Birth control: pick the best method for your life

Trying to choose birth control can feel overwhelming. You want something that works, fits your routine, and matches your health. Below I’ll cut through the noise with clear facts, real numbers, and easy next steps so you can make a smart choice fast.

Start with effectiveness. Long-acting reversible options — IUDs and implants — are over 99% effective and forgettable once placed. The shot is about 94% typical use. Pills, the patch, and the ring are roughly 91% typical use because people miss doses. Condoms are about 85% typical use, but they’re the only method that helps prevent STIs. Fertility-awareness methods and withdrawal are less reliable (mid 70s to high 70s). If avoiding pregnancy is the top priority, IUDs and implants are the easiest and most reliable.

Choosing the right method

Ask yourself three practical questions: How long do you want protection? Can you take a daily pill or do you want something set-and-forget? Do you need STI protection? If you want no regular action, consider an IUD or implant. If you prefer non-hormonal options, a copper IUD or condoms are solid. If you’re breastfeeding or can’t use estrogen, progestin-only pills, the implant, the shot, or a hormonal IUD are good choices.

Side effects matter. Spotting, breast tenderness, nausea, or mood changes are common with hormonal methods. Serious risks are rare but real — combined hormonal methods (pills, patch, ring) slightly increase blood clot risk, especially if you smoke and are over 35. If you have migraine with aura, a history of blood clots, or certain heart conditions, your provider will likely steer you away from estrogen-containing options.

Getting and using birth control safely

You can get most methods through clinics, primary care, or telehealth. IUDs and implants need in-person placement. Pills, patch, and ring are often available by prescription; some places offer same-day pickup or delivery. If buying online, use accredited pharmacies and avoid sites that don’t ask for basic medical info — fake pills and wrong doses happen.

Watch for drug interactions. Enzyme-inducing drugs (like some seizure meds and certain antibiotics such as rifampin) can reduce hormonal pill effectiveness. Always tell the prescriber about other meds, including supplements and herbal products like St. John’s Wort.

Missed dose? Check your pill leaflet or contact your clinic. As a simple rule: if you miss one combined pill, take it as soon as you remember and use a backup for a short time; if you miss more, use a condom or emergency contraception and call your provider. Emergency contraception options include levonorgestrel (OTC within 72 hours), ulipristal (prescription up to 120 hours), and the copper IUD (most effective if placed soon after sex).

Want help choosing? Talk to a clinician who knows your medical history. Bring a list of meds, your smoking status, and whether you plan to get pregnant soon. Good contraception should fit your body and your life — not the other way around.