“I need safe long-term birth control.”
Tough Call. Any form of birth control requires a detailed cost-benefit analysis. But its important to use “new math” in the equation, says Rebecca Booth, MD, an OB-GYN practicing in Louisville, Kentucky, and author of The Venus Week: Discover the Powerful Secret of Your Cycle … at Any Age. “The new low-dose birth control pills are radically different from the pills of our mothers generation,” she says. “The same is true of the progestin-containing intrauterine device (IUD), Mirena. Theres really a new landscape with lots of good choices.”
So, which is better? From an effectiveness standpoint, the IUD provides more-effective long-term contraception and lessens menstrual bleeding. “Once its placed, youre 99 percent protected against pregnancy, without having to do anything else, for 5 to 10 years,” says Healths gynecological expert Katharine OConnell, MD.
As for the Pill, more women are likely to occasionally forget to take it, rendering that method less effective. “But if a woman is a perfect Pill-taker, shes got 97 percent protection against pregnancy. And given all the noncontraceptive benefits of the Pilllighter periods, no cramps, less acne, cancer defenseit may be an overall better method,” she says.
If cost is an issue, the Pill might be a better choice. “Taking it doesnt require a huge up-front investment,” Booth says. “The Pill can be started or discontinued without a lot of decision-making and without much notice. The IUD, in contrast, requires a doctors visit to put it in and get it outand an initial investment of about $750, which can be prohibitive for many young women.”
Individual risks play heavily into the decision, too, OConnell says. “If you are a smoker over age 35 or have migraines with an aura, the Pillwhich would raise your risks of a heart attack or strokeisnt for you. Whether you plan to have children soon or are anemic (studies show theres more menstrual bleeding with a copper IUD) also needs to be considered.”