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Condoms vs. Birth Control: Which One is Most Effective, When?

Condoms vs. Birth Control: Which One is Most Effective, When?

  • Rebekah Louise
    Reviewed By: Julie Lamonoff, CNM, OBGYN-NP, Shannon DeVita DNP, FNP-BC, CPNP-PC
    Updated:

Have you been wondering whether hormonal birth control or condoms are more reliable? There are various considerations to weigh up when choosing birth control.

Already leaning towards hormonal birth control? See if the pill is right for you with an online health consultation.

Questions such as contraceptive effectiveness, if you want to protect yourself against pregnancy or an STI (or both), price, and availability all play a role.

So let's take a closer look at how effective condoms are and how other birth control options stack up.

Are birth control pills more effective than condoms?

To put it simply, birth control pills are more effective in preventing pregnancy than condoms. Surprised? Let's take a look at the figures.

Typical vs. perfect use of condoms and birth control

Typical use means you use condoms or the contraceptive pill correctly most of the time, with the occasional error, such as the condom breaking or forgetting to take birth control pills. Perfect use means you follow birth control or condom instructions correctly each time you use them.

With typical or average use, here's how effective birth control pills vs. condoms are in preventing pregnancy:

  • Birth control pills are 91% effective

  • Male condoms are 87% effective

With perfect use of birth control pills and condoms:

  • Birth control pills are 99.7% effective

  • Male condoms are 98% effective

STI protection

While birth control pills are effective at preventing an unplanned pregnancy, condoms are the only method that can protect against sexually transmitted infections (STIs).

If you wish to protect yourself against pregnancy and STI's, the best option is to use hormonal birth control and a condom when you have sex.

When condoms work (and fail)

So what are condoms? For starters, there are two types: one for males and one for females. Let's talk about each of them and how effective they are in preventing pregnancy and STIs.

The male condom

The male condom is a thin barrier that sits over the penis when it's erect. Condoms protect against pregnancy and STI's, such as chlamydia, gonorrhoea, and human immunodeficiency virus (HIV).

Condoms work by collecting semen after ejaculation, to stop it from entering the inside of the vagina.

Male condoms can be made from three different materials:

  • Latex

  • Polyurethane

  • Animal skin (this material doesn't protect against STIs)

Some male condoms have a substance called spermicide at the end of them. Spermicide kills sperm and condoms with spermicide are slightly more effective at preventing pregnancy than condoms without it.

Used correctly and consistently every single time (perfect use), the risk of pregnancy is around 2% every time you have sex with a condom.

Condoms aren't always put on properly or they can split, so they aren't the best contraception to prevent pregnancy. They are, however, the best option for lowering your chances of an STI.

Condoms can tear if they're used with a petroleum-based lubricant, such as Vaseline. So make sure your lubricant is condom-friendly before you have sex.

Condoms are easy to get your hands on. You'll be able to find them in most drug stores, in vending machines (often in restrooms), certain health care clinics, or mailed to you. The great news is they're not expensive and you can sometimes get them for free.

The internal (female) condom

The internal (female condom) is often made out of polyurethane and, like the (external) male condom, is a thin but strong plastic.

The internal condom can be placed into the vagina up to 2 hours before having sex. There's two rings: one sits inside the vagina just below the cervix and the other sits outside the vagina and covers the vulva.

Internal condoms are 75% to 82% effective with typical use. With perfect use, they're 95% effective.

The internal condom isn't as effective as the external condom and can fail, for example, if it tears, is placed incorrectly, or semen is spilled when it's removed.

Here's what you need to know about both

Condoms are good to use for 3 to 5 years. After this, they become less effective and are more likely to break or tear.

If the condom is stiff, sticky, or dry, don't use it. It's a sign it's out of date, so toss it and use another one.

Both male and female condoms can be an option for women who can't take hormonal birth control. For example, some women are advised not to take birth control pills due to side effects or health conditions, such as blood clots, high blood pressure, liver problems, or diabetes.

You can use condoms with or without spermicide while breastfeeding. However, condoms may irritate the inside of the vagina if you're breastfeeding due to an increase in hormones. If you're experiencing vaginal dryness, use a lubricant (should be non petroleum-based lubricant if you're using the male condom).

You may be thinking that doubling up and using a male and a female condom will offer you extra protection, but it's not recommended to use both at the same time. Using both at the same time can cause them to rip or bunch up. Jewelry or long nails can also cause condoms to rip, so it may be a good idea to remove any rings on your hands before applying them.

Does birth control replace condoms?

Birth control pills are oral contraceptives that are taken every day at the same time to prevent pregnancy. There are two types of birth control pills: combined pills that contain the hormones estrogen and progestin, and the mini-pill which contains progestin only.

The hormones in the birth control pills stop pregnancy by:

  • Preventing ovulation: Blocking the egg from being released from the ovary;

  • Thickening the cervical mucus to make it harder for sperm to swim into the uterus; and

  • Thinning the uterine lining so if an egg was fertilized, it would be less likely to attach to the uterus

Other types of hormonal contraceptives include:

  • Implant: contains progestin

  • Injection, such as Depo-Provera: contains progestin

  • Contraceptive patch: contains estrogen and progestin

  • Vaginal ring, such as NuvaRing: contains estrogen and progestin

  • Intrauterine Device (IUD): contains progestin

You'll need to get a prescription before you're able to take birth control pills. With your prescription you can collect your pills from a drug store, telemedicine provider, and health clinics such as Planned Parenthood.

Birth control pills are an effective way of lowering your chances of getting pregnant if you have sex. But they do not protect against STI's. Condoms are the main form of birth control to prevent STI's being passed on to a sexual partner.

Effectiveness of reversible birth control methods vs. condoms

Let's take a look at the different kinds of hormonal birth control and their typical effective rate in protecting against pregnancy.

  • Combined pill: 91% effective

  • Progestin pill (mini-pill): 91% effective

  • Injection: 94% effective

  • Contraceptive patch: 91% effective

  • Vaginal ring (NuvaRing): 91% effective

  • Intrauterine Device (Mirena): 99.8% effective

  • Contraceptive implant (Implanon): 99.95%

Although the copper intrauterine device (IUD) isn't hormonal, it's 99.2% effective at preventing pregnancy.

The below methods are known as barrier methods. Let's take a look at how effective they are at preventing pregnancy:

  • Diaphragm: 88% effective

  • Cervical cap: 71-86% effective

  • Fertility awareness-based: 76% effective

  • Birth control sponge: 76-88% effective

  • Spermicide (Foams, gels, creams): 72% effective

So we can see that hormonal birth control methods are more effective at preventing pregnancy than the typical use of male condoms (87% effective) and female condoms (79%).

However, if male condoms are used perfectly every time you have sex, then they are 98% effective at stopping a pregnancy from occurring, placing the condom slightly higher than the contraceptive pill and barrier methods.

Effectiveness of hormonal IUD vs. condoms

The intrauterine device (Mirena) is 99.8% effective at preventing pregnancy. Stacking this up against the typical use of male condoms (87% effective) and the typical use of female condoms (79%), we can see that the IUD is significantly more effective at preventing pregnancy.

However, the IUD cannot protect against any STI's. If you're using an IUD, it's important to also use condoms if you're looking for highly effective birth control and protection from STI's.

Effectiveness of permanent methods of birth control

We've looked at the reversible methods of birth control. But do the permanent methods stack up at preventing pregnancy?

Sterilization surgery for males, also known as a vasectomy, is a procedure where the tubes that carry sperm are cut or sealed. In females, a tubal ligation is a surgery where the fallopian tubes are cut or blocked.

For both female and male sterilization, the chances of getting pregnant after sterilization is less than 1%.

Effectiveness of emergency contraception

Emergency contraception is a form of birth control that can be taken after you've already had unprotected sex. It works best when taken within 3 days of when sex occured, but can be used up to 5 days.

You might have heard it called Plan B and you can get it without a prescription. This medication along with other pills containing levonorgestrel can lower your chances of becoming pregnant by 75%-89%.

Condoms vs. birth control: Which is best for you?

So back to the big question. Are condoms or birth control more effective? If you want to prevent pregnancy, hormonal birth control or a copper IUD (hormone-free) could be your best option.

If you want to reduce your chances of getting an STI, then you may want to use a male or female condom each time you have sex. But if you wish to protect yourself from both an unintended pregnancy and an STI, then using both will offer you the best protection.

Sources:

Trussel, J. Contraception. Contraceptive failure in the United States. Published March 12, 2011.

National Library of Medicine. MedlinePlus.gov. Male Condom. Reviewed June 9th, 2021.

Planned Parenthood. How do I get condoms? Accessed June 24, 2021.

National Library of Medicine. MedlinePlus.gov. Female Condom. Reviewed May 25, 2021.

Cleveland Clinic. Birth Control Pill: The Pill. Reviewed July 21, 2020.

Boutin K, Henninger M. et el. Society of Behavioural Medicine. Women's Health: Facts about birth control, STIs and condoms. Accessed June 11, 2021

Centers for Disease Control. Appendix D: Contraceptive Effectiveness. Published April 25, 2014.

Planned Parenthood. How effective are cervical caps? Accessed June 24, 2021.

U.S. Food & Drug Administration. Accessdata.fda.gov. Birth Control Guide. Published 2011.

Planned Parenthood. What's the Plan B morning-after pill? Accessed June 12, 2021.

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