There are tons of birth control options. Some, like condoms and The Pill, are more well known than others, but that doesn’t necessarily mean they are the best choice for you. When it comes to choosing your method, consider the following questions. These are the questions doctors will ask before prescribing birth control. Giving them some thought before your appointment can help you have a more informed conversation with your doctor and help you make the right choice faster.
1. Do you have any illnesses or medical problems? Some conditions mean doctors can’t prescribe some hormonal methods. If you have ever had a blood clot or a strong family history of blood clots, or if you get migraines with “auras,” doctors can’t prescribe you an estrogen-containing birth control. (Aura’s are neurologic signs that happen before a migraine appears, for people that get them it’s usually visual disturbances like seeing spots or dark fields in your vision.) It’s ok to take estrogen if you just have headaches without auras. If you are prone to depression or panic attacks or severe mood swings then getting the birth control shots can sometimes make them worse. Be honest with yourself and your doc if that is the case. You don’t want to take a medicine that will make you feel bad.
2. Are you taking any other medications? Some medicines make birth control pills less effective. Most seizure medications, the antibiotic used to treat tuberculosis, and the herbal supplement St. John’s Wort will decrease the effectiveness of the pill. Also some studies suggest that drinking very large quantities of grapefruit juice can reduce it’s effectiveness.
3. Are you at risk for STIs? If you are not in a monogamous relationship with a partner who has been tested, or if they sleeping with other people, you are at risk for STIs. You will want to use condoms 100% of the time to protect yourself. If you are not using condoms and have multiple partners or your partner is unfaithful, the IUD is not the best choice for you. If you get a sexually transmitted infection like chlamydia with an IUD in place it can cause a more extensive pelvic infection called pelvic inflammatory disease (PID).
4. Are you in an exclusive relationship with a trustworthy partner? If you have both been tested for STIs prior to starting a sexual relationship and there are no other partners, you can skip the condoms. If you are reliably taking another form of birth control, however, you should still use them to reduce any risk of disease transmission.
5. Are you ok with the potential of getting pregnant? If not, then use effective birth control! Withdrawal and rhythm method are terrible forms of birth control. The long acting methods (implant and IUD) are by far the most effective at a less than 1% failure rate and don’t require you to remember anything other than to have it inserted. The shots are also very effective as long as you remember to get them on time every 3 months.
6. Do you and your partner have or plan to have spontaneous sex? Having a long-acting method like the IUD or implant means you don’t have to remember anything. If you are taking your pill or using your ring or patch as directed, then you’ll be protected during an unplanned romp. It is helpful to keep condoms in your purse so they are readily available, and they can also offer you additional protection in the rare event that a longer acting method fails. The sponge and diaphragm require planning and careful use and make spontaneous sex difficult.
7. Can you remember to do something every day at the same time? If so, then the birth control pill is easy. It’s minimally invasive, and you don’t have to get shots or procedures. It’s also a little easier than the ring or patch, but if you can’t remember to take them, they won’t work. You can get pregnant, and it will cause spotting and irregular periods to forget pills. If you can’t remember to take your medication you should use a longer acting method.
8. Do you have a regular schedule? If you have a regular schedule then it is easier to remember the pill. If you travel with school groups or sports teams, or if you are frequently on the go, you may find it difficult to remember you birth control. Or you may go on a trip and forget to pack it. In this case the implant, IUD, shots, or the ring may be the best options.
9. Are you sensitive to hormones or other medications? If so there are a few options. There are very low dose birth control pills available to try or the progesterone-only pill. If even these small doses of hormones bother you then you may want to consider an IUD. Even though the Mirena has hormone in it, only a tiny amount gets into your circulation, it mostly just works inside your uterus to cause light or no periods, which make a lot of women happy. If you want to avoid even that amount of hormone, then you can consider the copper IUD. There is no hormone at all and it is extremely effective. If you’re nervous about having an IUD inserted, then condoms are the best bet for you. Just remember to use them every time.
10. Do you have heavy or irregular periods or significant cramping? If so, then you may want to consider a hormonal method of birth control to regulate your periods and reduce the amount of bleeding and cramping. Any of the methods will work, pills, patches, ring. The shots typically cause you to stop having periods. The implant isn’t as good at controlling periods, it typically causes more irregular bleeding. The copper IUD causes heavier bleeding and cramping with periods, so if you have bad periods to start, then this is not the best option for you. The Mirena IUD also causes most women to have light to no periods. The pill, patch, and ring also can help if you have PMS symptoms.
The bottom line? The most effective methods are the longer acting ones, implant and IUD. So they are often recommended as a first-line method for teens. The downside? They require insertion by a doctor and that can be uncomfortable (though, pain medication is usually an option). The upside? They last for years- well worth the few minutes of discomfort to get them, and they work the best because there is no user error associated with them. If the thought of a procedure to get your birth control makes you squeamish, then the pills, shots, ring or patch may be the best for you, as long as you remember to take them. These can also make your periods regular, clear your skin, and help with PMS. Whichever method you use, still use condoms. The most important thing you can do besides preventing pregnancy is to protect yourself from a sexually transmitted infection.