There are hundreds of things to consider when making the choice. Now, keep in mind that birth control will affect everyone differently, but here are my personal experiences with each of the most widely known forms of birth control (BC)...
The pill is probably the oldest and most commonly used birth control medication on the market. It comes in many different levels of hormone concentration and allows for a bit of tailoring to your body's hormone requirements. Some people need more hormones to be free of negative side effects, as where others need a lower dose, so the pill is pretty flexible where that is concerned.
Pros: The ability to vary hormone doses allows you to figure out what your body responds best to. This helps cut down on negative side effects. Knowing what level of hormones your body needs will also help you make more informed choices about your future BC options. After stopping the pill most women may become pregnant within the first menstrual cycle after stopping the pill.
Cons: The most common issue with the pill is having to take it every day, around the same time in order for it to be 99.9% effective at preventing pregnancy. For scatter-brained people like me, something that requires so much consistency may not be such a good idea... my daughter is evidence of that. That's right, I got pregnant on the pill. Not because the pill is ineffective, but because there is so much room for human error. Another common issue is mood swings. Not everyone experiences them, but when I first started on the pill I became a rather angry and aggressive person. I would get belligerent about the dumbest things. this is where the difference in hormone doses available comes in handy, lower estrogen versions of the pill is what helped me get rid of the mood swings. Also, the first 3 months when your body is adjusting to the pill for the first time is a roller coaster. Not fun.
Recommendations: If taking a daily pill is not an issue for you then rock on, I applaud you for having better memory than I do, lol. Just be sure to take the pill according to the directions, because you CAN get pregnant while taking it if you're not careful. If you need a particular dose to control certain side effects, or certain natural issues like heavy bleeding or painful menstruation, the pill may be the choice for you. I would highly recommend that you plan to start taking the pill at least 3 months before you're actually intending to put it to use...if you're in a relationship, explain what the possible side effects are to your boyfriend or husband-to-be or you may be single before your adjustment period is over. That's actually how I knew John loved me enough to be serious about getting married... I was absolutely awful while adjusting but he stick with me.
There are two different types of IUD's despite the various brands. The two most common ones are ParaGard and Mirena. Mirena is a piece of flexible T shaped plastic infused with hormones that is inserted directly into the uterus and is 99.9% effective at preventing pregnancy for up to 5 years. The ParaGard is very much the same as Mirena but it has a copper coil around the vertical portion of the T and is 99.9% effective in preventing pregnancy for up to 10 years.
Pros: These methods are 'set and forget'. You have it inserted and you're good to go for 5-10 yrs, depending on which one you get. Pregnancy prevention is considered immediately effective after placement. Both methods are reversible and full fertility resumes immediately after removal. Mirena, being an intra uterine BC requires a very low dose of hormones, and results in little to no hormone transference into the blood stream. Mirena affects the uterus and ovaries almost exclusively. ParaGard is the only non-hormonal, non-barrier method of BC and at 10 yrs of proven effectiveness it holds the record for the longest lasting reversible BC method on the market. Though there is a bit of up front cost, considering that there is no monthly costs, these two are considered among the least expensive BC options. An IUD can also be inserted immediately after birth, which is great for mothers who want to make sure they don't end up with children who are too close in age.
Cons: Placement is a bit painful. For me it really wasn't that bad but I have heard of some women finding it excruciating. If you have had a pelvic exam before, that should give you a small idea of whether or not having an IUD put in will hurt, and how much. IUD's can, though this is rare, puncture through the uterine lining, into the intestines, or become embedded in the uterine wall...in any of these cases surgical removal will be required. This is rather rare though, and such instances are usually a result of the physician inserting the IUD improperly or with too much force, so avoid having the placement done by someone who is fresh out of school. An IUD is also almost exclusively given to women who have already had a child, so not everyone can get it. this is because the cervix in a woman who has not had a child is very tight and difficult to open, which means placement will be more difficult and much more painful. Also, their uterus will most likely be too small to hold the IUD. A woman who has had a child will have a much softer and more flexilble cervix, making for an easier, less painful placement and a larger uterus to house the IUD. Also, as the IUD is inserted into the uterus itself your uterus has to be at least a certain depth... mine, unfortunately is too small, despite having had a baby. I had one put in, just in the off chance that my uterus would accept it but by the next morning it was already 70% expelled and had to be removed immediately to prevent damage. I bled for a month after that. Prolonged bleeding after placement, or spotting between cycles, for the first 3-12 months is not uncommon with IUD's. It sucks but its the body's way of trying to get rid of the foreign object in the uterus, so its generally not anything to worry about.
Recommendations: As an IUD needs to stay in place for at least a year before most doctors will agree to remove it, you should make sure that you really don't want any more children within the next year. Also, if your doctor says your uterus is too small for an IUD and that they do not recommend placement...listen to them. Yes, there is a chance that your uterus wont push it out, but if it does you'll bleed for at least a month, and for no good purpose. So wait till you've had another child or two before trying again. If possible, have your doctor place the IUD shortly after you have given birth. Your uterus is larger then and may adapt to the size of the IUD as it shrinks down again, possibly increasing your chances of your uterus not expelling it. This way, if your body DOES reject it, you're already bleeding a lot anyway, so you're not going to have to deal with messy, or no, sex while you're recovering from the procedure. And since its a low dose hormone, or the copper version, you don't have to worry about it affecting your milk supply.
This is a high dose, long lasting hormone shot that is given once every 11-13 weeks and provides 99.9% protection from pregnancy within a week of getting the shot.
Pros: This option is great for women who struggle with remembering to take a pill every day, but are not eligible for an IUD. The depo shot is known for reducing menstrual cramps, and sometimes even causing a cessation in menstruation after having been on the shot for a while. While I was on it I didnt have a period for the first 2 months!
Cons: Like any high dose hormone there are mood swings associated with the adjustment period. Many women have reported weight gain, hair loss, as well as prolonged and mid-cycle bleeding. The depo shot also has to be injected into a large muscle, and most women are too petite to have it done in their arm, therefore it has to be injected in the thigh, butt, or deltoid muscles. The solution is thick and it takes about 30 seconds to fully inject it. The area is really rather sore for a few days afterward...like a deep muscle ache that just wont go away. And though man women experience a cessation in periods, others bleed almost non stop on it. I had 2 months without a period but then I bled for a little over a month straight after that...my body was trying to get rid of the endometrial tissue that had built up in my uterus from the hormones preventing me from having a normal period for 2 months. My doctor assured me that this bleeding would taper off after the 3rd shot but I was sick to death of bleeding and wanted something that wouldnt cause me any issues. Depo shot can also build up in your system and take a while to fully break down. I knew someone personally who had been on the shot for 3 years, decided she wanted to have another child but her fertility did not return for another 2 years after discontinuing the shot. However, I also know someone who got pregnant immediately during the few weeks when she was supposed to have gotten the next shot, so its a little unpredictable which of the two outcomes will happen with you.
Recommendations: Get the depo shot if you don't mind a little pain and a lot of blood and are ok with the possibility of needing to use a tampon or pad a lot. And just like the pill, be sure to start it a few months before you're planning to put its contraceptive abilities to use so as to spare any unsuspecting male the wrath of the hormonally insane. Since the shot can potentially take a while to fully wear off, only get it if you're not planning having children any time soon.
A flexible plastic ring, similar in size to your standard hair tie, that is infused with a low dose of hormones and is inserted vaginally for 28 days and removed for 7 days to allow for menstruation. When the ring is inserted into the vaginal cavity it generally rests with the back end of it up behind the cervix, and the front portion resting behind the pubic bone in the general vicinity of the G-spot. Vaginal contours and muscles keep the ring in place.
Pros: Because it is a vaginal form of BC its low dose. The ring is flexible but still rigid enough that most women can feel it if it changes position or starts to come out. Most men report that they are unable to feel it during intercourse. The ring is left in place for 28 days, then removed and another replaced 7 days later, so its much easier to remember than a pill since you can program a reminder in your phone to let you know when to make the switch. If your body can handle it you can actually skip periods by inserting another ring immediately after removal of the first one. Low dose means fewer side effects, so its pretty unusual for women to have mood swings on NuvaRing, even during the initial 3 month adjustment period. It can also, potentially, be used while still breastfeeding as very little hormone enters the bloodstream, but ask your doctor to be safe. Some women have reported that the placement of NuvaRing, being that its front edge rests on or near the G-spot, can actually increase her ability to orgasm during intercourse. Fertility returns within just 3 hours for ring removal, giving you plenty of freedom for family planing.
Cons: Some women have become pregnant while on NuvaRing but this is generally due to having left the ring in beyond its period of maximum effectiveness, removal during intercourse, or the ring falling out without the woman noticing (usually during the removal of a tampon, and possibly during sex or foreplay) without the ring being reinserted or replaced within 3 hours of removal. Some women can feel it and never become comfortable having it in. Some men report being able to feel it during sex.
Recommendations: Use it. See how it works for you. This is the one BC I have not had any issues with. I love it. I used to think I wanted an IUD and that was all I was looking at, till I found out I cant use one until my uterus gets stretched out a bit more. Now I'm thinking I may just keep the NuvaRing and forget about the IUD till I'm old and done with having children.
Unexpected Side Effects
So here are some side effects that aren't really ever discussed. Decreased libido. Libido? That means sex-drive. When I first went on the pill I had a dramatic decrease in my desire for sex. The totally uncool part about that, other than the obviously sucky ones, is that once you go off the pill your sex-drive doesn't immediately go back to the level it was before, it takes a little bit of time. Maybe a month or two, sometimes longer if it goes back to normal at all. Not all women experience this but its pretty common, so watch out for it. Also, decreased vaginal lubrication. That's right, birth control can make things a bit dry in your nether regions, so be sure to keep up on your hygiene and use lube during sex to help prevent infections. This too goes back to normal after discontinuing your BC. Some BC options, particularly the high hormone ones, can cause changes in skin coloration and moisture content as well as hair texture. After starting birth control my skin became slightly more oily and my hair developed a wave to it that I didn't have before. Some BCs are advertised as being able to reduce even get rid of acne, but others can actually cause you to break out really bad, again, this usually happens with the higher hormone level contraceptives. These changes are unpredictable but I do know a pretty reliable way to avoid experiencing these effects... use a low hormone birth control method such as NuvaRing or an IUD. The pill can be low dose but you specifically have to ask your doctor if you can try the lowest dose available. I was on a low estrogen pill for a little while and that seemed to reduce my negative side effects, but not all of them, so that isn't as reliable as the others.
Side Note: Something to keep in mind is that the use of any anti-biotic renders birth control useless, with the exception of the copper IUD. So whenever you have to take an antibiotic be sure to use an alternative method of contraception -preferably a barrier method coupled with a spermicide for extra effectiveness- for the duration of your course of antibiotics and for a few days after completing it. Just to be on the safe side. DO NOT discontinue useage of your BC while on the antibiotic. Doing so may result in bleeding issues as well as a longer lag in your protection from pregnancy.
I know that with so many options to choose from, making a choice between BC options can be a pretty intimidating task. Hopefully, what I have shared with you about the ones I have tried myself will help make that choice a little easier. But, as I am fond of reminding you, I am not a doctor. So if you have any questions about other health issues you might have, or more in depth questions about these birth control methods, please contact a physician. Again, I hope this has been helpful and answered some of the more practical questions you might have had. Thanks for reading and good luck!