There is no best contraceptive method. There is the one that fits how much you want to have to remember, what you want your periods to do, whether you want children in the foreseeable future, and what your medical history allows. This guide sets out those four and what each family of methods does.
The thing that separates methods most
Not how they work — how much they depend on you. The implant and both kinds of intrauterine device are fitted once and then require nothing to be remembered. Pills, injections and condoms all depend on something being done repeatedly and on time, which is why their effectiveness in ordinary use is lower than in perfect use.
If you have found yourself missing pills, that is not a failing. It is the clearest possible indication that a method which does not depend on remembering would suit you better.
What each family does
Barrier methods. Condoms are the only method here that also reduces the risk of sexually transmitted infections, which is why they are often used alongside another method rather than instead of one.
Combined hormonal methods, including the combined pill. They usually make periods lighter and more predictable and can help acne. They are not suitable for everybody, and the conditions that rule them out — migraine with aura, certain clotting histories, uncontrolled blood pressure, smoking over a certain age — are the reason the WHO publishes eligibility criteria and the reason this decision is made with a clinician.
Progestogen-only methods, including the progestogen-only pill, the injection and the implant. Bleeding patterns change and often become much lighter or stop; that is an expected effect rather than a problem. Fertility returns quickly after most of them; after the injection it can take several months to a year.
Intrauterine devices. A copper IUD contains no hormones and commonly makes periods heavier and more painful, particularly for the first three to six months. A hormonal IUD usually makes them much lighter and is itself a treatment for heavy bleeding. Both are long acting and both can be removed whenever you choose.
Emergency contraception is not an ongoing method. The widely available tablet is licensed up to 72 hours and works better the sooner it is taken; a copper IUD fitted within five days is the most effective form and can stay as ongoing contraception.
What it costs, and what is free
A range of methods is provided free through public facilities under the National Health Mission — condoms, oral contraceptive pills, emergency pills, the IUD including immediately after childbirth, the injectable, sterilisation, and the implant where it has been introduced. Availability varies by state and by facility, and the facility is the only place that can tell you what it has.
The questions that get you a real answer
Given my history, which of these are not suitable for me and why? Which do not depend on me remembering something? What will my periods do, and for how long? If I want a pregnancy in a year or two, does that change your suggestion? How do I stop this if I want to?
When to seek help the same day
On a combined hormonal method: calf pain or swelling, chest pain, breathlessness, a severe unusual headache, or sudden changes in vision. After an IUD is fitted: fever, worsening pain, or offensive-smelling discharge. And if you have had unprotected sex in the last five days and do not want to be pregnant, emergency contraception loses effectiveness with every day.
How this guide was written
AskHer's editorial team wrote this from the published guidance listed at the end of the explanations it links to — FOGSI, the Ministry of Health and Family Welfare, the ICMR, the World Health Organization, the RCOG and the NHS among them. It has not been signed off by a clinician registered in India, because no clinician has yet joined AskHer and had her registration checked. That is why no clinical reviewer is named on this page.
Nothing here is a diagnosis, and nothing here is advice about your particular situation. When a clinician does review a guide, her name and the date she reviewed it will appear here in place of this note.
This is general education. It cannot tell what is happening in your own body, and it does not replace seeing a clinician.