18 ways to not get pregnant

So you’re sexually active and don’t want to get pregnant? Join the club. While there’s always a chance of getting pregnant when having penis-to-vagina sex, there are countless types of contraception that can help lower your chances. There are also ways to have sex that can’t get you pregnant, including oral and anal sex. From natural methods to emergency contraception, this article covers 18 ways to have sex while preventing pregnancy.

How to have sex and not get pregnant

First things first, if you’re having sex (and don’t want to get pregnant), adopting a solid birth control plan is always the best place to start. From hormonal methods and barrier protection to sterilization and natural birth control options, let’s help you find the birth control method that works best for you and your lifestyle.

Sex that doesn’t lead to pregnancy

Before we get into birth control types, let’s first talk about types of sex. There are many ways to have sex besides penis-to-vagina penetration, and the good news is that none of them can get you pregnant. As a general rule, any type of sex between two females or two males cannot lead to pregnancy.

• Oral sex. You might know it as giving head, a blowjob, eating out, or going down; oral sex is when a person sexually stimulates the genitals of another person by using their mouth, lips, or tongue. This will not lead to pregnancy, regardless of the genders involved, since the mouth is not connected to the reproductive organs.
• Non-penis vaginal insertion. Fingering and inserting a dildo or vibrator into the vagina is a form of penetrative vaginal stimulation that can’t get you pregnant. Just make sure fingers and any toys are clean before inserting.
• Anal. Anal sex, which refers to penis-in-anus intercourse, is another type of sex that is unlikely to lead to pregnancy because the anus is not connected to the reproductive organs. (As we’ve discussed elsewhere, there is a small chance of pregnancy IF semen comes in contact with the vagina.) However, it’s important to know that you can get an STI from anal or oral sex. To lower your chances of contracting an STI, it’s always best to use a condom and ask your partner when they were last tested.
• Mutual masturbation. Mutual masturbation is when people use their hands or toys to stimulate their partner’s genitals. This can involve fingering, handjobs, stroking, clit stimulation, genital massage, or anal stimulation. This kind of sex does not lead to pregnancy since no semen is entering the vagina.

Sex that leads to pregnancy

The only kind of sex that leads to pregnancy is penetrative penis-to-vagina sex. This kind of sex can lead to pregnancy because semen can be ejaculated from the penis into the vagina and travel up to the fallopian tubes. In the fallopian tubes, sperm can fertilize an egg, which can result in a pregnancy. When the penis is erect, in preparation for ejaculation, a liquid known as “pre-ejaculate” or “pre-cum” is produced, which can contain active sperm. This sperm can reach the fallopian tubes and fertilize an egg, making it possible to get pregnant before ejaculation.

It’s also possible to get pregnant from semen during non-penetrative sex (where the penis doesn’t enter the vagina). This is because anytime sperm comes into contact with the vagina, even if it’s a small amount, there is a potential for pregnancy. For example, if your partner ejaculates very close to your vagina or if your partner's erect penis comes into contact with your vagina or vulva, a pregnancy could technically develop.

Hormonal Methods

Hormonal methods such as daily birth control pills, implants, rings, patches, and injections are effective, low cost, and easy-to-use pregnancy prevention options. They use hormones to prevent pregnancy by stopping ovulation (the release of an egg from the ovary) so sperm aren’t able to fertilize an egg.

• Birth control pill. One of the most commonly used methods of contraception in the U.S. is the birth control pill. If taken as prescribed, birth control pills can be over 99% effective. The “combined pill” contains both estrogen and progestin and stops ovulation, aka the release of an egg from the ovary. The estrogen and progestin also cause the mucus in the cervix to become thicker, which helps keep sperm from joining the egg. This type of pill must be taken daily.

The “mini-pill,” or progestin-only pill, is another type of birth control that only contains the hormone progestin (which also thickens cervical mucus and thins the lining of the uterus). The mini-pill must be taken at the same time every day. This type of birth control can make your periods lighter or stop them all together.

• Implant. Hormonal implants are tiny, thin rods that are inserted by a doctor under the skin and placed in your upper arm. It’s also known as Nexplanon® or the slightly older version known as Implanon®. Similarly to hormonal birth control, the implant releases a low and steady dose of the hormone progestin. This also suppresses ovulation and thickens the mucus of your cervix. These implants can last for up to 5 years!
• Vaginal Ring. The birth control ring (including Nuvaring® and Annovera®) is a small, plastic ring that you place into your own vagina. Rings are designed to be inserted for three weeks, then removed for a week to allow for withdrawal bleeding. When inserted, they start to release the hormones estrogen and progestin, which work together to prevent pregnancy. They are 99% percent effective when used correctly. However, if you forget to refill your prescription or don’t put the ring in on time, then the effectiveness can go down to 95%.
• Patch. The birth control patch (including Twirla® and Xulane®) is a hormonal contraceptive that is placed on the skin. The patch releases the hormones estrogen and progestin into your bloodstream to help prevent pregnancy. The patch is convenient because it can be placed on the back, buttocks, stomach, or upper arm. The patch lasts for one week. You put on a new patch every week for three weeks and then take a 1-week break. When used correctly, the patch is 99% effective at preventing pregnancy.
• Injection. The contraceptive shot (known as Depo-Provera®, the depo shot, or DMPA) contains the hormone progestin, which prevents ovulation and thickens cervical mucus. The shot is normally given by a doctor every 12 weeks and is over 99% effective at preventing pregnancy when used correctly. If you get your first shot within the first week after the start of your period, then you’re immediately protected. Otherwise, you need to wait a week or use a back-up method of protection in the meantime.

Barrier Methods

If you’re interested in non-hormonal or more temporary birth control options, barrier methods like female condoms, male condoms, diaphragms, spermicide, sponges, and cervical caps are good options. If used correctly, barrier methods are usually 93%-97% effective. They work by physically blocking any sperm from reaching the egg.

• Condom. Condoms are the most widely used and accessible form of pregnancy protection. They’re usually made from latex or polyurethane and are 98% effective when used correctly. To properly use a condom, place it over an erect penis and be careful not to tear or break the condom. Condoms work by blocking sperm from entering the vagina. They can also help protect you from STIs. Remember to never reuse a condom or use more than one at the same time to prevent tears.
• Female condom. This type of condom is a little soft plastic pouch that you put inside your vagina before sex. It creates a barrier that stops sperm from reaching an egg and helps prevent pregnancy and STIs. They’re available without a prescription and, according to the CDC, are about 95% effective when used correctly.
• Diaphragm and cervical cap. A diaphragm is a shallow cup that’s made of soft silicone. The cup helps prevent pregnancy by covering your cervix and stopping sperm from joining an egg. It’s important to apply spermicide, a chemical that slows down sperm movement, before each use. When used with spermicide, the CDC estimates that diaphragms have a failure rate of 4% with perfect use. For a diaphragm to be most effective, insert the cup a few hours before sex and leave it in place for 6 hours after sex. After 24 hours, it must be removed from the vagina.

Cervical caps (also known as Femcaps®) are similar to diaphragms. They’re both little cups made from soft silicone and cover your cervix. They have the same function and also work best when adding spermicide before inserting into the vagina. The only difference is that cervical caps are smaller than diaphragms, and the shape is a little different. You can also leave the cervical cap in longer than a diaphragm (up to about two days).

Spermicide and Sponge

Spermicide is made from the chemical nonoxynol-9 and is about 70% effective in preventing pregnancy. Nonoxynol-9 slows sperm down, making it harder for it to reach the egg. Spermicide can be used alone or with other birth control methods and comes in many different forms, like gels, film, and foams.

You can also use a sponge which is a barrier method that actually contains spermicide. It’s a small, round sponge made from soft and squishy plastic. It’s 86% effective for women who have never given birth and 73% for those who have. To be most effective, it must be placed deep inside the vagina so it can fully cover the cervix and block the entrance to your uterus so sperm can’t reach the egg. Once you’re done using the sponge, there is a fabric loop that you can use to help remove it (similar to a tampon string).

Intrauterine devices (IUDs)

IIntrauterine devices, aka IUDs, are a form of long-term contraception that are inserted into the uterus to help prevent pregnancy. They’re T-shaped plastic frames that must be placed by a trained healthcare professional and are over 99% effective at preventing pregnancies. They can also be used as emergency contraception when inserted up to 5 days after unprotected sex.

• Hormonal IUDs. Hormonal IUDs, like Mirena® and Kyleena®, have a range of recommended use. Some brands are only effective for 3 years while others may last up to 8 years. They work by releasing the progestin hormone, which thickens the cervical mucus to prevent sperm from entering the uterus and makes the lining of the uterus (the endometrium) less welcoming for fertilization. Some people will also experience ovulation suppression..
• Non-Hormonal IUDs. If you don’t want a hormonal IUD, you can choose the copper-based IUD (known as Paragard®). The copper wire in the IUD is coiled around the device, creating an inflammatory reaction that is toxic to sperm and eggs, which prevents pregnancy. This type of IUD is more than 99% effective at preventing pregnancy and can last for up to 10 years. Some women experience heavier periods with this IUD, but many prefer it because it is hormone-free.

Remember, IUDs do not protect against STIs, so it’s still a good idea to use a condom, especially with a new partner.

Emergency Contraception

If you end up having unprotected sex because your birth control method fails, like if the condom broke, you forgot to take your birth control pill, you didn’t insert your Nuvaring® on time, or for any other reason, emergency contraception can still help protect you from pregnancy.

• Morning-after pill and the Yuzpe method. A morning-after pill like Julie’s can be taken after unprotected sex to prevent pregnancy. These pills contain levonorgestrel, which delays ovulation and is 89% effective when taken within 72 hours of unprotected sex.

Before the morning-after pill came around, it was possible to make your own with multiple combination birth control pills (ones that contain estrogen and progesterone). This method is still used in many parts of the world where the morning-after pill isn’t available. It’s called the yuzpe method, and it works by taking two higher doses of a combined estrogen and progestin oral contraceptive 12 hours apart. Timing is similar to that of the morning-after pill – both doses should be taken within 72 hours after unprotected sex. This method can be 56% to 86% effective but, as you can imagine, comes with many other side effects because you’re also taking a large dose of estrogen.

Sterilization

For people wanting to stop their ability to conceive, sterilization is always an option.

• Tubal Ligation and Vasectomy. Men and women both have the option to be sterilized if they decide that children are absolutely not in their futures. Women can get a tubal ligation (tubes tied) which means the fallopian tubes are permanently blocked, clipped, or removed. This is meant to prevent fertilization of eggs by sperm and is irreversible. Men can have a vasectomy, which is when the small tubes in their scrotum that carry sperm are cut or blocked off, so sperm can’t leave their body and cause a pregnancy.

Natural methods

Last but not least, there are natural methods to prevent pregnancy that do not involve synthetic hormones, such as cycle tracking, the pull-out method, rhythm method, tracking your cervical mucus, and checking your basal body temperature.

• Cycle tracking & rhythm method. Cycle tracking or the rhythm method is a way of monitoring your period to help you know when you’re ovulating, or most fertile, so you can make sure to avoid sex or use protection during those days.You can use a period tracking app to help or you can track your period yourself with a calendar app on your phone or by hand.
• Pull-out method. Also known as “withdrawal,” the pull-out method is when the penis is pulled out of the vagina before ejaculation to keep semen from getting inside the vagina. This method has to be done on time and consistently, but because of the risk of pre-cum, it’s not 100% effective.
• Cervical Mucus. The hormones that control your menstrual cycle produce mucus in your cervix. To help prevent pregnancy, you can check your mucus and keep track of the change in color, texture, and amount. You’re most fertile when there’s a large amount of clear, stretchy, wet, and slippery mucus. Ovulation is likely happening during or one day after your last day of this type of mucus. On the days you’re ovulating, you should avoid having sex.
• Basal body temperature. Take your basal body temperature every morning after getting out of bed with a thermometer labeled “basal temperature” on the packaging. As time passes, you’ll start to notice a pattern. Once a month, your basal body temperature will increase less than a ½ degree Fahrenheit and remain at this peak temperature for two to three days — the day immediately before the temperature increase is most likely when you’re ovulating. This method isn’t necessarily helpful during your current cycle because the fertile window extends to five days before you ovulate, so tracking for a few cycles will help you identify a pattern. Thereafter, you’ll potentially want to avoid having sex during the five days before and one day after ovulation to prevent pregnancy.
• Lactational Amenorrhea method. Lastly, the Lactational Amenorrhea Method (also known as LAM) can temporarily help prevent pregnancy when you breastfeed. For this method to be effective, you must have a baby under six months old who’s fully breastfeeding, must not be currently menstruating (since giving birth), and breastfeeding every two to three hours. The breastfeeding hormones may stop your body from releasing an egg, and you can't get pregnant if you don’t release an egg. LAM is 98% effective against pregnancy for the first six months after giving birth.

Important tip: Natural methods are always an option, but they can be less effective than barrier and hormonal methods due to the larger room for error. Also, natural methods don’t protect from STIs, so it’s important to use extra protection whenever possible, especially with new or multiple partners.

While we love to share useful and helpful information, the above shouldn’t replace the advice of your healthcare professional. For questions about birth control and other women’s health issues, please talk to your doctor.