The Nourished Blog

Perfect and Typical-Use for Birth Control Methods

If you want to know how to best prevent pregnancy, it’s important to understand the efficacy rates of various birth control methods.

There are two big categories you can choose from: 

  1. Hormonal Contraceptives
  2. Non-Hormonal Contraceptives 

In this blog post, I’m going to dig-in to these two categories and explain the perfect and typical-use efficacy rates of various contraceptive methods.

While I’m a HUGE fan of the non-hormonal methods (which we will get to soon!) I first want to touch on perfect and typical use with hormonal birth control.

Hormonal Birth Control

There are quite a few hormonal birth control options (including the vaginal ring, arm implant, IUD and shot), but let’s focus on the most common one… the hormonal birth control pill (HBC). 

When taken perfectly, HBC is 98-99% effective. This means that you’re consistently taking your pill at the same time every day. 

Believe it or not, not everyone takes their pill perfectly (I was actually one of those people – eek!). 

Typical-use of the birth control pill actually drops its efficacy to 91%.

Things that reduce the accuracy of HBC:

  • Not taking your pill every day (aka doubling up on pills like I used too!)
  • Skipping days all together
  • Not taking your pills at the same time everyday
  • Certain medications and antibiotics 
  • Certain herbs and remedies

HCB obviously has a very high effectiveness rate, but you also have to balance this with potential side-effects of long-term use that may or may not be worth it for you.

We know that birth control can lead to gut and mineral imbalances, potential mood fluctuations, and a variety of other hormonal symptoms.

You always have to weigh the pros and cons and what works best for YOU and your lifestyle.

The Hormonal and the Copper IUD

Both the hormonal and copper IUD are a  “set-it and forget-it” type of birth control. This makes “typical use” of the method not applicable.

Meaning, both of these IUD options are 99% effective.

While the IUD can create a lot of mental ease due to its high efficacy rate – that doesn’t mean that iis side-effect free.

Both IUDs can trigger heavy bleeding and pelvic pain up to the first year of use. In addition, the synthetic progesterone in the hormonal IUD can trigger a variety of other symptoms (like mood fluctuations and gut dysfunction).

Again, weighing the pros and cons will be very important!

Now, on to my FAVORITE way to prevent pregnancy… Fertility Awareness Method and other natural birth control methods.

Natural Birth Control Methods

There are various forms of natural birth control that can be highly effective for avoiding pregnancy.

Let’s start with my personal favorite… Fertility Awareness Method (aka Natural Family Planning).

Fertility Awareness Method teaches you the 5-6 days that you’re fertile each cycle. 

You learn how to follow a special protocol in order to avoid pregnancy and this method is 99% effective with perfect use.

Fertility Awareness Method works because your body gives you very specific signs every day to determine your fertility status. 

These are called your fertility biomarkers and they include: cervical mucus, luteinizing hormone, and basal body temperature.

Perfect use of the method means you’re charting these biomarkers daily (it only takes a few minutes, promise!) and making an educated decision on unprotected sex.

Perfect use of FAM also means that you are following the rules of your method accurately to open and close your fertile window. 

I teach my clients how to use a peak day and luteinizing hormone count, as well as confirm you’re no longer fertile with basal body temperature.

What if you WANT to have sex when you’re fertile?

When it comes to having sex within your 5-6 day fertile window, FAM is only as effective as your chosen barrier method.

Meaning, when you chose to use a barrier method when you’re fertile, you’re now relying on THAT method of natural birth control. 

So what are some of your natural birth control options during the fertile window?


With perfect use – condoms are 98% effective at preventing pregnancy. But did you know that you can incorrectly use a condom and lower its efficacy rate, too?

Imperfect use of a condom drops its rate down to 83%.

Things that reduce the accuracy of condoms:

  • Accidentally ripping the condom
  • Not pinching the end before putting it on 
  • Using an oil-based lubricant like coconut oil, lotion, and vaseline (use a water-based!).
  • Not putting it on at the right time (pre-ejaculate can contain sperm)

Phexxi Birth Control Gel

Phexxi is an on-demand spermicidal gel that prevents pregnancy by lowering the pH of your vagina when sperm is there. This kills sperm as it prefers an alkaline environment for survival.

With perfect use Phexxi is 93% effective, but you MUST make sure to use it right before having sex, every time you’re in your fertile window.

I recorded a podcast episode with the founder of Phexxi here.

The Diaphragm

The diaphragm is a barrier method that sits inside your vagina and prevents sperm from passing through the cervix. It also works in tandem with a spermicide to prevent pregnancy.

With perfect use, diaphragms are 94% effective. They must be placed in the vagina (covering the cervcal opening) 1 hour before sex and it must continue to be worn 6 hours after sex. 

If you do not follow the rules of using spermicide, or putting your diaphragm in and taking it out at the correct time, this reduces the efficacy rate of diaphragms to 88%.

Caya is a brand you can look into.

Withdrawal Method

The withdrawal method (aka the pull out method) requires your partner to remove his penis and ejaculate outside of the vagina (and away from the vulva). 

With perfect use the withdrawal method is 96% effective.

This includes your partner removing his penis within plenty of time and also assumes he does not have sperm in his pre-ejaculatory fluid.

Typical use of the withdrawal method (aka the pull out method) is about


Here is a great article sharing more about the withdrawal method for your research!

Non-PIV Sex

Non-PIV sex emcompases other forms of intamcy that does not include penis in vagina sex. 

And as you may have guessed it… this is 100% effective! 😉 

Literally because there is no penis in vagina contact!


There are a variety of ways you can prevent pregnancy – both hormonal and natural options.

They are all highly effective with perfect-use.

My personal favorite is of course the Fertility Awareness Method. I also use condoms as my barrier of choice during my fertile window.

The Perk of Fertility Awareness Method is completely hormone-free and side-effect free birth control. 

This method is JUST as effective as hormonal birth control and the IUD with perfect use. And the efficacy rate is increased when you’re working with a certified instructor who can support you and teach you how to chart with accuracy.

If you want to learn more about birth control methods – check out my FREE Fertility Awareness Method class here!

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Hi, I’m Nina! I’m a Certified Fertility Awareness Educator who teaches women how to transition off of birth control and prevent pregnancy hormone-free.

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