Staying loyal to a great doctor or a genius hairdresserthat’s just smart. But when it comes to birth control, sticking with the same method throughout the years isn’t always the right move. "Your contraceptive should fit your health, lifestyle, and values," says Michele Curtis, MD, a professor of obstetrics and gynecology at the University of Texas Medical School at Houston. That’s because the more comfortable you are with your birth control, the more likely you are to use it consistentlymeaning less risk of an unintended pregnancy.
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Dating but not with a long-term partner
Your best bet: Condoms plus
a backup method Whether you’re 25 or 45, condoms are a must to guard against STDs. But since condoms also have a higher failure rate than other forms of birth control, it’s wise to double up. Hormonal contraceptivesthe Pill, patch, or vaginal ringare highly effective. As a bonus, they can also help regulate periods, reduce PMS symptoms, and lower the risk of some cancers.
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More back-up methods
If you want to avoid an estrogen-containing method, you can pair condoms with an intrauterine device (IUD)—either the hormone-free copper ParaGard or the progestin-containing Mirena. Other good options include Implanon, a progestin-releasing implant that’s inserted in the upper arm for up to three years; and Depo-Provera, a progestin injection that’s given every three months.
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Having sex relatively infrequently
Your best bet: a barrier method Condoms or another barrier method like a diaphragm are probably the easiest options for sporadic protection, says Sharon Mass, MD, an OB-GYN at Morristown Memorial Hospital in New Jersey. An IUD or hormonal methods are also good if you want continuous protection.
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Know your risks
But keep in mind that it’s a mistake to go on and off hormonal methods frequently. "The main risk with the Pill, the patch, and the ring is blood clots, and the risk is greatest in the first year," explains Andrew M. Kaunitz, MD, professor and associate chairman of the department of obstetrics and gynecology at the University of Florida College of Medicine–Jacksonville. "If you go on and off these methods, the risk likely occurs every time you restart."
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Thinking about getting pregnant in the next year or two
Your best bet: A barrier method or a hormonal contraceptive You’ll want a method that’s easily reversibleyou can stop it with little hassleand doesn’t cause a long delay until you ovulate again. Condoms are an obvious choice, but hormonal contraceptives also fit the bill. "Most people resume ovulation within two to three cycles after stopping a hormonal method," Dr. Mass says.
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A new mom who doesn’t want to get pregnant again soon
Your best bet: An IUD or Implanon "With an IUD or Implanon, you don’t have to think about birth control," says Sarah Prager, MD, an assistant professor of obstetrics and gynecology at the University of Washington School of Medicine in Seattle. Plus, they won’t reduce breast-milk production the way estrogen-containing methods can. (The progestin-only mini-Pill is also nursing-friendly.) If you’re not breast-feeding, you can use the Pill, patch, or ring starting about six weeks after childbirth (but not before then because of the risk for postpartum blood clots).
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Totally done having kids
Your best bet: An IUD, Implanon, or permanent birth control How sure are you, really? If you’re at all on the fence, IUDs and Implanon are good long-term, highly effective (but still reversible) options. But if you’re 100 percent positive your baby-making days are history, you have a couple of choices for sterilization, including tubal ligation or the nonsurgical options Essure or Adiana (implants that are placed in your fallopian tubes). And of course, there’s always the option of a vasectomy for your guy.
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Heading into perimenopause
Your best bet: A progestin-only or hormone-free method While many healthy nonsmokers may be able to safely use birth control pills through perimenopause, until we know more about the role of estrogen in perimenopausal and postmenopausal cases of breast cancer, the safest option is to go with a progestin-only method such as the Mirena IUD, Depo-Provera, Implanon, or the mini-Pill.
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Other perimenopausal options
Sterilization or the ParaGard IUD are also options if you don’t want to take hormones at all. If you use a method (such as the mini-Pill) that masks whether you’re still getting your period, your doctor can do a blood test to determine whether you’ve officially gone through menopause—and don’t have to worry about birth control any more.
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