Birth Control Options Explained

When patients ask Victoria Schooler, PA-C, which birth control method is right for them, she starts with four questions:

• Are you looking to prevent pregnancy for a few months, several years or are you interested in a permanent option?
• Do you have a history of migraines with aura, high blood pressure, blood clots, breast cancer or smoking?
• Are you trying to target anything else, like heavy or painful periods, endometriosis or acne?
• Would you prefer a daily pill, a weekly patch, a monthly ring, an injection every three months or a "set it and forget it" option like an IUD or implant?

“My goal is to help patients find the best option that fits their health, lifestyle and personal preferences,” says Schooler, a board-certified Physician Assistant at Henry Mayo Newhall Hospital.

Because each method works differently, the best choice often depends on how much maintenance you want, how long you want protection and whether you prefer hormonal or non-hormonal options.

Here are some birth control options available:

Long-acting reversible contraception (LARC), including hormonal IUDs, copper IUDs and arm implants (Nexplanon), are placed by a healthcare provider. These “set and forget” options can last for several years and can be removed when you decide to conceive.

Short-acting hormonal methods, such as pills, patches, vaginal rings and shots, vary by schedule: daily, weekly, monthly or quarterly.

Barrier methods include external condoms and internal options such as diaphragms, sponges and pouches. Condoms are the only birth control method that also helps protect against STIs.

Non-hormonal and on-demand methods, such as spermicides and vaginal gels or foams, are inserted into the vagina before intercourse to lower pH or immobilize sperm.

Ovulation tracking involves identifying fertile days and either abstaining from sex or using a barrier method during that window.

Permanent sterilization includes procedures such as tubal ligation and vasectomy.

Weight gain is a frequent concern when starting a new contraceptive method. “While many patients worry that all hormonal birth control causes significant weight gain, research shows that most have little or no effect on weight,” Schooler says. She adds that the birth control injection Depo-Provera is one exception.

Another common misconception is that birth control causes permanent infertility. “In reality, almost all reversible birth control methods allow fertility to return once the method is stopped,” she says. “For most people, ovulation resumes within weeks to a few months after discontinuing pills, patches, rings, hormonal IUDs, implants or non-hormonal IUDs.”

Overall, it typically takes a few menstrual cycles, or around 90 days, to adjust to a new contraceptive method. Temporary side effects are common during this adjustment window, but patients should contact their healthcare provider if symptoms feel severe, persistent or concerning.

The right birth control method is the one that fits your health, lifestyle and reproductive goals. A conversation with your healthcare provider can help you compare your options and choose the method that works best for you.