If You Don’t Want To Use Hormonal Birth Control Or Condoms, Here Are Your Options
by Emma McGowan
Originally Published: 
Two intrauterine devices as birth control solutions
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In this week's Sex IDK column, Emma McGowan, certified sex educator and writer, answers your questions about finding and using non-hormonal birth control methods that aren't condoms.

Q: What are the best non-hormonal birth control methods that are not condoms for people who can't take hormonal birth control due to health history?

When it comes to birth control, it seems like an increasing number of people are switching — or looking to switch — to a non-hormonal method. I took the plunge myself six years ago, when I decided to stop taking the Pill and see what happened. (Spoiler alert: Still have never been pregnant.) So I’m so happy to share some methods!

Before we jump into those non-hormonal BC methods, I want to take a minute and say I have no shade for hormonal birth control. The Pill was a great option for me for the first decade that I was having penis-in-vagina sex, but I chose to stop taking it mostly out of curiosity about how my body and sex life might change without it. Other people choose to take the Pill not even for contraceptive reasons, but to help regulate difficult periods or illnesses like endometriosis and polycystic ovary syndrome (PCOS).

Also, every person’s body is different and will have different reactions to different contraceptive options. While one person might have super heavy cramping with a copper IUD, for example, another might not notice anything at all after the first couple months. More options means more people taking control of their own destiny — and I’m all about that.

It should be noted that condoms are the only birth control method that protect you from getting sexually transmitted infections (STIs), though they can't protect against all STIs. So if you're not monogamous, keeping condoms around in addition to these other forms of birth control can prevent both pregnancy and STIs.

On that note, here are three awesome non-hormonal (and low hormone — more on that later) options for birth control.


Copper IUD

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The copper IUD — which is sold under the brand name Paragard — is one of the most effective forms of birth control out there and it doesn’t contain even one hormone. The IUD is a t-shaped, one-inch long object that’s inserted into the uterus through the cervix. Once it’s in there, the Paragard is effective for up to 12 years.

While hormonal birth control methods prevent pregnancy by blocking ovulation, the copper IUD doesn’t do anything to ovulation, but the copper is toxic to sperm and eggs — meaning, sperm won't swim towards your eggs, thereby preventing pregnancy. But don’t freak out when you read “toxic!” It’s totally safe for you, as long as you don’t have a rare condition called Wilson’s Disease.

So those are the pros — it’s a set-it-and-forget birth control method that lasts for a decade and doesn’t have any hormones. The cons, however, aren’t insignificant. A lot of people who use copper IUDs report heavier bleeding and cramping during their periods. That can make the Paragard untenable for some people, while others think that the pros outweigh the cons.


Hormonal IUD

Now, I know you asked for non-hormonal birth control methods and the heading of this section very clearly says “hormonal IUD,” but bear with me for a second, and I’ll explain.

While most hormonal birth control methods — including the Pill, the patch, and the implant — put hormones throughout your entire body, the hormonal IUD has a very small dose of hormones, and they’re localized only in your reproductive organs. In fact, when researchers tested blood in other parts of the bodies of hormonal IUD users, the levels of hormone were so low that they were basically undetectable. As a result, a hormonal IUD can still be option, even for people who have had bad reactions or who have medical conditions that prevent them from taking other forms of hormonal birth control.

The hormonal IUD is sold under four brand names: Mirena, Skyla, Liletta, and Kyleena. They last for three to five years, depending on the brand, and are one of the best long-acting reversible contraceptive (LARC) options that we currently have.



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And now we get to the non-condom barrier method — the diaphragm! The diaphragm is an old school birth control method that I, personally, have used for years. It’s a shallow silicone cup that you slather with spermicide before inserting it into the vagina, where it sits behind the pubic bone. After you have PIV sex, you have to leave it in for six hours to make sure the spermicide does it job. Then you take it out, wash it, and you’re good to go.

You need a prescription to get a traditional diaphragm, because the doctor has to fit you for it, but there’s also a new one-size-fits-most diaphragm called Caya that doesn’t require a fitting.

But while IUDs are great because you don’t have to think about them — like at all — diaphragms take considerably more work, and have a much higher margin of user error. They’re 94% effective with perfect use and 88% effective with typical use, according to the birth control experts over at Bedsider.

So while it’s not the most effective birth control methods, it is one of the least intrusive, and you only have to deal with it when you’re about to have PIV intercourse, having PIV intercourse, and recently had intercourse. For people who don’t want to user a hormonal birth control method and don’t want to go through the pain of an IUD or just don’t need a method that’s that long-acting, a diaphragm can be a great choice.

I think it’s great that we now have so many options — including hormonal birth control — to help us control when and if we get pregnant. It’s especially cool because, when I was a teenager, it often felt like the only option was the Pill. So hats off to more contraceptive choices! Hats off to having the power to decide if and when we want to have babies! In other words: Thanks, birth control.

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