Am Fam Physician. 2011;83(5):575-576
See related article on preventing gaps when switching contraceptives.
What is the best way to switch from one birth control method to another?
It is important to go straight from one birth control method to the next, with no gaps in between. This will help lower your chance of getting pregnant.
If you take birth control pills, you do not need to finish the pill pack before switching to another method. You can stop taking your pill at any point in the pack. If you are switching to pills from another method, you should start by taking the first pill in the pack. These rules also apply to switching from one kind of pill to another kind of pill.
You may have changes in your period after switching birth control methods. This is normal. Do not wait for your period before you stop the old method or start the new one.
When do I need to overlap birth control methods?
In some cases, you should have a few days of overlap. This means starting the new method before stopping the old method. This gives the new method time to start working before the old one wears off. The table shows which methods should overlap and how long the overlap should be. The overlap length appears in bold print.
| Switching to: | |||||||
|---|---|---|---|---|---|---|---|
| Switching from: | Pill | Patch | Ring | Depo (progestin)shot | Progestin implant | Progestin IUD | Copper IUD |
| Pill | No gap: take first pill of new pack the day after taking any pill in old pack | Start patch one day before stopping pill | No gap: insert ring the day after taking any pill in pack | Get first shot seven days before stopping pill | Insert implant four days before stopping pill | Insert progestin IUD seven days before stopping pill | Can insert copper IUD up to five days after stopping pill |
| Patch | Start pill one day before removing patch | — | No gap: insert ring and remove patch on the same day | Get first shot seven days before removing patch | Insert implant four days before removing patch | Insert progestin IUD seven days before removing patch | Can insert copper IUD up to five days after removing patch |
| Ring | Start pill one day before removing ring | Start patch two days before removing ring | — | Get first shot seven days before removing ring | Insert implant four days before removing ring | Insert progestin IUD seven days before removing ring | Can insert copper IUD up to five days after removing ring |
| Depo (progestin) shot | Can take first pill up to 15 weeks after the last shot | Can start patch up to 15 weeks after the last shot | Can insert ring up to 15 weeks after the last shot | — | Can insert implant up to 15 weeks after the last shot | Can insert progestin IUD up to 15 weeks after the last shot | Can insert copper IUD up to 16 weeks after the last shot |
| Progestin implant | Start pill seven days before removing implant | Start patch seven days before removing implant | Start ring seven days before removing implant | Get first shot seven days before removing implant | — | Insert progestin IUD seven days before removing implant | Can insert copper IUD up to five days after removing implant |
| Progestin IUD | Start pill seven days before removing IUD | Start patch seven days before removing IUD | Start ring seven days before removing IUD | Get first shot seven days before removing IUD | Insert implant four days before removing IUD | — | Can insert copper IUD right after removing progestin IUD |
| Copper IUD | Start pill seven days before removing IUD | Start patch seven days before removing IUD | Start ring seven days before removing IUD | Get first shot seven days before removing IUD | Insert implant four days before removing IUD | Insert progestin IUD right after removing copper IUD and use backup method for seven days | — |
When do I need a backup method?
If you do not want to overlap the old method and the new method, you can use a backup method instead. Backup methods include condoms and spermicide. For example, if you do not want to keep taking the pill after you get your first progestin shot, you can use condoms instead. You should use the backup method for the same number of days listed in bold print in the table.
If you do not want to use a backup method, you should avoid having sex for the same number of days listed in bold print in the table.
To prevent human immunodeficiency virus (HIV) and other sexually transmitted infections, always use condoms when you have sex.
