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Today's Birth Control Options

With so many contraception options available, do you know which one to choose? Our guide can help.
By Christina Boufis
WebMD Magazine - Feature

If you are not ready to start a family, are taking a break from having more kids, or are done with diapers for good, how do you know which birth control method to choose?

"I usually present birth control options from most to least effective," says Amy Whitaker, MD, assistant professor of obstetrics and gynecology at The University of Chicago Medicine. "Then, is there anything about a specific woman's medical history that would make a certain contraceptive unsafe for her to use?"

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Under the Affordable Care Act, many health insurance plans will provide free women’s preventive services, including mammograms, birth control and well-woman visits. Learn more.

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Other factors to consider: "How easy do you want the contraceptive to be? How important is pregnancy prevention at this time?" asks Anita L. Nelson, MD, professor of obstetrics and gynecology at the David Geffen School of Medicine at UCLA. "Are your periods heavy or bothersome? Can you use a birth control method to improve your quality of life?"

Read on for an overview of birth control choices, then check with your doctor about which method is best for you.

Intrauterine Devices

If you want "forgettable" birth control, you might choose an intrauterine device (IUD) or implant.

Hormonal IUD

What it is: The hormonal IUD is a small, T-shaped device that a doctor must insert and remove. It stays in your uterus for up to five years.

How it works: A small amount of a progestin (a synthetic form of the female hormone progesterone) is released every day, which thins the lining of the uterus and thickens cervical mucus, acting as a barrier to sperm.

Effective rate: 99%

Drawbacks: The hormonal IUD can cause irregular bleeding for the first few months of use, but that typically decreases by the fourth month, Nelson says.

Benefits: Menstrual bleeding is usually less heavy with a hormonal IUD. About 1 in 5 women will stop menstruating within a year of beginning use, which is medically fine and often beneficial for those who have heavy periods, Whitaker says. The IUD may protect against endometrial and cervical cancers.

Side effects:  Some women may have side effects caused by the hormones, such as headaches, nausea, and breast tenderness, but this is rare, says Whitaker.

Copper IUD

What it is: The copper IUD is inserted and removed by a doctor; it lasts up to 10 years.

How it works: The copper IUD works like a spermicide, explains Nelson, stopping the sperm from reaching the egg. It can also prevent the egg from attaching to the lining of the uterus.

Effective rate: 99%

Drawbacks and side effects: Unlike the hormonal IUD, the copper IUD may cause cramping and heavier, more painful periods in some women, but medication can help, Nelson says.

Benefits: "You get 10 years of protection with one five-minute procedure," says Nelson. "And it's immediately reversible" -- you just have your doctor remove it. The IUD may protect against endometrial and cervical cancers.

For both IUDs: Some women have mild cramping when the device is inserted. Women who have a pelvic infection must be treated before getting an IUD. There is a 1 in 1,000 chance of a small tear during insertion, which is easily treated, says Nelson. Note that neither IUD protects against sexually transmitted diseases (STDs).

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