The Best Birth Control Options To Consider for Your 20s and Beyond

Different phases of life may call for different types of contraception.

If you're using birth control, you shouldn't stick with the same method as you get older. It's often wiser to make some changes along the way. The best pick for you at one point in life might no longer be as beneficial at a later point. Also, it could be time for an update if you haven't thought about contraception in a while.

To make your selection, you and your healthcare provider should discuss several factors, including age. Age is important because of specific health issues and risk factors. That's because your lifestyle habits tend to change, Mary Jane Minkin, MD, clinical professor of obstetrics, gynecology, and reproductive sciences at the Yale University School of Medicine in New Haven, Conn., told Health.

Here's what you need to know about the best birth control options to consider using during your 20s, 30s, and 40s.

Birth Control in Your 20s

Using birth control pills, or oral contraceptives, might be ideal for you—or maybe not. Birth control pills are popularly used in individuals aged 29 and younger, according to a data brief published in October 2020 by National Center for Health Statistics (NCHS). However, Dr. Minkin noted that many people in their 20s live hectic lifestyles.

"Can you remember to take a pill every day? That's the major question," said Dr. Minkin. "If you look at the scientific literature, you'll see that the average number of forgotten pills can be as high as four per month." 

Each missed pill further reduces the efficacy of this method, so skipping several is risky if you're trying to avoid getting pregnant.

The good news: Birth control pills aren't your only option. According to the Centers for Disease Control and Prevention (CDC), other birth control methods include intrauterine devices (IUDs), implants, injections, patches, and vaginal rings. 

Some of those methods can be helpful if you forget to take birth control pills. For example, if you go the route of injections, you'll see your healthcare provider every three months for shots. It's something you don't have to remember to do every day.

Birth Control in Your 30s

If you're happy with the method you were using during your 20s, you might be able to stay with it, but there are some important caveats. 

"If you're over the age of 35 and you're a smoker, you shouldn't be taking birth control pills," explained Dr. Minkin. The same goes for rings and patches because the hormones raise your risk of a heart attack, stroke, or blood clot. Those risks exist for non-smokers and younger smokers but are much lower.

Whether you're a smoker or not, an IUD is one method you may want to consider in your 30s. IUDs can prevent pregnancy for a more extended period—for at least three years but up to 10 years, according to the National Library of Medicine. They can also be used as emergency contraception within five days of unprotected sex, or condomless, sex.

Of note, the Mirena IUD, which prevents pregnancy for three to five years, can also reduce or pause menstrual flow. It also potentially lowers your risk of developing endometrial cancer.

If you choose an IUD to delay pregnancy after giving birth, your cervix will be stretched out, so inserting the IUD is less painful than if you have never given birth. However, most people (including those who've never had children) can take an over-the-counter (OTC) painkiller before the procedure and feel fine, according to Dr. Minkin.

Birth Control in Your 40s

During your 40s, the transition to menopause (known as perimenopause) is also when fertility starts to decline. Though rare, pregnancies have happened among people in the age group. 

"I have personally delivered babies for three [people] who were 47 years old and not trying to get pregnant," said Dr. Minkin. Ultimately, you're not in the clear until you've gone a whole year without a period.

Low-dose birth control pills might be a good bet if you're dealing with symptoms of perimenopause—including hot flashes, night sweats, and irregular periods—and you aren't a smoker. 

"I use them a lot for [people] in their early- to mid-40s because it helps control their symptoms," explained Dr. Minkin.

According to the National Cancer Institute (NCI), some research suggests that hormonal birth control might raise the chances of breast and cervical cancer. However, Dr. Minkin added that any risk increase appears to be minimal. Still, if you're worried—perhaps because you also have a family history of breast cancer or other risk factors—then consider the copper IUD. 

"If your periods are regular and you just want reliable contraception, ParaGard [an IUD that prevents pregnancy for up to 10 years] is fabulous, and there are no hormones," mentioned Dr. Minkin.

Other Birth Control Considerations

Dr. Minkin said finding a birth control option that fits your personal needs is what's key. Your healthcare provider can help you decide which ones will work best for your situation. 

"I want to make sure that patients are using something they're comfortable with and that's compatible with their lifestyle," added Dr. Minkin.

If you have multiple partners (no matter how old you are), you need to use a condom to protect against sexually transmitted infections (STIs)—including chlamydia, gonorrhea, human immunodeficiency virus (HIV), and human papillomavirus (HPV). 

"I've had so many young [people] tell me, 'But I've had the HPV vaccine.' That's great—I'm delighted—but there are many other [STIs] out there that it doesn't protect against," said Dr. Minkin.

Additionally, even if you use birth control with low failure rates, like IUDs (0.1% to 0.8%) and injections (4%), per the CDC, pregnancy is still possible. If you find that you become pregnant while using birth control methods, contact your healthcare provider as soon as possible.

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