From IUDs to the pill to condoms, here is how each method works, how effective it is in real life, common side effects and what happens to your cycle when you stop.
The short answer
The most effective reversible methods are the ones you don’t have to remember: the hormonal IUD, copper IUD and implant, each with fewer than 1 pregnancy per 100 users a year. Pills, patches, rings and injections work well when used perfectly but fail more often in real life. Condoms are the only method that also protects against STIs. When you stop hormonal birth control, fertility returns quickly for most methods.
Methods at a glance
| Method | Typical-use pregnancies per 100 a year | Lasts | Good to know |
|---|---|---|---|
| Hormonal IUD | Under 1 | 3–8 years by brand | Periods often lighter or stop |
| Copper IUD | Under 1 | Up to 10 years | No hormones; periods may be heavier |
| Implant | Under 1 | 3 years | Irregular bleeding is common |
| Injection | About 4 | 3 months | Fertility can take months to return |
| Pill, patch or ring | About 7 | Daily, weekly or monthly | Can ease painful or heavy periods and acne |
| External condom | About 13 | Each time | Protects against STIs |
| Fertility awareness | 2–23 by method | Daily tracking | Needs training and regular cycles |
The short version
Choosing what suits you
- Want to forget about it: IUD or implant
- Painful or heavy periods: hormonal IUD, pill, patch or ring
- Can’t take estrogen (migraine with aura, smoking over 35, some clotting risks): progestin-only pill, hormonal IUD, implant, injection or copper IUD
- No hormones: copper IUD, condoms, fertility awareness
- Emergency contraception: a copper IUD within 5 days is most effective; levonorgestrel pills work best within 3 days
Coming off the pill: what to expect
- Fertility usually returns within weeks. You can get pregnant in your first cycle.
- Periods often return within 1 to 3 months. They may be heavier, more painful or less regular than on the pill.
- Conditions the pill was masking, such as acne, PMOS (PCOS) or endometriosis pain, may reappear.
- No months without a period: if you have no period for 3 months after stopping, take a pregnancy test and see a doctor.
“Post-pill syndrome” is not a medical diagnosis, but the symptom changes are real and usually reflect your natural cycle returning.
Where to get help
Family doctors, nurse practitioners, pharmacists and sexual health clinics can help. In BC, many prescription contraceptives are free through the provincial program, and pharmacists can prescribe hormonal contraception.
Frequently asked questions
What is the most effective birth control?
IUDs and the implant, with fewer than 1 pregnancy per 100 users a year.
How long after stopping the pill can I get pregnant?
Often within the first cycle. Fertility returns quickly for most people.
Why are my periods worse after stopping the pill?
The pill often makes periods lighter and less painful. Stopping it reveals your natural cycle, and conditions like PMOS or endometriosis may reappear.
Is birth control free in BC?
Since April 2023, BC covers many prescription contraceptives at no cost to residents.
Try the free period & ovulation predictor tool
Your next periods, estimated ovulation and fertile window, with a calendar. It takes about a minute and your answers stay on your device.
