You’re considering starting a new birth control method and have narrowed it down to the contraceptive implant or the birth control pill. But you’re uncertain which option is better for you. These two highly effective, reversible contraceptives offer their own pros and cons.
Read on for everything you need to know to decide whether the implant or the pill is right for your body, lifestyle, and family planning goals.
How The Contraceptive Implant and Birth Control Pills Work
First, let’s look at how these two birth control methods prevent pregnancy to understand better how they may affect your body.
The contraceptive implant (such as Nexplanon) is a small, thin rod comparable in size to a matchstick. It contains the hormone progestin. The implant is inserted under your upper arm’s skin by a healthcare provider. Once inserted, you can feel it under your skin, but it is not usually visible.
The progestin hormone thickens the mucus found on the cervix, which helps to inhibit sperm from entering the uterus to fertilize the egg. It also thins the uterine lining to possibly prevent the implantation of an egg that has been fertilized. Progestin may also sometimes prevent ovulation, depending on the woman.
The implant provides continuous pregnancy protection for 3-5 years before needing to be replaced. A healthcare provider can remove the implant anytime if you want to have a child or opt for a different birth control method. Fertility returns quickly after the implant is extracted.
Birth Control Pills
The birth control pill contains synthetic progestin and estrogen. Combination pills with both hormones are the most common. But the “mini-pill,” which has only progestin, is a good solution for women who shouldn’t take estrogen.
Birth control pills function similarly to the implant, thickening your cervical mucus while making your uterine lining thinner. They also typically prevent ovulation. You take one hormone pill by mouth daily to maintain the effects.
For combination pills, you take pills for 21 or 24 days, followed by 4-7 placebo pill days when you get your period. Then, you start a new pack. Some pills are designed so you only get your period a few times yearly.
Or you can take the pills continuously with no break to stop periods altogether. Pills start working after about a week if taken properly. Fertility returns within a couple of months of stopping.
Effectiveness of the Implant and Pills
Both the implant and pills are very effective forms of birth control that can be relatively easily reversed. However, the implant edges out pills slightly when it comes to its effectiveness in real-world scenarios.
With perfect use, meaning it’s used precisely as directed, less than 1 out of 100 women will get pregnant in a year using the implant. For combination birth control pills taken perfectly, that number is less than one pregnancy per 100 women yearly.
But with typical use, accounting for common human errors, implants remain just as effective at less than one pregnancy per 100 women. However, approximately 9 out of 100 women will get pregnant in a year, relying on combination pills with typical use.
The implant’s effectiveness stays sky-high since you don’t have to take any daily action after insertion. Whereas forgetting to take a pill, taking it late, or having medication interactions can reduce its real-world effectiveness.
Pros and Cons of the Implant and Pills
Now, let’s run through the main advantages and disadvantages of the implant compared to birth control pills.
- Lasts 3-5 years with low maintenance.
- Fertility quickly returns after removal.
- Most effective birth control method with typical use.
- Safe for women who can’t take estrogen.
- Often lightens periods or stops them completely.
- Insertion and removal procedures are required.
- Irregular or prolonged bleeding is common, particularly in the first 6 to 12 months.
- Uncommon side effects such as headaches, mood changes, and acne.
- Typically regulates periods and makes them lighter.
- Can control the timing of your period.
- May reduce menstrual migraines and acne.
- Fertility returns within a couple of months of stopping.
- Take pills at a time convenient for your schedule.
- Must be taken every day, at the same time.
- Estrogen risks such as blood clots for some women.
- Common side effects such as headaches, nausea, and sore breasts.
- Slightly less effective with typical use.
Health Considerations for the Implant and Pills
Before starting either method, your healthcare provider will review your medical history. Certain medical conditions may make the implant or pills riskier or not a good fit for your body.
The estrogen that birth control pills contain can increase the risk of health problems such as blood clots, heart attacks, or stroke in women older than 35 who smoke or suffer from conditions such as high blood pressure or migraines.
The progestin-only mini pill avoids estrogen. An implant with only progestin may be preferable for these women, too. Hormonal birth control may also not be advised for those with liver tumors, unexplained vaginal bleeding, or breast cancer.
Your provider can help determine what form of birth control is safest if you have these conditions. In addition to preventing pregnancy, the implant and pills offer some non-contraceptive benefits you may desire. Both can lead to lighter periods.
They may also reduce menstrual migraines, painful cramps, and premenstrual symptoms for some women. Certain pills may additionally help clear up acne and can help you achieve more regular periods.
Let Raleigh Gynecology & Wellness Guide You in Choosing Between the Birth Control Pill and the Implant
There are various options for safe, effective birth control today. While both the implant and pill are excellent choices, determining which is right for your body and lifestyle requires careful thought.
Raleigh Gynecology & Wellness healthcare experts take the time to understand your health background and birth control goals. We’ll help you choose between the implant vs. pill or explore the many other contraceptive options.