Know Your Options—A Guide to Choosing The Right Birth Control For You

By Nicole Mitchell
Art by Kelcie McKenney

Finding the perfect birth control for you is difficult. There are so many options, each with different side effects, lengths of efficacy, and more. If you’re struggling to find a new birth control, just starting, or straight-up curious, we want to help you make an informed decision. We’ve done the basic research so you don’t have to. (Although, you’ll still want to talk to your doctor about what’s best for you!)


The implant is a small rod that is safely implanted (ha) into your arm. It releases a hormone called progestin to help prevent pregnancy. The good news about the implant is that once it is in place, it can stay there for up to five years. No daily reminders needed.

Even better news is that the implant is 99% effective! It’s placed by a doctor, so there’s no need to worry about forgetting it or using it incorrectly, like you might with other birth control options.

So what’s the catch? Well, every medication has its side effects, so here are some of the implants: headaches, nausea, weight gain, and, sadly, ovarian cysts can occur.


For those of you with penises (or if you have a partner with one), you might want to take some notes: Like sterilization, a vasectomy is one of the most successful and accurate forms of birth control, with a nearly 100% success rate. Not just that, but vasectomies are safe as well. Side effects and risks involved with the procedure are typically minor and are able to be treated quickly.

Vasectomy FAQ:

How soon can I have sex after the procedure?

Most people can have sex a few days to a week after the procedure.

Will it hurt?

Your doctor will give you a local anesthetic, so the procedure itself shouldn’t hurt. But you might feel sore while healing.

Can it be reversed?

You should only get a vasectomy if you’re 100% sure you won’t want to reverse it in the future. While it can be reversed, it’s possible that your fertility might not come back. Plus, the reversal surgery is more complicated and expensive.

Diaphragm/cervical cap

The two are fairly similar, but how do they work? Both the diaphragm and cervical cap are placed inside the vagina, up against the cervix. (Think of a menstrual cup or disk). While the two cover the opening—preventing sperm to meet an egg—both are best used with spermicide.

The main difference between the two types of birth control is that a cervical cap is smaller. You can also keep a cervical cap inside the body for longer periods of time (up to two days). However, it’s important to note that diaphragms are slightly more effective at preventing pregnancy.

Internal condom

Internal condoms are 79% effective in preventing pregnancies, meaning 21 out of 100 people get pregnant while using the condom every year. For the best effectiveness, it’s recommended to use an internal condom alongside other birth control options. This ensures that you’re protected from STIs and preventing pregnancy. But don’t use a regular condom with an internal one because doubling up won’t give you extra protection.

Fun fact: You can use the internal condom in your vagina or anus. (Meaning you can have all kinds of protected fun!)

Tubal ligation

Tubal ligation (or sterilization) can be scary to think about. However, tubal ligation is a safe and effective surgical procedure that permanently prevents pregnancy. Tubal ligation is the most known form of female sterilization and is a surgical procedure that permanently closes, cuts, or removes pieces of the fallopian tubes.

Some people with uteruses who don’t have children and aren’t married find it difficult to be accepted for a tubal ligation by their doctor. The reason being that doctors might assume that the patient (or their partner) will want children in the future.

Like any medical procedure, there are some risks to tubal ligation; however, the surgery is typically considered safe. It’s important to know, though, that the vasectomy (or male sterilization) is an easier procedure with fewer risks.


There are currently two birth control patches available in the US—the Xulane and the Twirla patch.

In a perfect world, the patch would be 99% effective; however, since it is easy to make some mistakes while using the birth control, the patch is about 91% effective. There are some things that make the patch less effective, such as not replacing it for more than a day or two, certain antibiotics, and other medicines.

As for side effects, the patch can cause headaches, nausea, sore breasts, and more, but any effects typically go away after two or three months. For some people, the patch can help with period cramps and PMS.

Vaginal ring

Have you heard of the vaginal ring—commonly known as the NuvaRing?

The ring is 91% effective, and there are two options. The first option—and the most commonly known—is the NuvaRing. Typically the ring is inserted into the vagina and left there for three weeks, followed by one off-week, and then repeat. However, you can keep it in that last week to completely skip your periods if you want to. There is also a newer type of ring called Annovera, which is reused over one year. Similar to the NuvaRing, it’s kept in the vagina for three weeks and removed for one.

The positives: What’s nice about the ring is that you can put it in and forget about it for around a month. It’s not a pill you have to take every day at the same time, so it’s easier to remember to change it each month. If you choose to continue periods while you’re on the ring, they will most likely get lighter. It can also ease cramps and PMS.

The negatives: Headaches, sore breasts, and more vaginal wetness—the usual.

Intrauterine Device (IUD)

Like the birth control pill, it’s likely you know someone (or maybe you are that person) who uses the IUD to prevent pregnancy. You’ve heard all the stories—good and bad; but what all is there to consider when trying the IUD?

There are two different types: copper IUDs (like Paragard) and hormonal ones (like Mirena). Each with its own timeline and side effects, but the IUD can prevent pregnancy for up to 12 years.

It’s common for users to have spotting for three to six months after the insertion of the IUD, and in general, hormonal IUDs can make periods lighter or rid users of them completely. Copper IUDs, on the other hand, can possibly make periods heavier and worsen cramps.


Oh, condoms. The most commonly used form of birth control. We’ve all (hopefully) used them, we may not all love them. They come in different forms from flavored to glow-in-the-dark, ribbed to warming, internal, and more. But what are the facts?

While in the lab, condoms are 98% effective, unfortunately in real-world circumstances, they’re only 85% effective. The good news is, as long as you use them correctly and every time you have sex (oral, vaginal, and anal) they will protect you from STIs as well.

The best thing about condoms is that they are accessible. They don’t cost a fortune compared to other forms of birth control, and you can likely get free condoms from your doctor or local Planned Parenthood.

Fertility Awareness Method (FAM)

Hormonal birth control can be tough. The side effects can be painful, and it can be hard to find one that works right for you. For those of you who seemed to have tried it all or are looking for something more “natural,” fertility awareness method (FAM) might be a good move.

Fertility awareness is a form of birth control that is done completely on your own by tracking periods, temperature, daily discharge, or by following a calendar. These methods can be combined for greater efficacy, but in general, FAMs are only 76-88% effective. While there aren’t any side effects to FAM, it’s only recommended for those who understand when their body is ovulating and when it’s not.

If that’s something that you’re not completely comfortable with yet, it’s recommended to speak to a doctor who is experienced with FAM if you’re interested in starting it.


Everyone knows what the birth control pill is—or at least the idea of it. But did you know there are actually two different kinds of BC pills? There are combination pills, which have both estrogen and progestin (this is the most common type), and progestin-only pills.

It’s commonly thought that you have to take the BC pill every day within the same three hours. However, it’s only a requirement for progestin-only pills. It is, however, recommended for all types of birth control pills as a way to remember to take them each day.

Common side effects of each pill include nausea, headaches, sore breasts, changes in periods, and spotting. Luckily, the side effects of the birth control pill should go away after a few months of correct usage.


If you’re not scared of needles and need something low-maintenance, the birth control shot might be for you. The only upkeep you’ll need is a visit to the doctor’s office every three months for a quick injection. After that, you can forget about it for a little while.

The side effects can look like a shorter, lighter period (yay) as well as weight gain, headaches, or depression (not so yay).

If you’re looking for a short-term birth control and can see yourself trying to get pregnant in a year or two, this might not be the right pick for you because it may take up to 10 months for you to get pregnant after stopping the shot.

As always, there are pros and cons to every birth control. It just takes trial and error to decide what’s best for you, but educating yourself on what options exist is a good start. Visit the Planned Parenthood website for more birth control options and information, and talk to your doctor about what’s best for you.

Nicole Mitchell (she/they) is a writer and social media manager who graduated December 2020 with a degree in strategic communication. A few of her favorite things include cuddling with cats, listening to Bon Iver, making lattes, and running her book club (even though sometimes she forgets to read the books.)

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