There’s no such things as a one-size-fits-all form of birth control. Convenience, effectiveness, and the level of maintenance required (because, let’s face it, we’re not all good at sticking to a schedule) are just a few things to consider when you’re making the contraceptive call. Knowing what works for others can be super helpful, which is why we asked women to share why their current method works for them. Maybe one of these options will work for you, too!
“The hormonal IUD is totally comfortable and easy.”
For “set it and forget it” birth control, an IUD (intrauterine device) is both long-term and reversible, and it's considered to be one of the most reliable birth control methods out there. According to the Cleveland Clinic, it’s more than 99% effective.
Sarah, 39, from the suburbs of Detroit, is definitely a fan. She had her first hormonal IUD inserted when her youngest child was about a year old, and had it replaced five years later. “It’s so simple, effective, and, for me, has this really cool, magical side effect of eliminating menstruation,” she says. “I seriously only think about it twice a decade, and trust it completely. For me and my sexual partner, it’s totally comfortable and easy.”
Rhiannon, 39, from Durham, NC, agrees. She made the switch to the hormonal IUD after being on the pill for many years. “I took the pill unfailingly—I think I missed maybe a handful of doses in nine years,” she says. “But after my daughter was born, I knew my brain would be too scattered to take it as religiously as I had before.”
For others, it’s not just about convenience. “I got it several years ago to ameliorate the bad cramping I'd been dealing with since I was a teenager," says Meghan, 33, from Chattanooga, TN. And since she's stopped having her period altogether, the cramping is gone with it. “The degree to which it improves my quality of life has elevated it to a medical necessity, whether or not I'm sexually active,” she adds.
Because this IUD slowly releases progestin, the uterine lining remains thin, so bleeding usually lighter than before. Once it's removed, your regular cycle returns.
“The copper IUD is a long-term solution.”
While Sarah, Rhiannon, and Meghan all swear by the hormonal IUD, Katie, 25, from Baltimore, prefers the copper (non-hormonal) option. “Before getting the IUD, I tried several different kinds of oral birth control, with varying levels of progestin and estrogen,” she explains. “But [for me] there were negative side effects. I love the copper IUD. I do have heavier bleeding and slightly worse menstrual cramps now, but the trade-off is worth. As I have no plans for children any time soon, I like that the [copper] IUD is a long-term solution. I've got about five years left to use this one.”
Emily, 42, from Oneonta, NY, got the copper IUD not long after her 8-year-old daughter was born. At that point, she was unsure if she would have more children but was leaning toward not. “When I’d taken the pill in the past, I was forever forgetting it, or messing it up somehow, so that didn't feel like a great option.”
A downside of the IUD (either hormonal or non-hormonal) is that it can be uncomfortable to insert. “I found it painful, but it was also quick, so it really wasn’t a big deal.” Emily says. “The actual insertion took less than a minute, so similar to the length of time it takes to get a Pap smear. Just a lot more intense!”
Some birth control products require prior authorization from your insurance provider; in the case of the IUD, your medical provider must obtain permission from your health plan to confirm that it will cover the device prior to insertion. So, make sure you do this ahead of time.
“The vaginal ring is simple, and my periods are lighter.”
Zahra, 25, from New York City, loves her vaginal ring—a small, soft, plastic ring that releases a continuous dose of the hormones estrogen and progestin to prevent pregnancy—for many reasons.
“It’s so great," she says. “I switched to it from the pill because I was always missing pills. I was also noticing mood changes and anxiety. When I switched to the ring, those symptoms went away. It’s easy to insert, comfortable, and makes my periods lighter.”
“The pill is part of my daily routine.”
While some women don’t want to have to remember to take a birth control pill every day, it suits Ana, 29, from Orlando, FL. “It’s part of my daily routine,” she says. “I don’t have to go get a shot or a patch, or switch rings. Plus, I can skip a period if I want to.”
Ana previously had the vaginal ring but using it caused her anxiety, she adds. Unlike the pill, whose daily dosage she could choose to take (or not), “I was worried about going for anything like a shot that I couldn’t just stop taking.”
The pill has been the birth control method of choice for Sarita, 36, from Seattle, for 15 years—and she has no intention of switching. “I’ve never had any negative side effects,” she maintains. “It also completely eliminated my menstrual cramps, which is an added bonus!”
Planned Parenthood says the birth control pill is 99% effective when used perfectly—meaning, never skipping a pill. Again, people aren’t perfect, and memories sometimes do fail, so the actual efficacy rate is closer to 91%.
"The patch works even when I'm ill."
The birth control patch is a small, sticky, square patch that you attach to your skin like a bandage. You wear it on your upper arm, belly, butt, or back, and it releases estrogen and progestin into your body to stop you from ovulating (and thus, prevent pregnancy). When used correctly—meaning, you remember to replace it with a new patch every seven days—it’s more than 99% effective.
Miriam, 26, from Corpus Christi, TX, has used the patch for five years. “I have to remember to change the patch every week, but I don’t have to think about it every day,” she says. “It doesn’t interfere with my daily life at all. I can still go swimming, play sports, etc. And if I’m vomiting or have diarrhea—gross, I know, but it helps to know these things!—it still works, unlike the birth control pill.” (According to Planned Parenthood, the pill may not be as effective if you're taking certain medications, like antibotics, or if you vomit or have diarrhea within two hours of taking the oral contraceptive.)
“I use an online calendar to keep track of my next injection.”
The shot is an injection of the hormone progestin that provides birth control for three months. It can be administered at home or by a healthcare professional
Krista, 32, from Cincinnati, OH, has been getting the birth control injection for 18 months. “As a result, I have very light periods—which I’m delighted about—and I find it so much easier than taking a pill every day,” she says. “I love that I can get it and forget it until it needs renewing. I use an online calendar to keep track, so I never forget when I need my next shot.”
“The implant is less invasive than an IUD and is easily removed.”
The implant is a very small rod inserted under the skin of a woman's upper arm that releases progestin. It's invisible and prevents pregnancy for up to four years. It also has the added benefit of not requiring a vaginal exam.
Jenna, 20, from Los Angeles, started getting ovarian cysts when she was 13, and went on the pill. (Hormonal birth control is often prescribed for ovarian cysts because it prevents ovulation; it’s the process of ovulation that causes cysts to form.) But Jenna experienced low mood on the pill and decided to switch to the implant, which for her was a great decision.
“It only requires my attention every four years, so there’s no need to remember to take a pill or get the shot again,” she says. “It’s also much less invasive than the IUD, and it can be removed at any time. Also, my implant is progesterone only, not progesterone and estrogen, meaning it’s less likely to cause depression or mood irregularities.”
“Condoms have worked well for me.”
If you want a birth control method to prevent both pregnancy and sexually transmitted infections (STIs), condoms come recommended by both Jess and Elizabeth, who represent very different ages and life stages.
Jess, 24, from San Clemente, CA, relies on condoms to prevent pregnancy and protect her from STIs. “It’s the only method of birth control to cover both bases,” she says. “I’m not with a long-term sexual partner right now, so condoms are essential, quick, and easy.”
Elizabeth, 39, from New York City, actually uses two methods: "the pull-out method" (more on this below) as well as condoms during ovulation, when pregnancy has the highest odds of happening. “It’s worked well [for me],” she says. “I have never been pregnant by accident in 20 years of having sex.” She also likes having no hormones in her birth control. “I used birth control pills from ages 15 to 20 and found they affected my personality and made me quite heavy.”
According to Planned Parenthood, if you use condoms perfectly (i.e. consistently and correctly) every single time you have sex, they are 98% effective at preventing pregnancy. In reality, condoms are about 85% effective, because people aren’t perfect and neither are they.
“Diaphragms are a great on-demand option.”
Charyn, 47, from Seattle, is polyamorous and has male- and female-identifying partners. “I've yet to hit perimenopause and still have regular periods,” she says. “I typically use condoms for penis-in-vagina or anal sex, but on the rare occasion that I’m fluid-bonded with a penis-haver, I swear by my Caya diaphragm, used with spermicide.”
At this stage of her life, Charyn isn’t having non-barriered sex often enough to take a daily pill, and she says, “the thought of a copper IUD makes me cringe.” She sees her diaphragm as an easy to insert, on-demand solution. “It also works well as a barrier for period sex, and my partners barely notice when I’m using it,” she adds.
Planned Parenthood says about 12% of women who use a diaphragm get pregnant each year, meaning it’s 88% effective. However, it’s 94% effective when used exactly as instructed, every single time you have sex.
“Withdrawal hasn’t let me down—yet!”
Now, back to “the pull-out method.” Whitney, 31, from Wichita, KS, is currently relying 100% on this approach, also called the withdrawal method or coitus interruptus, when a male partner pulls out his penis before ejaculating—for birth control.
“I gave birth about four months ago, and I’ve have always had a challenging time finding a birth control pill that didn't affect my moods,” she says. “Since I'm still breastfeeding, my options are limited and I'm not ready for anything to go back up into my body. We've done pullout for years and haven't had any unplanned pregnancies—fingers crossed.”
It's important to note that the withdrawal method is still considered to be one of the least-effective birth control methods at preventing pregnancy, especially if your periods aren’t as regular as clockwork. Out of every five women using withdrawal or spermicide alone, one will get pregnant by the end of the year, according to the Cleveland Clinic.
“Ovulation tracking is great for my sex drive!”
Fertility awareness methods (FAMs), also called “natural family planning” (NFP) or “the rhythm method,” track your ovulation to prevent pregnancy. While doctors often advise against these approaches, which aren’t taught in medical schools because they’re widely viewed as antiquated, many women are big fans.
“I’ve been tracking my cycle for five years, and it’s kept me not pregnant when I don’t want to be and helped me get pregnant relatively quickly when we wanted baby No. 2,” says Kelly, 31, from Concord, NH. “I really love being hormone-free and getting more in touch with the natural fluctuations of hormones.” An added bonus? Staying so closely in tune of her own body’s fluctuations “is great for my sex drive too, which is nice!”
Some researchers out there think these so-called old-fashioned methods may be more reliable than previously thought. A scientific review published in Frontiers of Medicine suggests that previous failure rates of FAMs and NFP—as high as 24%—were tabulated from women who were asked what method they were using at the time of conception—without considering who among them were actively trying to get pregnant, thereby counting even intentional pregnancies as “failures,” say the researchers. So more research needs to be done.
Case in point: When Louise, 44, from Granada, Spain, was first thinking about getting pregnant about 10 years ago, she read Toni Weschler’s book, Taking Charge Of Your Fertility. “It changed my life,” she says. “We got pregnant easily both times and stayed not pregnant the rest of the time.”
However, Louise admits that even though cycle-tracking has worked for them for so long, she still sometimes feels “a little nervous” before her period comes. “I will say that if I had been in a situation where an unexpected pregnancy would be a huge crisis for health or financial reasons, I would have used something else,” she adds.
Ashley, 28, from Huntsville, AL, also relies on fertility awareness. “The symptothermal method [observing cervical fluid, basal body temperature, and other biological signs, such as changes in the cervix to identify fertile and infertile times] has improved communication between my husband and me,” she says. “The ‘burden’ of birth control isn’t totally on me, like it would be with a pill, or totally on him, like it would be with a condom. It requires a lot of communication as to whether or not we feel like that month is a good time to take a chance on pregnancy or not.”