How to Pick the Birth Control Method That’s Right for You

Pill, shot or ring? There are many highly effective pregnancy prevention methods to choose from

Illustration of woman thinking about different birth control choices

Babies are cute and cuddly, but not always on the radar. Thank goodness for birth control options — there are plenty of effective ways to avoid getting pregnant. (Hurrah!)

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In fact, every time you flip through a magazine, it seems there is another new birth control on the market. So how can you decide which method is the best for you?

How to choose the right birth control option for you

“My first question is always, ‘What’s most important to you?’” says Ob/Gyn Ashley Brant, DO. “For one woman, the answer is fewer side effects. For another, it’s a less painful period. Those preferences, plus the woman’s medical history, can help guide the decision.”

Dr. Brant discusses the available birth control options, along with their pros and cons.

Birth control pills

One of the most commonly used birth control methods is “the pill.” Birth control pills regulate your hormones to control the menstrual cycle. You take three weeks of active pills. During the fourth week, you take placebo pills, which don’t have hormones. That’s when you get your period.

Pros:

  • Less painful and lighter periods.
  • Reduced acne.
  • Reduced risk of ovarian cancer and endometrial cancer.
  • More than 95% effective at preventing pregnancy.
  • Can omit the placebo pills to skip a period (though discuss with your doctor first).

Cons:

  • Slightly increased risk of blood clots, usually in smokers and women with a history of other medical conditions. (There is a special type of pill called the “mini pill” or progestin-only pill, which is safe for women with medical problems that prohibit the use of regular birth control pills.)
  • Slightly increased risk of cervical cancer (though Dr. Brant says that could have more to do with sexual behavior than the pill itself).
  • Needs to be taken every day.

IUD (intrauterine device)

“The IUD is an excellent birth control option for women who want to take action and not think about it again for a while,” says Dr. Brant. “Your Ob/Gyn inserts a T-shaped device into the uterus during a quick in-office procedure. There are two forms of IUD, a copper version and a plastic version that contains hormones. IUDs work by making it nearly impossible for the sperm to reach the egg.”

Pros:

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  • More than 99% effective.
  • Lasts three to 10 years before needing to be replaced.
  • Hormonal IUDs: Can make periods lighter or even nonexistent (copper IUDs do not have that benefit).
  • Hormonal IUDs: May reduce risk of endometrial cancer.

Cons:

  • Requires a pelvic exam before insertion.
  • Insertion may be uncomfortable or even painful.
  • Risk of perforating the uterus during insertion (though that occurs in one of 1,000 women).
  • Unpredictable spotting for several months after insertion.

Condom

The condom serves as a barrier that prevents sperm from entering the uterus.

Pros:

  • The only birth control method that also protects against sexually transmitted diseases (STDs).
  • Can be used with other birth control methods for STD protection and improved protection against pregnancy.

Cons:

  • Inconvenience.
  • 20% failure rate.

Hormonal implant

It’s a small plastic rod inserted under the skin of the upper arm deliver a constant supply of pregnancy-preventing hormones into the bloodstream for three years.

Pros:

  • Similar to those of hormonal IUD.
  • Highly effective.
  • No pelvic exam required.
  • Inserted during a quick in-office procedure.

Cons:

  • As with the IUD, can cause unpredictable bleeding.
  • Could cause heavier periods, though in some cases periods are lighter.

The shot

Your provider can give you a pregnancy protection shot every three months.

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Pros:

  • Effectiveness similar to the pill.
  • May cause period to decrease or even disappear.

Cons:

  • Causes bone thinning (though it’s reversible once you discontinue the shot).
  • Requires a doctor’s visit for the injection four times a year.

The patch and the ring

The ring and patch deliver the same hormones as the pill. You place the patch on your skin and change it every week. The ring is a piece of flexible plastic that you place in your vagina and replace each month. You get your period when you remove the patch and ring for one week out of the month.

Pros:

  • Can be applied at home — no doctor’s visit necessary after initial prescribing visit.
  • Can omit the week of placebos to skip a period.
  • 95% effective at preventing pregnancy.

Cons:

  • Side effects such as changes in mood, breast tenderness and bloating (though they tend to go away after a couple of months of use).  
  • Need to remember to change the patch or ring.
  • Not good options for people who smoke, who have blood clots or who have or had cancer.

If you’d prefer that an overstuffed diaper bag not be in your immediate future, talk to your primary care doctor or Ob/Gyn to find the birth control method that fits your lifestyle.

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