The birth control shot and birth control pill are two effective forms of hormonal birth control, each with their own benefits, risks, and side effects. Does one work better than the other?
People can
choose from many different birth control options.
When choosing between
the shot and pills, people may want to consider their effectiveness, side
effects, risks, and convenience.
This article explores
the benefits and risks of the shot and pills for birth control and tips for
choosing between them.
What is the birth control shot?
Hormonal birth control
comes in several forms, including an injectable shot.
When using the shot, a
person will receive injections of a hormone every 3 months.
The birth control shot,
or Depo-Provera,
also contains progestin,
the hormone that prevents ovulation.
Progestin prevents the
ovaries from releasing an egg. This makes pregnancy very unlikely. The hormone
can also make the lining of the uterus less likely to allow an egg to implant.
What are birth control pills?
A person needs to
take birth
control pills at the same time each day.
There are many different
brands of birth control pills, each with slightly different levels of hormones.
There are two main groups of pills. Combination contraceptive pills
contain estrogen and
progestin. Progestin-only pills, or mini pills, do not contain estrogen.
Like the shot, all pills
contain progestin, which helps prevent ovulation.
The estrogen component
in the combination pills thickens the uterine lining, which provides stability
and controlled bleeding patterns. This is why people taking the combination
pill usually have a regular monthly period.
A person should discuss
which type of pill may be best for them with a doctor. For example,
progestin-only pills may be safer for people living with high blood pressure or
a higher risk of stroke.
Effectiveness
According to the Office on Women’s Health, the effectiveness rates of the
shot and the pill are slightly different. About 6 in every 100 people who have
the shot will become pregnant within the first year, while about 9 in every 100
people who take the pill will become pregnant within the first year.
If someone does not get
the shot as regularly as every 3 months, they are more likely to become pregnant.
Likewise, if a person
misses a pill or takes it later than the ideal time, this could make the pill less effective.
Certain medicines can
interfere with both the birth control shot and pills, which could reduce their
effectiveness. A person should ask their doctor about drug interactions when
taking a new medicine, including antibiotics.
If someone wants to
become pregnant after stopping birth control injections, it can take up
to 10 months on average.
Side effects
As with most medications,
birth control pills and the shot can cause side effects. People may wish to
discuss these with their doctor when considering the best option. The side
effects are similar for the shot and pills because they contain similar
hormones.
Side effects of the birth
control shot include:
- bleeding between
periods
- bone loss when
a person uses this option long-term
- headaches
- missed periods
- mood changes
- sore breasts
- weight gain
Doctors may advise that
a person receiving birth control shots take calcium supplements
to reduce the risk of bone loss. When they stop receiving birth control
injections, they will usually gain lost bone back.
Side effects of birth
control pills include:
- headache
- increased blood pressure
- mood
changes
- sore
breasts
- an upset stomach
- weight gain
Doctors associate the
mini pill with fewer side effects than combination contraceptives.
In rare cases, taking
the combination pill can cause blood clots and a higher risk of heart attack and stroke.
People are more likely to experience these complications if they are older than
35, if they smoke, or if they have a history of migraine.
Where to get birth
control
Birth control requires a
prescription. In recent years, online companies have made it easier for people
to get a prescription for and obtain birth control, such as pills, without
leaving their homes.
Some common ways to get
birth control pills include:
- Online: Companies
such as Hers and Nurx offer
full service birth control options that include prescription services and
discrete delivery of birth control pills. Many of the companies work with
a person’s insurance and
accept health savings account (HSA) money for payment.
- Pharmacies: A
person can have a doctor or other healthcare professional send a
prescription to their local pharmacy to fulfill the prescription.
- Clinics: Several
low cost or free clinics allow a person to obtain birth control pills or
other methods of birth control at their sites.
A person needs to visit
their doctor or healthcare professional’s office to receive the injection once
every 3 months for the shot.
Bleeding patterns
With the shot,
people may experience more sporadic bleeding patterns, but as
time goes on, they tend to have much lighter, less frequent episodes of
bleeding.
Some people even have a
total absence of periods after a while. The drawback is that they will not
necessarily know when they are going to bleed.
People may have irregular bleeding with pills initially, but
generally, this will become a regular, predictable bleed each month.
People can also take
pills on an extended cycle to avoid having periods every month. For the most
part, they will know when to expect a period. However, if they miss pills, they
may bleed unexpectedly.
Cost
The Affordable Care Act requires that all insurance
companies and Medicaid provide birth control methods at no additional cost. A
person living without insurance can visit a low or no-cost clinic to obtain low
cost or free birth control.
People without insurance
or who work for an employer with a religious exemption will need to pay for
birth control. However, they can use funds from their HSA or other accounts.
According to the National Women’s Health Network, one birth control shot
costs around $60 without insurance. Birth control pills typically cost $20–50
per month, but generic forms of pills can cost as little as $10 per month.
People who need
assistance paying for birth control can visit clinics to obtain low cost pills
and other birth control methods.
Which
one is right for me?
When a person uses them
in the way a healthcare professional directs, birth control pills and the shot
can effectively prevent pregnancy.
Some of the major
considerations include:
- Convenience: If
someone is worried that they will not be able to take their pill at the
same time every day, they may prefer the shot. If they do not want to go
back to the doctor’s office every 3 months, birth control pills may be
more convenient. A person can also order birth control pills online and
receive them on a subscription basis.
- Bleeding
patterns: Both the shot and pills can cause changes in
menstruation. The shot can make periods lighter, less frequent, and
unpredictable for some people. Combination pills can help regulate a
person’s menstrual cycle and allow them to predict when their period
arrives.
- Effectiveness: Both
contraceptive methods have similar effectiveness when a person uses them
appropriately, though the shot may be slightly more effective than the
pill.
- Side
effects: Both methods have side effects. Some people may
have different side effects than others, as each person’s body reacts
differently to hormones.
- Cost: The
Affordable Care Act requires Medicaid and insurance plans, except those
with religious exemptions, to cover the cost of birth control methods.
Those without insurance can acquire several types of birth control from
clinics that provide services for low or no cost.
Alternative birth
control options
Aside from the shot and
pills, people can use other prescription or nonprescription methods of
preventing pregnancy.
Nonprescription birth
control options include:
Prescription methods include:
People can use a prescription or nonprescription method together with male or female condoms for protection against sexually transmitted infections (STIs). Sponges and spermicide may not prevent STIs.
Frequently asked questions
Below are some of the
most common questions and answers about birth control shots and pills.
Is the Depo-Provera shot just as effective as the pill?
The shot offers slightly
better pregnancy prevention — 6 in every 100 people who receive it will become
pregnant in the first year. The pill offers similar protection, with 9 in every 100 people becoming pregnant in their first
year of taking the pill.
However, both methods
are only effective if the person follows recommendations for taking them. A
person taking the pill needs to take it at the same time every day, while a person
receiving the shot will need to schedule appointments with a healthcare
professional every 3 months to maintain their protection.
If a person does not
follow the schedule, they have a higher risk of becoming pregnant. A person can
also use barrier methods, such as condoms, in combination with the pill or the
shot, for further protection.
What should I do if I want to switch from the pill to the
shot?
A person should speak
with a doctor about switching from the pill to the shot. A doctor can provide
any specific guidelines for the individual.
A person should get
their first shot 7 days before their last pill and continue taking it
for the remaining 7 days.
What should I do if I want to switch from the shot to the
pill?
A person should also
speak with their doctor about switching from the shot to the pill. They may
provide additional, specific instructions to the person.
When switching from the
shot to the pill, a person can start the pill within 15 weeks from their last shot.
Do you still get your period on the shot?
A person’s period can
change and become irregular when receiving the shot, particularly in the first year. During this time, a person’s bleeding may
become unpredictable, heavier, and erratic.
After this, a person’s bleeding often lightens, with some
people no longer having any bleeding at all.
Does Depo-Provera cause infertility?
Depo-Provera does not
cause infertility. Most people can become pregnant within 10 months of their last injection.
Does the Depo-Provera shot hurt?
Like other shots, it can
cause mild discomfort, like a pinch, at the site of the injection.
A person may develop an
infection or reaction at the injection site. If this occurs, they should
contact a doctor as soon as possible.
Summary
Birth control pills and
shots are effective ways to prevent pregnancy. Both use similar hormones, so
they have similar side effects and risks.
Some people prefer the
convenience of only having to get a birth control injection every 3 months,
while others may like to receive their birth control pills in the mail as
needed.
A person should discuss birth control options with a
doctor.
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