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Friday, October 27, 2023

Choosing Your Birth Control Plan

By Dr. Robert Wool


With so many birth control options available, it can feel intimidating to choose which method is best for you. It’s a very personal, individual choice—there is no one-size-fits-all solution. Before choosing your birth control plan, you’ll want to take several factors into consideration, including safety, efficacy, ease of use, side effects, convenience and cost. Let’s take a look at a few of the available options and talk through some pros and cons.


Please remember that only condoms (external or internal) can protect you from sexually transmitted diseases (STDs). None of the other birth control options protect against STDs. It’s not a bad idea to go with both—using a condom in combination with another birth control method will protect against STDs and provide even greater effectiveness against pregnancy.


The Pill

The pill is very effective, preventing pregnancies in up to 92–99% of cases. The pill uses hormones—usually estrogen and progestin—that prevent ovulation so fertilization cannot take place. Some women don’t tolerate estrogen well, however, and in those cases, a non-estrogen alternative may be a better choice.


To be effective, the pill must be taken every day at about the same time and begins to lose its efficacy if you skip a dose or take it on an erratic schedule. So, while it’s a convenient, at-home “do it yourself” option, it does require diligence, consistency and a visit to your provider for a prescription. The pill is an affordable option, with costs ranging from $0 to $50 per month.


The Shot

The shot contains progestin but not estrogen, making it a good option if you don’t tolerate estrogen well. Statistically, it’s just slightly more effective than the pill, preventing pregnancy in up to 94–98% of cases when taken on schedule. The injection must be administered by your provider and re-administered every three months, which means making and keeping regular medical appointments. The shot can cost from $0 to $150 per injection.


The Implant

The implant is a great birth control option, both for convenience and effectiveness. This thin, matchstick-sized rod is implanted in your arm by a doctor or nurse and then continues to do its job for up to three years, with an amazing 99% effectiveness rate. Any side effects are usually temporary, subsiding after a few months. Like the injection, the implant contains progestin without estrogen. Your provider will have to remove and/or replace it every few years, requiring an occasional visit. This can be a pricier option, with costs ranging from $0 to $1,300 per implant.



Short for “intrauterine device,” an IUD is a flexible plastic item inserted by a doctor into the uterus to prevent pregnancy. The IUD is another “set it and don’t sweat it” option, remaining effective for years after implantation. It is also one of the most effective methods available, preventing pregnancies in up to 99% of cases.


There are two types: copper IUDs and hormonal IUDs. Copper IUDs don’t contain any hormones and protect against pregnancy for up to 12 years. Hormonal IUDs, which steadily release small amounts of progestin into the uterus, work for 3–8 years. Like the implant, the IUD can cost from $0 to $1,300 each.


The Patch

Worn on your belly, behind, back or (in some cases) arm, the patch is a convenient and effective birth control method. It successfully prevents pregnancy in up to 92% of cases, and while an initial visit to your provider is required for a prescription, you can apply the patches yourself at home.


The flip side to this convenience is that you’ll need to be vigilant about replacing your patches weekly and making sure to keep your prescription refilled—any timing gap in replacing your patch can decrease its effectiveness significantly. The patch contains a combination of estrogen and progestin, and costs between $0 to $150 per month.


The Condom

A condom is the only birth control option that also helps protect against sexually transmitted diseases (STDs). It is also a good choice if you only wish to think about contraception when you need it. You don’t need a prescription, or doctor visit to buy condoms—they are easily available, no questions asked.


However, male (external) condoms are only about 82% effective in preventing pregnancies compared to the higher efficacy rates of IUDs, implants, injections and pills. Combining a condom with one of these other methods protects against STDs and further decreases your risk of becoming pregnant. Condoms are very affordable, with costs ranging from $0 to $2 apiece.


The Pull-Out Method

The pull-out, or withdrawal, method is simply the act of withdrawing the penis from the vagina prior to ejaculation. It is most effective when combined with a condom—on its own, it has an effectiveness rate of about 76–78%. The timing is everything, and it has to be right every time, leaving little to no room for error. If you use the withdrawal method, you might want to consider having emergency contraception on hand.


Here for All Your Questions

This is just a quick overview of some of the birth control options available. It’s best to speak with your health care provider to get all the information you need to make a well-informed decision when choosing your birth control plan We are here to answer all of your questions thoroughly and without judgment. All questions are good questions. We just want you to be fully empowered in making the best decisions for your health. Please reach out with questions or to schedule an appointment.