Birth control options compared: pill, IUD, implant and injection

Long-acting options

Hormonal and copper IUDs and the contraceptive implant are the most effective reversible methods available — over 99 percent — because they remove the possibility of user error. Once placed, there is nothing to remember.

They last three to ten years depending on the device, can be removed at any time, and fertility returns quickly after removal.

Shorter-acting options

• The pill: taken daily, good cycle control, effectiveness drops with missed doses
• The patch: changed weekly, similar hormones to the combined pill
• The vaginal ring: changed monthly, low maintenance, discreet
• The injection: every twelve weeks, no daily task, return of fertility can be slow
• Condoms: the only method that also prevents sexually transmitted infections

Choosing between them

Ask yourself three questions: how much do you want to think about it, how do you feel about your periods changing, and how soon might you want to be pregnant? Those three answers eliminate most of the list quickly.

Medical history matters too. Migraine with aura, high blood pressure, smoking over 35, a history of blood clots or certain cancers can rule out estrogen-containing methods. Progestin-only and copper options usually remain available.

Side effects worth knowing

Irregular spotting is common in the first three to six months with almost every hormonal method, then usually settles. Persistent mood change, headaches or bleeding that disrupts your life are reasons to switch, not reasons to stop contraception entirely.

Book a review rather than quitting on your own — there is almost always another option that suits you better.