Choosing birth control can feel overwhelming. There are more options than ever, and each one comes with its own set of pros, cons, and quirks. The good news? There is no single "best" method. The best one is the one that fits your body, your lifestyle, and your plans.
This guide walks through six of the most common hormonal and long-acting methods: IUDs, the pill, the patch, the ring, the implant, and the shot. We will cover how they work, how effective they are, common side effects, and what to consider when making your choice.
In Arizona, most insurance plans and AHCCCS cover birth control at no out-of-pocket cost under the ACA. Title X clinics across the state also provide low-cost or free contraception, including in rural areas where provider access can be limited.
IUDs (Intrauterine Devices)
IUDs are small, T-shaped devices placed in the uterus by your provider. There are two types: hormonal (like Mirena, Kyleena, and Liletta) and copper (Paragard). Hormonal IUDs release a small amount of progestin and last 3 to 8 years depending on the brand. The copper IUD uses no hormones and lasts up to 10 years.
IUDs are over 99% effective. Once placed, you do not have to think about them. Insertion takes a few minutes and can cause cramping, but most people tolerate it well. Hormonal IUDs often make periods lighter or stop them entirely. The copper IUD may make periods heavier, especially in the first few months.
The Pill
Birth control pills come in two forms: combination pills (estrogen plus progestin) and progestin-only pills (the "mini-pill"). You take one pill every day at roughly the same time. With perfect use, the pill is 99% effective. With typical use, it is about 91% effective because it is easy to miss a dose.
Pills can regulate periods, reduce cramps, and clear up acne. Side effects may include nausea, breast tenderness, and mood changes, though many people adjust within the first few months. The mini-pill is a good option if you cannot take estrogen due to migraines, blood clot risk, or breastfeeding.
The Patch
The patch (Xulane or Twirla) is a small adhesive square you stick on your skin once a week for three weeks, then take a week off. It delivers estrogen and progestin through the skin. Effectiveness is similar to the pill: about 91% with typical use.
The patch is convenient if you do not want to remember a daily pill but are not ready for a long-acting method. It can cause skin irritation at the application site. In Arizona's hot summers, sweat and swimming can occasionally loosen the patch, so check it daily and apply it to clean, dry skin.
The Ring
The vaginal ring (NuvaRing or Annovera) is a flexible ring you insert yourself and leave in place for three weeks, then remove for one week. NuvaRing is replaced monthly. Annovera lasts a full year. Both release estrogen and progestin.
The ring is about 91% effective with typical use. Many people find it easier than daily pills. You should not feel the ring once it is in place. Side effects are similar to other combined hormonal methods. Some people experience increased vaginal discharge or mild irritation.
The Implant
The implant (Nexplanon) is a tiny flexible rod inserted under the skin of your upper arm. It releases progestin and lasts up to 3 years. At over 99% effective, it is one of the most reliable methods available. There is nothing to remember or replace in the meantime.
The most common side effect is irregular bleeding, especially in the first 6 to 12 months. Some people stop getting periods entirely. Insertion and removal are quick office procedures done with local numbing. Your provider can usually do it during a regular visit.
The Shot
The shot (Depo-Provera) is a progestin injection given every 3 months at your provider's office. With perfect use, it is 99% effective. With typical use, it is about 94% effective because some people miss their scheduled injection window.
The shot often reduces or stops periods after a few doses. However, it is linked to temporary bone density loss with long-term use, so your provider may recommend calcium and vitamin D supplements. After stopping the shot, it can take several months for fertility to return, which is important to know if you are planning a pregnancy in the near future.
How to Think About Choosing
There is no wrong answer here. The method that works best is the one you will actually use consistently. Consider how you feel about hormones, whether you want something low-maintenance, how important it is to have regular periods, whether you plan to get pregnant in the next year or two, and how you feel about side effects like weight changes or mood shifts.
Your OB-GYN can help you weigh these factors. Many Arizona providers offer same-day IUD and implant insertions, so you do not need multiple appointments. If cost is a concern, ask about AHCCCS coverage or Title X clinic options in your area.
A Note About Effectiveness Numbers
When you see "99% effective," that means fewer than 1 in 100 people using that method will get pregnant in a year. "Typical use" numbers account for real life: forgotten pills, late shots, and human error. Long-acting methods like IUDs and implants have almost no gap between perfect and typical use because there is nothing to forget. That is a big part of why providers recommend them so often.
Side Effects Worth Discussing with Your Provider
All hormonal methods can cause side effects. Most are mild and improve within 2 to 3 months. However, contact your provider if you experience severe headaches or migraines (especially with aura), chest pain or shortness of breath, leg swelling or pain on one side, heavy or prolonged bleeding that does not improve, or significant mood changes including depression. These could indicate a rare but serious complication, especially with estrogen-containing methods.
Questions to Ask Your Provider
- Which methods are safe for me based on my health history?
- How will this method affect my period?
- What should I do if I experience side effects?
- How quickly can I get pregnant after stopping this method?
- Is same-day insertion available for IUDs or implants?
- Will my insurance or AHCCCS cover the full cost?
- What are my options if I cannot use estrogen?
- How does this method interact with my current medications?
Frequently Asked Questions
Does birth control cause weight gain?
Most studies show that the pill, patch, ring, IUD, and implant do not cause significant weight gain. The shot (Depo-Provera) is the exception, with some people gaining 5 to 10 pounds over the first year. Individual responses vary, so talk to your provider if weight is a concern.
Can I switch methods if I do not like the one I chose?
Absolutely. You can switch birth control at any time. Your provider can help you transition smoothly from one method to another without a gap in protection. It is completely normal to try a few methods before finding the right fit.
Do IUDs hurt to insert?
Insertion involves some cramping, and experiences vary widely. Some people feel mild discomfort, while others find it quite painful. Many Arizona providers now offer numbing options, anti-anxiety medication, or other comfort measures. Ask about pain management when scheduling your appointment.
Is birth control covered by AHCCCS?
Yes. AHCCCS covers all FDA-approved contraceptive methods, including IUDs, implants, pills, patches, rings, and the shot. There is no cost-sharing for contraception under most plans. Title X clinics also provide free or low-cost birth control regardless of insurance status.
Will birth control affect my ability to get pregnant later?
No. Fertility returns after stopping any method, though the timeline varies. It can return within days with the pill, patch, or ring, and within weeks with the IUD or implant. The shot may delay fertility for several months after the last injection.