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There are several different types of birth control on the market now leaving women with many questions as to their effectiveness, side effects and long term consequences. Unfortunately there is no perfect option that is free of side effects, that is unless, of course, abstinence is counted. However many opt not to make this choice.
Therefore it is important to combine your current health with your goals (true pregnancy prevention or other women’s health issues as well) and talk with your health care provider. Here are some things to consider when looking at the two most common forms that might work for you.
First and most common is the birth control pill, also known as the oral contraceptive pill. This pill is taken daily for three weeks then stopped for seven days to allow for a menstrual period. Or it may be continued in some cases for three months straight. In rare cases pills may be taken continuously without a bleed.
The pill is typically a combination of a synthetic estrogen and progestin that works to suppress ovulation. A woman cannot become pregnant if there is no egg release.
There are various forms of the pill and amounts of estrogen and progestin within them.
Typical side effects can include: change in menstrual cycle, mood changes, increased vaginal discharge, decreased libido, skin changes, weight changes, increased risk for gall stones, and increased risk for blood clots.
Women who smoke, have migraines with aura, have diabetes, or have a personal history of cardiovascular disease should not use the pill. When used correctly (i.e., taken at the same time every day) the effectiveness against pregnancy is 92-98 percent.
The pill does not protect against sexually transmitted infections such as gonorrhea, chlamydia, HIV/AIDS, HPV or trichomoniasis.
Next most common is the IUD, or intrauterine device. This is a small T-shaped device that is inserted up into the uterus during an office procedure (only local anesthesia required).
There are two types of IUDs. First is the ParaGard, also known as the copper T. It does not have any hormone in it. Instead it relies on the copper wrapped around the T-frame causing local inflammation to create an inhospitable environment for the egg and sperm. This IUD lasts 10-12 years after insertion.
The Mirena and Skyla IUDs are hormonally-based in that they both contain progestin, similar to that found in the birth control pill. They are inserted the same way as the Paragard however the Mirena lasts five to seven years and Skyla (which is newer and has a smaller design for those women who have never been pregnant) lasts three years.
Their effectiveness against pregnancy is about 99 percent. They can be removed relatively easily in office through a simple, quick procedure.
The most common side effects for all three IUDs are pain with insertion, back pain, and spotting or irregular cycles for the first three to six months during the adjustment period. There is a small risk for expulsion after insertion, and perforation through the uterus.
The ParaGard may increase menstrual cramps and increase menstrual flow.
The Mirena typically diminishes cramps and reduces flow. However there is a risk for ovarian cysts and acne.
None of the IUDs prevent against sexually transmitted infections such as gonorrhea, chlamydia, HIV/AIDs , HVP or trichomoniasis.
There are other forms of birth control such as barrier methods (condoms or diaphragm), the Depo-Provera injection, the implant, the patch, the ring, tubal sterilization, ablation and tubal blockers (Essure). To learn about different birth control options, and what might work best for you, check out this article.
Then you'll be best prepared to talk with your health care provider about which form suits your needs and your health best.
Sources:
1) Foster, D. (2009). Optimizing the Use of Oral Contraceptives. Web. 14 April, 2013.
http://www.medscape.com/viewarticle/588425
2) Reuter’s Health Information (2013). U.S. Approves First New IUD in 12 Years. Web. 14 April, 2013.
http://www.medscape.com/viewarticle/777413
3) Waknine, Y. (2009). Levonorgestrel IUD Approved to Treat Heavy Menstrual Bleeding. Web. 14 April, 2013.
http://www.medscape.com/viewarticle/709854
4) Barclay, L. (2011). IUDs, Implants Most Effective Reversible Contraceptive. Web. 14 April, 2013.
http://www.medscape.com/viewarticle/745108
Reviewed April 15, 2013
by Michele Blacksberg RN
Edited by Jody Smith
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