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IUD vs. the Pill: Which Birth Control is Best for You?

The pill and the IUD are two of the most popular — and effective — forms of birth control available. Which one is the right choice for you? It depends on your lifestyle, related goals, and personal comfort level. Learn more here.

You’re sexually active, but you aren’t looking to start or expand your family any time soon. To prevent an unintended pregnancy, you need a reliable form of contraception — and you’ve already narrowed down your options to the two most popular methods: the birth control pill and an intrauterine device (IUD).

Which of these two contraceptives is best for you? Our New Beginnings OB/GYN team can help you make the right choice with confidence. In this month’s blog, Dr. Christina Parmar and Dr. Rania Ibrahim take a closer look at how an IUD compares with the pill.   

Set-it-and-forget-it birth control 

An IUD is a tiny T-shaped device that blocks sperm from entering the uterus. There are two types of IUDs: one releases the hormone progestin to prevent ovulation, and the other releases copper ions, which strongly repel sperm.  

LARC method

As a form of long-acting reversible contraception (LARC) — also known as “set-it-and-forget-it” birth control — IUDs are designed to effectively prevent pregnancy for years at a time without any effort on your part: Progestin-releasing IUDs can stay in place for 3-8 years, while copper-emitting IUDs remain effective for up to 12 years

Highly effective

IUDs are over 99% effective at preventing pregnancy, meaning that fewer than one in 100 women who use this form of birth control get pregnant each year. In fact, outside of total abstinence (no sexual intercourse), IUDs are the most effective contraceptive. One reason they’re so effective? There’s no chance for “user error.”  

Easily reversible

IUD insertion is a quick procedure done in our office. You can have your gynecologist remove the device as desired (i.e., when you’re ready to get pregnant or switch to another form of birth control), or you can have it replaced at the recommended time for continued long-term use.

The hormonal birth control pill

Birth control medications use female sex hormones to stop ovulation, so there’s no egg to fertilize when you have sex. Combined oral contraception (the pill) contains estrogen and progestin. For women who can’t take estrogen, the mini-pill provides a progestin-only option. 

Daily method

Hormonal birth control pills are a form of short-acting contraception: You must take the pill daily to retain its pregnancy-prevention protection; what’s more, you must take it at roughly the same time each day (within a three-hour window) for it to remain fully effective. 

Variable efficacy 

If you use oral contraception perfectly — meaning you take it at about the same time daily, and never forget a single day — the pill is 99% effective (a near-match to IUD efficacy). 

In practice, however, the pill is closer to 93% effective, meaning seven in 100 women who take it get pregnant each year. This lower “real world” efficacy rate simply comes down to user error; most women forget to take the pill at times. 

Regulated periods

Using the pill is easy — you simply take one pill at about the same time each day (i.e., upon waking, with dinner). Each one-month pill pack has 3-4 weeks’ worth of hormonal pills (usually colored) and 4-7 days’ worth of placebo pills (usually white). 

After you’ve taken all the hormonal pills in one cycle, you take the “reminder” hormone-free pills to stay consistent. Your period arrives while you’re taking the placebo pills.  

Easily discontinued

When you want to stop taking the pill, it’s easiest (i.e., less disruptive to your cycle) to simply not restart the medication after finishing the placebo pills. While it can take a few months for your period to adjust to the change, it’s possible to get pregnant right away.

IUD vs. the pill: considerations 

Both the pill and the IUD are about equally as effective when used properly, and both allow you to start trying to get pregnant right away after discontinuing use. Still, each method has major differences that likely make one a better choice than the other for you. 

The IUD may be the best option if you:

  • Want the most effective contraception available 
  • Don’t want to have to think about birth control 
  • Aren’t confident you’d take the pill consistently 
  • Want a long-acting contraceptive that lasts for years
  • Want hormone-free birth control (copper IUD)
  • Can’t take estrogen (i.e., blood clot, smoking history)

The pill might be a better option if you:

  • Want a method you can start easily, right away 
  • Are comfortable with the daily pill commitment 
  • Want greater control over your menstrual cycle 
  • Have heavy periods you’d like to lighten or shorten 
  • Would potentially like to not have a period at all 
  • Don’t want the in-office IUD insertion procedure

Neither form of birth control protects against sexually transmitted diseases (STDs), but both can easily be paired with condom use to help prevent the transmission of STDs. 

The best contraceptive for you 

When choosing between the pill and an IUD, the best contraceptive for you depends on your lifestyle and related goals. We can help you further understand the pros and cons of each method by going over everything from convenience and ease of use to rate of “real-world” effectiveness and common potential side effects. 

To learn more about all your birth control and family planning options, schedule a visit at New Beginnings OB/GYN in Shenandoah, Texas, today.