Deciding Which Birth Control Is Right for You

If you’re in the market for a birth control method, you may have looked at the pill and the patch. Both methods use hormones to prevent pregnancy, but the way they deliver the hormones is different. You apply the patch to your skin once a week and forget about it. You have to remember to take birth control pills every day.

Whether you choose the pill or the patch, you’ll be equally protected against pregnancy. Before you decide, consider which method will be most convenient for you. Also, think about the side effects each form of birth control can have. It’s important to take certain things into consideration when deciding between the birth control pill and the patch.

Women have used the birth control pill since the 1960s. The pill uses hormones to prevent pregnancy. The combination pill contains estrogen and progestin. The minipill contains progestin only.

Birth control pills prevent pregnancy by stopping your ovaries from releasing an egg each month. The hormones thicken the cervical mucus, which makes it harder for sperm to swim to the egg. The hormones also alter the lining of the uterus, so that if an egg does get fertilized, it will be unable to implant in the uterus.

The patch contains the same hormones as the pill, estrogen and progestin. You stick it on your skin in of these areas:

  • upper arm
  • buttocks
  • back
  • lower abdomen

After the patch is in place, it delivers a steady dose of hormones into your bloodstream.

The patch works just like the pill. The hormones prevent an egg from being released and change both the cervical mucus and uterine lining. You only need to apply it once per week unlike the pill, which you take every day. After three weeks, or 21 days, of use, you remove the patch for one week.

One possible problem is that the patch can fall off. This is rare, and it happens with less than 2 percent of patches. Usually, the patch remains sticky, even if you get sweaty while exercising or take a shower. If your patch does fall off, reapply it if you can. Or, put on a new one as soon as you notice it’s gone. You might need to use a backup form of birth control if the patch has been off for more than 24 hours.

Both birth control methods are safe, but they do carry a small risk of side effects. Here are some of the more typical side effects that the pill can cause:

  • bleeding in between periods, which is more likely with the minipill
  • headaches
  • tender breasts
  • nausea
  • vomiting
  • mood changes
  • weight gain

These side effects usually improve after you’ve been on the pill for a couple of months.

The patch can cause side effects similar to those of the pill, including:

  • spotting in between periods
  • breast tenderness
  • headaches
  • nausea
  • vomiting
  • mood swings
  • weight gain
  • a loss of sexual desire

The patch can also irritate your skin, causing redness and itching. Because the patch contains a higher dose of hormones than the pill, the side effects may be more intense than with the pill.

Serious side effects from both the pill and patch are rare, but they can include heart attack, stroke and blood clots in the:

  • legs
  • heart
  • lungs
  • brain

Learn more: Which birth control is right for you? »

Certain birth control pills contain a different form of progestin called drospirenone. These pills include:

  • Yaz
  • Yasmin
  • Ocella
  • Syeda
  • Zarah

This type of progestin may increase your risk of blood clots more than usual. It can also raise the potassium level in your blood, which could be dangerous for your heart.

Because the patch delivers 60 percent more estrogen than the pill, it increases the risk of side effects like blood clots, heart attack, and stroke. Overall, though, your chance of having one of these serious side effects is still low.

For both birth control methods, the risk of serious side effects is higher in women who:

  • are age 35 or older
  • have high blood pressure, high cholesterol, or uncontrolled diabetes
  • have had a heart attack
  • smoke
  • are overweight
  • have a history of blood clots
  • have been in bed for a long time because of an illness or surgery
  • have a history of breast, liver, or uterine cancer
  • get migraines with aura

If one or more of these apply to you, your doctor may suggest using another birth control method.

It’s very important that you don’t smoke if you take the patch or pill. Smoking increases your risk of developing dangerous blood clots.

Be careful when taking certain medicines because they can make your birth control pill or patch less effective. These medicines include:

  • rifampin, which is an antibiotic
  • griseofulvin, which is an antifungal
  • HIV medicines
  • antiseizure medicines
  • St. John’s wort

If you aren’t sure which method you’d like to try, your doctor can be a great resource. They should be able to explain your options and answer any questions you may have.

There are a few things you may want to consider before choosing a birth control method:

  • Do you want to deal with regular upkeep, or would you rather have something long term?
  • What health risks are associated with this method?
  • Will you be paying out of pocket, or will this be covered by insurance?

After you make your decision, be sure to stick with this method for a few months so that your body can adjust. If you find that this method isn’t what you expected, there are many other options available.

Both the patch and pill are equally effective at preventing pregnancy. Your likelihood of getting pregnant depends on how closely you follow the directions. When women take the pill or apply the patch as directed, fewer than one out of 100 women will become pregnant in any given year. When they don’t always use these birth control methods as directed, nine out of 100 women become pregnant.

Talk through your birth control options with your doctor. Learn about all the benefits and the possible risks when making your choice. Pick the birth control that will be the most convenient for you and have the fewest side effects.