Non-hormonal Methods of Birth Control

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on March 25, 2025.

Birth control options for women who can't use hormones

Although they are popular, not every woman can use - or wants to use - the pill or other hormonal contraceptive for birth control.

• Some women cannot use hormones at all because of health reasons, breastfeeding, side effects or a host of other reasons.
• Some may only need occasional pregnancy protection and prefer not to use a full-time birth control method.
• Certain women prefer to avoid hormones in general based on family history or personal beliefs.

There are several birth control options that do not contain hormones, that are effective if used correctly, and that are usually affordable, or even free.

What is hormone-free birth control?

There are several hormone-free methods of birth control, but their effectiveness can vary widely.

• barrier methods, such as the condom, sponge, cervical cap, or diaphragm
• spermicide
• non-hormonal vaginal gel (Phexxi)
• the copper IUD (Paragard) and Miudella
• natural family planning (fertility awareness methods or the rhythm method)

Be sure to review the general effectiveness rates of various birth control methods (seen in this example chart). Discuss which option might be best for your personal situation with your doctor.

In general, spermicide should always be used with a condom or diaphragm to increase its effectiveness.

A male condom (latex or plastic, not lambskin) or internal condom is the best way to protect against any form of sexually transmitted disease (STD), including HIV and AIDS. A male latex condom or internal condom should be used in combination with other birth control options (i.e., pill, patch, shot, IUD, sponge) if protection against STDs is needed.

Advantages with non-hormonal birth control methods

• Can be used short-term (except copper IUD) if the need for birth control is only occasional. Some methods are easily accessible without a prescription at retail stores, and can be packed easily for travel.
• For women who cannot, or choose not to use hormones (for medical, breastfeeding, or other reasons) the barrier methods, such as the cervical cap, condom, diaphragm, contraceptive sponge are available. Spermicide (use with a condom) and copper IUD are also all hormone-free methods.
• Many methods are inexpensive, but may NOT be covered by insurance because they are available over-the-counter (OTC). They may be covered under a Health Savings Plan.
• The copper IUD (Paragard, Miudella) are long-term options that must be inserted by a healthcare provider. Contact your doctor or health clinic for further information. It should be covered by your health insurance, but you should check first.

Disadvantages with non-hormonal birth control methods

• Except for the copper IUD, these methods require careful and consistent use to prevent pregnancy. They may be associated higher failure rates when compared to birth control pills or other hormonal birth control options.
• Some methods cannot be used during menstruation.
• Some females may not like placing or leaving devices in the vaginal canal, or may find it uncomfortable.
• Certain methods, such as a diaphragm or condom, may interfere with sexual spontaneity.
• Some products may be more expensive because they require a prescription and a doctor visit.

Side effects with non-hormonal birth control methods

Common side effects

Non-hormonal barrier method birth control has few side effects. 

Some women or men may have irritation, dryness, or allergies associated with devices placed in vaginal canal, such as the condom, cervical cap, diaphragm, contraceptive sponge or spermicides. If side effects occur with use, contact your healthcare provider.

More serious side effects

Serious side effects are rare with the non-hormonal barrier method of birth control, like with the condom, diaphragm, or cervical cap; although allergies can rarely occur, especially if latex is present. Toxic shock syndrome may rarely occur with the contraceptive sponge.

The copper IUD can be linked with serious side effects and may include: pelvic inflammatory disease (PID), uterine perforation, embedment in wall of uterus, life-threatening infection, endometritis (inflammation of the uterine lining), ectopic pregnancy, and IUD expulsion.

Other warnings and side effects may occur with the use of non-hormonal birth control. It is important to review the specific consumer information for your birth control choice. Discuss these serious side effects with your healthcare provider. Tell your healthcare provider about all other medications you take, including prescription, over-the-counter, vitamin and herbal supplements.

Non-Hormonal Birth Control Options

Cervical Cap

Brand: FemCap (2nd generation)

• Barrier method; flexible cap placed over cervix. Use every time. In order for a cervical cap to work best, it must be used with spermicide (a cream or gel that kills sperm). Can be inserted 15 minutes to 40 hours prior to intercourse. May last 1 to 2 years.
• Must be prescribed by a health care provider. Comes in 3 sizes based on your pregnancy history. A valid prescription must be sent to the pharmacy before it can be shipped.
• Used with spermicide; cap must stay in place 6 hours after intercourse, but do not leave in vagina for more than 48 hours (2 days).
• Do not use during menstrual period due to higher risk for toxic shock syndrome (rare but serious). Use another form of contraception (like condoms) during your menstrual cycle.
• May cause vaginal irritation or allergies if allergic to silicone.
• Cost $0 to $275 per cap (this includes the cost of the exam); insurance will probably cover your cost in the US. Spermicide is about $5 to $15 per package.
• In general, effectiveness ranges from 71% (for people who have given birth) to 86% effective (for people who have not given birth) per Planned Parenthood. The second generation FemCap has been proven to be over 92.4% successful with normal use in preventing pregnancy when used with the recommended spermicidal gel.
• Does NOT protect against STDs.

Condom (male)

Various options available without a prescription at retail stores and pharmacies. It’s best to use latex or plastic condoms, not lambskin, to help prevent both STDs and pregnancy.

• Barrier method; placed over penis and prevents sperm from entering the uterus. Use new condom every time.
• May be made of latex; allergies or irritation are possible. Latex or plastic (latex-free) condoms protect against pregnancy and STDs; lambskin condoms protect against pregnancy but NOT STDS like HIV.
• Protects against STDs (like HIV/AIDs) if used correctly.
• Do not use with a female (internal) condom due to a chance of tearing the condom. Can use a condom with a sponge, cervical cap, or spermicide for better protection.
• Inexpensive, easily accessible at retail stores. Not covered by insurance; costs vary range from $5 to $20.
• 87% effective; to increase effectiveness rate use a condom with spermicide.
• If the condom breaks, leaks, or slips consider emergency contraception use (Plan B, etc). Contact your pharmacist right away.

Internal (female) Condoms (can be used by any gender)

FC2 Internal Condom (prescription only). Internal condoms can provide portable protection for all genders.

• Barrier method; thin lining that goes into vagina to protect uterus from sperm; can place up to 8 hours prior to sex. Also used for HIV protection with anal sex. Use a new one every time.
• Can protect against STDs if used correctly; made of polyurethane and nitrile (soft plastic) non-latex cover. People of any gender can use them for vaginal or anal sex.
• 79% effective; Do not use with a male condom due to a chance of tearing the condom.
• Can get online or through a family planning or health clinic. Pharmacist can order with prescription. Cost may be as little as $0. 
• May cause irritation, burning, rash.

Diaphragm

 Example brand: KoroFlex, Ortho-Diaphragm

• Barrier method; silicone cup placed over cervix prior to sex; reusable but use every time.
• Used with spermicide; must remain in place 6 hours after intercourse; use additional spermicide if have intercourse again or more than 6 hours after diaphragm originally inserted.
• May cause vaginal irritation.
• Must be fitted and prescribed by a health care provider.
• Do not leave the diaphragm in place for more than 24 hours.
• Costs $0 to $75, plus cost of exam; can last up to 2 years.
• 83% effective.
• Does NOT protect against STDs.

Contraceptive Sponge

Example brand: Today Sponge, no prescription needed (may currently be out of production in the U.S)

• Barrier / spermicide method; do not use if sulfite allergy. A foam-like vaginal insert embedded with spermicide (nonoxynol-9); wet with small amount of water prior to use.
• The sponge can be inserted up to 24 hours before sex, but sponge must remain in place for at least 6 hours after last intercourse; but do not leave in place longer than 30 hours total.
• $15 to $20 for package of 3 sponges. Was previously available in pharmacies, no fitting required, but may no longer be found on shelves.
• May cause irritation due to nonoxynol-9. Use correctly and follow package directions.
• Do not use during menstrual period due to higher risk for toxic shock syndrome (rare but serious).
• 78% to 86% effective; failure rate higher in women who have already had children.
• Does NOT protect against STDs.

Spermicide

Brand examples: Encare Vaginal Inserts, Gynol II, Conceptrol, Delfen Foam. Available without a prescription at retail stores and pharmacies.

• Spermicidal creams, jellies, foams, films, vaginal suppositories; usually contains nonoxynol-9, a chemical that kills sperm to prevent fertilization.
• Spermicides are typically inserted into the vagina shortly before intercourse; may cause irritation and may not last more than one hours; read package directions.
• Cost is roughly $5 to $20 for a multi-pack.
• 79% effective when used alone; 
• To increase effectiveness should use with a condom or diaphragm. Using spermicide plus a condom gives you extra protection from pregnancy and protects against STDs.
• Not covered by insurance (over-the-counter product).
• Does NOT protect against STDs.

Non-hormonal vaginal gel

Brand name: Phexxi (lactic acid, citric acid and potassium bitartrate). Requires a prescription from your doctor.

• Phexxi is a prescription product used for the prevention of pregnancy and as an on-demand method of birth control.
• Gel is inserted in vagina before sex to help stop sperm getting to an egg. Phexxi prevents pregnancy by lowering the pH in your vagina and slowing sperm movement.
• Phexxi is NOT effective for the prevention of pregnancy when administered after sex.
• Comes in a pre-filled, single-dose applicator. Insert into the vagina immediately before (or up to one hour before) each episode of vaginal intercourse. Once inserted, effective only for one hour. Follow the directions for use on the package.
• About 86% effective. To increase effectiveness can be used with a condom or diaphragm. Avoid using Phexxi with contraceptive vaginal rings (like the NuvaRing).
• May be covered by insurance or the manufacturer may be able to offer financial assistance.
• Does NOT protect against STDs.

Copper Intrauterine Device (copper IUD)

ParaGard IUD; must be prescribed and inserted by a health care provider.

• Non-hormonal IUD; inserted by healthcare provider within 7 days of menses onset; replace after 10 years.
• Do not get if you have a copper allergy, Wilson's Disease, or a bleeding disorder.
• Common side effects include longer and heavier periods or spotting; these may subside after 2 to 3 months.
• Serious side effects may include pelvic inflammatory disease (PID), uterine perforation, IUD expulsion, ectopic pregnancy.
• If a period is missed, promptly be evaluated for pregnancy; do not use in pregnancy, PID, postpregnancy or postabortion uterine infection in the past 3 months; cancer of the uterus or cervix; infection in the cervix.
• 99% effective; a highly effective form of long-lasting birth control. After the IUD is taken out, it is possible to get pregnant.
• Can be expensive (free to $1,800) but insurance may pay. Requires doctor visit and insertion. Effective for up to 10 years.
• Does NOT protect against STDs.

Miudella IUD: must be prescribed and inserted by a healthcare provider.

• A low-dose, copper-containing intrauterine device (IUD) indicated for up to 3 years use for prevention of pregnancy in females of reproductive potential.
• Miudella is inserted into the fundus of the uterine cavity, and must be removed or replaced after 3 years.
• 99% effective in studies over a cumulative 3-year study period.
• Miudella is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the Miudella REMS program to ensure healthcare providers are trained on the proper insertion of Miudella prior to first use.
• Warnings and precautions associated with Miudella include risk of ectopic pregnancy; increased risk of spontaneous abortion, septic abortion, premature delivery, sepsis, septic shock, and death if pregnancy occurs; pelvic inflammatory disease; perforation resulting in embedment or translocation; partial or complete expulsion; and altered bleeding patterns.
• Common adverse reactions (incidence ≥ 5%) include heavy menstrual bleeding, dysmenorrhea, intermenstrual bleeding, pelvic discomfort, procedural pain, pelvic pain, post procedural hemorrhage, dyspareunia (painful sex).
• Does NOT protect against STDs.

Natural Family Planning

Also called fertility awareness methods (FAMs), the calendar or rhythm method.

• Must avoid sex when fertile and ovulating. 
• May monitor bodily changes such as cervical mucous changes, body temperature and/or chart your menstrual cycle on a calendar to determine most fertile time.
• Involves no hormones or devices.
• Inexpensive.
• 77% to 98% effective with typical use. If you use multiple FAMs together, they may work better.
• Does NOT protect against STDs.

Learn More: Permanent Birth Control Methods

This is not all of the information you may need to know about non-hormonal methods of contraception and does not replace the information given to you by your healthcare provider. Discuss this information and any questions you have with your doctor or other healthcare provider.

See also

• Birth Control Pills (Oral Contraceptives)
• Birth Control Pills and Your Period
• Birth Control Pills: Benefits, Risks & Side Effects
• Birth Control Pills: Why do I get breakthrough bleeding?
• Emergency Contraception: What You Need to Know
• Emergency Contraceptives: Morning After Pills & OTC Options
• Grapefruit and Birth Control Pills: Your Questions Answered
• Missed your birth control pill? Here's what to do
• What are the options for permanent birth control?

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer