Mar 1, 2011 Table of Contents

Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education Web site.

Information from Your Family Doctor

How to Switch Birth Control Methods

Am Fam Physician. 2011 Mar 1;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.

How to Switch Birth Control Methods

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


IUD = intrauterine device.

Adapted from the Reproductive Health Access Project. http://www.reproductiveaccess.org.

How to Switch Birth Control Methods

View Table

How to Switch Birth Control Methods

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


IUD = intrauterine device.

Adapted from the Reproductive Health Access Project. http://www.reproductiveaccess.org.

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.


This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.

Copyright © 2011 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests.

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