The shot and the pill are two effective forms of hormonal birth control, each with their own benefits and risks. Does one work better than the other?

People can choose from many different birth control options.

When choosing between the shot and pills, people may want to consider their effectiveness, side effects, risks, and convenience.

This article explores the benefits and risks of the shot and pills for birth control and tips for choosing between them.

Hormonal birth control comes in several forms, including an injectable shot.

When using the shot, a person will receive injections of a hormone every 3 months.

The birth control shot, or Depo-Provera, also contains progestin, the hormone that prevents ovulation.

Progestin prevents the ovaries from releasing an egg. This makes pregnancy very unlikely. The hormone can also make the lining of the uterus less likely to allow an egg to implant.

A person needs to take birth control pills at the same time each day.

There are many different brands of birth control pills, each with slightly different levels of hormones. There are two main groups of pills. Combination contraceptive pills contain estrogen and progestin. Progestin-only pills, or mini pills, do not contain estrogen.

Like the shot, all pills contain progestin, which helps prevent ovulation.

The estrogen component in the combination pills thickens the uterine lining, which provides stability and controlled bleeding patterns. This is why people taking the combination pill usually have a regular monthly period.

A person should discuss which type of pill may be best for them with a doctor. For example, progestin-only pills may be safer for people living with high blood pressure or a higher risk of stroke.

According to the Office on Women’s Health, the effectiveness rates of the shot and the pill are slightly different. About 6 in every 100 people who have the shot will become pregnant within the first year, while about 9 in every 100 people who take the pill will become pregnant within the first year.

If someone does not get the shot as regularly as every 3 months, they are more likely to become pregnant.

Likewise, if a person misses a pill or takes it later than the ideal time, this could make the pill less effective.

Certain medicines can interfere with both the birth control shot and pills, which could reduce their effectiveness. A person should ask their doctor about drug interactions when taking a new medicine, including antibiotics.

If someone wants to become pregnant after stopping birth control injections, it can take up to 10 months on average.

As with most medications, birth control pills and the shot can cause side effects. People may wish to discuss these with their doctor when considering the best option. The side effects are similar for the shot and pills because they contain similar hormones.

Side effects of the birth control shot include:

Doctors may advise that a person receiving birth control shots take calcium supplements to reduce the risk of bone loss. When they stop receiving birth control injections, they will usually gain lost bone back.

Side effects of birth control pills include:

Doctors associate the mini pill with fewer side effects than combination contraceptives.

In rare cases, taking the combination pill can cause blood clots and a higher risk of heart attack and stroke. People are more likely to experience these complications if they are older than 35, if they smoke, or if they have a history of migraine.

Birth control requires a prescription. In recent years, online companies have made it easier for people to get a prescription for and obtain birth control, such as pills, without leaving their homes.

Some common ways to get birth control pills include:

  • Online: Companies such as Hers and Nurx offer full service birth control options that include prescription services and discrete delivery of birth control pills. Many of the companies work with a person’s insurance and accept health savings account (HSA) money for payment.
  • Pharmacies: A person can have a doctor or other healthcare professional send a prescription to their local pharmacy to fulfill the prescription.
  • Clinics: Several low cost or free clinics allow a person to obtain birth control pills or other methods of birth control at their sites.

A person needs to visit their doctor or healthcare professional’s office to receive the injection once every 3 months for the shot.

With the shot, people may experience more sporadic bleeding patterns, but as time goes on, they tend to have much lighter, less frequent episodes of bleeding.

Some people even have a total absence of periods after a while. The drawback is that they will not necessarily know when they are going to bleed.

People may have irregular bleeding with pills initially, but generally, this will become a regular, predictable bleed each month.

People can also take pills on an extended cycle to avoid having periods every month. For the most part, they will know when to expect a period. However, if they miss pills, they may bleed unexpectedly.

The Affordable Care Act requires that all insurance companies and Medicaid provide birth control methods at no additional cost. A person living without insurance can visit a low or no-cost clinic to obtain low cost or free birth control.

People without insurance or who work for an employer with a religious exemption will need to pay for birth control. However, they can use funds from their HSA or other accounts.

According to the National Women’s Health Network, one birth control shot costs around $60 without insurance. Birth control pills typically cost $20–50 per month, but generic forms of pills can cost as little as $10 per month.

People who need assistance paying for birth control can visit clinics to obtain low cost pills and other birth control methods.

When a person uses them in the way a healthcare professional directs, birth control pills and the shot can effectively prevent pregnancy.

Some of the major considerations include:

  • Convenience: If someone is worried that they will not be able to take their pill at the same time every day, they may prefer the shot. If they do not want to go back to the doctor’s office every 3 months, birth control pills may be more convenient. A person can also order birth control pills online and receive them on a subscription basis.
  • Bleeding patterns: Both the shot and pills can cause changes in menstruation. The shot can make periods lighter, less frequent, and unpredictable for some people. Combination pills can help regulate a person’s menstrual cycle and allow them to predict when their period arrives.
  • Effectiveness: Both contraceptive methods have similar effectiveness when a person uses them appropriately, though the shot may be slightly more effective than the pill.
  • Side effects: Both methods have side effects. Some people may have different side effects than others, as each person’s body reacts differently to hormones.
  • Cost: The Affordable Care Act requires Medicaid and insurance plans, except those with religious exemptions, to cover the cost of birth control methods. Those without insurance can acquire several types of birth control from clinics that provide services for low or no cost.

Aside from the shot and pills, people can use other prescription or nonprescription methods of preventing pregnancy.

Nonprescription birth control options include:

Prescription methods include:

People can use a prescription or nonprescription method together with male or female condoms for protection against sexually transmitted infections (STIs). Sponges and spermicide may not prevent STIs.

Below are some of the most common questions and answers about birth control shots and pills.

Is the Depo-Provera shot just as effective as the pill?

The shot offers slightly better pregnancy prevention — 6 in every 100 people who receive it will become pregnant in the first year. The pill offers similar protection, with 9 in every 100 people becoming pregnant in their first year of taking the pill.

However, both methods are only effective if the person follows recommendations for taking them. A person taking the pill needs to take it at the same time every day, while a person receiving the shot will need to schedule appointments with a healthcare professional every 3 months to maintain their protection.

If a person does not follow the schedule, they have a higher risk of becoming pregnant. A person can also use barrier methods, such as condoms, in combination with the pill or the shot, for further protection.

What should I do if I want to switch from the pill to the shot?

A person should speak with a doctor about switching from the pill to the shot. A doctor can provide any specific guidelines for the individual.

A person should get their first shot 7 days before their last pill and continue taking it for the remaining 7 days.

What should I do if I want to switch from the shot to the pill?

A person should also speak with their doctor about switching from the shot to the pill. They may provide additional, specific instructions to the person.

When switching from the shot to the pill, a person can start the pill within 15 weeks from their last shot.

Do you still get your period on the shot?

A person’s period can change and become irregular when receiving the shot, particularly in the first year. During this time, a person’s bleeding may become unpredictable, heavier, and erratic.

After this, a person’s bleeding often lightens, with some people no longer having any bleeding at all.

Does Depo-Provera cause infertility?

Depo-Provera does not cause infertility. Most people can become pregnant within 10 months of their last injection.

Does the Depo-Provera shot hurt?

Like other shots, it can cause mild discomfort, like a pinch, at the site of the injection.

A person may develop an infection or reaction at the injection site. If this occurs, they should contact a doctor as soon as possible.

Birth control pills and shots are effective ways to prevent pregnancy. Both use similar hormones, so they have similar side effects and risks.

Some people prefer the convenience of only having to get a birth control injection every 3 months, while others may like to receive their birth control pills in the mail as needed.

A person should discuss birth control options with a doctor.