How to know which birth control pill is right for you

Babies are cute and cuddly, but that doesn’t necessarily mean you want one, at least not right now. Thank goodness for birth control options — there are plenty of effective ways to avoid getting pregnant. In fact, every time you flip through a magazine, it seems there’s another new birth control on the market. So, how can you decide which method is best for you?

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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 person, the answer is fewer side effects. For another, it’s a less painful period. Those preferences, plus the individual’s medical history, can help guide the decision.”

Questions to ask yourself and your healthcare professional about birth control

In deciding what birth control method is right for you, ask yourself questions like:

• Do you think you want to have children someday? How soon?
• How effective is the birth control method you’re considering? How important is it that the method be very effective? How significant would an unplanned pregnancy be?
• Will you be able to use the birth control method correctly every time? Are there factors that might impact that ability?
• What are the potential side effects of the methods you’re considering? How would you feel if these side effects happened to you?
• What are you periods like, and are you looking for a method to help make them lighter or more regular?
• Is your partner willing to participate in preventing pregnancy by using condoms or considering a vasectomy (permanent contraception for men)?
• How often do you have sex, and how many partners do you have?
• How will you protect yourself from sexually transmitted infections?
• Do you have any health conditions that would impact the safety of certain forms of birth control?
• How much control do you prefer over your birth control method? Some methods require a healthcare visit to stop.

Know your birth control options

Once you’ve considered these questions, sort through the various birth control methods to help you determine which one seems right for you (bearing in mind that some of them can be used together for additional protection).

Dr. Brant walks you through some of the most popular birth control options on the market now.

Birth control pills

One of the most commonly used birth control methods is “the pill.” Birth control pills regulate your hormones to control your 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 people who smoker and women with a history of other medical conditions. (There is a special type of pill called the “mini pill” or progestin-only pill that 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,” Dr. Brant says. “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:

• 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.
• Must be inserted and removed in a healthcare setting.
• Insertion may be uncomfortable or even painful.
• Risk of perforating your uterus during insertion (though, that occurs in 1 of 1,000 women).
• Unpredictable spotting for several months after insertion.

Condom

The condom serves as a barrier that prevents sperm from entering your 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.
• No impact on your menstrual cycle.

Cons:

• Inconvenience.
• 20% failure rate.

Hormonal implant

It’s a small plastic rod inserted under the skin of your upper arm to deliver a constant supply of pregnancy-preventing hormones into your 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 healthcare provider can give you a pregnancy protection shot every three months.

Pros:

• Effectiveness similar to the pill.
• May cause periods 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’ve had cancer.

Contraceptive gel

This non-hormonal method of birth control is inserted into your vagina before sex to stop sperm from reaching your eggs. It does this by lowering the pH in your vagina, which makes it more difficult for sperm to move, or by destroying the sperm.

Pros:

• Only need to use it when you’re going to have sex.
• About 86% effective at preventing pregnancy.
• No impact on your menstrual cycle.
• Can be used with other forms of birth control, including condoms, diaphragms and the pill.

Cons:

• Inconvenience.
• If used incorrectly, only 86% effective in preventing pregnancy.
• Cannot be used in conjunction with the birth control patch.
• In some people, it causes vaginal irritation or infections (up to 1 in 5 people).

Next, talk to your doctor

If you’d prefer not to hear the pitter-patter of little feet anytime soon, talk to your primary care doctor or Ob/Gyn to find the birth control method that’s best for you.

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