Medically reviewed by Dr. Nancy Shannon, MD, PhD on August 10, 2020
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.
Other Common Questions
If the questions above didn’t narrow down your choices any further, don’t worry. Every woman has different expectations for her birth control, and a single Q&A may not be able to cover every single one.
If you have some additional questions you need answered, we’re here to help. Here are some of the most common:
What birth control has the fewest side effects?
For the vast majority of women, hormonal birth control will cause no side effects whatsoever. Side effects that do appear are often mild and almost always go away within the first several months of regular usage. Still, messing with the natural hormone levels in the body can produce noticeable changes for some women.
Any hormone-containing birth control has the potential for side effects, but some come with slightly lower risk than others. Methods that only contain progestin, such as the minipill or the shot, won’t cause some of the serious side effects that can occur with estrogen-containing birth control
Non-hormonal birth control options, such as condoms or copper IUDs, are the only options that cause no hormone-related side effects, though women with allergies to latex or copper should likely consider other methods instead.
What’s the best birth control for long-term protection?
All hormonal contraceptives can be taken with the long-term in mind, but some are better suited for continuous usage than others. The implant, for example, is usually effective for between 3 and 5 years after insertion, as are hormonal IUDs. Copper IUDs, however, are the longest-lasting, with most capable of preventing pregnancy for up to a decade.
The shot is a mid-range option that you can consider if you’re not yet ready to commit to an IUD or implant. It lasts for three months at a time and can be administered in by a healthcare professional or at home.
What’s the best birth control to help with periods and PMS?
Every hormone-based birth control option has the potential to interact with your menstrual cycle in some way, but every woman’s body will have a different reaction to each method. Birth control pills are the most common way to reduce period flow, but any cyclical option like the patch or the ring has the ability to do so as well if used at all times.
Whereas cyclical birth control options give you the option of keeping your period, the shot is particularly effective at halting periods, with nearly three quarters of women losing theirs after a year of continuous use. You may have to try out a couple of different birth control methods before you know which affect your menstrual cycle in the way you want, but most women will find that there’s an option out there for them.
What birth control prevents weight gain?
Reports of birth control causing weight gain are greatly exaggerated: most women will experience no weight gain on birth control, and those that do rarely put on more than a couple of pounds. The shot is the only method proven to stimulate weight gain in some women, and those that did gain weight on the shot often lost it soon after they adopted a different method.
The hormone estrogen, which is found in some common birth control options, can increase water retention in the body, causing some women to put on slight amounts of water weight. Women particularly concerned about weight gain on birth control should consider progestin-only options, if possible.
What’s the best birth control for women without insurance?
For those with insurance, nearly all common methods of birth control are accessible and affordable. Uninsured women have access to these same options, but sometimes at a much steeper price.
Birth control pills are usually the most affordable option for women without insurance, with many generic pills costing as little as $15 per pack. The ring, patch, and shot are all more expensive, and you can find the out-of-pocket prices listed for dozens of different brands here on our website.
If you’re struggling to know what’s right for you, answer a few quick questions and our medical professionals can help find the best birth control for you.
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