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Birth Control Management

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Contraception is available in many forms, and you can decide which is right for you based on your lifestyle, personal preferences and health. Your needs may vary, for instance, based on whether or not you are in a monogamous relationship, or the level of diligence you would have to adhering to your chosen method of birth control. A woman may also decide on one form of birth control over another based on her age, frequency of sexual activity, and desire to have children in the future.

The different contraceptive methods include:

  • Barrier methods (condoms or diaphragms/spermicide)
  • Hormonal methods (birth control pills, vaginal rings, injections, or emergency contraceptive pills)
  • Intrauterine methods (IUD)
  • Sterilization (tubal ligation)
  • Behavioral (calendar-based methods, withdrawal method)

General considerations about birth control:

  • Some methods take careful planning, such as the birth control pill, which is meant to be taken at the same time every day to prevent pregnancy.
  • When considering a form of birth control, it is important to REALIZE® that the only method of contraception that also prevents sexually transmitted diseases (STDs) is condoms.
  • The most effective form of birth control, and the only fool-proof method, is abstinence.
  • No method of birth control after one year of unprotected sex for women of childbearing years is 85% ineffective, meaning 85% of these women will become pregnant.

Barrier Methods

These methods are designed to prevent semen from contacting the vagina. Barriers are removable and are an option for women who do not want to use hormonal contraceptive methods.

Condoms

The most popular barrier method is male condoms, which is a thin sheath that covers the penis during sex and prevents semen from entering the woman’s body. A female condom is also available, which is inserted into the vagina before sex, and serves the same purpose. Barriers are encouraged for any couple engaging in sexual activity that is not part of a monogamous relationship, to prevent the spread of STDs and pregnancy. Condoms are the only birth control method that also prevents STDs, since there is a barrier between the penis and vagina. Condoms are available in latex, polyurethane or lambskin (lambskin condoms do not prevent STDs), and should be disposed after each use. Condoms are 98% effective with perfect use, and 85% effective with typical use. Condoms can slip off the penis, break or tear from improper use such as ripping the condom when opening the package or using the condom after its expiration date. Follow the instructions in the package to maximize effectiveness, or use a back-up method of birth control, such as birth control pills along with condoms. Do not use two condoms at once, as this actually has a higher failure rate than only using one because of the friction of rubber on rubber.

Diaphragm

Another form of a barrier is the diaphragm, which is a shallow, flexible cup inserted into the vagina before sex to block semen from entering the uterus. A woman should also use spermicidal cream with the diaphragm, which destroys sperm. The diaphragm should be kept in place for 6 to 8 hours after intercourse, to prevent pregnancy. Diaphragms may be reused after being removed and cleaned with warm water and soap, and they should be replaced every one to three years. Diaphragms are advantageous for monogamous couples where the woman does not want to use hormonal methods for contraception and the man does not want to wear condoms. Another advantage is that because there is no disruption to the woman’s menstrual cycle, there is no reversal or wait time before a woman can get pregnant if contraception is no longer wanted. The diaphragm should be dispensed by a gynecologist to ensure it is the right size, where it covers the cervix properly. Diaphragms with spermicide have a 94% effectiveness rate with perfect use, and 84% effectiveness rate with typical use.

Cervical Caps

Similar to a diaphragm, but smaller and more rigid, the cervical cap serves the same purpose and is used in the same manner. They are slightly less effective than diaphragms, with a 91% effectiveness rate with perfect use, and 84% effectiveness rate with typical use.

Contraceptive Sponges

These soft, disposable foam sponges are filled with spermicide to prevent pregnancy, and they are inserted into the vagina before intercourse. They prevent sperm from entering through the cervix to the uterus, and then spermicide kills sperm cells. Contraceptive sponges are 91% effective with perfect use, and 84% effective with typical use.

Hormonal Methods

These methods utilize hormones to regulate or stop ovulation during the menstrual cycle. Ovulation is the process when a woman releases a mature egg that is available for fertilization. Hormonal methods stop ovulation so a woman cannot get pregnant, and these methods may also create thick mucus on the cervix to further prevent sperm from entering the uterus. Hormonal methods are available in different forms, from pills, injections, patches, gels, vaginal rings, intrauterine systems, and rods. Hormonal methods must be prescribed and monitored by healthcare providers.

Women who are not in monogamous relationships should also have her partner wear a condom in addition to using hormonal methods. This maximizes the effectiveness of birth control as well as preventing STDs. While no method of birth control and STD prevention is 100% effective other than abstinence, combining these methods is 98.8% effective with typical use and over 99.9% effective with perfect use.

Oral Contraceptives

This form of birth control is prescribed and monitored by a healthcare professional, and dispensed in the form of monthly pill packs. The packs contain three weeks of active pills with hormones and one week of inactive, placebo pills. The pill contains a combination of synthetic estrogen and progestins that prevent ovulation. Some women take the pill not only for birth control but for its ability to make periods more predictable and shorter, and because the pill can also help curb mild or moderate acne. Women who smoke are not recommended to use birth control pills. When used perfectly and taken at the same time every day without missing any pills, the pill is 99.7% effective. However, with typical use, the pill is 92% effective.

Contraceptive Patch

“The patch” is a form of birth control that is applied on a weekly basis on the first day of a woman’s menstrual cycle and then changed every 7 days until the fourth week when a woman has her period and does not wear the patch. The patch works by administering a steady dose of hormones into the bloodstream, and some women may find it more convenient than the pill, which has to be taken daily and at the same time for a steady stream of hormones. The patch is 99.7% effective with perfect use, and 91% effective with typical use.

Injectable Contraception

This form of contraception involves monthly appointments to a gynecologist to administer an injection of hormones to inhibit ovulation. One of the key benefits is that it is an especially good choice for women who have poor compliance at taking their daily pills. A disadvantage is that it requires time-consuming monthly visits to the doctor to get a new injection, and the slight pain that goes with the injection. However, injectable contraception is extremely effective, with a 99.8% effectiveness rate.

Vaginal Rings

This is a small device shaped like a ring that is inserted into the vagina to provide a controlled release of hormones that stop ovulation. The ring is kept in the vagina for three weeks, then removed during the week of the woman’s period. A new ring is used for the following month. A benefit of the vaginal ring is that it only requires monthly action to prevent pregnancy. One of the disadvantages is the potential for the ring to fall out while removing a tampon, during intercourse or straining during a bowel movement. The vaginal ring is 99.7% effective with perfect use, and 91% effective with typical use.

Emergency Contraception (EC) Pills

EC pills, or “morning after pills,” are taken after unprotected sex or contraceptive failure that may prevent pregnancy if taken soon after semen exposure. The pill may be purchased over-the-counter for any woman 15 years of age or older, with proof of age. This method is advantageous for women whose birth control failed, was not taken, or if they had nonconsensual vaginal sex, and it can be taken within 5 days of unprotected sex. The pill is not abortion, because it pregnancy does not occur right after sex – it may take up to 6 days for the sperm and egg to meet after having sex.

Intrauterine Methods

Intrauterine devices (IUD) are small T-shaped devices that are inserted in the uterus and left inside for as long as 12 years at a time, or whenever the woman wants to stop contraception. The IUD is inserted into the vagina and then implanted in the uterus, by a gynecologist who knows how to properly place it. Research cites that IUDs are the most effective form of birth control, and one key benefit is the lack of maintenance required by the woman who has the IUD. Periods are often much lighter and may even stop with IUD birth control.

Copper IUD

In the U.S., an IUD called ParaGard® is the only copper IUD currently approved by the FDA. It is effective for up to 12 years, and can be removed if the woman would like to stop contraception. The copper IUD works by causing an inflammatory reaction to prevent sperm from fertilizing an egg. ParaGard can also be utilized as a form of emergency contraception and is highly effective, but much more expensive than the morning after pill.

Hormonal IUD

The hormonal form of IUD, called Mirena®, releases progestin into the uterus, and prevents sperm from reaching or fertilizing the egg. It may also inhibit ovulation. The hormonal IUD may be used for up to 5 years. Hormonal IUDs reduce heavy periods drastically, with an 80% reduction in bleeding after 3 months, and 90% reduction after 6 months. For some women, menstrual bleeding stops altogether. This may be seen as an advantage for women who hate getting their period, or a disadvantage for women who appreciate the peace of mind their period gives them, so they know they’re not pregnant.

Sterilization

Surgical procedures can permanently sterilize a woman so she can no longer become pregnant. These procedures are irreversible, so a woman should be 100% sure she no longer wants children. Sterilization is safe, effective, and makes birth control simple for the rest of a woman’s childbearing years. Hormones do not change from sterilization, and it does not cause menopause or make menopause occur earlier in life.

Tubal Ligation

This surgical procedures permanently ties off the fallopian tubes, which effectively blocks the path between the ovaries and uterus, so sperm cannot reach the egg to fertilize it, and the egg cannot reach the uterus.

Sterilization Implant

This procedure is less well-known, but just as effective. It works by blocking the fallopian tubes, as a tube is inserted through the vagina. Next, a soft, flexible implant is inserted into each fallopian tube. Scar tissue gradually forms around the implants, so sperm cannot reach the eggs.

Hysterectomy

Although not intended as a means of birth control, hysterectomy (removal of the uterus) ends a woman’s childbearing years. The surgery may also involve removal of the ovaries and fallopian tubes. Hysterectomy is usually recommended by a gynecologist for medical reasons, such as gynecological cancers.

If you have any questions or concerns about birth control and management, West Medical is happy to help. Out team of gynecologists is happy to provide you with the best options available to you today. To learn more about birth control management and to discover which method is best for your needs, please call our offices at (855) 690-0565.

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