Down There Care

Birth Control Briefs: Non-Hormonal Methods

By Gabi Powell Janaya Britton Jillian LoPiano, MD Lindsey Lavoie, WHNP

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Finding the right birth control method can be *sigh* TOUGH. The hustle and bustle of this method versus that can make you feel overwhelmed and weary about which will work for you.

To help relieve your stress, we’ve curated the need-to-knows in a three-series, birth-control breakdown so you can weigh the considerations of each method:




In this brief, we’ll be tackling that second category: non-hormonal!

Non-hormonal methods are contraceptives that don’t include that extra *umph* of hormones, like progestin and estrogen. So why exactly might a Betty choose non-hormonal over a hormonal option?

Some may opt-out of hormonal methods because of health conditions + sensitivities or have had bad experiences with side effects of a hormonal method in the past. A Betty might also have absolute contraindications where added components (estrogen and/or progestin) are an absolute no-go or relative contraindications that may cause complications with hormonal contraceptives. Other Betties might simply prefer to be medication-free!

Ultimately, BC comes down to your lifestyle and body—and every Betty is unique + different. 💛

Here at Betty’s Co., we believe it’s your prerogative to choose or opt-out of a BC method, but you’ve gotta know your stuff first! Sooo…let’s look at the facts, shall we?



Copper IUD



The copper IUD, sometimes known by its brand name Paragard, is a small, T-shaped device made of plastic and natural copper (don’t worry, it’s safe!) that is placed into your uterus in your doctor’s office.



The T-shaped hero disrupts the sperm before it makes a pit stop at the egg. The IUD doesn’t disrupt your cycle and it can work for up to 12 years – can you believe that?!

You can get an IUD inserted at any time of the month. Typically, the best time is in the middle of your period when your cervix (i.e. your uterus opening) is softer, making it easier for the device to pass through.

Following insertion, you’ll notice strings hanging from the IUD. Now, these strings won’t dangle like a tampon string BUT their purpose is similar: to help with removal down the line. Be sure to check for those strings every so often to make sure your IUD is in place. But, no tug o’ war games with the strings, Betties. Doing so could move your IUD out of place!



Highly effective, babe. We’re talking 99% effective as your routine contraception. In the case of a whoops!, the copper IUD still comes through as an emergency contraceptive – 99% effective if placed within five days of unprotected sex.

Not only does the copper IUD work, but it’s long-acting and reversible, so if you decide to become pregnant, you’ll be able to quickly after it’s removed.



Is it the IUD or the BFF? Because the way these perks are looking 👀…. it’s giving best friend for life.

Let’s run through her resume:

✅ IUDs last long and don’t interrupt gettin’ down and dirty! *wink wink*

✅ It’s safe for those with medical conditions that require them to avoid estrogen and/or progestins!

✅ This option is great for people looking for a low-key method…you’re the only one that’ll know it’s there!

✅Oop! and did I mention that it can last up to 12 years??? That low-maintenance longevity ALONE is a perk!



Diaphragm + Cervical Cap



The diaphragm and cervical cap are two different devices placed into the vagina against the cervix. A diaphragm is a shallow, dome-shaped cup of silicone. The cervical cap is a silicone cup, too, but it looks more like a boat-shaped doll hat. We’re batching these devices together because they share the same modus operandi.



These devices cover your cervix to prevent semen from entering the uterus and subsequently the fallopian tubes. Insert two hours before intercourse and let it cook for at least eight hours post-intercourse.



Since both methods are utilized during sex, how well they work depends on how you use them. For optimal protection and effectiveness, a fitting by your medical provider plus using spermicide is a must.

There is a catch: The effectiveness is lower than implantable devices like an IUD and Nexplanon. Keep that in mind if you are leaning towards getting a diaphragm or cervical cap.



You can put a diaphragm or cervical cap in hours before sex and have sex as many times as you please while it’s in. Speaking of intercourse—it won’t ruin the mood! You and your partner won’t be able to feel it during sex. Unlike the diaphragm, cervical caps don’t require a prescription.



External Condoms



Ahhhh, the OG birth control method of the century! You may call it a rubber, jimmy hat, or the love glove, but we all know it as *drumroll*…the external condom. An external condom starts off looking like a token in its packaging. The condom is stretched out to cover the penis, acting like a protective glove.

The OG condom goes by many names and serves several looks. You can find ‘em in a variety of sizes, a variety of materials – latex, non-latex, animal skin – and some brands can include spermicide. Choose your own adventure!



The external condom covers the penis to keep sperm inside of the condom and away from the vagina. This method helps with preventing pregnancy and reducing the risk of STIs, too!

Now, how the heck do we put this thing on?!



First, check the expiration date! It might not be an edible delight like your finest salami or a slice of provolone cheese, but it can go bad just the same. Keep an eye out for those digits, Betties!When you unwrap the condom, be careful to not rip it. Got a rip? Don’t worry. Just throw it away, grab another wrapped-up condom, and try again!



A good trick to help the condom slide on is to put a drop (or two) of lube inside the condom. This can make it easier to slip on and make it a more comfortable, pleasurable experience for your partner.



When placing it on, leave an extra space at the tip to collect the semen, and then pinch the air out. Unroll it over the penis as far as you can*, smooth out the air bubbles to avoid any breakage, add lube, and then you’re good to go!

*If your partner is uncircumcised, pull back the foreskin before you roll the condom on.*

And remember—one condom per erection! Stock ‘em up and keep a couple on you at all times!

Congrats, you got it on! Now, let’s pull it off.



To take a condom off, it takes two. Your partner has to pull out before they’re no longer erect. One of you has to hold the base of the condom to make sure none of the semen spills out. Once the condom is rolled off of the penis, throw it in the trash (no flushing down the toilet!).



With perfect and consistent use, (meaning a condom is always used and never breaks or falls off) external condoms are 98% effective in preventing pregnancy. But say we’re talking real-world, typical use…condoms still hold up with 85% effectiveness! We love those numbers but should note this method is less effective than implantable devices like an IUD and Nexplanon.



External condoms give you double whammy protection, preventing unwanted pregnancy and STI exposure, including HIV. Also, this is a method that won’t break the bank and is easy to access–no prescription needed!


Internal Condoms


Think of an external condom but make it ✨inverse✨—This condom goes into the vagina and is held in place by a flexible ring inside the vaginal part. It looks like an elephant trunk, but it does what it needs to do!



Internal condoms work just like an external condom, except it’s inside vs being out. It works as a barrier by preventing sperm from entering the vagina. The process of inserting an internal condom is much like putting in a tampon:



First, you gotta get comfy. The condom is pre-lubricated but if you want more *razzle-dazzle*, you can add more lube. For that extra protection, spermicide is an option, too!



Next, squeeze the sides of the closed-end ring together and insert it like a tampon. Then, push the ring as far as you can into your vagina—it’ll go allllll the way to the cervix.



Lastly, pull out your finger and let the outer ring sit outside of your vagina. This helps the condom stay in place and acts as a barrier to help protect you from STIs contracted through skin-to-skin contact.



To remove it, you just squeeeeeeze that outer ring, twist it closed to avoid semen spillage, pull the condom out, and throw it away. DO NOT flush! Use a trash can and make sure it’s out of reach for kiddos and pets!



Betties, that’s on you! You must insert it and use it every time you have intercourse. That said, because condoms require a manual application, the margin for error is greater than other options, like the IUD.



This is a great birth control method for preventing STIs! You don’t need a prescription, so it removes the task of having to pick it up from a pharmacy. The internal condom can also stay in place, even when your partner loses their erection.





Phexxi is a non-hormonal, contraceptive vaginal gel that only needs to be used “in the moment.” A prescription will typically provide you a box of 12, one-time use, pre-filled applicators.



Phexxi reduces sperm motility and creates an incompatible environment for sperm by maintaining an acidic pH level in the vagina. When Phexxi is applied, a layer of gel covers the vaginal and cervical surfaces, which allows it to remain in place and maintain this acidic environment.



Phexxi’s effectiveness relies on when and how often you use it. This method only works if you use it before sex, Betties. It will not prevent pregnancy if used after sex. This method also must be used every. single. time. for penis-in-vagina intercourse, EVEN if it’s within an hour! Phexxi is less effective compared to hormonal options, with a 13.7% risk of pregnancy with typical use.



Phexxi’s perfect for the Betty who wants a hormone-free option and more control.



Take time to review Phexxi’s fine print first. Constant application is critical, so if you’re not looking to punch pause in the heat of a moment or feel you’d get lax with an every-sesh, Phexxi coating, consider an alternative BC method.



Reviewing your options on your own is necessary, yes, but talking to a medical provider to make sure an option is the right one for you is the most important step.

So…take a second, Betties. You’ve got the knowledge and the tools now. You can do this!

Breathe, look over the considerations for each method and see which methods make sense for you. After that? Bombard your GYN with every note and question you’ve got!


If you’re looking for a medical provider to make a BC recommendation that fits your body, preference, and lifestyle, book an appointment with Betty’s Co. We’re ready to listen, provide you-centric care and empower your healthcare decisions.



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