There is no single best birth control. The right method is the one that fits your body, your health history, and your plans, and that you can actually stick with. Some women want something they never have to think about. Others want a method they can stop any time. Some are also hoping to make periods lighter or cramps easier along the way.
Here is a plain-language look at the main birth control options, how well each one works, and what to think about as you decide.
How Effective Is Each Method?
Effectiveness is usually measured by how many women out of 100 get pregnant in a year of typical use, meaning real life, with the occasional missed pill or late shot. Based on CDC figures, here is how the main methods compare:
- Implant: more than 99% effective
- Hormonal and copper IUDs: more than 99% effective
- Tubal sterilization or vasectomy: more than 99% effective
- The shot: about 94% effective
- Pill, patch, and ring: about 93% effective
- Male condoms: about 87% effective
The methods at the top work so well because there is nothing to remember day to day.
Long-Acting Reversible Contraception (LARC)
Hormonal IUD
A small, T-shaped device placed in the uterus during an office visit. It releases a low dose of progestin and lasts several years depending on the type. Many women have much lighter periods, and some stop having them, which makes it a popular choice for women with heavy periods.
Copper IUD
A hormone-free IUD that can last up to 10 years. It is a good fit for women who want to avoid hormones, though periods may be heavier or crampier, especially in the first few months.
Implant
A small rod placed just under the skin of the upper arm that releases progestin for up to 3 years. It is the most effective reversible method available. Irregular spotting is the most common side effect.
All LARC methods can be removed at any time, and fertility returns quickly after removal.
Short-Acting Hormonal Methods
The Pill
Taken once a day. Combination pills contain estrogen and progestin, while the “mini pill” is progestin only. Many women like the pill for more predictable, lighter periods and fewer cramps. It works best when taken at the same time every day.
The Patch
Worn on the skin and changed once a week for three weeks, followed by a patch-free week. It works like the combination pill without the daily reminder.
The Ring
A flexible ring placed in the vagina that releases hormones. Depending on the type, it is replaced monthly or reused for a full year with a break each month.
The Shot
An injection given in the office every 3 months. It is a good fit for women who want privacy and do not want a daily method. It can take some time for fertility to return after stopping, so it may not be ideal if you want to get pregnant soon.
Barrier and Other Methods
Condoms are the only method that also protects against sexually transmitted infections, so many providers recommend using them along with another method. Other options include the diaphragm, spermicide, fertility awareness methods, and a non-hormonal vaginal gel. These tend to be less effective with typical use, but they can work well for some women.
Permanent Birth Control
If you are certain you do not want future pregnancies, permanent options include tubal sterilization for women and vasectomy for male partners. These are meant to be permanent, so they are worth a careful conversation with your provider.
Questions to Ask Yourself
- Do I want to get pregnant in the next year or two, or not for a long time?
- How do I feel about a daily, weekly, monthly, or every-few-years method?
- Do I want to avoid hormones?
- Would I like lighter periods or less cramping?
- Do I have health conditions like migraines with aura, high blood pressure, or a history of blood clots? Some methods with estrogen may not be safe in these cases.
- Do I smoke? Women over 35 who smoke usually should not use estrogen-containing methods.
Birth Control at Every Stage
The method that worked in your 20s may not be the best fit in your 40s. As you get closer to menopause, some methods can also help with irregular cycles and other reproductive health changes. Your yearly well woman visit is a great time to check that your birth control still fits.
Birth Control Counseling in Oxford, MS
The providers at Oxford OB/GYN take the time to talk through every option, answer your questions, and help you choose the method that works for you. Learn more about birth control at Oxford OB/GYN or schedule an appointment.
Frequently Asked Questions
What is the most effective birth control?
The implant and IUDs are the most effective reversible methods, preventing pregnancy more than 99% of the time. Permanent sterilization is similarly effective.
What birth control does not use hormones?
The copper IUD, condoms, the diaphragm, spermicide, a non-hormonal vaginal gel, and fertility awareness methods are all hormone-free. The copper IUD is the most effective of these.
Can birth control help with heavy or painful periods?
Yes. Hormonal methods like the pill, patch, ring, and hormonal IUD often make periods lighter and less painful. A hormonal IUD can reduce bleeding significantly for many women.
How soon can I get pregnant after stopping birth control?
For most methods, including the pill, IUDs, and the implant, fertility returns quickly after stopping. After the shot, it can take several months for cycles and fertility to return.