There are so many options when it comes to birth control — from condoms and oral contraceptives to vaginal rings, implants, and IUDs — that it can be hard to know which one to choose.
To help make your decision a little easier, let’s first break down the basics of how birth control prevents pregnancy. One way is by creating a barrier that blocks sperm from getting to the egg and fertilizing it. These methods include condoms, diaphragms, contraceptive sponges, and cervical caps.
Other birth control methods use hormones to prevent a woman from ovulating, so there’s no egg released for sperm to fertilize. These options include the pill, patch, shot, implant, and vaginal ring.
There are also IUDs, which work in two ways: The nonhormonal copper IUD prevents sperm from reaching the egg, while hormonal IUDs prevent ovulation and thicken the cervical mucus to create a barrier to block sperm, according to Planned Parenthood.
In general, hormonal methods — such as the combination birth control pill, which contains both estrogen and progestin — come with several benefits beyond pregnancy prevention: They help lighten periods, lessen painful cramps, quell PMS, reduce acne, and decrease the risk of uterine and ovarian cancers, according to Taraneh Shirazian, MD, an assistant professor in the department of obstetrics at NYU Langone Medical Center.
However, hormonal methods also come with some risks. “There is a risk of blood clots in using [a method with] estrogen in it, whether it’s the pill or the ring,” Shirazian tells Yahoo Lifestyle. “Any method that contains estrogen, if you are someone who has a history of blood clots or clotting disorder, you should not be on that.”
Paula Castano, MD, an associate professor of obstetrics and gynecology at Columbia University Irving Medical Center in New York City, adds: “If you have certain conditions, like obesity, diabetes, high blood pressure, or are older or a smoker, talk with your provider about which methods are safest for you to use.”
Hormonal birth control options also have some side effects, including nausea, breasts tenderness, and spotting between periods. Nonhormonal methods, like the copper IUD, can cause more painful menstrual cramps. “Not everyone experiences symptoms or side effects when starting a new method,” Castano tells Yahoo Lifestyle. “But if they do, they’re usually pretty mild and they should last only a couple of months.”
Each individual method also has its own unique pros and cons. For example, the pill needs to be taken every day, which may not work for some women. The birth control patch is effective for a week, but you’ve got to be willing to have a beige sticker on your body. Vaginal rings need to be changed only once a month, but you have to be comfortable inserting them inside the vagina. Although there’s discomfort in having them placed inside the uterus and post-procedure cramping, IUDs are a low maintenance, long-lasting method, and effective from three to 12 years, depending on which one you choose.
With the birth control implant, a physician inserts a small rod about the size of a matchstick into the skin of your upper arm, and the method is effective for up to four years. With condoms, you need to remember to have them on hand, but when used consistently and correctly, they not only prevent pregnancy but are also the only birth control method that helps protect against several STDs, according to the Centers for Disease Control and Prevention.
So how can you figure out what’s the best birth control method for you?
Shirazian recommends thinking about what your individual needs are — and being patient, knowing there might be some trial and error. Do you want an easily reversible method or a long-acting one? Do you care only about pregnancy prevention or want other benefits?
“If you have a sense of what you need when you go to the doctor, that’s very helpful, such as whether you want symptom control [for instance, reducing painful periods] or you don’t want to take something every day or you want to try something else,” Shirazian says. “Know the broad pluses and minuses so you can say, ‘It’s more important to me not to take something every day than it is to get rid of my acne.'”
She adds: “It’s the tradeoff. You’re getting some benefits and likely some annoyance [with each method]. You have to figure out the things you really need and what’s that rank order in your head of what’s most important so you can at least try that one first.”