The most common side effects of birth control methods are minor and temporary. But it’s important to be aware of the more serious risks, too, before you choose a contraceptive method.

While birth control is generally safe and effective, each method comes with its own set of risks and side effects. Some methods — especially hormonal or long-acting ones — carry more potential risks than others.

It’s also important to take the effectiveness of each birth control type into account. After all, pregnancy comes with its own risks, especially if it’s unintended.

Let’s break down the risks of each birth control method by category.

Lifestyle-based methods rely heavily on personal consistency and self-awareness. They’re lower risk, but they have higher failure rates compared to hormonal or device-based methods.

Abstinence and outercourse

Abstinence is when you avoid sex altogether, while outercourse is when you stick to non-penetrative sexual activity.

Outercourse is not risk-free. It’s important to remember that sexually transmitted infections (STIs) can be spread through non-penetrative sexual activity.

If followed perfectly, abstinence and outercourse are 100% effective at preventing pregnancy. These methods require strict adherence to be truly effective.

Fertility awareness

Also known as natural family planning, this method involves tracking ovulation and avoiding intercourse during fertile days.

There are many fertility awareness techniques, including basal body temperature, calendar (rhythm), and symptothermal methods.

There are no direct health risks of fertility awareness methods. But there are some drawbacks:

  • It requires diligent tracking.
  • It’s less reliable if your menstrual cycle is irregular.
  • It requires the cooperation of all partners.
  • It’s not particularly effective.

With typical use, natural family planning has a failure rate of 24%, which is higher than most other methods.

Barrier methods offer physical protection, usually with minimal side effects. Still, they’re not entirely risk-free.

Internal and external condoms

External condoms (placed over the penis) and internal condoms (placed inside a vagina) are popular birth control methods. They can also reduce your risk of STIs.

The risks include:

Both internal and external condoms may break or slip during sex, which can make them less effective at preventing pregnancy.

Diaphragm and cervical cap

The diaphragm and cervical cap are both flexible barriers. They’re placed inside the vagina before sex to block sperm.

The risks include:

The diaphragm is 83% effective with typical use. The cervical cap is 86% effective if you’ve never given birth, and 71% effective if you have.

Sponge

The sponge is a foam device inserted into the vagina that releases spermicide.

The risks include:

  • skin irritation from spermicide
  • UTIs
  • yeast infections
  • TSS if left in too long

The sponge is not safe to use during menstruation, and it may be less effective if you’ve given birth vaginally.

Spermicide

Spermicide is often used with other barrier methods. It’s a chemical that kills sperm. When used alone, it’s about 72% effective.

The risks include:

  • high rates of irritation
  • allergic reactions

See our list of the best types of spermicide.

These methods alter your hormone levels to prevent pregnancy. The side effects depend on the specific hormones used and your personal health history.

Generally, the risks of hormonal birth control include headaches, mood changes, and (more rarely) blood clots.

Shot (Depo-Provera)

The shot is administered every three months to prevent ovulation.

The risks include:

The shot is about 94% effective.

Once you stop getting the injection, it may take up to 18 months before you can conceive. For that reason, it’s usually suggested for people who don’t plan on becoming pregnant in the next two years.

Vaginal ring and skin patch

The ring is inserted into the vagina for three weeks, while the patch sticks to the skin and is replaced weekly. Both release hormones that prevent ovulation.

The risks include:

  • breast tenderness
  • increased risk of blood clots
  • nausea
  • spotting
  • irritation at the application site (for the patch)

The patch has a higher estrogen dose than other methods, which may slightly increase clotting risk.

Both contraceptive forms are about 91% effective with typical use.

Combination and mini pill

The pill is taken daily to prevent ovulation. Combination pills contain estrogen and progestin, while mini pills contain only progestin.

With typical use, they’re about 91% effective. But if you use it perfectly — that is, every day at around the same time — it’s more effective.

Common side effects include:

  • mood changes
  • nausea
  • weight gain
  • spotting

Rare but serious risks include:

  • blood clots
  • stroke
  • heart attacks (especially in smokers over 35)

Not all pills are the same. If one brand isn’t working for you, you may want to consider switching.

You might have been told that birth control pills may cause cancer. There is some evidence that the pill increases the risk of breast and cervical cancers and decreases the risk of endometrial, ovarian, and colorectal cancers.

However, the National Cancer Institute says that there isn’t a clear connection between birth control pills and cancer, and more research is needed.

Highly effective with minimal effort once in place, these methods can last for years. Side effects vary by type.

Hormonal implant

The implant is a matchstick-sized rod inserted under the skin. It releases hormones and is over 99% effective.

The risks include:

While rare, there’s a risk of nerve or blood vessel damage during insertion and removal.

Copper and hormonal intrauterine device (IUD)

IUDs are inserted into the uterus. Copper IUDs use no hormones, while hormonal IUDs release progestin. Both types are about 99% effective.

The risks of hormonal IUDs include:

  • irregular bleeding
  • cramping
  • slight increase in breast cancer risk

The risks of the copper IUD include:

  • increased menstrual cramps
  • increased menstrual bleeding

IUD insertion is typically painful. There’s also a risk of infection and uterine perforation, although the latter is rare.

Sterilization is intended to be permanent. These methods require a medical procedure and are considered safe, but not without risk.

Both tubal ligation and vasectomy are about 99% effective.

Vasectomy

A vasectomy is typically performed in a doctor’s office with a local anesthetic. Common side effects include minor bleeding and swelling after surgery.

Rare risks include:

  • chronic pain
  • sperm granulomas (inflammation at the site of the procedure)
  • delayed vasectomy failure (the vas deferens grows back together, causing viable sperm to appear in semen)

Contrary to popular belief, vasectomies don’t affect erectile function.

Tubal ligation

Tubal ligation is typically performed under general anesthesia. As with all surgeries involving a general anesthetic, there’s a chance of anesthetic-related side effects.

Common side effects include bleeding at the incision site and pain after the procedure. In rare cases of failure, ectopic pregnancy may occur.

There’s no perfect birth control method — only what works best for your needs, lifestyle, and health.

Some methods are nearly risk-free but require strict usage (like fertility awareness), while others are low-maintenance but come with more side effects (like hormonal methods).

The best way to choose a method is to discuss your options with a healthcare professional who can help you weigh the risks and benefits based on your health history and personal preferences.