary and resolves on its own
  • Breast tenderness: Breast tenderness or sensitivity may occur. If this symptom is severe or persists, seek medical advice
  • Swelling of the ankles/feet: Fluid retention can cause swelling in the ankles and feet. If this side effect is bothersome or becomes severe, consult your doctor
  • Weight change: Hormonal contraceptives can sometimes lead to weight changes. However, studies have shown that the Ortho Evra Patch is not associated with significant weight gain
  • Vaginal bleeding between periods: Spotting or breakthrough bleeding may occur, especially during the first few months of using the Ortho Evra Patch. This is usually temporary and resolves on its own. If the bleeding is heavy or persistent, contact your healthcare provider

Serious side effects of Evra

While rare, the Ortho Evra Patch may cause serious side effects that require immediate medical attention. If you experience any of the following symptoms, seek medical help right away:

  • Lumps in the breast: If you notice any lumps or changes in your breasts, it is essential to inform your doctor. Although these changes are often benign, they should be evaluated by a healthcare professional
  • Mental/mood changes: Hormonal contraceptives can occasionally affect mood. If you experience new or worsening depression or other mental health changes, consult your healthcare provider
  • Severe stomach/abdominal pain: If you develop severe or persistent stomach or abdominal pain, it is important to seek medical attention
  • Unusual changes in vaginal bleeding: Contact your doctor if you experience continuous spotting, sudden heavy bleeding, missed periods, or any other unusual changes in vaginal bleeding
  • Dark urine and yellowing of eyes/skin: Dark urine and yellowing of the eyes or skin can indicate liver problems. Seek medical advice if you experience these symptoms
  • Blood clots: Although rare, the Ortho Evra Patch may increase the risk of blood clots. Symptoms of blood clots can include chest pain, jaw or left arm pain, confusion, sudden dizziness or fainting, pain or swelling in the groin or calf, trouble speaking, sudden shortness of breath, unusual headaches, unusual sweating, weakness on one side of the body, vision problems or changes. If you experience any of these symptoms, seek immediate medical help
  • Allergic reaction: While rare, a serious allergic reaction to the Ortho Evra Patch can occur. Symptoms may include rash, itching, swelling (especially of the face, tongue, or throat), severe dizziness, or trouble breathing. If you suspect an allergic reaction, seek medical assistance immediately

It is important to note that not all women will experience these side effects, and many individuals using the Ortho Evra Patch do not have any significant adverse reactions. If you have any concerns or questions about side effects, consult your healthcare provider for guidance.

Sayana Press

Sayana Press is a revolutionary contraceptive injection that offers a convenient and effective method of birth control for women.

How does Sayana Press work?

Sayana Press, similar to other contraceptive injections such as Depo-Provera and Noristerat, releases the hormone progestogen into the bloodstream to prevent pregnancy. This hormone works by preventing the release of an egg each month (ovulation) and by thickening the cervical mucus, making it difficult for sperm to move through the cervix. Additionally, Sayana Press thins the lining of the womb, making it less likely for a fertilized egg to implant itself.

Unlike other injections, Sayana Press can be self-administered in the comfort of your own home. It comes in a pre-filled, single-use syringe that is easy to use. The injection is typically given in the tummy (abdomen) or thigh, and the process can be easily learned under the guidance of a healthcare professional. Contraceptive injections may be used if you are breastfeeding or after a baby’s birth.

Common side effects of Sayana Press

One of the common side effects of Sayana Press is changes in the menstrual cycle. Women may experience irregular bleeding, heavier or lighter periods, or their periods may even stop altogether. These changes can persist for several months after stopping the injections, but they usually resolve over time.

Some women may experience weight gain while using Sayana Press. It’s important to note that not all women will experience this side effect, and the weight gain may not be significant. However, if weight gain is a concern for you, it’s essential to discuss it with your healthcare provider.

There is a small risk of infection at the site of the injection. Additionally, while extremely rare, some women may experience an allergic reaction to the injection. If you notice any signs of infection or have an allergic reaction after using Sayana Press, seek medical attention immediately.

Using Sayana Press can affect natural estrogen levels in the body, which may lead to a temporary thinning of the bones. However, this does not increase the risk of bone fractures for most women. The bone density usually returns to normal after stopping the injections, and there is no evidence to suggest any long-term negative effects on bone health. In some cases, healthcare providers may recommend limiting the use of Sayana Press to two years to minimize any potential impact on bone density.

Making an informed decision

Choosing the right birth control method requires careful consideration of various factors. By understanding your options, effectiveness, reversibility, compatibility with personal beliefs, convenience, side effects, STI protection, and partner acceptance, you can make an informed decision.

Remember to consult with your healthcare provider or visit a family planning clinic to discuss your options in detail. They can provide personalized guidance based on your health, lifestyle, and individual needs. Ultimately, finding the right method of birth control will help you take control of your reproductive health and prevent unintended pregnancies.


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NowPatient has taken all reasonable steps to ensure that all material is factually accurate, complete, and current. However, the knowledge and experience of a qualified healthcare professional should always be sought after instead of using the information in this page. Before taking any drug, you should always speak to your doctor or another qualified healthcare provider.

The information provided here about medications is subject to change and is not meant to include all uses, precautions, warnings, directions, drug interactions, allergic reactions, or negative effects. The absence of warnings or other information for a particular medication does not imply that the medication or medication combination is appropriate for all patients or for all possible purposes.

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