Knowing your birth control options

They look like devices from outer space, but they’ve marked one giant leap for womankind. Here are the best methods for your age and life stage.

Decisions, Decisions…

When you’re choosing which birth control to use, you have a lot to think about. “Age is one of the first things to consider,” says Dr. Thomas Migliaccio, a gynecologist in Hoboken, N.J. “But you also need to factor in your menstrual and medical histories, convenience, and cost.” Generally, all the methods discussed here can be effective for most women. But to help narrow your options, these are the best bets based on what you’re probably looking for from your contraception.

In Your 20s and Early 30s

What’s on your mind

You could be looking to prevent pregnancy now but planning to conceive in the distant future. You might already have babies on the brain. Or you may be in between. In other words, you need contraception with some flexibility.

Methods to consider

* Depo-Provera

Delivered by an injection once every three months, Depo-Provera contains progesterone, which helps prevent ovulation and thickens cervical mucus to block sperm from entering the uterus. It can be a good choice for women who can’t take estrogen. This method is best for those who don’t plan to conceive soon, since in some cases it can take up to a year for fertility to return.

Benefits: The longer you’re on Depo-Provera, the lighter your periods become (some women even stop getting them). And you don’t have to take a daily pill.

Downsides: You have to visit your gynecologist every three months for an injection. Also, studies show that this method can cause bone loss over time, so you don’t want to stay on it longer than five years, says Migliaccio.

Cost: $40 to $100 a shot; may be covered by insurance.


* Birth-Control Pills

Oral contraceptives contain synthetic versions of the hormones estrogen and progesterone to prevent ovulation. “They mimic the hormones produced by your ovaries,” says Dr. Cindy Basinski, a gynecologic surgeon in Newburgh, Ind. “So your brain doesn’t signal your ovary to produce an egg.” Most pills contain both hormones. Several contain only progesterone; they’re often prescribed to women who can’t take estrogen or who are breast-feeding. Typically, you take pills that contain hormones (called “active” pills) for 21 to 24 days and placebos for four to seven days. The placebos trigger the body to bleed, as if you’re having a period (you aren’t, because you haven’t ovulated). “Continuous cycle” pills, like Seasonale, all but eliminate this pseudo-period. You take active pills for three months at a time and get a “period” four times a year. “This is safe—there’s no medical need to have a period on the Pill,” says Lauren Streicher, an assistant professor of obstetrics and gynecology at Northwestern University, in Chicago. Some women are wary of taking the Pill long-term in light of its purported link with breast cancer. But “the Pill does not appear to significantly increase your risk,” says Basinski. And those containing both estrogen and progesterone may reduce your risk of ovarian and uterine cancers.

Benefits: Lighter, regular periods (ideal for women with a history of heavy bleeding) and restored fertility as soon as you stop taking it. So, contrary to popular belief, you don’t have to be off the Pill for a few months before trying to conceive.

Downsides: The Pill can sometimes produce side effects, such as headaches or nausea, and it’s not recommended for women who have a history of blood clots or who are over 35 and smoke or are obese. And—obviously—you need to remember to take it every day.

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