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. In fact, 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 your contraception in a while.

To make your selection, you and your healthcare provider should discuss a number of factors, including your age. Age is important both because of certain health issues and risk factors but also because your lifestyle habits tend to change, Mary Jane Minkin, MD, clinical professor of obstetrics and gynecology at Yale University School of Medicine, told Health.

Here's a guide to birth control options you'll want to consider using during your 20s, 30s, and 40s.

Birth Control in Your 20s

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

"Can you remember to take a pill every day? That's the major question," Dr. Minkin said. "If you look at the scientific literature, you'll see that the average number of forgotten pills can be as high as 4 per month." Each missed pill further reduces the efficacy of this method, so skipping several is pretty risky if you're trying to avoid getting pregnant.

Birth control pills aren't your only option, however. The Centers for Disease Control and Prevention (CDC) noted several birth control methods you can use such as intrauterine devices (IUDs), implants, injections, patches, and vaginal rings. Some of these methods can especially be helpful if you tend to 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—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 in 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," Dr. Minkin explained. The same goes for rings and patches because the hormones will raise your risk of a heart attack, stroke, or blood clot. These risks exist for non-smokers and younger smokers, too, but are much lower.

Whether you're a smoker or not, one method you may want to consider in your 30s is an IUD. IUDs can prevent pregnancy for a longer period of time—for at least three years but up to 10 years, according to MedlinePlus. They can also be used as emergency contraception if used within five days of unprotected sex, or condomless sex. Of note, the Mirena IUD, which offers pregnancy prevention from three to five years, has benefits such as reduced or paused menstrual flow and the potential to lower the risk of having endometrial cancer.

If you choose this option to delay pregnancy after you've given birth before, your cervix has been stretched out, so insertion tends to be less painful than if you haven't had a baby. However, most women (including those who've never had children) can just take an OTC painkiller before the procedure and feel fine, Dr. Minkin said.

Birth Control in Your 40s

During this decade, the transition to menopause (known as perimenopause) is also when fertility starts to decline. But, though rare, pregnancies have happened among people in this age group. "I have personally delivered babies for three women who were 47 years old and not trying to get pregnant," Dr. Minkin said. Ultimately, you're not in the clear until you've gone a full year without a period.

If you're dealing with symptoms of perimenopause like hot flashes, night sweats, and irregular periods and you aren't a smoker, then low-dose birth control pills might be a good bet. "I use them a lot for women in their early- to mid-40s because it helps control their symptoms," Dr. Minkin explained.

Some research, according to the National Cancer Institute (NCI), has suggested that hormonal birth control might further raise the chances of breast and cervical cancer, though 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," Dr. Minkin explained.

Other Birth Control Considerations

Dr. Minkin said finding a birth control option that fits your personal needs is really 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," Dr. Minkin added.

If you have multiple partners—no matter how old you are—you need to use a condom every time to protect against sexually transmitted infections (STIs) such as chlamydia, gonorrhea, HIV, and HPV. "I've had so many young women 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," Dr. Minkin said.

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

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