In Your 30s and 40s
Intrauterine devices have come a long way since the 1970s. “There is a mountain of data attesting to their safety and efficacy,” says Espey. The most common device, called Mirena, is made of plastic and releases progesterone, which thickens cervical mucus to block sperm. Also, the T-shaped device itself causes minor inflammation in the uterus, which prevents implantation, says Espey. Mirena can be left in place for five years. Less common is the nonhormonal copper IUD, called ParaGard, which prevents pregnancy simply by creating inflammation; it can be left in place for 10 years. IUDs are placed in the uterus at the gynecologist’s office (you might feel slight cramping), and your doctor will examine you after about a month to make sure the device has stayed put.
Benefits: If you decide you want to get pregnant, your doctor can remove the IUD and “your fertility resumes quickly,” says Basinski. And for most women, Mirena produces lighter, shorter periods.
Downsides: Some women, especially those using the copper IUD, can develop heavier periods with stronger cramps.
Cost: From $800 for Mirena and from $700 for ParaGard; may be covered by insurance.
This matchstick-size rod is injected into your upper arm by a doctor ( you’ll get a shot of anesthetizing lidocaine beforehand). It contains progesterone to stop ovulation and thicken cervical mucus, and it lasts for three years. (Implanon is not to be confused with the Norplant device, which is no longer available in the United States.)
Benefits: “Implanon is a very effective long-term method of birth control, because once it’s placed, you can pretty much forget about it,” says Espey.
Downsides: Side effects can include acne, weight gain, and irregular periods.
Cost: $400 to $800; may be covered by insurance.