IUD. IUD stands for Intra-Uterine Device. An IUD is a piece of plastic roughly the size of ones thumb that is inserted through the cervix into the uterus. There it sits and is remarkably effective at preventing pregnancy. The way an IUD works is not fully understood but it is probably a combination of several factors. We do know that just the presence of something in the uterus, IUD or other object such as a uterine septum or fibroid, reduces pregnancy rates. IUDs are inserted during a simple in office procedure by a trained professional. These devices got a bad rep in the 70’s when a couple of specific types were pulled from the market after serious complications were discovered but the type available today has remained one of the safest and most popular methods of birth control world wide. Another benefit of this method is that though it is extremely effective and can be in place for as long as 10 years depending on the chosen brand, it is easily reversible in the office and return to fertility is quick in most cases. IUDs are great methods for women in long term monogamous relationships. If you are interested in this Birth Control Method contact your health care professional to learn more.
Fertility Awareness involves keeping meticulous track of ones menstrual cycle through monitoring of basal body temperature, cervical mucous and symptoms of ovulation. When done correctly it is a very effective method of pregnancy prevention but it is extremely labor intensive and requires a great amount of commitment on the part of the woman. There are entire books dedicated to teaching this method.
A Cervical cap is a small cup that fits relatively snugly over the cervix and works much the same way as the diaphragm does. A cervical cap must be fitted by a trained professional and the user must have special training to insert it properly.
Most people are familiar with condoms. Condoms are available in latex and non-latex materials. There are both male and female condoms. Male condoms are placed over the erect penis while female condoms are inserted into the vagina leaving a ring that sits outside the vagina. A flexible ring at the “tip” of the female condom is positioned over the cervix and holds the condom in place. Condoms have an efficacy rate in the 90%s with perfect use but human error brings that efficacy way down with “typical use”. Condom use has been shown to reduce the transmission of HIV/AIDS virus and other sexually transmitted diseases and infections.
The progesterone injection is a popular method for women who desire a fix it and forget it Birth Control Method. “The Shot” contains a time released progesterone that lasts approximately 12 weeks in a woman’s body. For this reason the a new injection is required every 10-12 weeks. Efficacy of “the shot” is 99+% and as long as the injection is received user error is non existent.
Birth Control Patch. The Birth Control Patch is a very thin patch self adhesive patch that is applied directly to a woman’s skin. The hormones(estrogen and progesterone)are absorbed through the skin(transdermally) at a controlled and constant rate while the patch is being worn. Each Patch is worn contains enough hormone to be effective for seven days for a woman of average weight. The patch is not recommended for women over 198 pounds. The patch must be changed every week for three weeks. The forth week of every cycle is a “patch free” week. When the third patch is removed it is not replaced. Most women will get a period during this “patch free” week. At the end of the “patch free” week a new cycle begins and a new patch is applied. The advantage to the patch for many women is that it requires a bit less attention than a daily pill. Some women may experience an allergic reaction to the adhesive on the patch. This and contraindications to estrogen use are reasons for women to avoid the patch as a Birth Control Method. Risk, Benefit and side effect profiles for the patch are similar to those of Combined Oral Contraceptive Pills as they contain the same types of hormones.
Finally we come to permanent sterilization. These are surgical procedures done by a physician and for all intents and purposes should be considered permanent.
- Male sterilization is called Vasectomy and involves cutting the Vas Deferens which is the tube that carries sperm from where it is stored in the testicles to the penis during ejaculation. This procedure is usually done under local anesthesia and can be done as an in office procedure. After Vasectomy, erection and ejaculation still occur exactly as before but the ejaculate contains no sperm. To learn about vasectomy reversal click here. Continue reading “Male and Female Sterilization”
Abstinence is the most effective method of Birth Control as well as the only way to prevent transmission of sexually transmitted infection and disease. Abstinence means not engaging in sexual intercourse.
I am placing these methods under Barrier Methods because they do work in part by creating a physical barrier in the vagina which blocks the passage of sperm into the vagina. Additionally, These methods all contain a chemical compound that kills sperm on contact. y themselves they are not effective methods for women who have sex more than three time per week but in combination with condoms they are quite effective. Some women find the chemical spermicide irritating and there has been some evidence that especially for these women, risk of transmission of HIV to them may be increased because of this irritation and subsequent skin compromise in the vagina.
A Diaphragm is a latex cup with a firm flexible lip. The cup is filled with spermicidal jelly and inserted into the vagina before intercourse. A diaphragm must be fitted to a woman’s body to ensure proper positioning. The flexible rubber ring must fit between the underside of the cervix and the pubic bone at the front of the vagina. A diaphragm is designed to block sperm from entering the cervix. The spermicidal jelly is an integral player in this method and without it the diaphragm is essentially useless. A diaphragm must be left in place for several hours after intercourse and if multiple acts of intercourse are desired, spermicidal jelly must be inserted into the vagina between acts for proper contraception. A diaphragm must be refitted after a 20 pound weight loss or gain and after childbirth. A diaphragm should also be replaced every 2 years as the latex tends to breakdown rendering the diaphragm potentially ineffective.
Progesterone implants were formerly designed as 6 small plastic sticks that contained small amounts of progesterone to be absorbed slowly into the body over a five year period. These sticks were surgically implanted just below the skin in the upper arm during a very simple in office procedure. The implants were removed from the consumer market several years ago and redesigned as two sticks that provide two years of contraception. The implantation and removal procedures are the same as the six stick counterpart. These implants have a high efficacy rate and are low/no maintenance. They contain no estrogen.
Contraceptive Vaginal Ring. “The Ring” is a flexible ring resembling a clear rubber washer made of a synthetic polymer that contains estrogen and progesterone. The ring is inserted deep into the vagina where it stays for three weeks. During that time the hormones are absorbed through the vaginal tissue into the bloodstream. After the third week the ring is removed and left out for a week. Most women will get a period during this “Ring free” week. After the “ring free” week a new ring is inserted and the cycle begins again. The ring has the same basic efficacy as COCPs with a blood hormone level of about half that of COCPs. For this reason the ring may be an option for women who experience unwanted side effects with COCPs. The ring contains estrogen and therefore may not be used by women who have absolute contraindications to estrogen use.
Birth Control Pills. There are two basic types of Birth Control Pills. Those that contain both estrogen and progesterone are the most prescribed Pills and are also referred to as Combined Oral Contraceptive Pills(COCPs). Within the COCPs are several different estrogen and progesterone combinations all with essentially the same efficacy(~99% with perfect use) and the same reported risk, benefit and side effect profiles. Different women may respond differently to individual pills and finding the one that fits the best with an individual is mostly a process of educated trial and error. The other type of Pill is one that contains no estrogen. These pills are also known as Progesterone Only Pills(POPs) or “The Mini-Pill. POPs are most often used in situations where contraception is desired but estrogen is contraindicated. Examples of such situations include breastfeeding mothers because estrogen can reduce breast milk production, women with a history of blood clots in their lungs or legs because estrogen containing Birth Control Methods increase their risk of recurrence of those blood clots, women who have a history of classic migraine for whom estrogen containing pills are contraindicated and women who simply experience unwanted side effects with COCPs such as persist ant headaches or persistent nausea. POPs are not quite as effective as COCPs and must be taken consistently at the same time everyday. For these reasons many women’s healthcare providers reserve them for women who cannot use other methods. Continue reading “Birth Control Pills”
Women today have more Birth Control options than ever before. Pharmaceutical companies, recognizing the various and different needs of women, are developing new products and new forms of Birth Control to meet those needs. These pages summarize the currently available Birth Control Methods and may direct you to sites where you can learn more detailed information. Continue reading “Birth Control”