Birth Control Options for Every Life Stageby Sarah Ludwig Rausch Health Writer
There are many birth control options out there—which is great, because that means you have choices! But which method is best for you? It depends on your health and your life stage. Maybe you're a single, active dater. Or, you’re busy juggling work and small children. Maybe you’re staring down an empty nest (and the bedroom is quieting down, too), or you never had kids (and you intend to keep it that way). Here are the methods to cruise, choose, and use—and switch up as your needs change.
In College? On Tinder, Bumble, or OKCupid? Condoms Are a Must.
You’re young. You’re dating. But we bet you a.) have no desire to get pregnant and b.) also want to steer clear of sexually transmitted infections (STIs), which are still very much a thing, with more than one million new infections recorded worldwide every day. At any age, if you are in a new relationship, condoms are still needed to avoid STDs (even if birth control is not necessary). For you, condoms 100% must be part of your birth-control picture, possibly paired with another longer-term backup method (ideas coming up next). Believe it or not, some people actually like how condoms feel even after they’ve settled down, says Dr. Jennifer Robinson, M.D., Ph.D., assistant professor of gynecology and obstetrics at Johns Hopkins Bayview Medical Center in Baltimore.
Condom Backup Plan #1: The Implant or the Shot
The implant looks like a small rod and takes under a minute to place in your upper arm, says Natasha Schimmoeller, M.D., assistant professor of family planning in obstetrics and gynecology at Cedars-Sinai in Los Angeles. It’s more than 99% effective, plus it’s good for up to three years. The injection (shot) is 96% effective, and it’s given in the arm or buttocks every three months. Women who use this method for a year or more have a higher likelihood of their periods stopping altogether, Dr. Robinson notes. The shot can also cause weight gain and thinning of the bones. Both methods contain the hormone progestin and can cause some temporary irregular bleeding.
Condom Backup Plan #2: The Hormonal IUD
You can get an IUD, a small, t-shaped device that’s placed in your uterus, at any age. The hormonal IUD contains progestin, and “it works by making the natural mucus in your cervix so thick that sperm can’t get through,” says Dr. Schimmoeller. Benefits: Many women have less bleeding and fewer cramps than before; it may decrease endometrial cancer risk; you can get pregnant immediately after removal; and it’s 99% effective in pregnancy prevention. Dr. Schimmoeller says you may notice some cramping during placement and for the first week after. These can stay in for three to six years.
Condom Backup Plan #3: The Copper IUD
The non-hormonal copper IUD is the longest-lasting reversible method—it’s FDA-approved for up to 10 years (Dr. Schimmoeller and Dr. Robinson say it can be used for 12—talk to your doctor). It’s also 99% effective at preventing pregnancy, and your fertility isn’t affected after removal. With this IUD, you may experience more bleeding and cramps during your period. Rare risks of any IUD include infection from insertion, the IUD falling out, or the device perforating the uterine wall, says Aparna Sridhar, M.D., associate clinical professor in obstetrics and gynecology at the David Geffen School of Medicine at UCLA.
Your Single Days Are Behind You. What's the Best Birth Control Now?
Maybe you’ve moved in with your partner or gotten married, but that doesn’t mean all the excitement is gone. Take the time to enjoy one another, one-on-one. Assuming you’re both exclusive, condoms don’t have to be part of the picture (unless you enjoy using them and they’re working for you). Your life can be focused on you—your work, school, fun activities, and your relationship. At this point, the Pill (estrogen and progestin combo or progestin-only) might be a great option. So might the patch or the vaginal ring (both with combo hormones).
Love Routine? Consider the Pill or the Minipill.
These methods require daily dosing, and the minipill, which is progestin-only, requires you take it roughly at the same time each day to be effective. (Dr. Schimmoeller says your "window" is three hours.) When used correctly, they prevent 93% of pregnancies. They’re great for times when your schedule is routine—maybe the golden era between college and new-parenthood. Your periods will be lighter than before on either type, and you may even have fewer periods on the minipill, Dr. Sridhar says. Plus, you have the option of not having a period at all on the combo pill if you skip the last week of your pack.
Also Worth a Look: The Patch and the Ring
With both the patch and the ring, you get the benefits of pills—including 93% effectiveness—just with less daily hassle. The patch is applied to your upper body (but not the breasts), abdomen, or buttocks, and it’s changed every week for three weeks, then left off for a week for your period. The ring goes inside your vagina for three weeks and it’s removed for the fourth week for your period. You then put in a new one for the next cycle. Dr. Robinson says these combo methods typically give you very predictable periods that tend to be shorter and lighter.
Young Kids in the House? You'll Want One Less Thing to Worry About.
When you’re both trying to juggle the needs of small children, time with each other, household chores, and work, you don’t want to have to think about birth control, too—especially if you’re chronically sleep deprived! This is when you might want to consider the patch, ring, or shot or IUD instead of having to remember to take the Pill every single day. For breastfeeding moms, non-hormonal options like the copper IUD, or progestin-only methods like the minipill, shot and implant are all safe. Once your milk production is established, a low-dose combo pill is safe to use, too.
A Few Considerations on Timing
There’s no rule saying you have to stick with any one method for a specific length of time, notes Dr. Robinson. For example, if you feel confident you don’t want any more kids for a while, she says an IUD is a cost-effective option once you hit the one-year mark after insertion. Or, you can get an implant for any amount of time, too. (Again, your fertility returns as soon as it’s taken out.) If you’re trying to space out kids or you want to get pregnant soon, keep in mind that it may take 10 months (or more) for fertility to return once you stop getting the shot.
Ready to Think Forever Protection?
If you’re 100% positive your family is complete or you know you don’t want kids—now, or ever—consider sterilization for you or your partner. Vasectomy is a safe outpatient surgery that has a relatively fast recovery, says Dr. Robinson. “It doesn’t affect sexual pleasure or the ability to have an erection,” she adds. Vasectomy is 99.85% effective in preventing pregnancy. Tubal ligation, a.k.a. “getting your tubes tied,” now often involves removing the fallopian tubes, rather than tying them, says Dr. Sridhar. “It’s highly effective (99.5%) and safe,” she says, plus it has been found to decrease the risk of ovarian cancer.
You're in Your 40s and Staring Perimenopause in the Face.
Yep, you still need birth control. Even when you’ve started perimenopause (Dr. Sridhar says this can range anywhere from 39–51) and your period is anything but predictable, you can still (gulp) get pregnant. You’ll need to take precautions until you hit menopause, defined as going one year without a period. There’s a bonus to using hormonal methods during perimenopause: Dr. Sridhar says methods with estrogen can help with hot flashes and make the transition smoother for some women.
Shots, Patches, Rings, Pills—The Choice is Yours.
Whether you're swiping right with a vengeance, you've just moved in with your partner, or the last of your kids is out the door (hello, independence!), Dr. Robinson says any of these methods are a safe pick. Just make sure that whatever you choose fits into your lifestyle without causing too many side effects, and that it’s compatible with any health conditions you have. If you don’t like what you’re currently using, try a different brand, type, or method. Life is too short—and sex is too fun!—not to love your birth control.