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The Birth Control Pill, Patch or Ring: Which is Most Effective?

Vicky Davis, FNP

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 10/30/2020

Choosing the right method of birth control can be a difficult decision — after all, you’ll generally stick with one method of birth control for some time. 

Today, a wide range of different hormonal contraceptives are available to prevent pregnancy and make enjoying your sex life easier. 

The birth control pill, ring and patch all use a combination of estrogen and progestin hormones to protect against unwanted pregnancy. Each form of contraception has its own advantages and disadvantages, as well as a slightly different effectiveness rate.

From convenience to effectiveness, we’ve compared the pill, ring and patch below to help you choose the best option for your needs and lifestyle. 

The Birth Control Pill

The birth control pill, or simply “the pill” for short, is a generally safe, convenient way to prevent pregnancy. It’s been around for decades, has a comparably high effectiveness rate versus other forms of birth control and, save for a few rare side effects, is one of the safest forms of contraception available.

Despite being referred to singularly as “the pill,” birth control pills come in several different forms. 

There are combination pills like Yaz®, Estrostep® and Ortho Tri-Cyclen®, which use estrogen and progestin hormones to stop you from ovulating and change the thickness of your cervical lining to stop pregnancy.

These birth control pills are also approved by the FDA for use as acne treatments, since they tend to suppress the hormones responsible for acne.

On average, combined birth control pills are 99 percent effective when used perfectly. In a “real life” setting, with the occasional forgotten or missed pill, combined birth control pills are about 91 percent effective at preventing pregnancy.

It takes about a week for the combined pill to start working, meaning you’ll need to abstain from sex or use another form of contraceptive for seven days after you start taking the pill.

Birth control pills also come in a progestin-only formula. Progestin-only pills are also known as “mini-pills” thanks to their smaller dose of hormones. Progestin-only pills don’t contain estrogen and instead use a light dose of a progestin hormone to block pregnancy.

On average, progestin-only birth control pills are 99 percent effective when used perfectly. Under “real life” conditions, such as the occasional missed or forgotten pill, this form of birth control is about 92 percent effective at preventing pregnancy.

Our guide to combined and progestin-only birth control pills covers these two forms of birth control in more detail. In general, both types of birth control are roughly equal in terms of effectiveness, provided you use them according to the instructions. 

Advantages of the Pill

The biggest advantage of the pill is its convenience factor. As long as you take your pill daily (around the same time), you’ll be protected against pregnancy. Most birth control pills come with a usage calendar, making it easy to keep track of which pill to take on which day of your cycle.

Birth control pills can also lighten your period, making them a good option if you get cramps and other forms of menstrual discomfort. 

If you opt for a combined birth control pill, you might also notice improvements in your skin. The hormones in combined birth control pills can suppress androgen production, giving you less oily skin and helping to prevent acne breakouts. 

Birth control pills are also linked to improvements in bone strength (depending on what age you use them), cyst treatment and suppression, a reduced risk of certain vaginal infections and a possible reduction in your risk of developing endometrial and ovarian cancers

Disadvantages of the Pill

The biggest disadvantage of the pill is the risk of side effects. While most side effects from the pill are relatively minor, you have a small risk of experiencing cardiovascular side effects such as blood clotting from most birth control pills.

Our guide to common and uncommon birth control side effects goes into these side effects in more detail, as well as how frequently they occur.

You might not be able to use the pill if you smoke, especially if you’re over 35 years of age. This is because the combination of hormones in most birth control pills can create health risks if you use cigarettes or other tobacco products.

Our guide to smoking and birth control covers this topic in more detail and lists alternative forms of birth control you can use if you’re a smoker. 

The combined birth control pill can also affect your sex drive. You might notice an increase or a decrease in your interest in sex after starting birth control, or no changes at all. 

Beyond these, the pill also has several minor disadvantages. You’ll need to take it every day at roughly the same time, meaning it might not be the most convenient form of contraception if you work a job that requires you to wake up at different times. 

The pill also doesn’t protect you from sexually transmitted infections, meaning you’ll need to use condoms or another barrier method of birth control, or undergo STI testing with your partner to have safe sex. 

Overall, the pill is the most popular form of hormonal birth control — and for good reason. It’s easy to use (although not the easiest form of hormonal birth control) and offers several extra benefits beyond contraception that make it great if you have acne or period discomfort.  

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The Birth Control Ring

Most commonly sold as NuvaRing®, the birth control ring works by continually releasing estrogen and progestin hormones into your vagina. These hormones stop you from ovulating and thicken the mucus in your cervix, making it more difficult for sperm to come into contact with an egg.

The hormones used in the birth control ring are the same as the hormones used in some forms of combined birth control pills. This means that the ring shares many of its side effects with the pill, from vaginal spotting to some cardiovascular side effects.

On average, the birth control ring is 99 percent effective when it’s used perfectly. Under “real life” conditions, it’s 91 percent effective. This means the ring is as effective as combined and progestin-only birth control pills as a contraceptive.

The birth control ring becomes less effective if you forget to replace it at the right time every month, or if you use medications such as griseofulvin (an antifungal), rifampin, certain antibiotics, St. John’s wort or certain HIV or anti-seizure medications. 

Advantages of the Ring

The ring is one of the most convenient forms of birth control available. Unlike the pill, which is designed for daily use, the ring needs to be inserted into the vagina once per month to be effective. 

Once you’ve inserted the ring, you can leave it in place for up to three weeks before removing it for your “ring-free week.” You do not need to remove the ring during sexual activity or for intense exercise. 

Like the pill, the birth control ring can make your period lighter and make menstrual cramps easier to manage. Although the ring isn’t approved by the FDA as an acne treatment, it uses the same hormones as a combined birth control pill and may help prevent acne breakouts. 

When you use the birth control ring, you also lower your risk of developing cysts, developing endometrial and ovarian cancers, iron deficiency and several infections in your uterus, fallopian tubes and ovaries.

In general, the secondary health advantages of the ring are very similar to those of the pill, since both options use the same type of hormones. 

Disadvantages of the Ring

From a convenience standpoint, the biggest disadvantage of the birth control ring is that you’ll need to change it on time, every month in order to stay protected from becoming pregnant. 

Like all forms of hormonal birth control, the ring can have side effects. The most common side effects are the same as those of the combined birth control pill, from spotting and nausea to an increase in headaches and breast tenderness. 

Just like the combined birth control pill, these side effects are most common during the first couple months of use and tend to get better over time. Also like birth control, the hormones in the vaginal ring might affect your level of interest in sexual activity

Because the birth control ring contains estrogen and progestin hormones, it can increase your risk of stroke, blood clots and other cardiovascular issues. These are most common in women over 35 years of age and should be discussed with your healthcare provider before you use birth control. 

Finally, like the pill, the ring doesn’t protect you from STIs, meaning you’ll need to use condoms or get tested for sexually transmitted infections with your partner to have safe sex. 

Overall, the birth control ring is a good choice if you want the protection of hormonal birth control but don’t like the idea of taking a pill every day. Since you only need to insert it once monthly, the ring can be a convenient, easy-to-use form of birth control. 

The Birth Control Patch

The birth control patch is a small patch that’s designed to stick onto your torso, upper arm, waist or buttocks. It looks similar to a bandage and works by slowly releasing estrogen and progestin hormones into your body.

Compared to the pill, the patch is a fairly new method of birth control. It’s been in use since 2001 and, according to the Guttmacher Institute, while it’s still used by tens of thousands of women, that number pales in comparison to both the ring and the pill.

Like the pill and the ring, the patch works by stopping your body from ovulating and by changing your cervical mucus levels. This makes it more difficult for sperm to come into contact with an egg, reducing your risk of becoming pregnant. 

The patch has a similar effectiveness rate as other forms of hormonal birth control. On average, the birth control patch is 99 percent effective at preventing pregnancy when it’s used perfectly. In “real life” conditions, the patch is about 91 percent effective at stopping unwanted pregnancy.

This means that the patch is equally effective as the pill, the ring and other hormonal forms of birth control. 

Like the pill and the ring, the patch has its own range of advantages and disadvantages. We’ve listed these below, as well as the unique characteristics of the birth control patch that you should be aware of before using it to prevent pregnancy.

Advantages of the Patch

Like the pill and the ring, the biggest advantage of the patch is how convenient it is to use as a method of birth control.

The birth control patch lasts for one week, meaning you’ll only need to take it off and replace it once every seven days. Normally, you’ll use three patches in a row before taking one week off at the end of your four-week cycle.

This makes the patch a great alternative to the pill if you don’t like swallowing a tablet every day, as well as a great option if you don’t like the feeling of the vaginal ring.

You can safely wear the birth control patch in the shower, the bath, while exercising and while swimming, meaning there’s no need to change your lifestyle if you choose to use the patch as your method of birth control. 

Like the pill and the ring, the patch can help to make your period lighter and easier to tolerate if you’re prone to period pain. It can also reduce your risk of developing ovarian cancer, as well as cancer of the bowels or uterus.

While it’s not approved as an acne treatment by the FDA, the hormones in the patch may also help to clear up acne breakouts and improve your skin.

Disadvantages of the Patch

From a practical standpoint, the biggest disadvantage of the patch is that it’s attached to your skin. This means it might be visible in some clothing, depending on where you choose to stick the patch on your body.

Although it’s uncommon, the patch can also fall off before the seven days are up. If the patch does come off, you should apply a new patch as soon as possible. If the patch is off for more than 24 hours, you should use an additional form of contraception (like a condom) to avoid accidental pregnancy.

From a health standpoint, the potential side effects of the patch are identical to those of the pill and the ring. The patch can cause mild side effects such as nausea, breast tenderness, spotting and weight gain, although these are usually temporary. 

The patch can also increase your risk of developing a blood clot, stroke or other cardiovascular health issue, although these are very uncommon. Like the pill and the ring, your risk of serious side effects from the patch is highest if you smoke and are above 35 years of age. 

Finally, the birth control patch might not be fully effective if you weigh more than 198 pounds. If you’re above this weight, the best approach is to discuss birth control options with your healthcare provider before choosing any specific form of hormonal contraception. 

All in all, the patch is a good choice if you don’t like the idea of taking medication daily to keep yourself protected from pregnancy and prefer the convenience of a stick-on patch to the vaginal birth control ring. 

Which Form of Birth Control is Most Effective?

From an effectiveness standpoint, the birth control pill, ring and patch are identically effective at preventing pregnancy. 

Used perfectly, all three forms of birth control have a 99 percent effectiveness rate. This means that just one woman out of every 100 who use the pill, ring or patch will become pregnant every year.

In a “real life” scenario, all three forms of birth control are about 91 percent effective at preventing pregnancy. 

Because the pill, ring and patch all use similar or identical hormones, the side effects of each form of birth control are very similar. While all three forms of birth control will protect you from becoming pregnant, none are designed to prevent STIs. 

Ultimately, the best form of birth control for you is the one that you find the easiest to use on a regular basis. If you like the predictability of the pill, make it your choice. If you like the ease of use of the ring or patch, make one of these options your go-to form of birth control.

Whether you opt for the birth control pill, the ring or the patch, follow the instructions provided with your medication and you’ll enjoy a convenient, effective form of contraception that helps you enjoy your life to the fullest. 

Learn More About Birth Control

Interested in learning more about birth control? Our guide to birth control and acne goes into more detail on how some birth control pills can help you prevent acne breakouts and improve your skin.

And our guide to birth control and your period will give you all the information you need to figure out how to best use birth control with your cycle.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

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