For better or worse, there are a lot of kinds of birth control out there. But while working to keep you pregnancy-free, they often cause some other changes to your body, and not all of them are pleasant. Here's what every woman should know about each type of birth control method before choosing the one for you. And remember, with so many options, if you aren’t loving your experience with the one you choose, you can (and should) talk to your gyno about finding a better match. There's no reason to stay in an unhappy relationship!
If you're curious whether your pill is a combo variety, a list of common brand names can be found here. So first, let’s start with a few of the beneficial side effects (yes, there are some!). “Taking estrogen in any form will likely make your period lighter and your skin better,” says Nerys Benfield, M.D., M.P.H., an assistant professor in the Department of Obstetrics & Gynecology and Women's Health at the Montefiore Medical Center Albert Einstein College of Medicine and an advisor for Bedsider.org. But taking estrogen pills can also lead to nausea (which Dr. Benfield says will normally ease up over time). You may also experience breast tenderness, headache, breakthrough bleeding or spotting throughout your cycle, and—very rarely—blood clots.
(Here's a list of brand names for progestin-only pills.) These are a great option for anyone who is looking for oral contraception without estrogen, which you might be avoiding if you are a smoker (blood-clot risk is higher for smokers) or are nursing (estrogen can dry up your milk), says Alyssa Dweck, M.D., an assistant clinical professor at the Mount Sinai School of Medicine. With progestin-only pills, Dr. Dweck says, women commonly see weight gain, acne and in rare cases, hair loss as side effects.
This small ring that you insert into the vagina each month releases the same combination of estrogen and progestin as the combo Pill but does it in a smaller dose and a bit more steadily. “With oral contraception, it can go up and down every day based on the way we process medication,” says Dr. Benfield. Of course, some people aren't crazy about the idea of inserting something into their bodies. “There’s that group of women who just don’t feel comfortable with anything in the vagina,” says Dr. Dweck, “and it can also cause a little bit of vaginal drainage, so some people who don’t love it for that reason.” During sex, the Nuvaring can also pop out—eek!
The patch has the same hormones as the pill and the ring, so from that aspect, it will have similar side effects, says Dr. Dweck. “On the good side, the better skin, the lighter period,” she says, “and on the downside, headaches and breast tenderness.” It’s also possible for the adhesive to irritate your skin. “We do recommend that each week, you put the patch in a different place,” said Dr. Benfield. If irritation persists, talk to your doctor about switching to another brand of the patch or switching methods altogether. “There also might be a higher risk of blood clots than with other forms of birth control,” says Dr. Dweck. “It has a black-box warning [an FDA label that calls attention to serious or life-threatening risks], which can scare patients and practitioners alike, but it’s still a great form of birth control,” she says.
Another progestin-only option, the Depo-Provera shot is administered every three months. It has the highest dose of all the hormonal choices and therefore the less-desirable effects (including weight gain) are slightly more common. “Most women who use it will not gain weight, but if you are one of the women who does, you can find another method that’s better for you and your body,” says Dr. Benfield.
This progestin-only hormonal option comes in the form of a small metal rod implanted beneath the skin, and it’s going to have the same effects as the other progestin-only methods. “Number one, you are going to have a change in your bleeding in the beginning,” says Dr. Banfield. It’s on the low-dose side of things, so breast tenderness and headaches are less likely. “The only nuanced difference in side effects is the actual placement itself,” Dr. Benfield explains. “You might have some soreness in your arm and some bruising around the implant right after the insertion, but that should resolve.”
You're probably aware of the main side effect of the IUD: There is a discomfort and cramping upon first insertion by your doctor. On the plus side, you get protection for three to five years (depending on the type you choose), and you get a lighter, less crampy period. “Eventually you might not have a period at all,” says Dr. Benfield. The hormonal IUD could also cause some of the typical hormonal downsides (breast tenderness and headaches) but there's a smaller chance you'll notice them than there is with oral contraceptives.
As far as side effects go, you should also consider what it's like to have sex while you've got an IUD. There are small strings on the bottom of the device that your partner mightfeel. “At first, the strings are a little stiff, but they soften over time,” says Dr. Benfield. And if the strings continue to be disruptive to your sex life, you can always get them trimmed, she says.
The experience of living with the copper IUD is the same as the hormonal one (insertion cramping, intercourse, etc.), but the major difference is your period will get heavier for the first year. “After a year the period should be where it was before,” says Dr. Benfield. “But with those first couple of months, I always tell my patients to be prepared and have pads on hand.”
Ah, condoms. These old faithfuls come with very few side effects, as long as you aren’t allergic to latex. “You’ll know within 20 to 30 minutes after using one if you have a latex allergy,” says Dr. Benfield. A red, bumpy rash will appear. And—get this—not only in the area where the condom has touched. “People would expect, ‘Oh, it’s going to be a rash where I put the condom,’ and that’s not necessarily the case. It can be anywhere on the body,” says Dr. Benfield. If an allergy presents itself, you can try polyurethane or natural condoms. The bells and whistles of some condoms on the market are also something to consider, says Dr. Dweck. She’s talking about vibrations, warming lubricant, spermicides—these things can cause irritations. “A plain condom with a separate water-soluble lubricant is always a safe choice,” she suggests.
OK, maybe the diaphragm’s most popular moment has passed, but it’s still one of the best female-controlled barrier methods when used properly. You’ll need to get fitted for one, and once you do, it’s inserted into the vagina just before intercourse. “The only complaint I hear about the diaphragm is from women who are already prone to urinary tract infections,” says Dr. Dweck. “You might see some more UTIs in this case.”
Another woman-controlled barrier method, the disposable sponge is placed in the vagina just before having sex and contains spermicide to help block the small swimmers from ever finding an egg. “It’s easier to put in than a diaphragm, but it’s not as effective,” says Dr. Banfield. "There isn’t a huge uptick in infections to speak of, and that’s probably because it’s not in the vagina for a very long time, she says. Dr. Dweck's experience? “As long as you aren’t sensitive to the spermicide, I’ve seen a lot of women love the sponge.”
No method is perfect, so evaluate the pros and cons of what you can live with before choosing one for you.