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The vaginal ring, more commonly known by its brand name NuvaRing®, is a small plastic ring you insert into your vagina. It releases small amounts of progestin and estrogen that are absorbed into the bloodstream through the vaginal wall.

Effectiveness: 99+% (perfect use); 91% (typical use)

Proper usage: Pinch the ring closed and insert it into your vagina until it feels comfortable (the exact positioning doesn’t matter) and leave it in for three weeks. Take it out for a ring-free fourth week, then insert a new ring on the the next week on the same day and time you inserted the ring before. (For example, if you originally started the ring on Sunday at 10am, start the new ring on Sunday at 10am four weeks later.)

If the ring slips out during intercourse or for any reason, or if you take it out for intercourse (usually not necessary), you will remain protected from pregnancy for the rest of that particular cycle on the ring, if you put it back in within three hours.

Just like with the birth control pills, you can suppress your periods by taking the ring out after the third week and immediately replacing it with a new ring.

Birth Control Patch

The patch is a small adhesive patch you can stick on your buttocks, lower back or anywhere on the upper body except for the breasts. It delivers a slightly higher dose of estrogen than both the pill and vaginal ring.

Effectiveness: 99+% (perfect use); 91% (typical use), but it seems to be less effective in women who weigh more than 198 pounds.

Proper usage: Use a new patch weekly for three weeks, then go patch-free for the fourth week. Stick on a new patch on the same day of each week, i.e. if you start using the patch on a Friday, every patch change should happen on a Friday. (Don’t forget to remove the previously used patch!) According to Scarleteen, you should place every new patch on a slightly different spot than where the old one was.

Some important notes on when you first start using the pill, the patch or vaginal ring

If you start using it within 5 days of the first day of your period, protection from pregnancy will begin immediately. If you start it later than 5 days after the start of your period, it will take 7 days for the protection to take effect. If you have vaginal intercourse during this first week, use another method of birth control, like condoms.

Progestin-only Hormonal Methods:

If you want a hormonal method but you currently smoke; have a history of blood clots, stroke or migraines; are currently breastfeeding; or have experienced negative side effects from birth control methods that contain estrogen, ask your healthcare provider if progestin-only hormonal methods may work for you.

Progestin-Only Pill

Also called the mini-pill, this method is a kind of birth control pill that only contains the hormone progestin. It comes in packs of 28 pills, all of which contain the hormone (unlike the regular birth control pill which has the “reminder” week of pills).

Effectiveness: 99+% (perfect use); 90% (typical use)

Proper Usage: Take one pill every day. Make sure to take it at the same time each day for greatest efficacy. You could become pregnant if you take the mini-pill 3 hours or more after your usual time and then have unprotected vaginal sex within 48 hours or if you forget to take the pill altogether that day and then have unprotected vaginal sex.

The mini-pill starts protecting against pregnancy 48 hours after you first start using it. Use a backup method of birth control, like condoms or spermicide, if you have sex within 48 hours after starting the mini-pill.

According to Planned Parenthood, if you take progestin-only pills you could get your period during the fourth week, not get your period at all, or have spotting/bleeding on and off during the month. Any of these effects are normal.

Birth Control Shot

Commonly known by its brand name, Depo-Provera®, this is a birth control method delivered by a shot into the arm or buttocks.

Effectiveness: 99+% (perfect use); 94% (typical use)

Proper Usage: Get the shot every 3 months.

Bone loss is a side-effect some women may experience while on the shot, so it is not usually recommended for young women (18 or younger) whose bones have not stopped growing, according to Scarleteen. Studies have found however that lost bone mass was generally regained after Depo-Provera wore off. Still, it is also not usually recommended for long-term use for any woman because of these bone loss concerns.

Protection starts 24 hours after the shot is administered.

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