Birth Control and Sterilization
How do I decide what option is right for me?
There are so many options available for birth control. Choosing the right option depends on a variety of factors:
- Are you planning to get pregnant within the next year?
- Do you have a blood clotting disorder?
- Do you have medical problems that would make hormonal methods a poor choice?
- Do you have uncomfortable menstrual symptoms (eg. Bloating, PMS, Acne) that you would like to suppress?
- Are you a smoker over age 35?
- What has been successful for you in the past?
Your doctor will discuss these factors with you and help you select the right method. The following information is a useful guide to the different options available to you.
Barrier Methods:
Barrier methods are the least effective choice in terms of actual prevention of pregnancy. However, they can reduce your risk of contracting Sexually Transmitted Diseases (STDs). These methods also do not carry any hormonal risk. If you are sexually active with multiple partners, you should use of condoms in addition to birth control.
Hormonal Contraceptives:
- "The Pill" - Combination BCP
Combination BCP has many advantages such as decrease in cramps, flow, PMS, and ovarian cysts. It also is a suppressive therapy for endometriosis and it decreases the risk of ovarian and uterine cancer. The pill does not delay child bearing. Once you are off the pill, you can get pregnant right away. Side effects could include any typical PMS type symptoms, but those usually resolve themselves within the first two cycles.
This pill is suitable for women 35 and over who smoke, and for breast feeding mothers. This hormonal combination will not increase your chances of Deep Vein Thrombosis, heart attack, stroke, or blood clot.
The Nuvaring is a small flexible plastic ring that is inserted into the vagina once a month. It provides low dose combination hormone therapy. The Ring provides the same benefits as the BCP Combination pill. The advantage is less remembering and overall lower dosage.
Depo-Provera is a Progesterone only shot that provides 99.5% effective birth control. The shot must be administered by your doctor every three months. It is suitable for smokers over thirty-five. Side effects can include irregular bleeding, weight gain, lack of period, or delayed fertility.
Intrauterine Devices
Intrauterine devices are placed directly in the uterus. They are 99.9% effective in prevention of pregnancy - as effective as tying your tubes, but not permanent. There is no user error, so once it is placed you run almost no risk of pregnancy. The device is placed in the office by your doctor with minimal discomfort. It does not affect future fertility. Rare side effects may include, uterine perforation at the time of insertion and possible ectopic pregnancy.
Paraguard is good for up to 10 years. It contains no hormones. In some cases it can increase cramps and flow.
Mirena is good for five years. It contains progesterone hormone that acts locally within the uterus. Mirena does not create systemic side effects because the progesterone only acts locally. 100% of women have decreased flow and up to 50% of women have no period as a result of using Mirena.
Sterilization
You should only consider sterilization if you are ABSOLUTELY SURE you no longer wish to be able to bear children. It is not meant to be reversible. Note that men can also be sterilized through a vasectomy, which is usually performed by a urologist.
- Traditional Laprascopic Tubal Occlusion
This procedure is the traditional method of sterilization. It is done by creating two small incisions in the abdomen and closing the fallopian tubes. This procedure is 99.9% effective. It is performed through same day surgery in the hospital. It is minimally invasive, but does require general anesthesia.
Essure is the latest in sterilization technology. It does not require an abdominal incision. The doctor identifies the tube openings by entering the uterus through the vagina. A spring coil is placed into each tubal opening. The bodies’ own scarring process seals the tubes. This procedure can be performed in the office with light sedation. A dye picture is required three months after the procedure to ensure that the tubes are closed. Therefore, a back-up method of contraception is required until the picture confirms the tubes are completely blocked. Since 2002, in the women who have had the picture confirming tubal closure, there has never been a reported pregnancy.
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