Gynecology – Contraception
- ORAL CONTRACEPTIVES:
- PATCH AND VAGINAL RING:
- INTRAUTERINE DEVICE:
- BARRIER METHODS:
- PERMANENT METHODS:
The birth control pill is the most popular choice for American women. The “pill” is made of estrogen and progesterone hormones. It is 99% effective if used properly and works by inhibiting ovulation. Ovulation is the process by which the ovary releases an egg to be fertilized. The “pill” needs to be taken every day. There is also a “minipill” that contains only progesterone and is perfect for breastfeeding moms.
The patch and the vaginal ring are like the birth control pill except with a different delivery system. The patch is attached to the skin like a bandage. It needs to be changed on a weekly basis. The vaginal ring is placed into the vagina where it secretes hormone locally. It stays in place for three weeks, then is removed for one week after which time a new one is placed for another three weeks. Both these methods are as effective as the “pill” and also work by inhibiting ovulation.
Progesterone may be injected every three months for excellent contraceptive protection. Irregular bleeding may occur initially but most women get to the point where they stop menstruating altogether. This is not harmful to your body as the progesterone keeps the lining of your uterus so thin that there is nothing to slough off each month. Like the “pill”, it also inhibits ovulation and is just as effective. It is perfect for women who should not be taking estrogens or have trouble remembering to take a pill every day.
The IUD has returned to popularity as a contraceptive option. This is a device placed into the uterine cavity by your physician, which is a fairly comfortable procedure done in the office. This is the most effective reversible method of contraception at greater than 99%. There are two types on the American market today – Paraguard and Mirena. The Paraguard lasts ten years and may cause a slight increase to your monthly flow & mild cramping. Mirena lasts five years and shouldn’t increase your flow or cause cramps. Both these types can be removed at any time with return to fertility. They work by decreasing motility of the tubes making it difficult for the sperm and egg to meet and thickening cervical mucous which makes it difficult for sperm to get into the uterus. There is also a new, smaller IUD recently introduced to the American market, Skyla. It lasts three years.
The diaphragm is a barrier method and doesn’t involve hormones, which may be a good choice for women who aren’t hormone candidates. It is slightly less effective than hormone methods – 94-95%. The diaphragm is to be fit by your physician. It is placed prior to intercourse and removed after. It fits over the cervix to prevent the entrance of sperm.
Condoms, female condoms and the sponge are barrier methods found over the counter. They are placed prior to intercourse and removed after intercourse. The effectiveness is approximately 94% if used with a spermicide.
Permanent methods of contraception include Essure tubal coils or tubaligation for women and vasectomy for men. These are to be used only if you are absolutely sure that you are done having children. These methods involve surgical procedures performed by your physician. The newest method in the United States, Essure, can be done in the office. Advantages over the traditional tubaligation include; less expense, faster recovery, no incisions, and a lower risk of complications.