Choosing birth control is a personal decision, and no single method is best for everyone. The right choice depends on your health, your plans, your preferences and what you want to avoid. The good news is that there are many safe, effective options. This overview can help you start the conversation with your provider, who can help you weigh them for your own situation.
Questions Worth Thinking About
Before your visit, it can help to think about:
- How important is it to you to avoid pregnancy right now, and do you want children in the future?
- Would you rather not think about birth control every day, or are you comfortable with a daily routine?
- How do you feel about changes to your periods, such as lighter, irregular or no bleeding?
- Do you have health conditions such as migraines, high blood pressure or a history of blood clots?
- Do you also need protection from sexually transmitted infections?
Long-Acting Reversible Methods
Intrauterine devices (IUDs) and the contraceptive implant are often called long-acting reversible contraception. They are among the most effective methods available, and once placed, they work for several years without any daily effort. When you want to stop, they can be removed, and fertility generally returns.
IUDs come in two main types: hormonal IUDs, which release a small amount of progestin, and copper IUDs, which contain no hormones. The implant is a small, flexible rod placed under the skin of the upper arm. All of these are placed during a brief in-person procedure.
Short-Acting Hormonal Methods
These methods use hormones to prevent pregnancy, and they work well when used consistently and correctly:
- The pill, taken every day. Combined pills contain estrogen and progestin, while progestin-only pills contain progestin alone.
- The patch, changed once a week
- The vaginal ring, which is replaced on a set schedule
- The shot, given every three months
Methods that contain estrogen are not a good fit for everyone. For example, they are usually not recommended for people who have migraine with aura, certain blood clotting risks, or who smoke and are over 35. Progestin-only and non-hormonal options are often available in those situations. Your provider will review your history and may ask for a recent blood pressure reading before prescribing.
Barrier and Other Methods
- Condoms, the only method that also lowers the risk of sexually transmitted infections. Many people use them along with another method.
- Diaphragms, cervical caps and spermicide, which are used at the time of sex and are generally less effective than hormonal or long-acting methods
- Fertility awareness methods, which involve tracking your cycle to identify fertile days. These take daily attention and work best with careful instruction.
Permanent Options
For people who are certain they do not want a future pregnancy, permanent options include tubal procedures, or a vasectomy for a male partner. These are surgical procedures done by a specialist and are meant to be permanent, so they deserve careful thought. Your primary care provider can talk through whether they make sense for you and help with a referral.
Emergency Contraception
Emergency contraception can lower the chance of pregnancy after unprotected sex or a birth control mistake, such as missed pills or a broken condom. It works best the sooner it is used. Some forms are available at pharmacies without a prescription, and a copper IUD placed soon afterward can also work as emergency contraception. If you are not sure which option fits, contact your provider promptly.
Side Effects and Switching Methods
Every method has possible side effects. Some, such as spotting or irregular bleeding with a new hormonal method, often settle down within the first few months. If a method is not working for you, you can change it. Talk with your provider before stopping, so you are not left unprotected while you decide what to try next.
What Can Be Done by Telehealth
Much of the birth control conversation works well by video: reviewing your history, talking through options, and in many cases starting or refilling the pill, patch or ring. Some methods need an in-person visit, including IUD and implant placement and the shot. Sagebrooke Family Medicine is starting as a telehealth practice, and when you need something done in person, we will help you arrange it. Many insurance plans cover birth control, but coverage varies, so check the details of your plan.
The best birth control is the one that fits your health and your life, and that you feel good about using.
Common Questions
Do I need a pelvic exam to start birth control? For most methods, no. An exam is part of placing an IUD, but the pill, patch, ring and shot can generally be started without one.
Can teens get birth control? Teens can talk with a provider about birth control. Rules about consent for minors vary by state, and your provider can explain them. Read more about adolescent health visits.
Will birth control affect my future fertility? For most methods, fertility returns soon after stopping. After the shot, it can take longer, sometimes several months or more.
Getting Started
When you are ready to talk about birth control, learn more about women's health at Sagebrooke Family Medicine, or read our guide to well-woman care through every stage of life.