Thursday, August 1, 2013

Contraceptive options

Contraception, more commonly known as birth control, is something all women think about and many women utilize at some point in their life.  Birth control allows women and families to prevent pregnancy, plan and time when they want to become pregnant, or space out when they have their children.  There are many options available.  Women often will change their birth control method depending on her preference, health, age, or other factors.  Many of these contraceptive options are also used for medical reasons not related to pregnancy-prevention.  It is important for women to understand what options are available, in order to make an informed decision with her provider about which method would be best.

Currently, the following contraception methods are available, with their relative effectiveness:

1) Permanent contraception (99.2-100% effective): male vasectomy, female sterilization (via Essure or tubal ligation) - non-reversible forms of contraception, require surgical or in-office procedure.  Generally, permanent procedures are done after women and families have completed their child-bearing and are sure they do not desire any more children.  A follow up visit is usually required to ensure the procedure was successfully completed.
Essure sterilization coils
Tubal ligation

 2) Extended implants (99.1-99.9% effective): Mirena IUD containing progesterone, Skyla IUD containing progesterone, Nexplanon arm implant containing progesterone, Paragard copper IUD.  Reversible methods that require a short in-office procedure, but then do not require the woman to do anything to ensure the birth control method is effective.  Each of these methods can be used for an extended period of time, but are reversible, meaning fertility returns once the method is removed from the body.  It is not required that a woman use the device for the entire time and can be removed early if she desires pregnancy or wants to change methods.
Mirena IUD
Life-span of one device:
- Mirena IUD: 5 years
- Skyla IUD: 3 years
- Nexplanon implant: 3 years
- Paragard copper IUD: 10 years
If a woman is happy with her method and wants to continue with the same method, it is possible to remove the device at the end of its effective time period, and insert a new one, or "piggy back" them.
Paragard Copper IUD

Nexplanon arm implant

Birth control pills
3) Hormonal methods (92-99% effective, depending on adherence and proper use): Depo-Provera progesterone injection every 12-13 weeks, daily birth control pills, NuvaRing vaginal ring used once a month, OrthoEvra patch applied to skin weekly.  Each of these methods require the patient to use the method correctly as directed (for example, taking the birth control pill every day at the same time).  If not taken or used effectively, the efficacy of the birth control goes down.


4) Barrier methods (76-90% effective depending on proper use with every intercourse): male condom, diaphragm, female condom, cervical cap, sponge.  The barrier methods need to be used with every act of intercourse, and need to be used as directed for maximum efficacy. 

Male condoms

5) Other methods (50-70% effective depending on proper use): Natural family planning, breast feeding, spermicide alone, withdrawal method. 

If you are interested in discussion any of the above methods, please let us know, and we are happy to sit down with you at an appointment and review all of the available options for you, including how they work, efficacy, risks and benefits associated with use, and answer any questions you may have.