What is birth control?
Birth control refers to any activity, medication, or equipment used to prevent pregnancy. There are many types of birth control available for women who do not wish to become pregnant. The decision on which method is right for you should be made with your physician, as well as with your partner.
Birth control methods work in different ways to prevent pregnancy, including the following:
-creating a barrier that blocks sperm from reaching the egg
-killing sperm
-preventing eggs from being released by the ovaries
-changing the cervical mucus to hinder sperm from moving into the uterus
-altering the tissue lining the uterus so that a fertilized egg cannot implant
What are the different types of birth control?
Some methods that do not require a prescription from your physician include the following:
abstinence – not having sexual intercourse.
spermicides – foams or creams placed inside the vagina to kill sperm; these may also provide some protection against sexually transmitted diseases, especially when used with a latex condom.
male condoms – a thin tube made of latex or a natural material that is placed over the penis. The sperm is collected in the end of the condom. Latex condoms may provide some protection against sexually transmitted diseases.
female condoms – a liner made of latex or natural material that is placed inside the vagina. Latex condoms may provide some protection against sexually transmitted diseases.
natural family planning – timing intercourse to avoid “fertile” days using various methods of monitoring body temperature, watching for changes in cervical mucus, and the use of ovulation prediction kits. This method, often known as the “rhythm” method, has a high risk for pregnancy.
Some methods that require a prescription include the following:
oral contraceptives (birth control pills) – medications taken daily that prevent ovulation by controlling pituitary hormone secretion. Usually, oral contraceptives contain the hormones estrogen and progestin. Some types are progestin-only.
In addition to prevention of pregnancy, oral contraceptives have several health benefits including regulating menstrual cycles and decreasing the amount and length of menstrual periods. This can help increase iron stores in women with iron deficiency associated with excessive bleeding. Prevention of certain ovarian and endometrial cancers is a significant benefit of the use of oral contraceptives. Some research has found that some benign (non-cancerous) breast diseases, including fibroadenoma and cystic changes, occur less frequently with the use of oral contraceptives. Recent studies have also suggested that oral contraceptive use may reduce the occurrence of severe disabling rheumatoid arthritis.
mini-pill – unlike the traditional birth control pill, the mini-pill has only one hormone, progestin. Taken daily, the mini-pill thickens cervical mucus and prevents the sperm from reaching the egg. The mini-pill also can decrease the flow of your period and protect against PID and ovarian and endometrial cancer.
Norplant/Implants – capsules containing the synthetic hormone levonorgestrel, implanted under the skin in the upper arm of a woman, which continuously prevent the ovaries from releasing an egg for up to five years. Anesthesia is required for insertion and removal of this type of birth control.
Depo-Provera – a progesterone-like drug given by injection to prevent pregnancy by stopping ovulation. The effects last for about three months and another injection must be given to continue birth control effectiveness.
monthly injections – a new type of contraceptive that combines two types of hormones, estrogen and progestin, in a monthly injection. These hormones work to prevent ovulation and continue regular menstrual periods. The injection must be repeated every 28 to 33 days to be effective.
patch – this is a skin patch worn on the body that releases the hormones estrogen and progestin into the bloodstream. It is most effective in women who weigh less than 200 pounds.
diaphragm or cervical cap – a dome-shaped rubber cup with a flexible rim that is inserted through the vagina to cover the cervix. This type of birth control must be inserted prior to having sexual intercourse.
hormonal vaginal contraceptive ring – a ring that is placed inside the vagina around the cervix. The ring releases the hormones estrogen and progestin.
intrauterine device (IUD) – devices placed in the uterus through the cervix by a physician. The IUD works by preventing an egg from being fertilized in the tubes or from attaching to the wall of the uterus. IUDs containing hormones must be replaced annually, while copper IUDs can last up to 10 years.
intrauterine system (IUS) – the IUS is a small T-shaped device that is placed inside the uterus by a physician. It releases a small amount of hormone each day to prevent pregnancy.
Essure- a thin tube is used to thread a tiny, spring-like device through the vagina to the uterus into each fallopian tube. A material in the device causes scar tissue to develop and permanently plug the tubes.
Surgery that results in the inability to become pregnant includes the following:
hysterectomy – removal of the uterus and usually the ovaries and fallopian tube. This is a permanent form of birth control.
tubal ligation or tubal occlusion (”tying the tubes”) – surgery to cut, cauterize, or band the fallopian tubes to prevent the egg from being transported to the uterus. Tubal ligation is designed to be a permanent method of birth control. Although certain types of tubal ligations can be reversed, the reversal procedure may not be successful.
vasectomy – cutting or clamping the vas deferens, the tubes that carry the sperm from the testes – are blocked. The testes still produce sperm, but the sperm die and are absorbed by the body. This is a permanent male birth control measure.
Methods that have been suggested as preventive, but may actually present a high risk for pregnancy include the following:
-withdrawal before ejaculation
-sexual intercourse during menstruation
-standing up immediately after sexual intercourse
-douching after sexual intercourse
Can’t remember to take the pill or need something longer term?
1. Intrauterine Device (IUD)
The intrauterine device, also know as “IUD”, is the most popular form of reversible birth control in the world with more than 85 million women users. An IUD is a soft flexible “T-shaped” plastic device that is inserted into the uterus to be used for contraception. The device is inserted and removed at separate office visits. The IUD is one of the safest, most effective and private methods of birth control.
Effectiveness: IUDs offer a very effective, safe, and hassle free contraception option and they last for a very long time.
Pregnancy: The ability to become pregnant returns quickly when IUD use is stopped.
There are two IUDs currently on the market in the USA:
a) The Mirena® IUD
Offers 99.9% effective birth control for up to 5 years. This device has a small amount of progestin hormone on it that usually makes your period lighter, and in some cases stops your period. Women tend to like these lighter periods on this IUD. Some women may experience irregular and/or heavier periods for the first 3 to 6 months after insertion but this usually resolves with ongoing use.
b) The ParaGard® IUD
Offers 97%-99% effective birth control for up to 10 years. The device is non-hormonal and has a small amount of copper on it. Occasionally women may have heavier periods on this IUD.
2. NuvaRing®
NuvaRing® is a once a month contraception. It is a comfortable, flexible contraceptive ring that prevents pregnancy by releasing a low dose of hormones. The ring need only be replaced once every four weeks – it is left in place for three weeks and taken out for the remaining week each month. Many women who use the vaginal ring have more regular, lighter, and shorter periods.
Effectiveness: Less than 1% of women will get pregnant each year if they always use NuvaRing® as directed and less than 8% will get pregnant each year if they don’t always use NuvaRing® as directed.
Pregnancy: If you decide you want to become pregnant, stop using NuvaRing®.
3. Depo-Provera®
Depo-Provera® is a birth control shot that is administered in the arm and lasts three months so you only have to think about it four times a year (every 12 weeks). The birth control shot does not contain estrogen, another type of hormone that is in many types of birth control, including the pill, patch, and ring. This means the shot can be a good choice for women who cannot take estrogen and for women who are breastfeeding. For most women, periods become fewer and lighter. After one year, half of the women who use the birth control shot will stop having periods completely. Some women have longer, heavier periods. Some women have increased spotting and light bleeding between periods.
Effectiveness: Less than 1% of women will get pregnant each year if they always use the birth control shot as directed and less than 3% of women will get pregnant each year if they don’t always use the birth control shot as directed.
Pregnancy: Because the birth control shot is long lasting, it can take a long time to get pregnant after getting your last shot – anywhere from nine months to more than a year. So, Depo-Provera® is not a good birth control method for you if you are thinking of getting pregnant soon.
For more information check out Savannah gynecologist.
Joe Edwards, M.D. is a Savannah gynecologist who enjoys writing about health issues that affect women. Check out his website Savannah OBGYN.
