What is the best birth control method for a young woman?

From the Guidelines

The best birth control method for a young woman is typically a long-acting reversible contraceptive (LARC) such as an intrauterine device (IUD) or hormonal implant. According to the most recent and highest quality study 1, hormonal IUDs like Mirena, Kyleena, or Liletta are effective for 3-7 years depending on the brand, while the copper IUD (Paragard) works for up to 10 years. The implant (Nexplanon) is effective for 3-5 years and is placed under the skin of the upper arm. These methods are over 99% effective at preventing pregnancy, require no daily action, and fertility returns quickly after removal.

Key Considerations

• LARCs are safe and effective for most women, including those who have never given birth and adolescents 1
• Providers should work with the client interactively to select an effective and appropriate contraceptive method, considering potential barriers to using the method under consideration 1
• A broad range of methods, including LARCs, should be discussed with all women and adolescents, if medically appropriate 1
• Information should be tailored and presented to ensure a client-centered approach, and providers should present information on potential reversible methods of contraception by using a tiered approach 1

Other Options

Other good options include hormonal methods like the pill (taken daily), patch (changed weekly), vaginal ring (changed monthly), or the shot (Depo-Provera, given every 3 months) 1. However, these methods may have lower effectiveness rates and require more daily action compared to LARCs.

Individual Factors

The best choice ultimately depends on individual factors including medical history, lifestyle, future pregnancy plans, and personal preferences 1. Side effects vary by method - hormonal options may affect menstrual bleeding patterns, while the copper IUD may cause heavier periods. A healthcare provider can help determine which method best suits a young woman's specific needs and circumstances after reviewing her medical history.

From the FDA Drug Label

The following chart shows the chance of getting pregnant for women who use different methods of birth control. The box on the bottom of the chart shows the chance of getting pregnant for women who do not use birth control and are trying to get pregnant. Skyla, an intrauterine device (IUD) also known as an intrauterine system (IUS),, is in the box at the top of the chart. TABLE II: Percentage of women experiencing an unintended pregnancy during the first year of typical use and the first year of perfect use of contraception and the percentage continuing use at the end of the first year, United States % of Women Experiencing an Unintended Pregnancy within the First Year of Use % of Women Continuing Use at One Year Method (1) Typical Use (2) Perfect Use (3) Chance d 85 85 Spermicides e 26 6 40 ... Pill 5 71 Progestin Only 0.5 Combined 0.1 IUD Progesterone T 2.0 1.5 81 Copper T 380A 0.8 0.6 78 LNg 20 0.1 0.1 81

The best birth control method for a young woman is not explicitly stated in the provided drug labels, but some options are listed, including:

• Skyla (IUD): a low-chance of getting pregnant (less than 1 in 100) and reversible
• Pill: 5% chance of unintended pregnancy in the first year of typical use, and 0.1% chance with perfect use for the combined pill 2
• IUD: 0.1-2.0% chance of unintended pregnancy in the first year of typical use, depending on the type of IUD 3 2 It is recommended that the young woman talk to her healthcare provider about the best birth control methods for her, considering her individual needs and health status.

From the Research

Types of Birth Control

• Combined oral contraceptives (COCs) are a popular choice for young women, as they offer effective contraception and other benefits such as regulation of menstrual cycles and reduction of menstrual cramps 4.
• Extended-cycle oral contraceptives are also increasing in popularity, as they provide a low-dose, combined active pill with fewer or no inactive pills 5.
• The patch and pill are other options, with similar efficacy and safety profiles, although compliance and unscheduled uterine bleeding may vary 6.

Factors to Consider

• The lowest effective dose of estrogen and progestogen should be prescribed, with pills containing levonorgestrel or norethisterone in combination with ethinyl estradiol 35 microgram or less considered first-line 4.
• Efficacy and safety of different birth control methods should be evaluated, including the Pearl Index and life-table pregnancy rate 6, 7.
• Unscheduled bleeding and spotting may decrease with increasing doses of estrogen within each cycle and after the first cycle 7.

Specific Birth Control Options

• Alesse, a low-dose monophasic combination oral contraceptive, has been shown to be effective and safe, with a Pearl index of 0.84 and a cumulative life table pregnancy rate of 0.0041 per woman entering the sixth cycle 8.
• An ascending-dose, extended-regimen levonorgestrel/ethinyl estradiol combined oral contraceptive has also been evaluated, demonstrating efficacy and safety with a Pearl Index of 3.19 and a life-table pregnancy rate of 2.82% 7.
• The extended-cycle oral contraceptive with continuous ethinyl estradiol has a similar efficacy and adverse effect profile compared to other extended-regimen OCs, with a low-dose, combined active pill containing levonorgestrel 100 μg and ethinyl estradiol 20 μg 5.