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

If you're using birth control, you may want to switch methods as you age. The best birth control pick for you at one point in life may no longer be as beneficial later. Also, if you haven't thought about contraception and are sexually active, thinking about birth control may help.

To make your selection, you and a healthcare provider should discuss several factors, including age. As you age, your lifestyle habits tend to change, Mary Jane Minkin, MD, a clinical professor of obstetrics, gynecology, and reproductive sciences at the Yale University School of Medicine, 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 during your 20s. People aged 29 or younger popularly use birth control pills. Still, birth control pills may not be ideal for people in their 20s who live hectic lifestyles, noted Dr. Minkin.

"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 reduces its efficacy. Skipping several pills is risky if you're trying to avoid getting pregnant.

The good news is that birth control pills aren't your only option. Other birth control methods include:

• Implants
• Injections
• Intrauterine devices (IUDs)
• Patches
• Vaginal rings

Those methods can be helpful if you forget to take birth control pills. For example, if you go the route of injections, you'll only see a healthcare provider every three months for shots. You don't have to remember to do it 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. However, 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 advice goes for rings and patches. 

Hormonal birth control methods raise your risk of heart attack, stroke, and blood clots. Those risks also exist for non-smokers and young smokers but are generally much lower.

Hormonal or Copper IUDs

An IUD is one method you may want to consider in your 30s. There are two types of IUDs, hormonal and copper IUDs, which prevent pregnancy for long periods. 

For example, hormonal IUDs can last three to eight years, depending on the brand. Also, copper IUDs can last up to 10 years. You can also use copper IUDs for emergency contraception within five days of unprotected sex.

Of note, the Mirena IUD, a hormonal IUD that prevents pregnancy for up to eight years, can also reduce or pause menstrual flow for up to five years. The Mirena IUD also potentially lowers your endometrial cancer risk.

If you've previously had a trial of labor or vaginal birth, then the shape of your cervical opening will be slightly different. So, inserting the IUD may be less painful than having 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, usually begins. During that time, fertility starts to decline. Still, pregnancies can happen during your 40s.

"I have personally delivered babies for three women 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

Low-dose birth control pills might be a good bet if you're over 40, a non-smoker, and have perimenopause symptoms. Those symptoms may include:

• Hot flashes
• Mood changes
• Sleep disturbances
• Vaginal dryness

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

Copper IUDs

Some evidence suggests that hormonal birth control might raise breast and cervical cancer risks. However, any risk increase appears to be minimal, noted Dr. Minkin.

Still, if you're worried, perhaps because you also have a family history of breast or cervical 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

Finding a birth control option that fits your personal needs is what's key, said Dr. Minkin. A healthcare provider can help you decide what type 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.

Condoms

If you have multiple partners, no matter how old you are, using condoms to protect against sexually transmitted infections (STIs) is important. Infections that spread through sexual activity include, but are not limited to, syphilis 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.

Contraceptive Failure

Also, pregnancy is still possible even if you use birth control with low failure rates, like IUDs (0.1% to 0.8%) and injections (4%).

If you find that you become pregnant while using birth control, contact a healthcare provider right away.

A Quick Review

Selecting the best birth control method depends on your preferences, risk factors, and lifestyle, which can all change with age. Re-evaluating your birth choices during your 20s, 30s, and 40s and making changes as needed can help.