What kind of birth control is right for me?
The type of birth control (or “contraception”) you choose depends on your needs. Some people only need to prevent pregnancy. Other people also may want to protect themselves or their partners from diseases that can be passed by having sex. These are called sexually transmitted diseases (STDs).
Some forms of birth control are more effective at preventing pregnancy than others. Barrier methods are not as effective as hormone methods or sterilization. Natural family planning can be just as effective if it is practiced with great care and commitment. However, the only way to make sure you do not get pregnant or get someone pregnant is to not have sex.
Barrier methods include condoms, the diaphragm, the sponge, and the cervical cap. These methods prevent pregnancy by blocking sperm from getting into the uterus and fertilizing an egg. You have to remember to use barrier methods every time you have sex, and you have to use them the right way every time for them to be effective.
Barrier methods can be made even more effective by putting spermicide on them. Spermicide comes as a foam, jelly, or cream, and kills sperm. Some barrier methods are packaged with spermicide already in them.
Condoms are an especially good choice if you or your partner have sex with other people or if either of you has had sex with other people in the past. Condoms can help prevent the spread of STDs.
We cannot recommend sponges or cervical caps as they are not consistently reliable. Condoms and/or diaphragms are highly dependent on how carefully and consistently they are used.
Birth Control Pills, Nuvaring, Patches
Combined estrogen and progestin methods work mostly by preventing ovulation (the release of an egg by the ovaries). These methods can cause some side effects such as nausea, headache, breast swelling, water retention, weight gain, moodiness or menstrual irregularities. However, most modern birth control pills have very low doses of hormones with minimal side effects.
The pill may reduce cramping and shorten the number of days of bleeding during the menstrual period. It is often prescribed as a treatment for menstrual problems, ovarian cysts and pelvic pain. It can be used continuously to have menses less often. It is safe and in fact has many health benefits for women. It is not given to smokers over 35 years of age. The Nuvaring contains an entire cycle of hormone in a silicon ring which is kept vaginally for 3-4 weeks at a time, slowly releasing the hormones. It must be changed monthly.
The minipill contains progestin only and is taken continuously. It has a little more breakthrough bleeding than combined birth control pills and takes several months to build up to full effectiveness. It is commonly used while Nursing as fertiloity is lower and bleeding is rare in the first months after childbirth.
Hormone Implants and Shots
Progesterone implants and shots work much like the pill. With implants and shots you do not have to think about birth control every day. They may have some side effects such as headache, and changes in periods, moods, and weight. They can be used while nursing.
Implanon is a single implant placed in the arm that prevents pregnancy for three years. It can be removed at any time. It is associated with a very low level of side effects but can have some light, unpredictable, painless bleeding during the time of its use.
Depo-Provera injections prevent pregnancy for three months. Initially there can be soime irregular bleeding, however with time menses tend to become infrequent or absent. It is used to treat women with heavy menses at times.
An intrauterine device, or IUD, is made of flexible plastic. It is put into a woman’s uterus by her doctor. It seems to stop sperm from reaching the egg or prevent the fertilized egg from attaching to the uterus.
IUDs, especially some types no longer in production, were related to an increase in infections. The chance of infection is highly associated with exposure to bacteria from new partners, ie., sexually transmitted infections. IUDs are generally reserved for women in stable relationships to minimize these risks. IUDs can result in heavier, crampier menses.
Mirena, an IUD with progestin built-in, is designed to reduce menstrual flow and cramping. It remains in place for five years but can be removed easily at any time. The most common side effects with Mirena include additional spotting in the short-term and then light or skipped menses later on. It is actually used as a treatment for heavy menses for some women. It can be used while nursing.
Sterilization is an procedure to permanently prevent pregnancy. If you are sure that you do not want to have children or do not want more children, sterilization can be a good choice.
Tubal ligation involves closing off the fallopian tubes in a woman so that eggs cannot reach the uterus. The fallopian tubes are what the eggs travel through to reach the uterus. Traditionally this was accomplished with laparoscopy, an outpatient operatiuon that requires anesthesia.
ESSURE is a new method of sterilization we are providing that involves placing small “plugs” in the tubes through the uterus. This is performed in a short office procedure while awake. It is meant to be permanent. The tube grows into the plug to block the tube. This takes as much as three months. A special x-ray is performed three months after the procedure to confirm the tube is blocked.
Men are sterilized with vasectomy. The man’s vas deferens (sperm ducts) are closed off so that sperm can’t get through. This is an operation performed in an office setting by a urologist.
Natural Family Planning
Natural family planning requires a couple to learn when in the woman’s cycle she can get pregnant (usually four days before and two days after ovulation) and use another kind of birth control or not have intercourse during those days. Natural family planning requires careful planning and commitment.
There are a number of ways to keep track of ovulation. The most effective ways involve using devices to determine when the woman is ovulating, such as a saliva tester or a cervical mucus tester, in combination with keeping track of the woman’s menstrual cycle. Many hospitals and churches offer courses in natural family planning.
Withdrawal is not effective. When a man tries to pull out before ejaculating, he usually leaves behind a small amount of fluid that leaks from the penis before ejaculation. This fluid has enough sperm in it to cause pregnancy.
Emergency contraception (also called “EC” or “the morning-after pill”) is a dose of hormonal pills that prevents the sperm from reaching the egg, or prevents a fertilized egg from attaching to the uterus. You have to take these pills within 72 hours of having unprotected intercourse, and another dose sometimes 12 hours after the first set of pills. They are available without a prescription from the pharmacist for women over 17 years old. Younger women can get a prescription from their doctor. Side effects can include nausea, headache, fatigue, dizziness and menstrual changes. .
Emergency contraception should not be used as a regular birth control method. It is used for emergencies only, such as if a condom breaks or slips off, if your diaphragm slips out of place, or if you forget your birth control pills two days in a row, and after rape.