IUD vs. the Pill: Choosing Which Birth Control Is Right for You

Preventing an unintended pregnancy requires reliable contraception. For many, the choice comes down to the two most popular methods: the pill and an intrauterine device (IUD).

Which one fits your life? At The Healthy Woman, with offices in Atlanta, Lawrenceville, and Newnan, Georgia. GA, our highly-skilled clinicians can help you make an informed decision.

In this month's blog, we break down 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.  

The LARC method

LARC, also known as “set-it-and-forget-it” birth control, is designed to prevent pregnancy for years at a time without any effort on your part. LARC is a progestin-releasing IUD that can stay in place for 3-8 years. Copper-emitting IUDs remain effective for up to 12 years. 

Highly effective

Both IUDs are over 99% effective at preventing pregnancy. Apart from total abstinence, IUDs are the most effective contraceptive. A big part of that is that there’s no chance for “user error.”  You can't forget to take it, and it won't get left behind on a weekend trip.

Easily reversible

IUD insertion is a quick in-office procedure. Your gynecologist will remove the device when you’re ready to get pregnant or switch to another type of birth control. You can also have it replaced at the recommended time for continued long-term protection.

A daily habit

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

Daily method

Birth control pills must be taken daily to maintain protection. You also need to take it at roughly the same time each day for it to remain fully effective. 

Variable efficacy 

If you’re diligent in following these instructions, the pill is 99% effective, just like the IUD. 

In practice, though, the pill is about 93% effective, due to women not always remembering to take it. 

Regulated periods

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 easy and less disruptive to your cycle. However, it can take a few months for your period to adjust to the change. It is 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 immediately after discontinuing use. Still, each method has significant differences that likely make one preferable 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 you 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 not to 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). 

To learn more about all your birth control and family options, call us at 770-809-1100 or request an appointment online today. We have offices in Snellville, Conyers, and Lawrenceville, Georgia, and our primary care team in Atlanta, Lawrenceville, and Newnan, Georgia.