Choice is a beautiful thing — when it comes to your body you might even call it a fundamental human right. But sometimes too many choices can feel like too much. That may be how you feel about birth control, with more than 100 types of pills, plus rings, shots, patches and more, it may feel hard to find the best birth control for your body and lifestyle. And if you’re already on contraception you might be questioning if there’s a better method out there than your current one.
To help you sort through the options, we broke down the five main questions to ask yourself as you find your ideal birth control method.
1. How long can you commit?
A) A long time!
If you know you don’t want to get pregnant any time in the near future (or just ever) then it might make sense to choose an IUD or implant. The IUD is inserted through the cervical opening into the uterus by a medical provider and prevents pregnancy for 3-12 years (depending on the type of IUD). The implant is placed under the skin on the underside of your upper arm, near your armpit, and works for 3 years. Both implants and IUDs are reversible, meaning that if you do want to get pregnant you can have them removed and your fertility will return to normal. These methods have obvious benefits (“set it and forget it” for years) but on the downside, they require a doctor’s office procedure both to insert and remove, which may cost a lot—especially if you don’t have insurance.
B) Commitment makes me anxious
If you aren’t into long-term commitments (even for birth control), or think you might want to get pregnant soonish, then you probably want a contraception method that you can start right away, and stop whenever you like. You can get a prescription for the hormonal pill, patch, or ring and start using them any time. Decide you don’t need it anymore or want to try a different method? Simply stop taking the pill (or remove the patch or ring) and your fertility will return as soon as within a day. Another hormonal option, the birth control shot, ranks in the middle as a commitment: Inject it into your stomach or thigh (which you can do at home) and you’ll be protected from pregnancy for three months
2. How well do you stick with a schedule?
A) I’m on top of all the things, most of the time.
For birth control pills to be effective, you need to take one every day, and in the case of progestin-only pills (also called mini-pills) you need to take it within the same two-hour window every day (and if you miss your mini-pill by three hours or more you should use a back-up method of birth control for 48 hours). This definitely isn’t impossible to remember (and alerts from smartphones and watches can help), but if sticking with a routine is tricky for you then you should choose a birth control option that doesn’t require you to remember it daily.
B) Routines aren’t really my friend.
If remembering a daily pill is too much, then consider the patch (which you change once a week), the ring (once a month), the shot (every three months) or a long-acting form of birth control like the IUD or the implant.
3. Do you want your birth control to help with heavy periods, PMS, acne, or other hormonal health issues?
A) Yes, 1000 times yes
The birth control pill and other hormonal methods regulate your menstrual cycle and usually reduce or eliminate menstrual-related health issues like PMS and hormonal acne. All combination pills (those that contain both estrogen and progestin) will regulate and lighten your period and reduce cramps and hormonal symptoms generally, but certain pills are specifically FDA-approved to treat acne: Yaz, Ortho Tri-Cyclen, Beyaz, and Estrostep FE.
Any hormonal birth control should reduce PMS, by preventing the hormonal fluctuations that bring it on, but studies show that pills containing the combination of ethinyl estradiol (a type of estrogen) and drospirenone (a progestin) may be most effective at preventing the extreme PMS known as Premenstrual Dysmorphic Disorder (PMDD). These include Ocella, Yaz, Beyaz and their generics.
Progestin-only forms of birth control — progestin-only pills, the birth control shot, and the hormonal IUD — also lighten your period, and in some cases make it disappear entirely, but often cause irregular spotting, especially in the beginning as your body is adjusting.
B) No, I’m good
If heavy or painful periods aren’t really an issue for you and you’re looking for a long-term option you could go with the copper IUD, which doesn’t contain any hormones, but often does lead to heavier periods. Instead of using hormones to prevent pregnancy, the copper in the IUD works by creating an environment that’s toxic to sperm.
4. Do you want to skip periods entirely?
A) Sign me up
Combination birth control pills and the birth control ring make it easy to say “see ya” to your period. Simply skip the placebo week of pills, or leave the ring in for four weeks and immediately replace it with a new ring. By taking your hormonal birth control continuously you won’t bleed or experience any menstrual symptoms you might otherwise have from the drop in hormones during the week off of birth control. (However, when you first start skipping periods you will probably experience some spotting or light bleeding as your body adjusts).
Note that the best pills for period skipping are monophasic combination pills, which deliver the same dose of estrogen and progestin every day. Triphasic pills, which contain different levels of hormones depending on the week, aren’t great for period skipping, and progestin-only pills, which you take every day without a “placebo” week don’t let you skip your period, though in many cases your period will become lighter or even disappear on progestin-only pills.
B) No, I kinda like my cycle
If you’re into the rhythm of a monthly period, and the regular confirmation that you’re not pregnant, then you can use any combination birth control and take a break every three weeks for a period, by taking the placebo pills or doing a week without a patch or ring.
Since you prefer a regular cycle then progestin-only pills, the birth control shot, the birth control implant, and the hormonal IUD may not be for you. These progestin-only contraceptives might make your period go away over time, and often cause spotting, especially in the beginning.
5. Do you have insurance?
A) Yes 🙂
Most insurance plans cover birth control (it’s required by law, though there are some exceptions including exemptions for religious institutions). Your plan should cover any FDA-approved, physician-prescribed method without a copay, meaning you have lots of options.
B) No 🙁
Not a problem! Generic birth control pills are very affordable, and there’s a generic pill to fit your specific needs—whether you’re looking to skip periods, control acne, or need a progestin-only formula. If you want the birth control patch, ring, or shot, you will have to pay more ($150 and up) if you pay out-of-pocket. The out-of-pocket prices for the birth control Nurx offers are clearly listed on our website.
The Bottom Line
Lots of contraception options is ultimately a very good thing, and the Nurx medical team is ready to help you decide which birth control is best for you.
This blog provides information about telemedicine, health and related subjects. The blog content and any linked materials herein are not intended to be, and should not be construed as a substitute for, medical or healthcare advice, diagnosis or treatment. Any reader or person with a medical concern should consult with an appropriately-licensed physician or other healthcare provider. This blog is provided purely for informational purposes. The views expressed herein are not sponsored by and do not represent the opinions of Nurx™.