Let us start with something fundamental: contraception is a good thing. Being able to control fertility is one of the essential freedoms women fought for in the twentieth century. No young woman today should give it up without making a genuine choice.
Now the real question begins. Contraceptive methods are not all the same. None is perfect. And choosing the pill by default is not necessarily the best choice for you. What I want to offer here is an honest overview.
The pill: what you are not always told
The pill remains the most commonly prescribed contraceptive for young women in France. It is effective, widely reimbursed and straightforward to use. It suits many women very well. If that is you, there is no reason to change simply to follow a trend.
But some effects are not always discussed: sexual desire may decrease, lubrication may be reduced, and mood may change. Some women experience depression without connecting it to the pill. Skin, weight and breast tenderness can also change. If you notice these effects, they are not imaginary.
An interesting point about bleeding on the pill
Think you are having a period every month? That bleeding is not a menstrual period in the usual sense. It is ‘withdrawal bleeding’, triggered by stopping the hormones for a week. The origins of that break are surprising: in the 1950s, John Rock, one of the pill’s developers and a devout Catholic, hoped that mimicking the natural cycle would make it acceptable to the Church. The Pope ultimately rejected contraception in 1968, but the format remained. Decades later, pills are still commonly prescribed with a weekly break that is not medically necessary. The UK Faculty of Sexual and Reproductive Healthcare formally acknowledged this in 2019.
Why does this matter to you? Because continuous use without a break can be an option for some pills and may be more comfortable. It is a conversation to have with your gynaecologist about your particular prescription.
Other hormonal options
The hormonal IUD, such as Mirena or Kyleena, stays in place for several years and involves lower circulating hormone levels than the pill. Once largely reserved for women who had already given birth, it can also be offered to young women. Not having had children should not, on its own, be a reason to dismiss it.
The implant, placed in the arm, is a long-acting hormonal option with little day-to-day management. The vaginal ring and patch work on a principle similar to the pill, with a different method of delivery.
Non-hormonal options
The copper IUD can be a very good option for someone wishing to avoid hormones. It is effective, lasts several years and does not suppress the natural cycle. Its drawbacks include heavier or more painful periods for some women.
Condoms are also contraception, with the added benefit of protection against sexually transmitted infections (STIs). They are the contraceptive option that combines both roles. Failure can happen, often because of incorrect use. Consider them at the beginning of a relationship, alongside another reliable contraceptive method.
The symptothermal method involves observing temperature and cervical mucus to identify fertile days. It can be effective when practised correctly, but correct use is the difficult part: it demands consistent daily attention. If that is not realistic for you, there is a risk of pregnancy. Be honest with yourself about what you can manage.
How to choose: four practical considerations
Your daily consistency: if you forget things easily, a pill you must take every day may not suit you; consider a long-acting method. Your feelings about hormones: if using them bothers you, explore the copper IUD or barrier methods. Your relationship situation: condoms are essential with a new partner. Your medical history: some methods have contraindications, including increased vascular risks when certain pills are combined with smoking after the age of 35.
For your first time specifically
At a minimum, use a condom. Alongside it, plan your ongoing contraception: the pill, an IUD or another method. What matters is making the decision, obtaining any necessary prescription and having it ready beforehand, rather than improvising in the moment.
If your gynaecologist refuses to discuss alternatives or dismisses your preferences, seek another clinician. Doctors who are trained to listen to young women do exist.
And what about your partner?
Contraception is not your responsibility alone. It is something to address together: condoms, conversations, medical follow-up and shared costs. If your partner treats it as ‘your thing’ and refuses to take an interest, that tells you something about how he views the responsibilities that come with sex.