You’re past the 30-year milestone and you think you’ve got this adulting thing under control. Then comes your 35th birthday and at your annual OBGYN appointment you learn that it’s time to reevaluate something you thought you already had under control – birth control.

The health game changes once you hit your mid-thirties. While many Women can stick with a hormone based birth control option, for women who smoke or women with certain health conditions there may be a need for some tweaking.

Estrogen is usually the key ingredient that is a concern for women over 35 who have a history of cancer, diabetes, hypertension, blood clots, migraines, liver or bladder disease. Smoking poses an additional problem with it comes to birth control because it interacts with estrogen in the arteries in a way that increases the risk of heart attack and stroke.

For women over 35 who are healthy oral contraceptives or other estrogen based birth control can still be a viable option. Another factor to discuss is if you plan on having children. If so you’ll need reversible contraception.

Only your doctor can tell you which birth control method will best suit your medical and lifestyle needs. But go informed, when you know the basics it’s easier to talk with your doctor and work together to choose the right birth control option for your particular needs.

Here are some of the most common birth control options available on the market today:  

1. The Combination Pill (brand names Ortho Tri-Cyclen, Yaz, Yasmin and many more)
   Known usually as “the Pill,” this oral contraceptive contains a combination of hormones to prevent pregnancy. The pill must be taken at the same time every day in order to be effective. Women who have a history of heart attack, stroke or migraines, and certain cancers should not take this pill.
2. The Mini Pill (brand names Micronor, Nora-BE, Nor-QD, Ovrette and more)
   Unlike the combination pill, the mini pill does not contain estrogen, which makes it safer for women who smoke, have diabetes, heart disease and women who are breastfeeding. Like the combination pill, this pill should be taken at the exact same time every day to be effective.
3. The Extended Cycle Pill (brand names Seasonale, Seasonique)
   This pill lets you have a period only four times a year. Sounds pretty appealing, right? Speak to your doctor about whether getting a minimal number of periods is safe for you.
4. IUD, Intra-Uterine Device (brand names Paragard, Mirena)
   There are different types of IUDs, some plastic and some metal, some with hormones and some without. All types must be inserted by your doctor, and once in, they can be good for up to ten years. Some doctors only recommend IUDs to women have previously given birth, since the device itself expands your uterus. IUDs also tend to be expensive (a few hundred dollars, depending on the type), so they are best for women who want long-term birth control.
5. Implant (brand names Implanon, Norplant, Nexplanon)
   This little match-stick-sized implant is inserted under the skin on your upper arm. It can last for three years and costs a hefty chunk of money (up to $800). The benefit is that it is nearly 100% effective, and you don’t have to remember to take a pill at the same time every day.
6. Vaginal Ring (brand name NuvaRing)
   This is a small ring made of plastic that contains estrogen and progestin, like the combination pill. You place the ring in your vagina for three weeks, and then remove it so you can have a regular period. This ring is not meant for women who smoke, have high blood pressure or history of cancer.
7. Diaphragm (brand names Milex Wide Seal, Ortho All-Flex, Semina, SILCS) Diaphragms are made of rubber and, when inserted correctly, cover the cervix. A diaphragm should always be used with spermicide for maximum effectiveness. You must be fitted for a diaphragm by your doctor, but it is not a painful procedure. Women whose weight regularly fluctuates by more than ten pounds should avoid using a diaphragm, as well as women who get frequent bladder infections.
8. Condoms (brand names Durex, LifeStyles, Trojan)
   One of the most common forms of contraception, condoms protect against pregnancy and STDs by preventing sperm from entering the uterus. If you or your partner are allergic to latex or polyurethane, find another option! (Lambskin condoms do not protect against STDs).
9. The Patch (brand name Ortho Evra)
   Slap a patch on your arm, tush or abdomen, and hormones will be released into your body. Women who are at high risk for blood clots should avoid this method.
10. Emergency Contraception (brand names Next Choice, Plan B, Plan B One-Step)
    Also known as “the morning-after pill,”emergency contraception should only be used as a back-up birth control, not your number one choice. Emergency contraception contains higher doses of the hormones found in the combination pill and works best if taken within 72 hours of having sex. Plan B is available over-the-counter, but only to women over 18. Minors can get it with a prescription.

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