To know which solution is the most effective for you, you'll have to try them. In this case, considering the risk of side effects from Accutane, I suggest that you try to rebalance your cycle with low-dose hormones. The pill and the IUD are both good choices and if your doctor has offered them to you, you should not have any contraindications to taking them. If you ask me, the pill probably offers the easiest solution here. It will be easier to discontinue if you have a side effect and may be able to control your menstrual cycle disturbances a little more quickly. It is important to know that at your age you should not smoke while taking the pill. Indeed, it increases the risk of side effects. All pills are effective in this respect. There are some pills that contain an anti-androgenic progestin, but to my knowledge they have not proven to be more effective than "normal" pills. We look forward to seeing you.