Effectiveness of contraceptive method

Effectiveness of a contraceptive method may be paramount if pregnancy would pose a serious health risk (eg in those with cardiac failure, recent breast cancer, some mental health conditions or complex psychosocial situations).

The estimated effectiveness and efficacy of contraceptive methods is listed in Estimated effectiveness and efficacy of contraceptive methods. Typical use (effectiveness) and perfect use (efficacy) can vary by population; younger people generally experience higher failure rates (reduced effectiveness), because they have higher background fertility than older people.

Long-acting reversible contraception (LARC) (which includes intrauterine contraceptive devices (IUDs) and the etonogestrel implant) is the most effective reversible method of contraception.

Patient information about the effectiveness of contraceptive methods and benefits of LARCs is available from Family Planning Alliance Australia.

Table 1. Estimated effectiveness and efficacy of contraceptive methods
Contraceptive method	Effectiveness with typical use (%)	Efficacy with perfect use (%)
Extremely effective with minimal patient involvement (‘set and forget’)
etonogestrel implant	99.95	99.95
levonorgestrel-releasing IUDs	99.7 to 99.9	99.7 to 99.9
copper IUD	99.5	99.5
sterilisation (male and female)	99.5	99.5
Very effective with typical use
depot medroxyprogesterone	96	99.8
combined oral contraceptive (COC)	93	99.5
vaginal ring	93	99.5
progestogen-only pill	93	99.5
Least effective with typical use
condoms: external (male)	88	98
diaphragm	82	86
withdrawal	80	96
condoms: internal (female)	79	95
fertility awareness methods	76 to 93	95 to 99.6
Note: IUD = intrauterine contraceptive device