What is contraception?
How does contraception work?
What is emergency contraception and how does it work?
How effective are contraceptives?
Are contraceptives safe? What are the common side effects of contraception?
How can I choose a method of contraception?
How do contraceptives affect the menstrual cycle?
Where can I find contraceptives?
Do contraceptives protect against sexually transmitted infections (STIs)?
Can contraceptives cause abortions?
Can contraceptives cause infertility?
What are common myths and taboos about contraceptives?
Why are there not more male methods of contraception?
Do contraceptives encourage young people to have sex?
Do contraceptives save lives?
How are contraceptives related to human rights?
What contraceptives does UNFPA procure?
Are any of the supplies UNFPA procures abortifacient?
What is contraception?
Contraception is the act of preventing pregnancy. The term can be used to describe a medication, a device, a surgical procedure or a behaviour. Human beings have used contraceptives to prevent pregnancy since ancient times.
Hormonal contraceptives include the oral contraceptive pill, hormonal contraceptive injections, include implants, intrauterine devices (IUDs), vaginal rings and patches. There are also barrier methods, such as condoms, diaphragms and cervical caps. And there are permanent contraception methods, which most commonly take the form of tubal ligation for women and vasectomy for men.
Contraceptive behaviours can include abstinence from sex, exclusive breastfeeding during the first six months after delivery (lactational amenorrhea), as well as various methods of determining when a woman is fertile to avoid sex during those times. Historians speculate that withdrawal, also called coitus interruptus or pulling out, may be the earliest form of contraception (though importantly this contraceptive behaviour is much less effective than modern methods).
Contraception, by definition, does not include abortion or any abortion-causing medications, procedures or behaviours.
The terms family planning and birth control are often used as synonyms for contraception. However, family planning can also refer to information and health services that help people become pregnant when they want to.
How does contraception work?
There are many methods of contraception. Different contraceptives work in different ways.
Hormonal contraceptives can take the form of oral contraceptives (often called “the pill”), implants, injectibles, rings, patches or hormonal IUDs. The hormones in these contraceptives can prevent the release of eggs from the ovaries (ovulation), block sperm by increasing cervical mucus, or both.
Lactational amenorrhea (exclusive breastfeeding) also prevents the release of eggs from the ovaries and is effective during the first six months after delivery.
Non-hormonal contraceptives work in different ways, either by affecting the movement of sperm or acting as a barrier between the sperm and egg.The copper in a copper IUD, for instance, affects the movement of sperm so that it cannot meet and fertilize an egg. Male and female condoms create barriers that prevent sperm from meeting an egg. Tubal ligation (also called tubal sterilization) blocks an egg from meeting sperm. Vasectomy blocks sperm from meeting an egg.
Behaviour-based contraception, or fertility awareness methods like the rhythm method or basal body temperature method, avoid unprotected vaginal intercourse during the days that a woman is fertile (the days leading to or immediately following) ovulation. Withdrawal (also known as coitus interruptus or pulling out) attempts to keep sperm out of a woman’s body. Abstinence is the avoidance of sexual intercourse entirely.
Contraceptives have different efficacy rates, which should be considered when choosing a method (see How can I choose a method of contraception?).
What is emergency contraception and how does it work?
Emergency contraceptives are a form of contraceptive that a woman can take shortly after having unprotected sex or experiencing failure of another form of contraception (such as a torn condom) to prevent pregnancy. These are most effective the sooner they are used after unprotected sex and are effective up to 120 hours after intercourse. Methods include emergency contraceptive pills and copper-bearing IUDs.
Emergency contraceptives are especially critical for survivors of sexual assault and other women who are not able to negotiate contraception use, such as women experiencing intimate partner violence, sex trafficking or other forms of disempowerment.
Alternative names for emergency contraception include post-coital contraception and the morning-after pill. Emergency contraception inhibits or delays ovulation. Emergency contraception does not end a pregnancy or harm a developing embryo.
Emergency contraception prevents 95 per cent of pregnancies when taken within five days of intercourse.
How effective are contraceptives?
Contraceptives have very different efficacy rates. It is important to remember that contraception is less effective if not used perfectly at all times – this is referred to as “typical use”. Typical use accounts for events such as occasionally missing a pill or a condom breaking during sex. Modern methods of contraception are significantly more effective than “natural” family planning methods, both when looking at consistent, correct use and typical use.
The most effective forms of contraception are permanent methods and long-acting reversible contraceptives (LARCs). LARCs include contraceptive implants and intrauterine devices, which are over 99 per cent effective at preventing pregnancy with both typical and perfect use. This means that if 100 women use the method, less than 1 woman will experience an unintended pregnancy within the first year of use. Both of these methods are effective for several years (from 3 to 5 years for implants, depending on type, and from 5 to 12 years for the IUD, depending on type) before needing to be replaced, which can be a benefit to some users.
Contraceptive pills, injections, vaginal rings and patches all have efficacy rates of over 99 per cent with perfect use, and over 90 per cent with typical use. Condoms are 82 per cent effective with typical use – but when used correctly, they also protect against sexually transmitted infections and HIV infection. (Condoms are the only form of contraception that can protect against STIs and HIV, providing “dual protection”.) So-called “natural” family planning methods, such as withdrawal (also known as coitus interruptus or pulling out) or the rhythm method, are not considered modern methods of contraception and are between 80 and 85 per cent effective with typical use.
Importantly, no form of contraception is perfect. Even abstinence from sexual activity – considered by many to be a “fail-safe” method of controlling fertility – can fail when a woman or girl experiences rape or coercive sex, an all too common occurence globally.
When choosing a method of contraception, it is important to consider the efficacy rate, one’s ability to use the contraceptive correctly, as well as factors such as side effects (see What are the common side effects of contraception?).
Are contraceptives safe? What are the common side effects of contraception?
Modern forms of contraception are among the most prescribed and well-studied medications in existence. Hormonal contraceptives are safe for most people, but as with all medicines, there are some associated side effects. Side effects of hormonal contraception can include mood swings and headaches. Non-hormonal contraception, such as the copper coil, can make periods heavier. Such side effects typically disappear within a few months.
Hormonal contraception can also pose a mildly increased risk of blood clots. For this reason, hormonal contraceptive pills may not be suitable for older women, particularly for individuals already at increased risk of heart disease. The overall risk is marginally higher than for women not taking the pill, and the risk is lower than that associated with pregnancy, delivery and the postpartum period.
There is a slightly higher risk of developing breast cancer and cervical cancer for women who take oral contraceptives. However, using contraceptive pills also lowers an individual’s risk of developing ovarian or endometrial cancer.
In recent years, alternative methods of preventing pregnancy have become popular, particularly on social media. These include cycle tracking apps and fertility awareness methods, including the daily checking of temperature. These methods are increasingly promoted as “safer” contraceptive methods. While these methods may work for some, they won’t work for everyone. It is important to remember that so-called “natural methods” are significantly less likely to prevent pregnancy than modern methods (see How effective are contraceptives?).
It is also important to note that unintended pregnancy itself poses a health risk for women. Individuals should weigh the potential side effects of the contraceptives available to them against the risks of unintended pregnancy. On average, more than 700 women die every day from causes related to pregnancy and childbirth. Additionally, over 60 per cent of unintended pregnancies end in abortion and 45 per cent of all abortions are unsafe, causing between 5 and 13 per cent of all maternal deaths.
How can I choose a method of contraception?
Choosing a contraceptive method is a personal decision. A trained healthcare provider or family planning counsellor can offer accurate, unbiased information on:
- The effectiveness of each method in preventing pregnancy
- Potential side effects and risks relevant to each person
- How comfortable and safe the individual feels using the method
- Whether the individual can use the method correctly all the time
- Cost and availability
- Whether the method prevents against sexually transmitted infections
Some contraceptive methods, like the contraceptive pill, should be taken at the same time each day for maximum efficacy, which may not be suitable for some lifestyles. Many methods can now be accessed through self-care options, such as over-the-counter oral contraceptives or community-based distribution of injectables, allowing people to manage their own reproductive health safely and privately.
Being able to openly and respectfully discuss contraceptive options is an important part of a healthy relationship. Ideally, people and their partner (if they have one) should discuss contraceptive options to support joint responsibility.. Unfortunately, there are many situations in which people experience reproductive coercion, sexual violence or other conditions that make joint decision-making unsafe or impossible. In all situations, an individual’s rights to choice, bodily autonomy and informed-decision making must be upheld, including the right to choose whether and when to use contraception and which method best suits their individual needs and preferences.
How do contraceptives affect the menstrual cycle?
Hormonal contraceptives can impact menstrual bleeding. Some methods can increase the frequency or amount of bleeding, while others can decrease it. Periods may become lighter or heavier, longer or shorter, or even absent. Spotting and irregular bleeding are common side effects of several hormonal contraceptive methods, particularly in the first few months of use. Some contraceptives, like the copper coil, can make periods heavier and more painful during the first few months of use.
Many women use hormonal contraception for reasons other than pregnancy prevention. For example, the combined pill or the hormonal IUD may be used to treat painful or heavy periods, or even conditions such as endometriosis or polycystic ovarian syndrome.
Withdrawal bleeding is the period one might experience while taking hormonal contraception. It occurs when switching to a new pill pack, patch or ring. Although withdrawal bleeding may feel like a menstrual period, it is not technically the same, as it is the body’s response to the drop in contraceptive hormones. Some women choose to skip this withdrawal bleed completely.
Menstruation typically resumes within three months of stopping hormonal contraception. How quickly menstruation resumes depends on several factors, including how long it was used and the method used. For contraceptives like injectables, it may take three to six months for normal menstruation to resume.
When coming off hormonal contraception, it is important to be aware that symptoms suppressed by the method, such painful periods, may return.
Where can I find contraceptives?
Some contraceptive methods require a prescription from a doctor, while others are available over-the-counter. Oral contraceptive pills are now available over the counter in more than 100 countries worldwide. Condoms can be purchased at local pharmacies, supermarkets, vending machines or obtained for free from local family planning organizations in most places.
Other contraceptives, such as the contraceptive implant, patch or IUD, are generally only available from a healthcare professional. Permanent contraception, such as vasectomy or tubal ligation, are surgical sterilization procedures that must be performed by a doctor.
Do contraceptives protect against sexually transmitted infections (STIs)?
Most contraceptive methods do not protect against sexually transmitted infections. The correct and consistent use of condoms in addition to a modern method of contraception (“dual protection”), is recommended to prevent STIs, including HIV. Both male and female condoms protect against STIs, including human immunodeficiency virus (HIV). And even with condom use, there is a small risk of contracting an STI if either partner has an asymptomatic infection. Sexually active individuals should undertake regular testing for STIs in order to treat any potential infection as soon as possible.
Can contraceptives cause abortions?
No. Contraceptives do not cause abortion or miscarriage. According to globally recognized medical authorities such as the World Health Organization, American College of Obstetricians and Gynecologists and the United Kingdom’s National Health Service, modern contraceptives act by preventing fertilization or ovulation. This means that they prevent pregnancy from occurring in the first place and do not disrupt an existing pregnancy or affect a fertilized egg that has already implanted.
Emergency contraception also prevents pregnancy from occurring in the first place. As it does not terminate a pregnancy, it cannot be classified as an abortifacient. Emergency contraception is not effective if a person is already pregnant and it cannot induce an abortion or miscarriage.
Can contraceptives cause infertility?
Contraceptives do not cause infertility. While some hormonal methods, such as injectable contraceptives, may temporarily delay the resumption of ovulation and menstruation, this is a temporary condition and does not lead to permanent infertility. In most cases, fertility returns to normal within a few months of discontinuing a hormonal method. Fertility returns immediately after discontinuing a non-hormonal method of contraception.
Contraceptives also do not reduce ovarian reserve – a woman’s egg count – and they do not lead to early menopause. A woman’s ovarian reserve decreases naturally with age and this timeline is not altered by use of contraception.
What are common myths and taboos about contraceptives?
Myth: You need to take regular breaks from using contraceptives.
Fact: There is no medical reason to take regular breaks from contraceptives. There is a common misconception that hormones from birth control “build up” in the body, and that the user should take breaks for health reasons. However, taking a break from contraceptive use can lead to unintended pregnancy. It may also lead to the return of symptoms the method was helping to manage, such as heavy or painful periods.
Stopping and starting contraceptives such as the pill could actually do more harm than good. This is because the risk of developing serious side effects from using hormonal contraceptives is highest in the first few months of starting the pill, or when restarting after a break. The risk of a blood clot, for example, is higher in the months immediately after starting or restarting the birth control pill after a break of at least one month, which is why many healthcare providers discourage starting and stopping the pill repeatedly.
Myth: Birth control damages your fertility.
Fact: The effects of contraceptives on your ability to conceive are reversible. This means that your fertility will return once you stop using the contraceptive. Using contraception does not damage fertility or reduce ovarian reserve. (See Can contraceptives cause infertility?)
Non-hormonal methods of contraception can simply be discontinued for fertility to return to normal. If using a hormonal method, fertility will typically return within a few months of stopping.
It is important to note that pregnancy can occur as soon as contraception is stopped.
Myth: Natural methods of family planning are safer than hormonal methods.
Fact: Modern methods of contraception are some of the most prescribed medications on the planet. While natural methods of family planning,such as the rhythm method or the basal body temperature method, may work for some people, they are not as effective at preventing pregnancy as modern hormonal and non-hormonal methods, such as condoms, contraceptive pills and IUDs. With perfect use, natural methods can have a moderate level of efficacy, but perfect use is challenging to maintain for many women, particularly over long periods of time.
UNFPA recognizes that people from certain cultural backgrounds may prefer to use natural methods of family planning and these methods are included in UNFPA-supported family planning counselling. However, the most effective methods of contraception are modern methods.
While there are some side effects associated with modern methods of contraception, the vast majority of women do not experience any severe or long-lasting effects (See Are contraceptives safe? What are the common side effects of contraception?). For women unable to use hormonal contraceptives, there are other non-hormonal methods which are more effective than natural methods, for example the copper coil.
Myth: Contraceptives change who women are attracted to.
Fact: There is no good evidence for the idea that hormonal contraceptives alter who a person is attracted to. Similarly, starting or stopping birth control does not affect the quality of a romantic relationship in any significant way.
Changes in desire and sex drive, however, can sometimes occur as a side effect of hormonal contraception. This may impact feelings of attraction towards a sexual partner. Trained healthcare providers can provide information on alternative contraceptive options, including non-hormonal methods.
Sexual attraction is complex, and hormone levels are just one component of what shapes attraction and the people we are attracted to.
Myth: You shouldn’t use contraception if your partner doesn’t want to/if you are married.
Fact: Every individual has the right to decide whether or not to become pregnant. This choice should not be determined by anyone else – including romantic partner(s). Women and girls should not be pressured to have unprotected sex, even with long-term partners, if it is not their choice to do so. Pressuring an individual to have unprotected sex against their will is a serious issue known as reproductive coercion. This is a form of abuse and a violation of an individual’s right to bodily autonomy and reproductive freedom. Women and girls have the right to say no to sex for any reason, including if their partner does not agree to use contraception.
Myth: You shouldn’t use contraception if you are not married.
Everyone has the right to use contraception and to make decisions about their reproductive health. Some people assert that providing contraceptives to unmarried young people promotes “promiscuous” behavior. This is false. Research shows that providing people, particularly adolescents, with access to information and services related to their sexual and reproductive health is not linked to any increase in sexual activity.
In some cases, however, healthcare providers themselves promote this myth, basing guidance on personal preference rather than medical guidelines. Biases can be based on marital status, but also on age, parity (number of births a person has had) or other factors. These kinds of biases pose a significant barrier to quality services and information on family planning.
For most people around the world, sex is a normal part of adolescence and adulthood. Any individual engaging in sexual activity has the right to use the method of contraception that works for them and to access accurate information about the options available to them.
Why are there not more male methods of contraception?
Much of the responsibility for procuring and using contraceptives has historically fallen on women. However, male methods of contraception do exist, and new hormonal methods are under development. Male contraceptive methods currently include condoms (male condoms), spermicide and vasectomy.
For decades, researchers have been exploring and developing hormonal birth control pills for men, but progress has been slow. Methods under development include long-acting reversible contraceptives (LARCs), daily oral pills, transdermal gels, monthly injectables, and implants. Many of these methods work similarly to hormonal birth control for women.
Research shows that many men would like to have access to more methods of contraception. Both women and men are responsible for practicing safe sex. All individuals, regardless of gender, should have access to quality information on their sexual health and a variety of contraceptive methods available to them in order to make safe, informed choices.
Do contraceptives encourage young people to have sex?
No. There is no evidence that access to contraceptives increases sexual activity among young people. Research shows that providing young people with accurate information about sexual health and teaching them how to use contraception correctly leads to more responsible choices and the practice of safer sex. Similarly, there is no evidence that having access to contraceptives encourages individuals to have sex with more partners.
Access to contraception reduces rates of unintended pregnancy and unsafe abortion, both of which pose significant health risks for women and newborns worldwide. Improved access to contraception also leads to significant declines in adolescent pregnancy rates.
All young people have the right to accurate, quality information about their bodies and their sexual and reproductive health. Comprehensive sexuality education enables young people to protect and advocate for their health, well-being and dignity by providing them with the knowledge and skills required to make informed choices about their bodies and their sexuality.
Do contraceptives save lives?
Pregnancies carry risks, particularly in crisis settings. By preventing unintended pregnancies, contraceptives reduce the incidence of pregnancy-related complications, maternal death, stillbirth, neonatal death and unsafe abortion. If all women in developing regions with an unmet need for contraceptives had access to modern methods, maternal deaths would be reduced by about a quarter.
Contraceptives allow women to space their pregnancies. This is a proven method of improving health outcomes for both mother and child – including lower infant mortality and improved health of the mother and other children in the household.
Contraceptives are also extremely cost-effective: Every US$1 invested in contraception yields multiple dollars in savings through reduced pregnancy‑related medical care and better maternal and child outcomes.
How are contraceptives related to human rights?
Under international human rights law, all States must ensure sexual and reproductive health services, including modern forms of contraception. Access to contraception is a central component of the right to health and is key to the autonomy and agency of all individuals, particularly women and girls.
According to the latest estimates, 259 million women of reproductive age have an unmet need for contraception. Individuals may not have access to contraception for a variety of reasons, including difficulties with access, limited choice of methods, gender-based restrictions, or cultural opposition. When access to contraceptives is restricted or controlled, individuals may be subjected to harmful practices and violations of their human rights, such as forced pregnancy or unsafe abortion.
Contraceptives allow women and girls to exercise their right to decide whether and when to become pregnant. They also ensure that women can have safe sexual experiences without risking unintended pregnancy.
Access to contraceptives is therefore central to achieving gender equality. When women and girls can plan whether and when to have children, women are more likely to complete their education, improve their earning power, and gain autonomy within their households. This improves the security and well-being of women and girls and that of their families.
What contraceptives does UNFPA procure?
UNFPA is the world’s largest procurer of reproductive health commodities for the public sector, playing a unique and essential role in global health. UNFPA procures male condoms, female condoms, injectable contraceptives, oral contraceptives, contraceptive implants, intrauterine devices, emergency contraceptives and personal lubricants. These contraceptives are supplied to individuals around the world.
In 2024, UNFPA procured $141 million in reproductive health commodities. This included 1.36 billion condoms, 98 million doses of injectable contraceptives, 67 million oral contraceptives and 10 million contraceptive implants.
UNFPA increasingly distributes long-acting reversible contraceptives (LARCs), including implants, to meet increasing demand.
Are any of the contraceptives UNFPA procures abortifacient?
No. Contraceptives procured by UNFPA are not abortifacient because contraceptives cannot be used to induce abortion. Even if a contraceptive is used after a pregnancy is established, it still won’t cause an abortion or miscarriage (see Can contraceptives cause abortions?).
UNFPA does not fund or perform abortions. UNFPA does not support the use of abortion as a method of family planning. UNFPA is committed to supporting and providing voluntary family planning services.
UNFPA stands opposed to all forms of reproductive violence, including coercive abortion, forced pregnancy and the discriminatory practice of gender-biased sex selection.
