Though most women choose to use contraceptive pills to prevent pregnancy, sometimes they just don’t work very well. Some women have trouble with taking them because of the way they affect their hormones; others simply forget to take them and then wind up at risk of getting pregnant. To solve each of these problems, long term birth control might be a great option. Here are a few of the best out there.

6 Common Types of Long Term Birth Control

1.       Intrauterine Device (IUD)

There are two specific types of intrauterine devices available, one with hormones, and one with copper. They are inserted into the uterus through a simple outpatient procedure.

• Effective period: The hormonal IUD is good for three to five years, depending upon which manufacturer; the copper IUD is often good for seven to ten years.
• How it works: The hormonal IUD continuously releases hormones that thin the uterine lining and thicken the cervical mucus; both of those things help prevent pregnancy. The copper IUD affects the mobility of sperm, preventing it from reaching the egg.
• Success rate: Either type of IUD results in less than one percent of users becoming pregnant.
• Possible risks: The IUD has been known to be expelled with your period; sometimes there is the risk of infection or uterine rupture from improper placement, though these situations are rare.

2.       Birth Control Implant

The implant is a small, flexible rod that is inserted under the skin of your arm with the intention of providing long term birth control. This can be done during a simple office visit.

• Effective period: Most implants are good for three years before they must be removed and replaced.
• How it works:The implant releases progestin, which interferes with the reproductive cycle.
• Success rate: The implant is 20 times more effective than pills, patches or rings. Just like the IUD, less than one percent of women using this method will become pregnant.
• Possible risks: There is the risk of some bruising at the insertion site, which should quickly go away. Some women might experience a lessening or cessation of periods, which means they should take pregnancy tests occasionally to ensure they are not pregnant.

3.       The Shot (Depo-Provera)

The shot is an injection given in the upper arm. It feels like a typical shot, such as one you might get for the flu; there is some slight pain, and possible soreness for a day or so afterward.

• Effective period:Women with the shot must have a new shot every three months to ensure their continued protection against pregnancy; as long term birth control, it might not be suitable for use for more than two years.
• How it works: The shot is filled with progestin, which disrupts the reproductive cycle and prevents pregnancy.
• Success rate: Among those who get the shot, one in 100 women will get pregnant. If you skip a shot or otherwise don’t get it done on schedule, your risk of getting pregnant rises to six percent.
• Possible risks: The shot can eventually cause your bones to thin, so those who are at risk for osteoporosis should not use it. Those who have had breast cancer or Cushing’s disease should also avoid this shot.

4.       Sterilization

This is considered a permanent form of birth control that usually requires a surgical procedure. Some doctors will only perform sterilization if a woman has already had at least one child or has reached a certain age. This is the ultimate in long term birth control.

• Effective period: This is considered a permanent procedure, so the effective period begins once the healing is complete. For the Essure device, this happens after three months of healing. For the surgical sterilization, this happens within a matter of hours.
• How it works: Surgical sterilization is done by cutting and cauterizing the fallopian tubes, effectively preventing the egg from being released from the ovaries. With the Essure device, scar tissue builds up around the device that has been inserted into the fallopian tubes, effectively sealing them off completely.
• Success rate: Those on the Essure method have reported effectiveness of 99.8%. Those who undergo surgical intervention have about the same success rate.
• Possible risks: Side effects can be severe immediately following the surgery or placement. The biggest risk with Essure is an ectopic pregnancy, which can be life-threatening, but is very rare.

5.       Contraceptive Patch

The patch is worn on your body, usually on your arm, tummy or rear. It releases various hormones into the skin which are absorbed by your body, and thus work together to prevent pregnancy.

• Effective period: The contraceptive patch must be replaced every seven days. Replacement is as easy as putting on a band-aid.
• How it works: The patch releases small amounts of hormones continuously, thus preventing ovulation.
• Success rate: The patch has a success rate on a par with the contraceptive pill, but there is less chance of forgetting it, since it must be changed outonly every seven days.
• Possible risks: There is a very small risk of blood clots.

6.       Vaginal Ring

The vaginal ring is a small ring inserted into the vagina, where it nestles against the cervix. This ring releases hormones that help prevent pregnancy.

• Effective period: The ring is inserted for a period of three weeks, and then should be removed while you have your period. A new ring is inserted each month.
• How it works: The ring contains progestin and estrogen, which thicken the cervical mucus and help prevent ovulation.
• Success rate: The ring is as successful as the patch or the contraceptive pill, when it is used correctly.
• Possible risks: Blood clots have been reported by some women who use the ring. It is also very important to have a proper fit; otherwise the ring might fall out without being noticed, leaving you open to pregnancy.