Choosing Birth Control: What Matters to You?

Birth control methods vary in how effective they are at preventing pregnancy. If avoiding pregnancy is one of your highest priorities, you may want to consider a method that provides very high effectiveness without requiring you to remember to use it regularly.

IUDs and the birth control implant (Nexplanon) are among the most effective reversible options because they work continuously once placed. Pills, patches, rings, condoms, and other methods can also work very well, but their effectiveness depends more on using them correctly and consistently.

If you're comfortable with a little more possibility of pregnancy in exchange for other priorities, such as avoiding hormones or procedures, that may influence which options are the best fit for you.

Want to Compare Efficacy Rates?

• Birth Control Comparison Tool  (Bedsider.org)

I'd love lighter periods or no periods.
Several hormonal birth control methods can make periods lighter, shorter, or sometimes stop them altogether. Hormonal IUDs and continuous use of the pill, patch, or ring are especially helpful when reducing bleeding is a priority. Depo and Nexplanon may also decrease bleeding over time, although bleeding patterns can be less predictable.

I'd like more control over when I bleed.
The pill, patch, and ring offer the most flexibility if you'd like to skip periods, delay bleeding for a vacation or special event, or have more control over when bleeding occurs.

I'd prefer regular monthly bleeding.
That's possible with many birth control methods. If having predictable bleeding each month is reassuring or simply your preference, we can take that into account when choosing a method.

I already have heavy or painful periods.
Birth control can sometimes treat these symptoms in addition to preventing pregnancy. Some methods are particularly effective at decreasing heavy bleeding and cramps, while others may cause more irregular bleeding or make periods heavier.

“I'd rather not have to think about it.”
An IUD or Nexplanon may be a good fit if you don't want to think about birth control on a regular basis. Once placed, these methods work continuously for several years without requiring a daily, weekly, or monthly routine.

“I don't mind keeping up with it.”
The pill, patch, and ring may be good options if you don't mind managing your birth control regularly. Pills are taken daily, patches are changed weekly, and vaginal rings are typically changed monthly. Depo-Provera falls somewhere in between, with an injection given every 3 months.

“I'd prefer to avoid hormones.”
There are several hormone-free options. The copper IUD and barrier methods, such as condoms, do not contain hormones. Vaginal contraceptive gels or spermicides, such as Phexxi, are used around the time of sex and are another hormone-free option. Fertility-awareness methods are also hormone-free but require more attention to cycle tracking and timing.

One thing to keep in mind:
If you'd prefer to avoid hormones because of a previous side effect or concern, let me know. Different hormonal methods contain different types and amounts of hormones and work differently in the body. A bad experience with one method doesn't necessarily mean you'll have the same experience with another.

“I'm comfortable with a procedure if it means long-term birth control.”
An IUD or Nexplanon may be worth considering. Both are placed during a brief office procedure and then provide highly effective birth control for several years without requiring you to remember anything regularly.

“I'd rather avoid a procedure.”
There are plenty of options that don't require insertion or placement, including the pill, patch, ring, Depo-Provera, condoms, and other nonhormonal methods.

Birth control can sometimes do more than prevent pregnancy. If you have other symptoms you'd like to improve, let me know. Depending on the method, birth control may also help with:

• Acne

• Heavy periods

• Painful periods

• Irregular periods

• PMS or PMDD symptoms

• Menstrual migraines

These goals may help us narrow down which options are the best fit for you.

“I may want to become pregnant fairly soon.”
Most reversible birth control methods allow fertility to return quickly after they are stopped or removed. Depo-Provera is an exception because return to ovulation can take longer after the last injection. If you think you may want to become pregnant soon, that may be worth considering when choosing a method.

“Pregnancy isn't in my plans for a while.”
Long-acting methods such as an IUD or Nexplanon can provide birth control for several years, but they can also be removed at any time if your plans change.

“I'm certain I don't want a future pregnancy.”
If avoiding pregnancy long-term is one of your highest priorities, you may want to consider a long-acting method such as an IUD or Nexplanon, or permanent birth control if you're confident you never want a future pregnancy.

Your medical history matters too. Conditions such as migraine with aura, high blood pressure, a history of blood clots, certain cancers, and some medications can affect which birth control options are safest for you.

You don't need to figure this out yourself. We'll review your medical history together and consider any health conditions, medications, or other factors that may affect your options.

Curious whether a particular medical condition affects your options?

• Contraceptive Medical Eligibility Criteria (CDC)