If you’ve ever wondered what kind of birth control your female gynecologist uses, wonder no more: It’s likely to be an IUD.
“Among family planning physicians, the hormonal IUD is certainly the top choice,” Dr. Morse says.
In the general population, sterilization and prescription birth control pills are among the most used.
With so many safe, effective and reliable birth control methods, there’s something that works for every woman, says Shanthi Ramesh, MD, a family planning fellow in the UNC School of Medicine Department of Obstetrics and Gynecology.
“It’s truly about a patient’s priorities and preferences. Talk to your doctor about what works best for you,” Dr. Ramesh says.
This guide, which features birth control options that can be prescribed by UNC physicians, is a good first step to figuring out what’s best for you.
“Women know their bodies and their lives, and they know what works for them,” Dr. Morse says. “I see my role as guiding them in making that decision.”
Delivery: Take a pill every day at the same time.
Pros: It’s easy to use, easy to access, affordable, and it can be prescribed by a family doctor, an OB-GYN or at a health clinic. The pill can sometimes help clear up acne and ease painful periods.
Cons: The birth control pill must be taken daily. If you’re not someone who can remember to do something every single day, this probably isn’t the choice for you.
How long it lasts: Most women can get pregnant “very quickly” after they stop taking the pill, Dr. Ramesh says. In fact, 79 percent of women get pregnant within one year. But those numbers decrease once women are older than 35.
What you need to know: Combined hormonal methods—which include both estrogen and progestin—are generally safe for most women, but they can be associated with a small but increased risk of deep vein thrombosis, heart attack and stroke. That risk goes up in women who are older than 35, women who smoke and women who have multiple risk factors for cardiovascular disease.
IUD (Intrauterine Device)
Delivery: A health care provider inserts the small, plastic device inside your uterus.
Pros: IUDs are some of the most effective birth control methods available. They’re safe, long-lasting and instantly reversible. When you’re ready to have a baby, you could get pregnant as soon as a health care provider removes the IUD.
Cons: “Some women are definitely afraid of insertion—or perhaps just the idea of something foreign in their bodies just doesn’t seem right,” Dr. Morse says. “The idea of taking a pill just seems much easier for some women.”
How long it lasts: An IUD lasts three to 12 years.
What you need to know: A health care provider inserts the device, which works by minimizing the chance that the egg and sperm can meet. If a sperm is unable to get to an egg, there can’t be a pregnancy. This effect is achieved either through the hormone progestin, which thickens the cervical mucus and won’t let sperm through, or through a hormone-free copper IUD, which has a spermicidal effect.
Dr. Morse says IUDs are very effective. “What I tell my patients is that within three months, this should be a nonentity in your life. There shouldn’t be any major side effects. There should be no effect on your sex life. You should have minimal to no bleeding.”
Vaginal Ring (Brand Name: NuvaRing)
Delivery: The flexible, bendy ring is inserted into the vagina.
Pros: It’s painless, and it doesn’t require daily or even weekly attention or remembering to take pills.
Cons: “Some women just don’t like the idea of putting something foreign into their vagina,” Dr. Morse says.
How long it lasts: Insert the ring into the vagina, and it stays there for 21 days, after which you remove it and wait seven days before inserting a new ring. While the ring is out, you’ll get your period. You can also insert a new ring every 21 days for a continuous dose of birth control or even extend its use and place a new one on the first day of each month. A health care provider must prescribe the ring, but you can insert it yourself.
What you need to know: “Patients tend to love the NuvaRing because they get some of the same benefits like improvement in acne without having to take a pill daily, and with a lower dose overall of hormone,” Dr. Ramesh says.
Delivery: A doctor inserts the implant—a thin rod about the size of a matchstick— into the upper arm.
Pros: It’s simple, effective and convenient. “It is the most effective form of birth control—even more effective than sterilization,” Dr. Ramesh says.
Cons: Most women don’t find the insertion painful, as a numbing cream is used, but a handful of women do, says Dr. Amy Bryant, a UNC family planning physician.
How long it lasts: An implant can last up to four years.
What you need to know: The implant releases progestin into the body to stop you from getting pregnant.
Delivery: A health care provider gives you this shot in your arm or butt.
Pros: You only have to worry about birth control once every three months.
Cons: It is the only birth control method that studies have linked to weight gain, so women starting Depo, and especially teens, should keep an eye on their weight during the first year of use, Dr. Ramesh says.
How long it lasts: Three months per injection; you can get pregnant as soon as 12 weeks after receiving your last shot.
What you need to know: “Depo tends to be one of those methods you either love or hate,” says Dr. Ramesh. “I see patients who have used Depo for years and love it, and those who hate it after a few shots.” Depo has been associated with delayed fertility, so it’s not a great choice for women who want to get pregnant within one year.
Delivery: You place the small, sticky piece of beige material, like a bandage, on your body. You can put it on your butt, stomach, back or upper outer arm.
Pros: You set it and forget it … at least for a week at a time.
Cons: The patch can be less effective for women who weigh more than 198 pounds.
How long it lasts: You change the patch every week for three weeks, and the fourth week you go without the patch and get your period. You can get pregnant as soon as you stop using the patch.
What you need to know: Side effects associated with the patch are minor and typically vanish after a few months of use. They include skin irritation, breast tenderness, headache and breakthrough bleeding.
Delivery: This is administered by a pill or copper IUD.
Pros: It’s accessible. Some forms of the “morning-after pill” are available over the counter in pharmacies and health centers. Having a copper IUD placed instead of a pill is the most effective form of emergency contraception.
Cons: The effectiveness of the morning-after pill diminishes the longer you wait to take it, and it’s less effective for women who weigh more. An IUD requires a doctor’s visit.
How long it lasts: Depending on the kind, the morning-after pill can be taken three to five days after unprotected sex—the sooner, the better. The IUD must be inserted within five days of sex.
What you need to know: Some morning-after pills are less effective if you have a body mass index that’s higher than 25, so a copper IUD could be a better option. With a BMI over 30, the pill may not work at all.
Emergency contraception should not be a “Plan A” or main form of birth control, Dr. Ramesh says.
“It’s for when something fails or you go on a trip and you forget your birth control pills, or you find yourself in a situation you didn’t expect to be in,” Dr. Ramesh says.
Delivery: Surgery prevents pregnancy by cutting, burning and clipping the fallopian tubes or placing an insert in the tubes.
Pros: This is highly effective and permanent.
Cons: The surgery can be expensive, even with insurance, Dr. Ramesh says. It is not a good option for anyone who may want to become pregnant in the future.
How long it lasts: “We think of this as truly permanent,” Dr. Ramesh says. “It’s for someone who is not going to have any more children, regardless of how their life or circumstances could change.”
What you need to know: While sterilization can be reversed, reversal requires complicated surgeries or fertility treatments that can cost thousands of dollars. Also, if a woman gets pregnant after being sterilized, there’s a 1 in 3 chance that she can have an ectopic (or tubal) pregnancy, which can be life-threatening.
Talk to your doctor about which birth control method is right for you. If you don’t have a doctor or OB-GYN, find one near you.