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Here's How To Pick The Best Birth Control Method For You

Read this before you go to your doctor.

Birth control is not one-size-fits-all. It's not even one-size-fits-most.

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Think of it like a bra: What works for your unique body and lifestyle won't necessarily work for someone else. There's no "perfect" one, but there is probably one out there that's perfect for you. And what works for you now might not work for you in 10 years.

So just like you wouldn't waltz into a department store and blindly take whatever bra was offered to you first, you shouldn't assume that your doctor will know exactly what birth control is right for you without some background.

BuzzFeed Health teamed up with a board-certified gynecologist to create a guide that helps you decide which birth control is right for you.

BUT we're not going to tell you exactly what to use — sorry, we're journalists, not your doctor. That decision will likely be based on not just your health and lifestyle but your insurance coverage and access to certain methods. What we can do is tell you exactly what questions to ask your doctor so that you can make an informed decision about your birth control.

Zachary Ares / BuzzFeed News

OK, you've made the appointment with your doctor or gynecologist and you're ready to talk birth control. Great! BuzzFeed Health spoke with Dr. Mary Jane Minkin, board-certified OB-GYN and clinical professor at Yale School of Medicine, for the important questions that will help you narrow down your options.

Scroll allllll the way down for a checklist you can save/share/print/whatever so that you don't forget these questions when you go.

1. Are you currently sexually active, or do you plan to become sexually active soon?

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This is the first thing you should bring up with your doctor so that you can talk about what kind of pregnancy protection you're looking for in a birth control method, says Minkin. For instance, someone who isn't having sex yet may have different priorities than someone who lives with their partner and is having sex all the time.

Equally important: Will you be needing pregnancy protection for that kind of sexual activity? If you're only hooking up with a same-sex partner, you might not be as concerned with getting the most effective, most foolproof method.

2. What birth control methods have you used in the past?

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Your doctor will want to know what methods you've used before, and what you liked or disliked about them. Were you averaging three missed pills a month? Did one method make you feel nauseated or depressed? Did you have a lot of spotting with an IUD? This will help your doctor figure out what methods (and what hormones) might work best for your body.

Keep in mind that it might take some trial and error to find the right fit. For instance, all those different types of combined birth control pills contain different doses of estrogen and different kinds of progestin. And the way these two hormones work together in the body may differ from person to person.

Minkin says doctors typically like to start with a pill that contains a low dose of estrogen. Rarely, that can cause breakthrough bleeding or vaginal dryness in some people, in which case the doctor may suggest a pill with a little more estrogen. Similarly, some people are sensitive to different kinds of progestin (the other hormone found in hormonal birth control pills), which may result in mood changes. If that's the case, your doctor can suggest a pill with a different type of progestin.

3. What kind of birth control method would fit easily into your daily life?

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Maybe you travel a lot for work and you're often waking up in different cities/time zones. Maybe you're a nurse or a flight attendant or you just know that your daily schedule is kind of all over the place. In these cases, remembering a daily pill might be difficult. Your doctor might suggest something that's harder to mess up — like the ring, patch, IUD, implant, or shot.

4. Do you have any medical conditions?

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It might not seem like your gynecologist needs to know your entire medical history, but it's important when it comes to prescribing a birth control method. That's because certain methods of birth control should not be used if you have certain conditions — like uncontrolled high blood pressure, advanced diabetes, and lupus. Some of these cases are strict, whereas others will depend on your overall health and specific risk factors, says Minkin. Similarly, certain uterine abnormalities would make IUDs off limits.

So don't hold anything back when it comes to divulging your medical history with your doctor. They may even request a physical if you haven't had one in a while. You can find a full chart of medical conditions and how they can affect your birth control options here.

5. Do you smoke?

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If you're under 35, being a smoker doesn't technically dictate which birth control methods you can take. "I'm not thrilled she's a smoker, but she can still take the pill," says Minkin.

But if you smoke and you're 35 or older, you shouldn't take combined hormonal contraceptives (birth control methods with both estrogen and progestin) like the pill, the ring, or the patch. That's because these risk factors, taken together with oral contraceptive use, can increase your risk of stroke.

6. Do you get migraines? Do they come with an aura?

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If you get menstrual migraines every month around your period, birth control with estrogen may actually give you relief by regulating your cycle, says Minkin. In fact, some people with menstrual migraines prefer extended-cycle contraceptives that only give you a few periods a year.

But there's a huge caveat here: If you get migraines with aura (meaning you experience specific visual changes with your migraines — like flashes of light, blind spots, squiggly lines, etc.), you should not take combined hormonal birth control like the pill, the ring, or the patch. That's because this type of migraine may increase the risk of having a stroke.

7. How are your periods?

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Does your period generally resemble a floodgate opening? Maybe you want some assistance with that. Most hormonal birth control can help regulate your cycle, which often leads to lighter, lovelier periods. The hormonal IUD in particular is typically associated with periods that stop entirely after a while. The copper IUD, on the other hand, won't do anything to help your flow (since it's hormone-free) and some say it can even make it worse.

You should also let your doctor know if your periods are really long or erratic, which could be a sign of polycystic ovary syndrome (PCOS). Similarly, you should tell them if you experience severe pelvic pain around your period, which could be a sign of endometriosis. Hormonal birth control is often used to treat these conditions, says Minkin, so it's worth bringing up to your doctor.

8. Would you prefer to skip periods or would that completely freak you out?

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With the hormonal IUD, most people report their periods stopping entirely after a while. You can also skip your periods with extended-cycle birth control pills. That might be amazing for some people, or it might be terrifying if you're someone who relies on that monthly cue for reassurance.

So if you're someone who really needs that period every month to prove you're not with child, maybe don't try a hormonal IUD.

9. Do you have a personal or family history of blood clots?

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This is a pretty major one. In case your doctor doesn't bring it up, let them know if you've experienced a blood clot (deep venous thrombosis) or pulmonary embolism in the past. The use of combined hormonal birth control (like the pill, the ring, and patch) is not recommended for someone with a history of blood clots.

However, having a family history of blood clots doesn't necessarily mean you can't use these methods, says Minkin. That's because there's a difference between having a genetic predisposition to blood clots and just having one because you broke your leg, for instance. Still, let your doctor know if anyone in your family has had a blood clot so that they can test you for any clotting mutations. If it turns out that you are predisposed to blood clots, they probably won't recommend the pill, ring, or patch. Instead, they may recommend the IUD, implant, shot, or progestin-only pill.

10. Have you had (or do you currently have) breast cancer?

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Be sure to tell your doctor if you have a history of breast cancer, or if you currently have breast cancer. The use of any hormonal birth control method is not recommended while someone has breast cancer, and it's typically not recommended after you've had breast cancer, either.

However, having a family history of breast cancer does not limit you to certain birth control methods, says Minkin.

11. Do you have a family history of ovarian cancer?

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Interestingly, the use of birth control pills is recommended for anyone with a family history of ovarian cancer, says Minkin, because it's been shown to reduce your own risk of ovarian cancer.

"Having a family history of ovarian cancer might push me toward birth control pills for that person," says Minkin.

12. Do you suffer from severe PMS?

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If your PMS is particularly debilitating and comes with symptoms of anxiety or depression, it might be premenstrual dysphoric disorder (PMDD). In addition to your normal (but more severe) PMS signs, symptoms of PMDD can include a lack of interest in daily activities, sadness or hopelessness, mood swings with bouts of crying, panic attacks, irritability or anger, and trouble sleeping or concentrating. You can find out more about PMDD here.

So, why bring this up to your doc? Birth control pills with a specific type of progestin called drospirenone (like Yaz and Beyaz) have been approved to treat PMDD, says Minkin.

13. What about severe acne?

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Hey, if you're going on birth control anyway, might as well see what other benefits you can get, right? According to Minkin, people with acne often find more relief with estrogen-containing birth control, like the pill, the patch, or the ring.

14. Do you have any mental health conditions or concerns?

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While there isn't strong research to suggest that birth control actually causes mood disorders, there are plenty of people who anecdotally say certain methods have affected their mental health. A recent global study found an association between being prescribed the birth control pill and being prescribed antidepressants, although it was just a correlation.

So if you already experience anxiety, depression, or another mental health condition, should you bring it up to your doctor? Minkin says yes. Not only is it great to talk about any and all concerns with your doctor before starting a new medication, but Minkin says she may sometimes consult with a person's therapist or psychiatrist before prescribing something. It doesn't hurt to get everyone on the same page.

15. What other medications are you taking?

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In general, birth control doesn't interact with most common medications. Even most antibiotics won't make it less effective, says Minkin, but a few specific ones will. So tell your doctor if you're taking any other medications — particularly those for tuberculosis, seizures, or HIV — as they may interact with combined hormonal contraceptives (like the pill, patch, or ring).

16. Would you prefer a completely non-hormonal method?

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While many people enjoy the benefits that come with hormonal contraception (a regular cycle, lighter periods, less acne, etc.), others would prefer to prevent pregnancy without the hormones. In that case, your options are the copper IUD, condoms (male and female condoms), and fertility awareness-based methods.

17. What will you be doing to minimize your risk of STIs and HIV?

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Finding a reliable birth control method is great, but even the most effective methods should be used in conjunction with condoms or dental dams if you're at risk for STIs or HIV, says Minkin.

FYI: Being "at risk" doesn't just mean you're having sex with multiple partners. You can be at risk for STIs even in a monogamous relationship if you're not totally sure of your partner's status. And the only way to be sure of your status is by getting tested, because most STIs show up without any noticeable symptoms.

So, unless you and your partner(s) have been recently tested (and are only hooking up with each other), keep using condoms or dental dams for vaginal, anal, and oral sex — all of which can expose you to STIs. If you're already sexually active, talk to your doctor about getting tested while you're getting your birth control.

18. Do you want to get pregnant sometime in the next year?

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Hey, maybe you only want a short-term birth control fix. In this case, the birth control shot (Depo-Provera) wouldn't be a good option, as it can take up to 10 months or longer for ovulation to return after stopping it. With other methods, it's possible to get pregnant pretty much immediately after you stop using them, says Minkin. Your doctor might also suggest something that takes a bit less time to adjust to, like the pill or the ring versus the IUD.

Got all that?

Zachary Ares for BuzzFeed News
Lixia Guo / BuzzFeed News

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