In-office shot (Depo-Provera)

Using the shot is linked to temporary bone density loss, especially for people who use the shot for more than two years in a row. Once you stop using the shot, your bone density typically goes back to normal. To help you have healthy bones, whether you are using the shot or not, you can make sure you eat foods with calcium and vitamin D and do weight-bearing exercise, like walking or dancing.

Probably. Almost everyone has some unpredictable bleeding or spotting in the first three months of using the shot, but over time the spotting usually gets better—or goes away completely.

If you have high blood pressure, methods with estrogen—the combination pill, the ring, and the patch—may make your blood pressure even higher, increasing the risk of a heart attack or stroke. Fortunately, there are lots of highly effective birth control options that are safe and estrogen-free like the progestin-only pill, all types of IUD, the implant, and the shot. Talk to a health care provider about your blood pressure and what birth control is an option for you.

One out of every 40 or 50 shot users experience some hair loss. Usually this is more like seeing extra hair on the brush or shower drain (kind of like after giving birth and progesterone levels are similarly levels). Usually that doesn’t mean going bald or have noticeably thinner hair on the shot.

Birth control methods with no hormones, like the non-hormonal IUD, condoms, sterilization, lactational amenorrhea[RW5] , and hormonal methods that don’t contain estrogen—the shot, hormonal IUDs, the implant and the mini-pill—are all safe to use immediately after giving birth. Combination pills, the ring, and the patch, which contain estrogen, shouldn’t be used until three weeks after giving birth, since estrogen and being postpartum both increase the risk of blood clots.

It can be complicated to tell exactly how hormonal birth control affects mood, but you’re the only one who truly knows how you feel. Everyone reacts to birth control differently, so if you feel your birth control might be contributing to depression, talk with your health care provider. It might be a matter of switching methods or deciding whether to avoid hormonal birth control altogether, or you may choose to wait it out since some negative side effects go away with time.

For most people, the risk of blood clots is low when they use the combination pill, the ring, and the patch. But smoking increases this risk. If you are over 35 and smoke 15 or more cigarettes a day, the combination pill, patch, and ring are not safe options for you. If you’re over 35 and you smoke less than 15 cigarettes a day, talk to your provider about whether these birth control methods are safe options for you.

There are positive and negative things to say about every method. And everyone’s different—so what you experience may not be the same as what someone else experiences. And what side effects are “worth it” to you might be different than for someone else.

You can start by thinking about what’s most important to you about your method. Is your top priority using the method that will be the most effective at preventing pregnancy? Something easy to use? Something that makes your period lighter? Something that you can stop and start without seeing a provider? There are birth control options for all of these. It’s also common to try more than one birth control option before finding one that works for you, so don’t settle if your current option isn’t working.

If you have health insurance—whether it’s from work, school, your parents, the ACA marketplace, or Medicaid—chances are good that you’ll be able to get this method with no out-of-pocket cost.

If you don’t have insurance or if you’re on a plan that doesn’t cover birth control, the shot can be expensive. You can also ask for the generic version, which is usually much more affordable than the brand name version. Depending on your income, you may be able to go to a low-cost clinic to get the shot at a reduced cost. You can also check with the manufacturer to see if they offer a discount or coupon to help you pay for the shot.

Most people who use hormonal birth control—combination pill, patch, ring, implant, shot, and hormonal IUDs—will have less painful periods than those who don’t. This is because these methods of birth control make the lining of the uterus thinner. There’s less tissue in the uterus to shed (that’s what happens when you have your period), so periods are lighter. One special note on the implant and the shot: for some people, these methods cause more days of spotting or bleeding in between periods, but periods become lighter and less painful overall.

Using a method of birth control with estrogen, like the combination pill, patch, and ring, increases your risk of forming a blood clot, but if you have no history of stroke, blood clots, or heart attack, and your family members have never experienced a blood clot, the risk is still quite low. If you have a history of these medical conditions, you have a higher risk of forming a new blood clot already so adding birth control with estrogen to the mix increases that risk and isn’t recommended.

Progestin-only methods like the implant, mini-pill, shot, and IUDs don’t increase your risk. If you’re worried about blood clots, we recommend talking to a health care provider about which birth control options are the safest for you.

It’s totally okay to use birth control privately, but some methods are much easier to keep private from a partner than others. To keep your method private, think about how your partner might discover it. Some methods, like condoms, internal condoms, and the pull-out method, are hard to hide from a sexual partner (they are actually more effective with your partner’s help). For the pill, patch, and ring, someone could find your birth control or the packaging, but once you swallow the pill, no one knows you are using it. The IUD is also very discrete, but some partners may be able to feel the strings during sex. Overall, the shot is the most private method once you get it, but it could change your period, so someone might notice. If you are looking for a permanent solution, sterilization surgery is also undetectable, but getting surgery can be hard to hide (and there may be age restrictions and waiting periods depending on your insurance).