With so many birth control options on the market, choosing the right one for you can feel overwhelming. But it doesn’t have to be. Whether you’re considering using the pill, patch or ring, or you’re wondering if something longer-acting, like an IUD, implant, or injection, would be better for you, these tips can help you make a choice that’s best for your body—and your life.
1. Be Honest With Yourself
If you’re choosing birth control for the first time or just considering switching methods, start by asking yourself how the method will fit into your lifestyle, suggests Elizabeth Harrington, M.D., an obstetrician-gynecologist at the Family Planning Clinic at UWMC-Roosevelt in Seattle. If you can trust yourself to remember to take a pill at the same time every day, then oral contraceptive might work for you. But if you’d rather not think about it, one of the longer-acting methods might be a better bet.
Do you feel most comfortable having a monthly period or could you do without it? Do you feel comfortable using a method with a somewhat higher failure rate? Do you feel strongly about being able to stop using a method whenever you want? Do you want to get pregnant in the next few months? Are you in a sexual relationship that might put you at risk for a sexually transmitted infection? These are all important questions to keep in mind when making a decision.
2. Know Your Risks
Depending on your health history, your healthcare provider might determine that you aren’t a candidate for certain methods, says Harrington. Estrogen-containing birth control isn’t recommended for women with estrogen-sensitive cancer, high blood pressure, a well-known genetic predisposition to estrogen-sensitive cancers, migraine with aura, severe diabetes, or a history of blood clots in the leg, stroke or heart disease. Women over the age of 35 who smoke cigarettes also should avoid estrogen-containing methods. Your provider can help you decide if the risks of pregnancy outweigh the risk of adverse events.
3. Understand Negative Side Effects
While most women tolerate the pill and other hormonal methods very well, others report experiencing mood changes, weight gain or a dip in libido. On a population scale, researchers haven’t been able to peg hormonal birth control as the culprit behind these side effects, explains Harrington. It can be hard to isolate the birth control from everything else that’s going on in your life that might cause these changes, she says. Libido, for example, may be connected with the health of the sexual relationship you’re in and your body image, and weight gain may be related to just getting older.
For progestin-only methods, the main side effect women complain about is irregular spotting, says Harrington. On these methods, you won’t get a “normal” period, but you may experience light bleeding that isn’t easily predicted.
“Progestin makes the lining of your uterus really thin, but that thin lining comes out without warning,” she says.
Other potential side effects of birth control include weight gain from the injection and heavier, crampier periods from the copper, nonhormonal IUD.
4. And Positive Ones
Not all side effects are negative, and plenty of women choose birth control for non-sexual reasons. For example, combined hormonal contraception, including the pill, patch and ring, helps control acne in some women, says Harrington. That’s likely because of the way estrogen affects the liver, she says.
Heavy bleeding and PMS symptoms may also be alleviated with certain methods, says Harrington. Be sure to mention any of these symptoms to your provider.
5. Consider Costs
Most birth control is free or low cost for women on many insurance plans, Medicaid and other government programs. But cost can be a factor, says Harrington.
“Cost is definitely a consideration for many women who either have insurance that doesn’t fully cover contraception, don’t have insurance or have copays that are astronomical,” she says.
If you’re paying out of pocket, long-acting reversible contraception, like IUDs and implants, is the most expensive. It may cost you about $1,000 to have an IUD placed if you’re uninsured or if your insurance won’t cover it. Brand name birth control pills can cost up to $100 per month without insurance, but there are generic options for as low as $4. Also think about something called “cost-effectiveness,” suggests Harrington. That’s the price divided by how long it lasts, she explains. So, if you pay $800 out-of-pocket for a copper IUD you leave in for 10 years that amounts to under $7 per month.
If you’re unsure what’s covered under your plan, call your insurance provider and make sure that what you’re planning to do is covered before you go in and that where you’re planning to go is in your network, suggests Harrington.
6. Don’t Be Afraid to Experiment
Luckily, you don’t have to pick a birth control for life. It’s totally fine to try a few things out and see how they make you feel. And just because the side effects you’re experiencing aren’t necessarily directly related to birth control doesn’t mean they aren’t real or that you need to suffer through them, says Harrington.
“Everyone’s biology is different,” she says. “If you have concerns about your method, there’s a reason there are multiple options. If you’re not happy with your method, talk with your doctor about changing it.”