The Complete Guide to Birth Control: Every Method Compared
Pills, IUDs, implants, patches, condoms, fertility awareness. There are more birth control options than ever. This guide compares every method side by side so you can make an informed decision with your healthcare provider.
Birth Control at a Glance
Birth control methods fall into five categories:
- Hormonal methods: The pill, hormonal IUD, implant, shot, patch, ring
- Non-hormonal methods: Copper IUD, condoms, diaphragm, spermicide, fertility awareness, withdrawal
- Permanent methods: Tubal ligation, vasectomy
- Emergency contraception: Plan B, ella, copper IUD
Most effective reversible methods: Implant (99.95%), hormonal IUD (99.8%), copper IUD (99.2%)[6][7]
Table of Contents
- How Birth Control Works: A Quick Overview
- Hormonal Birth Control Methods
- Non-Hormonal Birth Control Methods
- Permanent Birth Control Methods
- Emergency Contraception
- The Complete Birth Control Comparison Chart
- IUD vs. Pill: The Most Common Decision
- How to Choose the Right Birth Control for You
- Birth Control and Your Cycle: What Changes?
- Tracking Side Effects: Why It Matters
- How Go Go Gaia Helps
- Frequently Asked Questions
Medical Disclaimer
This article is for educational and informational purposes only and does not constitute medical advice. Birth control is a medical decision that should be made in consultation with a qualified healthcare provider. Effectiveness rates, side effects, and suitability vary by individual. Always discuss your health history, current medications, and reproductive goals with your doctor before starting, switching, or stopping any contraceptive method.
When Maya's doctor asked what birth control she wanted, she froze. "I just said 'the pill' because it was the only one I could name," she recalls. "I didn't know there were so many options, or that some would be a much better fit for my lifestyle."
Sound familiar? You're not alone. Most of us learn about birth control through friends, social media, or rushed doctor's appointments, not through a thorough comparison of every option available. The result? Many women end up on a method that doesn't work well for them and assume that's just how birth control feels.
It doesn't have to be that way. There are over a dozen birth control methods available today, each with different effectiveness rates, side effect profiles, and impacts on your cycle. The "best" method is the one that fits YOUR body, lifestyle, health history, and goals.
This guide walks you through every method: how it works, how effective it is, what it does to your period, and who it's best for. That way you can have an informed conversation with your healthcare provider.
How Birth Control Works: A Quick Overview
What Happens During a Normal Cycle
To understand how birth control works, you first need to understand what it's preventing. In a typical menstrual cycle (learn more in our complete period tracking guide):
- Your brain signals your ovaries to develop follicles (potential eggs)
- One follicle matures and releases an egg (ovulation), usually around day 14
- The egg travels down the fallopian tube where it can be fertilized by sperm
- If fertilized, the egg implants in the uterine lining. If not, the lining sheds (your period)
Birth control intervenes at one or more of these steps.
The Four Ways Birth Control Prevents Pregnancy
- Suppressing ovulation: No egg released means no pregnancy possible (pills, patch, ring, shot, implant)
- Thickening cervical mucus: Makes it difficult for sperm to reach the egg (hormonal IUD, mini-pill, implant, shot)
- Thinning the uterine lining: Makes implantation less likely (hormonal IUD, pills)
- Creating a physical or chemical barrier: Blocks sperm from reaching the egg (condoms, diaphragm, spermicide, copper IUD)
Most hormonal methods use multiple mechanisms simultaneously, which is why they're so effective.
Hormonal vs. Non-Hormonal: What's the Difference?
Hormonal methods use synthetic versions of estrogen and/or progestin (synthetic progesterone) to prevent pregnancy. They change your natural hormone cycle, which is why they affect your period, mood, and other body systems.
Non-hormonal methods work without altering your hormones. Your natural cycle continues as normal. You still ovulate, still produce your own estrogen and progesterone, and still get a true period. The trade-off is that most non-hormonal methods are less effective than hormonal ones (the copper IUD is the exception).
Hormonal Birth Control Methods
Combined Oral Contraceptive Pills ("The Pill")
What it is: A daily pill containing synthetic estrogen and progestin. The most commonly prescribed birth control method worldwide.
How it works: Primarily suppresses ovulation. Also thickens cervical mucus and thins the uterine lining.
Effectiveness: 99.7% with perfect use, 93% with typical use (meaning about 7 in 100 women get pregnant per year in real-world conditions, mostly due to missed pills).[3][6]
Hormones: Estrogen + progestin (combined). Dozens of formulations with different progestin types and estrogen doses.
Duration: Daily. You must take it at the same time every day.
Cost range: $0–$50/month (often covered by insurance; free with many plans).
Common side effects: Nausea (usually resolves in 1–3 months), breast tenderness, headaches, spotting between periods, mood changes.[3] Serious but rare: blood clots, stroke (higher risk in smokers over 35).[2]
Period/cycle impact: Periods become lighter, shorter, and more predictable. Many women experience less cramping. You bleed during the placebo week, but this is a withdrawal bleed, not a true period. You're not actually ovulating. Some pill packs let you skip periods entirely.
Best for: Women who want predictable periods, acne improvement, or the ability to easily start and stop. Also used to manage PCOS, endometriosis, and heavy periods.
Hormonal IUD (Mirena, Kyleena, Liletta, Skyla)
What it is: A small T-shaped device inserted into the uterus that releases levonorgestrel (a progestin) locally.
How it works: Thickens cervical mucus, thins the uterine lining, and may suppress ovulation in some women (especially with higher-dose versions like Mirena). Most of the hormone stays in the uterus rather than circulating through your whole body.
Effectiveness: 99.8%, one of the most effective methods available.[3][6] No user action required after insertion.
Hormones: Progestin only (levonorgestrel), primarily local effect.
Duration: 3–8 years depending on the brand (Mirena: up to 8 years; Kyleena: 5; Liletta: 8; Skyla: 3).
Cost range: $0–$1,300 upfront (including insertion), but over its lifespan works out to roughly $15–$50/year. Covered by most insurance.
Common side effects: Irregular bleeding/spotting for the first 3–6 months, cramping after insertion, headaches. Fewer systemic side effects than the pill because hormones act locally. Rare: expulsion, perforation during insertion.
Period/cycle impact: Periods typically become much lighter. About 20% of Mirena users stop getting periods entirely after one year.[3] Some women still ovulate (especially on lower-dose versions like Kyleena and Skyla), meaning you may still experience some cyclical symptoms. Learn more about how to tell if you're ovulating, even on hormonal birth control.
Best for: Women who want long-term, low-maintenance contraception; those who want lighter periods or no periods; women who can't take estrogen; those who want fewer systemic side effects than the pill.
The Implant (Nexplanon)
What it is: A matchstick-sized rod inserted under the skin of your upper arm that releases etonogestrel (a progestin).
How it works: Suppresses ovulation and thickens cervical mucus.
Effectiveness: 99.95%, the single most effective reversible contraceptive available.[3][6][7]
Hormones: Progestin only (etonogestrel), systemic.
Duration: Up to 3 years.
Cost range: $0–$1,300 upfront (including insertion); works out to about $35/month over 3 years. Usually covered by insurance.
Common side effects: Unpredictable bleeding is the most common complaint. Some women get frequent spotting, some get no periods, some get irregular longer bleeds. Also: headaches, mood changes, weight changes, acne (can improve or worsen).
Period/cycle impact: Highly variable. About one-third of users stop getting periods, one-third get lighter/infrequent periods, and one-third experience irregular or prolonged bleeding. This unpredictability is the #1 reason women have it removed early.
Best for: Women who want the most effective reversible method with zero daily maintenance; those who can't take estrogen; women who want a discreet method.
The Shot (Depo-Provera)
What it is: An injection of medroxyprogesterone acetate given by a healthcare provider every 3 months.
How it works: Suppresses ovulation and thickens cervical mucus.
Effectiveness: 99.8% with perfect use, 96% with typical use (late injections are the main failure point).[3][6]
Hormones: Progestin only (medroxyprogesterone acetate), systemic. Higher dose than other progestin methods.
Duration: One injection every 12–13 weeks.
Cost range: $0–$150 per injection ($0–$600/year).
Common side effects: Weight gain (average 5 to 8 lbs in year one, the one method consistently linked to weight gain[3]), headaches, mood changes, decreased bone density with long-term use (usually reversible after stopping), decreased libido.
Period/cycle impact: Irregular bleeding and spotting for the first few months. After one year, about 50% of users stop getting periods entirely. After two years, about 70% have no periods.
Best for: Women who want a method they only think about 4 times a year; those who can't take estrogen; women who want to stop their periods; those who prefer injections over daily pills.
Important note: The shot is the one method where fertility return is significantly delayed. It can take 6 to 12 months after your last injection for ovulation to return.[3] Not ideal if you might want to get pregnant within the next year.
The Patch (Xulane)
What it is: A small adhesive patch worn on the skin that delivers estrogen and progestin through the skin. You wear one patch per week for 3 weeks, then go patch-free for 1 week.
How it works: Same as the pill: suppresses ovulation, thickens cervical mucus, thins uterine lining.
Effectiveness: 99.7% with perfect use, 93% with typical use.[3][6] May be less effective in women over 198 lbs.[2][3]
Hormones: Estrogen + progestin (combined), systemic. Delivers a higher overall estrogen dose than most pills.
Duration: Weekly (change patch once per week).
Cost range: $0–$150/month.
Common side effects: Similar to the pill plus skin irritation at the patch site. Slightly higher estrogen exposure may mean more estrogen-related side effects (breast tenderness, nausea, headaches).
Period/cycle impact: Similar to the pill: lighter, more predictable withdrawal bleeds during the patch-free week. Can skip the patch-free week to skip periods (with doctor's guidance).
Best for: Women who want the pill's benefits but can't remember a daily pill; those who prefer weekly rather than daily action.
The Ring (NuvaRing, Annovera)
What it is: A flexible ring inserted into the vagina that releases estrogen and progestin. NuvaRing: use 3 weeks in, 1 week out, replace monthly. Annovera: reusable for a full year.
How it works: Same as the pill: suppresses ovulation, thickens cervical mucus, thins uterine lining.
Effectiveness: 99.7% with perfect use, 93% with typical use.[3][6]
Hormones: Estrogen + progestin (combined), systemic but lower dose than the pill or patch because hormones absorb through vaginal tissue.
Duration: Monthly (NuvaRing) or yearly (Annovera).
Cost range: $0–$200/month (NuvaRing); $0–$2,200/year (Annovera, but works out cheaper monthly).
Common side effects: Similar to the pill. Some women report increased vaginal discharge or irritation. Generally fewer systemic side effects than the pill due to lower hormone doses.
Period/cycle impact: Similar to the pill: lighter, predictable withdrawal bleeds. Can be used continuously to skip periods.
Best for: Women who want combined hormonal contraception without daily pills; those who experience GI side effects on the pill (ring bypasses the digestive system); women who want a lower hormone dose.
Tracking Tip: Hormonal Methods
Even on hormonal birth control, tracking how you feel matters. Different formulations contain different progestin types, and each affects women differently. Log your mood, energy, headaches, skin changes, and bleeding patterns when you start or switch methods. After 3 months, you'll have real data to share with your doctor about whether this method is working for you, instead of just guessing.
Non-Hormonal Birth Control Methods
Copper IUD (Paragard)
What it is: A T-shaped device wrapped in copper wire, inserted into the uterus. The only highly effective, long-term, non-hormonal contraceptive available.
How it works: Copper creates an inflammatory response in the uterus that is toxic to sperm. Also changes the uterine lining to prevent implantation.
Effectiveness: 99.2%, comparable to hormonal methods, with no hormones involved.[3][6]
Hormones: None. Your natural cycle continues completely unaltered.
Duration: Up to 10–12 years.
Cost range: $0–$1,300 upfront; works out to as little as $10/year over its lifespan. Covered by most insurance.
Common side effects: Heavier periods and worse cramps, especially in the first 3–6 months (this is the main downside). Spotting between periods. Cramping after insertion. Rare: expulsion, perforation.
Period/cycle impact: Your natural cycle continues. You still ovulate, still get true periods, still experience all four cycle phases. But periods are typically heavier and crampier, especially at first. For some women this settles down after 6–12 months; for others it's ongoing.
Best for: Women who want long-term, hormone-free contraception; those who want to maintain their natural cycle; women who can't or don't want to use hormones; those who want something they can "set and forget."
Condoms (External and Internal)
What they are: External (male) condoms are thin sheaths worn over the penis. Internal (female) condoms are pouches inserted into the vagina before sex.
How they work: Physical barrier that prevents sperm from reaching the egg. Also the ONLY birth control method that protects against STIs.
Effectiveness: External: 98% with perfect use, 87% with typical use. Internal: 95% with perfect use, 79% with typical use.[3][6]
Hormones: None.
Duration: Single use. Must use a new one every time.
Cost range: $0–$2 each (often free at clinics and health centers).
Common side effects: Latex allergy (non-latex options available), reduced sensation for some users. No systemic side effects.
Period/cycle impact: None. Your cycle is completely unaffected.
Best for: Anyone who needs STI protection (can be used alongside other methods); those who want non-hormonal, non-invasive contraception; couples who don't want to use other methods; backup method for other contraception.
Diaphragm and Cervical Cap
What they are: Silicone cups that cover the cervix, used with spermicide. Inserted before sex and left in for 6–8 hours after.
How they work: Physical barrier blocks sperm from entering the uterus; spermicide kills remaining sperm.
Effectiveness: Diaphragm: 96% with perfect use, 83% with typical use. Cervical cap: 86% with perfect use, 71 to 86% typical use (less effective in women who've given birth).[3]
Hormones: None.
Duration: Reusable for 1–2 years; must be used with spermicide each time.
Cost range: $0–$90 for the device plus $5–$15 per tube of spermicide.
Common side effects: UTI risk may increase, vaginal irritation from spermicide, must be comfortable with insertion.
Period/cycle impact: None.
Best for: Women who want a non-hormonal method they control; those who only need contraception occasionally; women who are comfortable with insertion and planning ahead.
Spermicide and Contraceptive Gel (Phexxi)
What they are: Chemical products inserted into the vagina before sex. Traditional spermicides contain nonoxynol-9. Phexxi is a newer prescription gel that works by maintaining vaginal acidity.
How they work: Spermicide kills or immobilizes sperm. Phexxi maintains vaginal pH at a level hostile to sperm.
Effectiveness: Spermicide alone: 82% with perfect use, 72% with typical use. Phexxi: 93% with perfect use, 86% with typical use.[3] Both are significantly more effective when paired with a barrier method.
Hormones: None.
Cost range: Spermicide: $5–$15 per package. Phexxi: $0–$285/month (often covered by insurance).
Common side effects: Vaginal irritation, increased UTI risk (spermicide). Phexxi has fewer irritation issues than traditional spermicide.
Period/cycle impact: None.
Best for: As an additional layer of protection combined with condoms or a diaphragm. Not recommended as a sole method for women who need highly reliable contraception.
Fertility Awareness Methods (FAM)
What it is: Using daily tracking of fertility signs (basal body temperature/BBT, cervical mucus, and/or cycle timing) to identify fertile days and avoid unprotected sex on those days. Also called Natural Family Planning (NFP) or the rhythm method (though modern FAM is far more accurate than the old-school rhythm method).
How it works: You identify when you're ovulating through biological signs and abstain from sex (or use barrier methods) during your fertile window, typically about 6 to 8 days per cycle.
Effectiveness: Highly variable. Symptothermal method (combining BBT + cervical mucus): 99.6% with perfect use, 88 to 98% with typical use depending on the method and instruction quality.[3] Calendar-only methods: much less reliable. Apps like Natural Cycles (FDA-cleared): 93% with typical use.
Hormones: None. Your cycle is completely natural.
Duration: Ongoing daily tracking required.
Cost range: Free to $100/year (BBT thermometer + optional app subscription). If you're comparing apps for FAM, our guide on how to choose a period tracker app covers what to look for.
Common side effects: None physical. Requires significant commitment to daily tracking and communication with partner about fertile days.
Period/cycle impact: None. In fact, FAM gives you the deepest understanding of your own cycle. You'll learn exactly when you ovulate, how long your luteal phase is, and what your unique patterns look like.
Best for: Women who want zero hormones and zero devices; those in committed relationships willing to track daily and abstain/use barriers during fertile days; women who want to deeply understand their cycle; couples open to pregnancy if the method fails.
Withdrawal (Pull-Out Method)
What it is: The penis is withdrawn from the vagina before ejaculation.
How it works: Prevents sperm from entering the vagina (in theory).
Effectiveness: 96% with perfect use, 80% with typical use.[3] Pre-ejaculate can contain sperm, and timing is imperfect in practice.
Hormones: None.
Cost: Free.
Period/cycle impact: None.
Best for: Couples who would be okay if pregnancy happened; as a backup to another method (like condoms or FAM); when no other method is available. Not recommended as a primary method for women who need to avoid pregnancy.
Permanent Birth Control Methods
Tubal Ligation
What it is: Surgical procedure that closes, cuts, or removes the fallopian tubes to permanently prevent eggs from reaching sperm.
Effectiveness: 99.5%.[3]
Hormones: None. Your cycle continues normally.
Period/cycle impact: None. You still ovulate and get periods as usual. Some women report changes, but research shows the procedure itself doesn't affect periods.
Reversible? Reversal surgery exists but is expensive, not always successful, and not covered by insurance. Consider this permanent.
Best for: Women who are certain they don't want (more) children. Typically requires counseling and may have a waiting period.
Vasectomy
What it is: Surgical procedure that cuts or blocks the vas deferens in the male partner, preventing sperm from being released during ejaculation.
Effectiveness: 99.85% (after confirmed zero sperm count, takes about 3 months post-procedure).[3]
Hormones: None.
Period/cycle impact: None (it's the partner's procedure).
Best for: Couples who are certain they don't want (more) children. Simpler, safer, cheaper, and more effective than tubal ligation.
Emergency Contraception
Emergency contraception (EC) is not intended as a regular birth control method. It's a backup for when your primary method fails (broken condom, missed pills, unprotected sex).
Plan B (Levonorgestrel)
How it works: High-dose progestin that delays or prevents ovulation. Does NOT terminate an existing pregnancy.
Timing: Most effective within 72 hours of unprotected sex; can work up to 120 hours but effectiveness decreases with time.
Effectiveness: Reduces risk of pregnancy by about 85% if taken within 72 hours.
Availability: Over-the-counter, no prescription needed, no age restriction.
Cost: $25–$50.
Limitation: May be less effective in women over 165 lbs.[1][3] If you weigh more, ask your doctor about ella or the copper IUD.
ella (Ulipristal Acetate)
How it works: Delays ovulation by blocking progesterone receptors. More effective than Plan B, especially on days 3–5 after unprotected sex.
Timing: Effective up to 120 hours (5 days) after unprotected sex, with consistent effectiveness throughout that window.
Effectiveness: Reduces risk of pregnancy by about 85% (but maintains effectiveness longer than Plan B).
Availability: Prescription required.
Cost: $35–$90.
Limitation: May interact with hormonal birth control. Ask your doctor about timing if you're on the pill.
Copper IUD as Emergency Contraception
How it works: When inserted within 5 days of unprotected sex, the copper creates an environment hostile to sperm and prevents implantation.
Effectiveness: Over 99%, the most effective emergency contraception available.[1][3] AND it then works as ongoing birth control for up to 10 to 12 years.
Limitation: Requires a healthcare provider for insertion.
The Complete Birth Control Comparison Chart
| Method | Type | Effectiveness (Typical Use) | Hormones | Duration | Common Side Effects | Period Impact | Reversible? |
|---|---|---|---|---|---|---|---|
| Implant | Hormonal | 99.95% | Progestin | 3 years | Irregular bleeding, headaches | Unpredictable; ~33% stop periods | Yes |
| Hormonal IUD | Hormonal | 99.8% | Local progestin | 3–8 years | Spotting, cramping initially | Much lighter; ~20% stop periods | Yes |
| Vasectomy | Permanent | 99.85% | None | Permanent | Post-procedure soreness | None (partner's procedure) | No |
| Tubal ligation | Permanent | 99.5% | None | Permanent | Surgical risks | None | No |
| Copper IUD | Non-hormonal | 99.2% | None | 10–12 years | Heavier periods, cramps | Heavier, crampier periods | Yes |
| Shot | Hormonal | 96% | Progestin | 3 months | Weight gain, mood changes | Irregular → no periods | Yes (delayed) |
| Pill | Hormonal | 93% | Estrogen + progestin | Daily | Nausea, headaches, mood | Lighter, predictable bleeds | Yes |
| Patch | Hormonal | 93% | Estrogen + progestin | Weekly | Skin irritation, nausea | Lighter, predictable bleeds | Yes |
| Ring | Hormonal | 93% | Estrogen + progestin | Monthly/yearly | Discharge, headaches | Lighter, predictable bleeds | Yes |
| FAM | Behavioral | 88–98% | None | Ongoing daily tracking | None (requires commitment) | None (natural cycle) | Yes |
| External condom | Barrier | 87% | None | Single use | Reduced sensation, allergy | None | Yes |
| Phexxi gel | Non-hormonal | 86% | None | Per use | Irritation, UTI risk | None | Yes |
| Diaphragm | Barrier | 83% | None | Reusable (1–2 yrs) | UTI risk, irritation | None | Yes |
| Withdrawal | Behavioral | 80% | None | Per use | None | None | Yes |
| Spermicide alone | Chemical | 72% | None | Per use | Irritation, UTI risk | None | Yes |
Effectiveness rates based on CDC[6] and WHO[5] data. "Typical use" reflects real-world effectiveness including human error.[3] Sorted by typical-use effectiveness.
IUD vs. Pill: The Most Common Decision
The pill and the IUD are the two most popular prescription birth control methods. If you're choosing between them, here's what to consider.
When the Pill Might Be Right for You
- You want easy start/stop flexibility (planning pregnancy soon? easy to quit)
- You want to improve acne (certain pill formulations are FDA-approved for acne)
- You like having predictable, regular withdrawal bleeds
- You're comfortable with taking a pill at the same time daily
- You want to skip periods by running packs back-to-back
- You have PCOS and need androgen reduction (combined pills with anti-androgenic progestins)
When an IUD Might Be Right for You
- You want a "set it and forget it" method (nothing to remember daily/weekly/monthly)
- You want the highest effectiveness without sterilization
- You want lighter periods or no periods (hormonal IUD)
- You want to avoid estrogen (IUD is progestin-only)
- You want fewer systemic side effects (hormonal IUD acts mostly locally)
- You want hormone-free contraception (copper IUD)
- You want long-term coverage without thinking about it
Key Differences at a Glance
| Factor | The Pill | Hormonal IUD |
|---|---|---|
| Typical effectiveness | 93% | 99.8% |
| User action needed | Daily pill | None after insertion |
| Hormones | Systemic estrogen + progestin | Local progestin only |
| Acne improvement | Yes (certain types) | Variable (may worsen) |
| Period impact | Lighter, predictable | Very light to none |
| Fertility return | 1–3 months | Immediate after removal |
| Upfront cost | Low ($0–$50/mo) | Higher ($0–$1,300 once) |
How to Choose the Right Birth Control for You
Questions to Ask Yourself
- How important is effectiveness? If an unplanned pregnancy would be seriously problematic, lean toward higher-effectiveness methods (IUD, implant)
- Do you want hormones or not? Some women feel great on hormones; others prefer to keep their natural cycle
- How much maintenance are you willing to do? Daily pill vs. set-and-forget IUD vs. per-use condoms
- Do you want your period to change? Some women love lighter/no periods; others want to keep their natural cycle as a health indicator
- Are you planning pregnancy in the near future? Avoid the shot if pregnancy is planned within 1–2 years
- Do you need STI protection? Only condoms protect against STIs, so you may need a combined approach
- What's your budget? Most methods are free with insurance, but check your plan
Birth Control for Specific Conditions
Birth Control for PCOS
Combined oral contraceptive pills are a first-line treatment for PCOS.[2] They regulate periods, reduce androgen levels (improving acne and excess hair), and protect against endometrial hyperplasia from irregular shedding. Pills with anti-androgenic progestins (like drospirenone or cyproterone acetate) provide the most benefit. Learn more in our complete guide to PCOS.
Birth Control and Mood / Mental Health
Some women experience mood changes, increased anxiety, or depression on hormonal birth control, particularly with certain progestin types or higher-dose methods like the shot. Research suggests the risk is small but real, and is higher in teenagers.[4]
If you have a history of depression or mood disorders, discuss this with your doctor before starting hormonal contraception. The hormonal IUD tends to have fewer mood effects than systemic methods because hormones act locally. Non-hormonal methods eliminate mood concerns entirely.
The most important thing you can do: Track your mood daily when starting or switching birth control. Three months of mood data tells you (and your doctor) far more than memory alone.
Birth Control for Endometriosis / Heavy Periods
The hormonal IUD is one of the most effective treatments for heavy periods and endometriosis pain. Combined pills (taken continuously, without the placebo week) can also help. The copper IUD is generally NOT recommended if you already have heavy periods, as it will likely make them heavier.
Questions to Ask Your Doctor
- "Based on my health history, which methods am I a good candidate for?"
- "What side effects are most common with this method, and when should I call you?"
- "How will this affect my period?"
- "How long should I give this method before deciding if it's working for me?"
- "What happens if I want to get pregnant? How quickly does fertility return?"
- "Is this method covered by my insurance?"
- "If this method doesn't work for me, what would we try next?"
Birth Control and Your Cycle: What Changes?
Understanding what happens to your cycle on birth control is important, and it's something most doctors don't explain well. This section is our differentiator, because no medical website tells you what to expect month-by-month or how to track your experience.
Hormonal Methods Suppress Your Natural Cycle
On combined hormonal methods (pill, patch, ring), your natural cycle stops. You're not ovulating, and the bleeding you get during the hormone-free week is a withdrawal bleed, not a true period. Your body isn't going through the four natural phases described in our cycle syncing guide.
On progestin-only methods (hormonal IUD, implant, shot, mini-pill), the picture is more nuanced. Some women still ovulate on lower-dose progestin methods (like Kyleena or the mini-pill), while others don't. This means some women on progestin-only methods may still experience cyclical symptoms.
What Happens When You First Start (Month-by-Month)
Month 1: Your body is adjusting. Expect irregular bleeding, spotting, nausea, breast tenderness, headaches, and mood fluctuations. These are adjustment symptoms, not necessarily permanent side effects.
Month 2: Side effects typically start improving. Bleeding becomes more predictable on the pill/patch/ring. IUD spotting may still be happening. Your body is adapting to the new hormone levels.
Month 3: The adjustment period is largely over. Most side effects that were going to resolve have done so by now. This is when you can fairly assess how the method is working for you.
Months 4–6: Your new normal. If you're still having bothersome side effects at this point, they're likely ongoing and worth discussing with your doctor about switching methods.
What Happens When You Stop
Coming off hormonal birth control affects women differently:
- Pill/patch/ring: Most women get a period within 1–3 months. Some experience "post-pill syndrome" with irregular cycles, acne flare-ups, hair changes, or mood swings as natural hormones ramp back up
- Hormonal IUD: Periods typically return within 1–2 months of removal
- Implant: Fertility returns quickly after removal, usually within 1 month
- Shot: Can take 6–12 months for ovulation and regular periods to return, the longest delay of any method
Your Cycle on Non-Hormonal Methods
If you're using condoms, a diaphragm, FAM, or withdrawal: your cycle is completely natural. You ovulate, you have a true luteal phase, you get a real period. Nothing changes hormonally.
If you're using the copper IUD: your hormonal cycle is also natural, but you may notice heavier flow and more cramping, especially in the first 6 months. Your cycle phases remain unchanged.
Tracking Tip: Know Your Baseline
If you're currently on birth control and considering switching or stopping, start tracking your symptoms NOW, even on your current method. This gives you a baseline to compare against. When you switch, you'll be able to see exactly what changed, rather than relying on memory. Go Go Gaia makes this easy with one-tap daily logging.
Tracking Side Effects: Why It Matters
Here's what no medical website tells you: knowing your birth control options is only half the equation. Tracking your actual experience is the other half.
Two women on the exact same pill can have completely opposite experiences. One loves it, one is miserable. Your body's response to a specific birth control method is unique to you, influenced by your genetics, existing hormone levels, gut health, stress, and dozens of other factors.
The only way to know how YOUR body responds is to track it.
The 3-Month Rule
Healthcare providers generally recommend giving a new birth control method 3 full months before deciding whether it works for you. The first 1–2 months involve adjustment symptoms that usually resolve on their own.
But here's the problem: after 3 months, most women can't accurately remember how they felt in month 1 vs. month 3. Memory is unreliable, especially for gradual changes. This is where tracking changes the conversation.
What to Track When Starting or Switching
Track these daily (it takes less than 30 seconds in Go Go Gaia):
- Bleeding/spotting: When, how much, any pain
- Mood: Anxiety, irritability, sadness, stability, happiness
- Energy levels: High, medium, low
- Headaches: Frequency, severity
- Skin changes: Acne improvement or worsening
- Libido: Increased, decreased, unchanged
- Breast tenderness: Present or absent
- Nausea or GI changes: Especially in the first month
- Sleep quality: Any changes from your baseline
- Weight changes: If relevant to you
When to Call Your Doctor
Seek Medical Attention If You Experience
- Severe headache (worst headache of your life), especially on estrogen-containing methods
- Chest pain or shortness of breath
- Severe leg pain or swelling (one leg), possible blood clot
- Vision changes (blurred vision, flashing lights, loss of vision)
- Severe abdominal pain
- Heavy bleeding that soaks through a pad/tampon every hour for 2+ hours
- Signs of allergic reaction (hives, swelling, difficulty breathing)
- Jaundice (yellowing of skin or eyes)
- Depression or suicidal thoughts (don't wait, seek help immediately)
Also schedule a follow-up if side effects haven't improved after 3 months, or if your quality of life is significantly affected. Bring your tracked data. It makes the conversation more productive and helps your doctor recommend alternatives. Our PMS guide also covers how to distinguish birth control side effects from premenstrual symptoms.
How Go Go Gaia Helps
Track Side Effects With One Tap
Log mood, energy, headaches, bleeding, skin changes, and more in seconds. Go Go Gaia is designed for daily logging that doesn't feel like a chore. One tap and you're done.
Correlation Insights
Go Go Gaia doesn't just store your data. It analyzes it. After a few weeks of tracking, you'll see patterns: "Headaches decreased by 60% after month 2" or "Mood scores improved from an average of 4 to 7 after switching methods." This is the evidence-based approach to birth control. Not guessing, but knowing.
Cycle Tracking on Any Method
Whether you're on the pill, have an IUD, use FAM, or are completely hormone-free, Go Go Gaia adapts. Track bleeding patterns on hormonal methods, monitor your natural cycle on non-hormonal methods, or chart your fertile signs for FAM. One app, any method.
Share Data With Your Healthcare Provider
Generate a detailed health report to bring to your doctor's appointment. Instead of saying "I think I've been more anxious," you can show 3 months of daily mood scores with clear trends. This changes the conversation from subjective complaints to objective evidence.
Taking Control of Your Birth Control Experience
Don't just take birth control. Track how it makes you feel. Go Go Gaia gives you the data to make confident decisions about YOUR body.
Download Go Go Gaia FreeJoin thousands of women making evidence-based health decisions with tracking.
Frequently Asked Questions
The most effective reversible methods are the implant (99.95%), hormonal IUD (99.8%), and copper IUD (99.2%). These are called LARCs (Long-Acting Reversible Contraceptives) and require no daily user action. Permanent methods (vasectomy and tubal ligation) are the most effective overall.
Most methods do not cause significant weight gain in research studies. The Depo-Provera shot is the one method consistently linked to weight gain (average 5–8 lbs in the first year). The pill, IUD, implant, patch, and ring have not been shown to cause meaningful weight gain in large studies, though individual experiences vary. Tracking your weight when starting a new method helps you see your personal response.
Non-hormonal methods (copper IUD, condoms) have no hormonal side effects. Among hormonal options, the hormonal IUD tends to have fewer systemic side effects than the pill because hormones act mostly locally. But the "best" method depends on your body. What's side-effect-free for one woman may not be for another. Tracking how you feel for 3 months gives you real data to decide.
Most women can get pregnant within 1–3 months of stopping the pill, removing an IUD, or removing the implant. The shot is the exception: it can take 6 to 12 months for fertility to return. There is no evidence that long-term birth control use causes permanent infertility.
Yes. The hormonal IUD, the pill, and the implant can all significantly reduce cramps and heavy bleeding. The hormonal IUD is particularly effective, and many users experience lighter periods or no periods at all. The copper IUD, however, typically makes periods heavier and crampier.
Neither is universally better. It depends on your needs. The IUD is more effective (99.8% vs. 93% typical use), lasts years, and requires no daily action. The pill gives you more control (easy to start/stop), can improve acne, and lets you skip periods. See our detailed IUD vs. pill comparison above.
Some women experience mood changes on hormonal birth control, while others feel no difference or even feel better. Research suggests a small but real increased risk of depression, especially in teenagers and with certain progestin types.[4] Tracking your mood daily when starting or switching birth control helps you identify whether the method is affecting you.
Yes! Combined oral contraceptive pills are a first-line treatment for PCOS. They regulate periods, reduce androgen levels (improving acne and excess hair), and protect against endometrial hyperplasia. Your doctor can help choose a pill formulation that best addresses your specific PCOS symptoms.