We know smoking is bad for us, but we still deserve effective birth control options, without the lecture, right? There are about 20 percent of current smokers (women, ages 35-64 in the U.S.), who need to know how to prevent pregnancy with more options than just condoms.
Luckily, there are many contraception options for women over 35 who smoke. These women are advised to avoid hormonal contraceptives containing estrogen (including the combination pill, the ring, and the patch), as the risk for cardiovascular disease is highly increased.
Hormonal Methods:
Depo-Provera ("the shot" or "DPMA") contains progestin-only, and is a long-acting injection given every 3 months at your doctor's office. It is 99 percent effective at preventing pregnancy.
Mirena IUD: IUD (intrauterine device) is inserted into your uterus, and contains progestin-only. It is replaced every 12 years, and is more than 99 percent effective at preventing pregnancy.
Implant: Contains progestin-only, and is a small matchstick-sized rod that is inserted into your inner upper arm, replaced every three years. It is 99 percent effective at preventing pregnancy.
ParaGuard IUD: Does not contain any hormones, and is inserted into your uterus, and replaced every five years. It is more than 99 percent effective at preventing pregnancy.
Barrier Methods:
Diaphragm: Latex cup that is inserted into your vagina prior to sex. It contains no hormones, and is about 94 percent effective at preventing pregnancy.
Female Condoms: Polyurethane condom that is inserted inside a woman's vagina prior to sex. It contains no hormones, and is 95 percent effective at preventing pregnancy.
Spermicides: Lotions, creams, gels, suppositories or vaginal film that contain substances that cause sperm to become immobile. They do not contain progestin or estrogen, and should be used in combination with other birth control methods, as they are closer to 85 percent effective (when used alone) at preventing pregnancy. Please know spermicides that contain Nonoxynol-9 can increase your risks for becoming infected with certain STDs (sexually transmitted diseases) and STIs (sexually transmitted infections) as they can cause irritation or tissue damage to the genital tract.
Withdrawal Method: ("pull out" method): This is a method men and women use to prevent pregnancy during sex, when the man withdraws his penis from the vagina before ejaculating. When used alone, it is typically only 85 percent effective, and I included it because it works great when used in combination with a barrier method (condoms, for example).
Women over 35 who smoke do need to be aware of their birth control options because as a consequence to the lack of information it may lead some women to not fully disclose their smoking status with their doctors. These women are aware that smoking is considered "bad", but they need real information to help prevent pregnancy...and save the quitting lecture for another time. (Please know that a good health care provider will still provide women with cessation resources, however!).
What is the doctor's role?
There have also been clinical reports of women being prescribed hormonal contraceptives by their health care providers, despite the fact that they are current smokers. Whether the doctors did not inquire about smoking status, or the women did not provide this crucial information is unknown; it is important for women to take charge of their health and know the facts.
Why is estrogen-containing hormonal contraception harmful to this group of women?
"Women who smoke and also use oral contraceptives (birth control pills) increase several times their risk of coronary and peripheral artery diseases, heart attack and stroke compared with nonsmoking women who use oral contraceptives."
If you smoke and are over age 35, you have many highly effective contraception options.
It is important to keep your doctor "in the know" about any changes to your smoking status, and to educate yourself on your birth control and safer sex options.