Most are aware of two popular contraceptive methods – condoms and birth control pills. But did you know that there are nine types of birth control available today? The choice of birth control you make today based on your age, plans for future childbearing or your social situation will change with time. It is easy to switch from one method to another if you are not happy with the method you chose or as your life changes.
Condoms are the most widely used method to prevent infections that are sexually transmitted such as Gonorrhea, chlamydia, trichomonas, syphilis and HIV. They are also a very good method of birth control provided they are used properly. They are not 100% effective for pregnancy protection and may be used in combination with contraceptive gels and foams which are sold over the counter for women. The combination of condom and a vaginal contraceptive gel is as good as protection with birth control pills. There is also a female condom available.
Diaphragms: Another barrier method for women that can be used at the time of sex. You need to be fitted and then the diaphragm will last many years. It is easily placed in the vagina just before sex and should be used with contraceptive gel and left in 6-8 hours or overnight. It is then easily removed, washed and placed in a box for the next time use. This is for highly motivated women who will use it every time. It is very effective is used properly.
Most birth control pills contain a combination of estrogen and progesterone. Around since the 1960s birth control pills are very safe and very effective if taken daily at the same time. They are not associated with weight gain. They are useful for relieving menstrual cramps and make the flow lighter. Upon discontinuation fertility usually returns quickly. Spotting in the first few months is a temporary annoyance. They should not be used by smokers over age 35. They can be continued until age 50 in the healthy nonsmoker. Very small risk of blood clots and stroke is associated with combination birth control pills. The 'mini pill' refers to progesterone only pills which are commonly used in nursing mothers or for women who cannot take estrogen. They are not as effective and do cause more spotting and therefore are not as popular.
Similar to birth control pills in that they have both estrogen and progesterone, it is absorbed through the skin from a patch which is changed weekly for 3 weeks and then one week off to menstruate. They
are very effective if used properly. Same warning applies for smokers and risk of blood clots.
Contraceptive Ring (Nuvaring):
It is a soft flexible ring that is inserted into the vagina by you and left in place for 3 weeks. Once in you will not feel it and can have sex and all other activities as usual. You remove it after 3 weeks and throw it away and will have a period. After the week a new one is placed. It contains estrogen and progesterone like the pills and patches and therefore has the same risks. It is very highly effective and a good choice for women who think that they will have a hard time remembering to take pills daily at the same time.
Nexplanon is a matchstick size rod that is placed under the skin of the upper arm in the doctors office. It is a progesterone only method and lasts for 3 years. It offers excellent protection but is associated with irregular periods. After 3 years, or sooner, it can be removed in the office and if desired a new one can be placed. There is no risk of clots or warnings for cigarette smokers because there is no estrogen.
Depo Provera Injections:
Given every 3 months as an injection in the arm this is another highly effective method of birth control that does not have estrogen. Temporarily it will cause vaginal bleeding as progesterone is the hormone that causes the periods. After time the bleeding lessens and then there are no periods. Many women prefer this method because it offers excellent protection and they are happy not to bleed. It is completely reversible though it may take up to 6 -12 months for periods to become regular again. It can be continued until age 50.
IUDs, or intra-uterina devices, have become very popular because they offer excellent protection and no additional action except the insertion which is done in the doctor’s office. There are a few types and all are very effective:
The copper IUD (Paraguard) contains no hormones and can be left in place for up to 13 years. If pregnancy is desired, it is easily removed in the office and fertility returns at once.
Mirena, Kyleena, Skyla: These IUDs contain progesterone and cause the periods to stop with time as in the depo provera injections. Very little of the hormone enters the blood stream and therefore is a very good method of protection for women who are happy not to menstruate and do not want to use a hormonal method of birth control.
We are lucky to have so many choices today. You need to consider your lifestyle and have a discussion with your gynecologist to decide which method is right for you.
Call 631.587.2500 to schedule an appointment today.