HEALTH & MEDICINE :: FEBRUARY/MARCH 2007
Methods of Contraception
What is meant by the term contraception? Contraception is the preventing of unintended pregnancy. There are many methods of contraception. People who need contraception are generally aware of the most common types of birth control. There are birth control pills, condoms, diaphragms, spermicides, and more permanent methods such as tubal sterilization and vasectomy. The purpose of this article is not to go over all methods of contraception, but to introduce people to some of the newer methods of contraception, which tend to be easier to use, reduce user failure (such as forgetting to take your pill), and have fewer side effects. With each new method I will describe the product, explain advantages and disadvantages, and inform you of the failure rate.
The first new method to discuss is birth control pills. Not that birth control pills are new; they have been around since 1950. The hormones that are in them have not changed much since the 50’s. The difference is the reduced dose of medication and the duration of the pill-free interval. Many newer pills now will only have 4 days of placebo rather than the traditional 7 days. The purpose of this is for women to have shorter and lighter periods. The side effects are similar to traditional pills, and they are all better than 99% effective. If a short monthly period is not desired, then there are pills that can be taken for 3 months and women will have only 4 periods a year. The disadvantage with the extended duration pill is a more frequent incidence of mid-cycle bleeding.
Two forms of contraception that may be less familiar are NuvaRing® and Ortho Evra®. NuvaRing is a small silastic ring that is inserted into the vagina. The ring releases a continuous amount of estrogen and progesterone into the blood stream. The ring remains in the vagina for 3 weeks. After the third week it is taken out for 1 week, and the woman has her period. Because the ring is left in place for 3 weeks and does not have to be taken daily, it has a slightly lower failure rate than pills. It is also associated with less nausea because it does not have to be taken orally and the dose of estrogen is less than the pill. It may also reduce the amount of episode of infection for women who get frequent vaginal infections.
Ortho Evra is a contraceptive patch. It is placed on the abdomen, arm, or buttock. It releases hormones through the skin and the hormones are then absorbed in the blood steam. It is 99% effective, but the effectiveness begins to decrease if the woman weighs more than 190 pounds. The patch is placed once a week, and is worn for 3 consecutive weeks. After 3 weeks, no patch is worn for 1 week and the woman has a period. The side effects are similar to the birth control pill, but there may be less nausea because it is not taken orally. The glue from the patch can cause discoloration of the skin where it is placed. The patch is usually very well tolerated.
One of the most effective forms of contraception is the IUD. The IUD is as effective as a tubal sterilization, however, unlike tubal sterilization, it is completely reversible. Many women think poorly of IUD’s based upon past IUD’s; however, both the ParaGard® and Mirena® IUD are both very safe and very effective. Both have better than 99% effectiveness. There is a small risk of infection with insertion, and the device is not intended for use by women who are at a high risk of getting a sexually transmitted infection. Getting a sexually transmitted infection with an IUD can result in life threatening infection. IUD’s are inserted by a health care professional. The benefit of the Mirena is that women have significantly reduced menstrual flow and shorter periods with the device.
It is important to remember that none of the contraceptive methods discussed protect a woman against sexually transmitted diseases, including HIV and AIDS. It is also advised that a woman avoid smoking while using any of the above methods of birth control. Smoking greatly increases the risk of a heart attack, stroke or blood clot formation while using hormonal birth control. When used as directed, the contraceptive options available to women are extremely effective and are more convenient than ever. There are other new methods of contraception available to women which will be discussed in future articles. If you have any questions about or are interested in any new method of birth control please contact your health care provider.
For more information or to schedule an appointment, please contact Dedicated to Women at their Dover location by calling 302-674-0223 or at their Middletown location by calling 302-389-4009.
