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    Do You Know Your Long-Term Birth Control Options?

    The IUD continued...

    Copper IUDs are hormone-free. Copper works like a spermicide and prevents sperm from fertilizing an egg.

    Women who want a hormone-free form of contraception (meaning less potential side effects) often choose these devices. Hormone-free birth control, though, does not have the same effect on your menstrual cycle.

    “It’s not true for all women, but in general, periods may be a bit heavier and crampier with the copper IUD,” Micks says. “It’s not a method that we would choose in a woman who is already having heavy periods.”

    Birth Control Implant

    Your doctor inserts this small, thin, and flexible plastic rod into your arm. Like a hormonal IUD, the implant releases progestin into your body. It works for up to 3 years, and your doctor can remove it any time before that.

    Also like IUDs, implants are also 20 times more effective than pills, patches, or rings.

    Some women have irregular bleeding during the first 6 to 12 months. For most, periods get lighter and happen less often.

    “What comes with the implant is that it’s very unpredictable,” Micks says. “Some will stop having periods, but some will have quite a bit more bleeding.”

    With her patients, Micks says, “if they don’t see themselves wanting to get pregnant within a year, then I recommend that they do an IUD or an implant,” she says. “They can have it taken out any time, even a day later, a month later, whenever.”

    The Shot (Depo-Provera)

    This method protects against pregnancy for 3 months at a time. It uses progestin to do that.

    Only 1 in 100 women who get the shot every 12 weeks will get pregnant. For those who don’t get their shot on schedule, 6 out of 100 will get pregnant.

    Similar to other progestin methods, the shot can cause irregular bleeding during the first year. About half of women will have fewer and lighter periods after that. Others may have spotting or heavier, longer periods.

    The shot can cause bone thinning, which stops after the injection wears off. For this reason, women at risk for osteoporosis should use a different form of birth control.

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