Birth Control options
June 28, 2010
Dr. Rebecca Eia
Birth Control Options
The Centers for Disease Control says almost half of pregnancies in the U.S. are unplanned although several safe, effective methods of birth control are available. The choice of birth control depends on factors such as a person's overall health, age, frequency of sexual activity, number of sexual partners, desire to have children in the future, and family history of certain diseases. A woman should talk to her health care provider about her choice of birth control method.
Copper T IUD—An IUD is a small device that is shaped in the form of a "T." Your doctor places it inside the uterus to prevent pregnancy. It can stay in your uterus for up to 10 years. This IUD is more than 99 percent effective at preventing pregnancy.
Mirena intrauterine system (IUS)—The IUS is a small T-shaped device like the IUD. It is placed inside the uterus by a doctor. It releases a small amount of progestin each day to keep you from getting pregnant. The IUS stays in your uterus for up to five years. The IUS is more than 99 percent effective at preventing pregnancy.
Oral contraceptives—Also called "the pill," it contains the hormones estrogen and progestin. A pill is taken at the same time each day. If you are older than 35 years and smoke, have a history of blood clots or breast cancer, your doctor may advise you not to take the pill. The pill is 92–99 percent effective at preventing pregnancy.
Mini pill—Unlike the pill, the mini-pill only has one hormone, progestin, instead of both estrogen and progestin. It is taken at the same time each day. It is a good option for women who can't take estrogen. They are 92–99 percent effective at preventing pregnancy.
Patch—This skin patch is worn on the lower abdomen, buttocks, or upper body (but not on the breasts). It releases hormones progestin and estrogen into the bloodstream. You put on a new patch once a week for three weeks. During the fourth week, you do not wear a patch, so you can have a menstrual period. The patch is 92–99 percent effective at preventing pregnancy, but it appears to be less effective in women who weigh more than 198 pounds.
Hormonal vaginal contraceptive ring— The NuvaRing releases the hormones progestin and estrogen. You place the ring inside your vagina. You wear the ring for three weeks, take it out for the week you have your period, and then put in a new ring. It is 92–99 percent effective at preventing pregnancy.
Injection or "shot"— Women get shots of the hormone progestin in the buttocks or arm every three months from their doctor. It is 97–99 percent effective at preventing pregnancy.
Implant—The implant is a single, thin rod that is inserted under the skin of a women's upper arm. The rod contains a progestin that is released into the body over three years. It is 99 percent effective at preventing pregnancy.
Newer, permanent options
Laparoscopic supracervical hysterectomy uses a thin, lighted telescope-like instrument called a laparoscope, which acts like a video camera, along with small surgical instruments that are all inserted through three to four tiny incisions (less than 1/4 inch each) in the navel and abdomen. Using the instruments, the surgeon carefully separates the uterus from the cervix and removes it through one of the openings. The cervix, the bottom part of the uterus, is left intact. Because this type of surgery does not require the surgeon to make a large abdominal incision, you will not have the same kind of visible scar typical with most traditional, "open" surgeries.
LSH causes less stress to the body. It was developed to reduce pain, minimize scarring and shorten recovery time. The procedure can be done on an outpatient basis, which means a woman can be home resting comfortably within 24 hours and back to her normal activities in less than a week. As with all surgery, hysterectomy involves risk, including potential blood loss, infection and damage to other internal organs.
LSH preserves the cervix, which some research suggests may help to reduce the risk of pelvic floor prolapse, urinary incontinence and other complications associated with total hysterectomies. Because the cervix is left in place, however, you must be willing to continue annual pap smears to screen for cervical cancer.
Essure is a permanent birth control procedure that works with your body to create a natural barrier against pregnancy. This gentle procedure can be performed in a doctor's office in less than 10 minutes.
Unlike other permanent birth control, the Essure procedure does not require cutting into the body or the use of radiofrequency energy to burn the fallopian tubes. Instead, an Essure trained doctor inserts soft, flexible inserts through the body's natural pathways (vagina, cervix, and uterus) and into your fallopian tubes. The very tip of the device remains outside the fallopian tube, which provides you and your doctor with immediate visual confirmation of placement.
During the three months following the procedure, your body and the inserts work together to form a natural barrier that prevents sperm from reaching the egg. During this period, you must continue using another form of birth control (other than an IUD).
After three months, you must undergo an Essure Confirmation Test to verify you are protected from the worries of unplanned pregnancy. The test uses a dye and special type of x-ray to ensure both that the inserts are in place and that the fallopian tubes are completely blocked.
Unlike birth control pills, patches, rings, and some forms of IUDs, Essure does not contain hormones to interfere with your natural menstrual cycle. Your periods should more or less continue in their natural state.
The Adiana procedure is similar to the Essure procedure, with minor differences. It works by stimulating your body's own tissue to grow in and around tiny, soft inserts that are placed inside your fallopian tubes. A slender, flexible instrument (delivery catheter) is passed through the vagina and cervix and into the uterus to deliver a low level of radiofrequency energy (i.e., energy that generates heat to create a superficial lesion) to a small section of each fallopian tube. A tiny, soft insert—about the size of a grain of rice—is placed in each of your fallopian tubes, right where the energy was applied. As with the Essure procedure, you must use another form of birth control over the next three months, while new tissue grows in and around the Adiana inserts, eventually blocking your fallopian tubes.